Q: Female pt 33 yoa. Had 3 abortions between 18-21. Now she fears she can't have kids.
Menses: 28 days, heavy first 1 1/2 days, lasts 3 days, dk red color, medium size clots, slight cramps a few hours before period starts, slight lower back soreness, ovulation checked by MD is normal. She has slight work and family related stress. Sleep is not restful and wakes at 5am. Bowel movement is only soft (not loose) and sticky about 3-5 days prior to period. Other than that BM is usually firm and long. Her sex drive is low.
Tongue: teethmark, pink-red (sometimes purple), swollen MJ area (especially a few days before period starts).
Pulses: Bilateral deep, thready and weak.
Furthermore, she can't come in for acupuncture treatments so solely relies on herbal formulation. What kinds of herbs should I give her? The 4 phases or something else?
Is this a case of true infertility, or just fear of infertility? How long has this patient been trying to conceive?
A: According to the symptoms, it looks like SP+KD deficiency with Blood stagnation. In her case, the three abortions may have led to Blood stasis in the uterus. The following formula will tonify the SP+KD, address the Blood stasis, and assist in creating a stable environment for the fetus:
10g Du Zhong
10g Xu Duan
10g Sang Ji Sheng
10g Shan Yao
10g Bai Zhu
10g Bai Shao
6g Lu Jiao Jiao
6g Ren Shen
4g Zhi Gan Cao
4g Huang Qin
8g Sha Ren
8g Dang Gui
8g Xiang Fu