By Andrew Gaeddert
This is the fourth installment of a series of articles on questions that practitioners commonly ask, and the second part exploring frequently encountered gynecologic issues in administering herbal formulas.
HORMONAL ISSUES
Should Woman’s Balance be used all month? Is it all right to use after the period? Are there any negative side effects over the long term? Should women be concerned about dependency? Is Woman’s Balance compatible with birth control pills?
In general it is best to use Woman’s Balance all month except during menses. If a patient finds the formula does not agree with her she will know. There is no problem with becoming dependent on Woman’s Balance. The formula can be used while taking birth control pills.
Do you have any herbal experience with excess body hair; the patient is a 33- year-old woman with polycystic disease and rapid weight gain. Electrolysis leads to more hair in the area and plucking leaves scars on the skin.
You can treat the scars with Resinall K, but not the excess hair. Your patient might need to see an endocrinologist or gynecologist for excess body hair.
A 34-year-old female patient is taking Maternal Herbal and Eight Treasures. She is still blood deficient and stagnant. When she stops taking herbs her energy comes back. What is your analysis?
Blood deficiency may take a long time to adjust, especially if she’s not eating red meat. In terms of feeling better, when not taking herbs you could adjust the dosage (i.e. take 50% less or 50% more) and see what happens.
Finally, you might consider Marrow Plus instead of Eight Treasures. Marrow Plus is a stronger formula.
One week before her period the patient experiences depression, crying and stabbing pain. During her period she has excess bleeding, cold hands and feet and experiences anxiety.
Use Woman’s Balance all month up until the period to regulate Qi. One week before her period add Channel Flow to promote blood flow. During the period if there are cold signs consider Postpartum; if there are heat signs consider Unlocking to stop bleeding.
A 56-year-old woman with uterine prolapse wants help with incontinence.
For urinary incontinence use Astra Essence; add Virility Caps with cold signs. For fecal incontinence, use Source Qi. For uterine prolapse, you can use Raise Qi (Bu Zhong Yi Qi Tang) long term.
FEMALE ATHLETES
Patient has had no period for 4 months. She exercises a lot, has irregular periods and kidney/yin deficiency. Her tongue is red, a little fur, a strong pulse, healthy, and no fatigue. She is an attorney and lives a very high powered life – high intensity. Eats little fat and doesn’t eat enough, a struggle to get her to eat. Dinner consists of steamed vegetables. She was tested for menopause but was normal. She also has a history of bulimia.
If her body fat is below 20% or she is approaching menopause it may not be possible to regain her period. I would use Astra Essence and Calm Spirit (2 capsules each QID) as an overall approach. I would also counsel her to add healthy fats such as olive oil and fresh fish to her diet.
A 37-year-old woman is training for a marathon. She has weak lungs with an allergy and asthma history. She keeps getting sick. She trains heavily, about 70 miles per week. What would your approach be?
CordySeng, ½ teaspoon TID, with either Astra Essence (3 capsules TID) if yin and yang deficient, or Astra 8 for lung Qi deficiency.
INTERSTITAL CYSTITIS
My client has been diagnosed by her M.D. as having interstitial cystitis. She has cramps and a burning, painful sensation with urination and has frequent urination. She has been on three rounds of antibiotics and two rounds of antifungal drugs during the last two months. Her pulse is weak and her tongue is purplish with a thin yellow- gray coating.
I would recommend Unlocking formula (3 capsules QID) as well as PB-8 Acidophilus in order to restore healthy bacteria (2 capsules BID). I would follow up in a week. Unlocking is designed to remove heat and toxins in the lower burner and has herbs to protect the spleen, however, if she has loose stools or feels cold, add Six Gentlemen (2 capsules QID).
A female patient has interstitial cystitis, heaviness, a little burning and her mother died recently as well. Currently she is using Clearing plus Ease Plus. It hasn’t really cleared up. What would you suggest?
Frankly, it’s a tough condition. If the patient has been faithfully taking the herbs for 4 weeks or more at the correct dosage, I would rethink my strategy. You might consider Unlocking and Ease Plus. If it has been less than 4 weeks you might want to give it more time.
