How to ask about menstruation during gynecological consultation
Inquiring about women’s menstrual periods and taking off conditions can help to understand the status of patients’ internal organs, meridians and qi and blood, which is of great significance for the diagnosis and treatment of diseases.
Menstruation Menstruation is regular, and the uterine bleeding caused by it is the main feature of women’s maturity.
Menstruation has a normal cycle, menstrual period (indicating duration), menstrual flow, menstrual color and menstrual quality.
Under normal circumstances, the menstrual cycle is about 28 days. It is normal to lead or lag 7 days. The menstrual period is 3-7 days. The volume of a menstrual period is 50-80 ml.Sticky, blood-free, and odorless.
Periodic anomalies: Physiological periodic anomalies: there are points of conjunctive month, declining period, avoiding year and dark period.
Menstruation occurs once every two months and is called bimonthly. Menstruation occurs once every three months and is called menstrual period. It is called menstrual period once a year. Menstruation does not come for life and is pregnant.Dark scripture.
Pathological cycle abnormalities: usually divided into early menstruation, late menstruation, menstruation has no regular difference.
(1) Premenstrual period: refers to the menstrual cycle more than 7 days in advance, or even twice a month, known as the premenstrual period.
The causes of this disease are mostly related to Qi deficiency and blood heat.
If the menstruation is early and the amount is large, the color of the menstruation is purple or crimson, the texture is thick, and the patient’s tongue is red, it is blood fever, causing blood to be delusional.
If the menstruation is early and the color is light, the menstrual scale is thin, and the patient’s lips and tongue are pale, it is a deficiency of qi, because the qi deficiency is incapable of controlling the whole body, causing the menstruation to advance.
(2) Late menstruation: Refers to the menstrual cycle that recedes more than 7 days, or even once every 40-50 days. It is called late menstruation, also known as delayed menstruation.
The cause is both deficient and real. Most of the deficient ones are caused by camp blood, and the yang deficiency is caused by insufficient blood, and the blood is not filled.
Most of them are blocked due to qi stagnation and blood stagnation, or cold coagulation and stasis.
If the amount is small in the late menstrual period and the color is dark, there is a block in the cold abdomen and the person who refuses to press is a blood cold; if the amount is small in the late period, the color is dim, the menstruation is thin, the abdomen is cold and painful, and the person who likes to press the temperature is a cold.In the later period of menstruation, the amount is small, pale, and the quality is thin, which belongs to blood deficiency; in the later period, the amount is small or normal, the color is dull or red, and the abdomen is full and painful, which is Qi stagnation.
(3) Irregular menstrual cycle: It means that the menstrual cycle is indefinite, or one after the other, advanced, and more than 7 days back, it is called irregular menstrual cycle, also known as menstrual disorder.
The pathogenesis is mostly liver stagnation and qi stagnation, but also kidney deficiency.
If the menstrual cycle is not fixed, the menstrual flow is more or less, the color is dark and red, or there is chest pain, breast cancer pain symptoms, mostly liver depression, emotional damage, liver dysfunction, qi and blood disorders, Blood Sea’s ability to accumulate blood is abnormal.
Abnormal menstrual flow Under normal circumstances, the amount of menstrual flow may vary slightly due to individual differences (physical or age). When the human body is affected by pathogenic factors, there will be too little or too much menstruation, or even suddenlyPathological changes that continue to shed blood.
(1) Menstrual cycle: refers to the menstrual cycle is generally normal, but the menstrual flow is increased than usual, and the menstrual cycle is said to be more.
Mostly due to qi deficiency, blood is not taken, or blood heat precipitates blood, and blood stasis is cohesive and blood is not due to menstruation.
Those with a large amount of light and light color, thin water, and shortness of breath are mostly qi-deficient. If the amount is large and bright red or purple, sticky with spots and accompanied by upset and thirsty, it is blood heat;If the amount is large and the color is dark with blood clots, and those who refuse to press with abdominal pain are blood stasis.
(2) Lack of menstruation: It means that the menstrual cycle is basically normal and the menstrual flow is significantly reduced; or the menstrual period is shortened and the menstrual flow is reduced, which is called less menstrual flow.
The disease is mostly caused by insufficient blood, empty blood, or blood stasis, dampness of phlegm, blocking blood vessels, and poor blood flow.
