Menstruation that does not follow a regular cycle, occurring either earlier or later without a fixed pattern, is referred to as "irregular menstrual cycles," also known as "menstrual disorder." If this condition persists for a long time without improvement, it not only makes conception difficult but also easily progresses to "dysfunctional uterine bleeding." However, around the age of 49, when menstruation is about to cease but has not yet stopped, it is common to experience irregular cycles, which is considered a normal physiological phenomenon.

bubble_chart Pattern Analysis

1. Liver Depressionkidney Deficiency︰Menstruation sometimes comes early, sometimes late, or occurs once every two months, or twice in one month, with varying amounts of blood flow. Before menstruation or at the onset, there may be breast distending pain, or lower abdominal distension and fullness with pain extending to both flanks and soreness in the lower back. The pulse is deep and weak, possibly with a wiry quality. A few patients may only exhibit irregular menstrual cycles without other accompanying symptoms. This condition arises from liver depression and kidney deficiency, leading to dysfunction in the free flow and storage of qi, which disrupts the Chong and Ren meridians' regulation of qi and blood. As a result, the menstrual cycle becomes irregular, manifesting symptoms such as breast distension, abdominal fullness, flank distension, and lower back soreness. However, the duration of menstruation remains within the normal range, and even if the flow increases occasionally, it does not become as heavy as in "menorrhagia." This is the key distinction between the two conditions. Treatment should focus on soothing the liver and tonifying the kidneys. Recommended formulas include Menstruation-Stabilizing Decoction or Kidney-Tonifying Liver-Regulating Decoction.
2. Deficiency of Both Heart and Spleen︰Irregular menstrual cycles with scanty and pale flow, dizziness, palpitation, mental fatigue, lack of strength, and loose stools. The tongue texture is pale with a white coating, and the pulse is weak and thin. Due to deficiency of both the heart and spleen, insufficient qi and blood, and the Chong and Ren meridians lacking nourishment, the menstrual cycle becomes irregular. The key points for differentiation are scanty and pale flow without distending pain, accompanied by symptoms such as dizziness, mental fatigue, poor appetite, and loose stools. The treatment should focus on tonifying and replenishing the heart and spleen, using the formula Returning to Spleen Decoction.

bubble_chart Documentation

1. Jingyue Quanshu．The Rules for Women: "When desires are not fulfilled, leading to deep contemplation and accumulated melancholy, the heart and spleen qi become knotted, injuring the source of the Chong and Ren meridians, and the kidney qi diminishes daily. In mild cases, menstruation may come early or late; in severe cases, it may gradually lead to amenorrhea. This condition should be treated by addressing the heart, spleen, and kidney together."