A 52-year-old woman complained of night sweats and insomnia, i.e. she was having trouble falling asleep, feeling very hot, and when she could sleep she would awaken covered in sweat. She was also experiencing some hot flashes during the day, at which times she would sometimes also sweat a great deal. She occasionally also felt dizzy.
The patient's periods had become very infrequent over the past few years, occurring only every 3 or 4 months. When they did occur, they were unpredictable as well: sometimes scanty and sometimes more discharge than usual was apparent. She was finding that she was becoming more and more irritable, especially when her periods occurred, but also in relation to her hot flashes.
She also complained of headaches starting, especially on the top of her head. She had noticed that they seemed to accompany a bitter taste in her mouth. The patient also claimed that an increase in fibre recently had helped her bowels, which were beginning to move more slowly, possibly tending towards constipation.
Her tongue tip was reddish in colour and the tongue's body had a thin, white coat. Her pulse was slightly wiry and rapid on the right, and weaker on the left, especially at the Kidney position.
Diagnosis: Kidney and Liver Yin deficiency with some signs of Liver Yang Rising, probably as a consequence of the Liver Yin deficiency. The Kidney Yin deficiency was apparent in the decrease of her periods, plus the night sweats, constipation and hot flashes. The Liver Yin deficiency showed in the unpredictability of her periods, her irritability and her dizziness. The Liver Yang rising showed in regards to the headaches she was starting to get, and the bitter taste in her mouth.
Treatment Principle: Tonify the Kidney Yin and Liver Blood. Some points to smooth the Liver and clear some Heat to help to suppress the Liver Yang, but only secondarily to Tonifying.
Acupuncture Points: SP 6, BL 18, BL 20, BL 23, LR 8, KD 3, KD 6, LI 4, LR 3, RN 4
Herbal Formula: Liu Wei Di Huang Wan (Six Ingredient Pill With Rehmannia), augmented with the addition of Di Gu Pi and Zhi Mu.
After one month of treatment the patient was feeling much better. She had only the occasional hot flash, and her night sweats, insomnia and dizziness had all disappeared. She was no longer experiencing headaches, and her mood was much better as well.
By Richard Lobbenberg, Registered Acupuncturist and TCM Practitioner
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