Usually the menstrual flow is small and the color is light, and the person with dizziness is blood deficiency; the menstrual flow is light, red or dark, the space is thin, and the lumbar spine is weak, the kidney is deficient in essence and blood;And the color is purple and black with blood stasis, accompanied by lower abdomen, pain and refusal to press, belongs to blood stasis; less menstruation and reddish color, thick gaps, mostly phlegm dampness.
(3) Collapse: refers to a sudden vaginal bleeding or inexhaustible bleeding during menstruation. The former comes rapidly and the amount of bleeding is large, such as landslides, which are called collapses, and most drips are constantly leaking like a house.
The two can be transformed into each other and often appear alternately, so they are generally referred to as collapse.
The formation of metrorrhagia is mostly caused by blood heat, spleen or kidney deficiency, blood stasis and other factors that damage the impulse, which leads to loss of solidity, which can not overcome menstrual blood and cause blood delusion.
Those who have a lot of blood and are eager or inexhaustible, with bright red and thick gaps, are blood heat; if they are both upset and hot, they are hypothermia; if they are thirsty and hot, they are real heat.
When the blood is faint and thin, accompanied by shortness of breath and fatigue, the person with pale face is spleen deficiency and Qi depression; if the waist and knees are weak, the person with cold chills and limbs is a kidney yang deficiency; the color is bright red and slightly sticky, andThose with dizziness, tinnitus, and weak waists and knees are of kidney yin deficiency.
If the time is now, the time is collapsed, the time is leaked, the blood color is purple and black with bruises, the lower abdomen is painful, the tongue is dark, and the blood is dark.
(4) Amenorrhea: Healthy women usually have menarche at about 14 years old. If they are more than 18 years old, they will have menarche, or if their menstruation is normal and interrupted for more than 3 months, it is called amenorrhea.
However, women’s temporary menopause during pregnancy, lactation and some girls may have menopause for 1-2 years after menarche, which are normal physiological phenomena and not amenorrhea.
Amenorrhea is formed due to deficiency and reality. Most of those who are deficient are due to liver and kidney deficiency, weakness of qi and blood, yin deficiency, blood dryness, or spleen deficiency, resulting in insufficiency of essence and blood, emptiness of blood and sea, which leads to amenorrhea.Wet block, so that the blood vessels are blocked, and the menstrual blood does not flow down to form amenorrhea.
If the 18-year-old has not had menstruation, or the amount of menstrual flow is gradually reduced to amenorrhea, and the waist and legs are soft, dizziness and tinnitus are liver and kidney deficiency.
If the menstruation is gradually postponed, the menstrual flow is small, the color is light, and then the menstruation is dizzy, the palpitations are short, the patient’s tongue is pale, and most of them are weak in qi and blood.If the menstrual flow is small and gradually ceases, and the five are upset and hot, the two frowns are red, there is night sweats, the tongue is red, and the moss is less, it is Yin deficiency and blood dryness.
If menstruation is stopped for several months, it is accompanied by depression, irritability, irritation, fullness of the chest, or refusal to press the abdomen and pain, and those with spots on the tongue are qi stagnation and blood stasis.
If the menstruation is stopped, and the chest is full of stuffiness, vomiting, phlegm, and obesity, it is a dampness of phlegm.
The color and particle size abnormality is generally the color of dark red and thick consistency, which belongs to blood heat; the color of light red sieve is thin, and the blood is less dissatisfied; the color of purple is dark and there are spots, which is cold coagulation.Retention; dark red with bruises, blood stasis.
Women with menstrual abdominal pain have menstrual cramps and lower back pain during menstruation or before and after menstruation. They are called menstrual abdominal pain and dysmenorrhea.
The cause of the disease may be due to emotional injuries or six sexual kinks, causing choking and stasis, and impaired blood flow; or due to inadequate congenital endowment or acquired dietary fatigue, resulting in liver and kidney deficiency and lack of essential blood;Or the spleen and stomach are weak, the biochemistry is insufficient, and the responsibility is lost.
Clinically common symptoms include qi stagnation and blood stasis, cold and damp stagnation, damp and hot betting, qi and blood weakness and liver and kidney deficiency.