FERTILITY
A female patient 43-years-old had Myofascitis ten years ago. She suffered great degradation and trauma in muscles in femur and calf areas. She has never quite recovered from Blood and Qi deficiency. She is now trying to conceive. What would you recommend to build blood and uterine wall to accept the egg?
I would certainly use Maternal Herbal. If there is still Qi and Blood stagnation add Channel Flow or AC-Q. If she is Qi and Blood deficient add Marrow Plus.
Woman is planning on artificial insemination, is receiving acupuncture and using the formula Fertile Garden. Is it okay to still use Fertile Garden?
I believe so, however sometimes fertility specialists say not to do anything else. In that case I would not.
I have a patient on Fertile Garden and want to know how long before it is effective? Would it be better to use Heavenly Water instead?
If the formula is used with an overall health plan for pregnancy, good diet, proper exercise etc, you can expect to see results in 3 to 12 months. I usually recommend either Fertile Garden or Maternal Herbal plus a formula that deals with specific issues, such as blood stagnation, liver Qi stagnation, weak blood, etc.
MENOPAUSE
My patient has been going through menopause for 17 years. She has tried Three Immortals but it didn’t seem to work. Any suggestions?
You may need to give it more time. It really depends on the diagnosis. For menopause with hot flashes, consider Three Immortals or Nine Flavor Tea (2-3 capsules TID) plus Coptis Purge Fire (1-3 capsules TID/QID). If vaginal dryness is more of an issue, I would suggest Nine Flavor Tea with Marrow Plus. With fatigue and dryness, I would consider Shen Gem with Marrow Plus.
A menopausal woman is taking Woman’s Balance and Three Immortals. She is depressed at certain times during the month and has a decreased libido. She has a history of cervical cancer, which she cured naturally. Is there anything else she should be taking?
I think the combination she is on is good. An alternative protocol would be Three Immortals and Aspiration instead of Woman’s Balance. Aspiration treats a pattern of heart deficiency with specific herbs for depression. Woman’s Balance is for liver Qi stagnation, and thus is usually used for anger and irritability.
A 50-year-old woman is using Three Immortals for mild menopause. Tests show her estrogen levels are very high. Could it be Three Immortals?
Three Immortals has no known estrogenic effects.
I am treating two (2) women for hot flashes. Both have had surgery for estrogen sensitive breast cancer. We are concerned about any estrogen-like (even phytoestrogen) components in the herbs. Do any of the herbs in Three Immortals have estrogen-like action? Would it be contraindicated in a woman with a history of estrogen sensitive breast cancer?
You have asked a very controversial question. Although I have never seen any strong data suggesting the herbs in Three Immortals have estrogen-like components, certain herbs may have phytoestrogen components, although weaker than soy, red clover, etc. Therefore there is no strong evidence that the formulas would be contraindicated. However I would not get into a fight with the oncologist over the use of Three Immortals.
My patient was taking Two Immortals. She is now taking Three Immortals. However, she is complaining of hot flashes. We need to address the kidney yin heat.
Your patient would not need Three Immortals at this point. I suggest Nine Flavor Tea (2-3 capsules TID) and Coptis Purge Fire (1-3 capsules TID/ QID) for kidney yin deficient heat.
DIGESTION
A woman in her early 50’s has chronic constipation, gas and bloating since her late 20’s. She has been on a high soy diet for the last few years; she also takes black cohosh, passionflower and supplements. These seem to work for menopausal symptoms, yin deficiency and excess heat. An acupuncturist she saw a few weeks ago gave her herbs for the constipation but that gave her diarrhea.
Try a soy free diet for two weeks and use Aloe 22 (1-3 capsules TID) and Quiet Digestion (1 with meals and 2 capsules TID). I also recommend reading Healing Digestive Disorders for lifestyle changes.
Andrew Gaeddert is an herbalist and author of the books, Healing Digestive Disorders and Chinese Herbs in the Western Clinic.