In TCM, herbal therapies are generally formula based and single herbs are rarely used. The herbs are not simply added in a cumulative fashion. Each ingredient in the formula is carefully balanced to accentuate its strengths and reduce side effects so as to create a synergistic curing effect. This part needs extensive training and real clinical experience. Self-medication is not encouraged. Appropriate formula prescriptions based on accurate differential diagnosis can only be made by qualified TCM physicians. In a worst case scenario, self-prescribing of herbal medicine may be harmful or even fatal.
Although the mechanisms of how certain herbal formulae work are not understood quite well, Chinese herbs have proven to be effective in treating infertility. One benefit is that they can have less accompanying adverse effects that often are present with Western pharmaceutical drugs. Herbal prescriptions may also work well as adjuvant therapy for conventional approaches too.
Peony, Motherwort herb & Rhemannia root (processed) are common ingredients in gynecological treatments.
A. Treatment Based on Syndrome Differentiation
The following are some examples of formulae designed for appropriate TCM syndromes:
1. Kidney-yang deficiency
Therapeutic principle: Warms the
kidney and womb, harmonizes the
Conception Vessel and
Thoroughfare Vessel.
Ex. Formula (1): Modified Yougui Bolus
Source: Jingyue Quanshu (The Complete Work of Zhang Jingyue).
Composition:
| Radix Aconiti Praeparata |
Monkshood root (processed) |
Shu fu zi |
| Cortex Cinnamomi |
Cassia bark |
Rou gui |
| Colla Cornus Cervi |
Deer horn glue |
Lu jiao jiao |
| Rhizoma Rehmanniae Praeparatae |
Rhemannia root (processed) |
Shu di huang |
| Rhizoma Dioscoreae |
Chinese yam |
Shan yao |
| Fructus Corni |
Asiatic cornelian cherry fruit |
Shan yu rou |
| Fructus Lycii |
Chinese wolfberry fruit |
Gou qi zi |
| Cortex Eucommiae |
Eucommia bark |
Du zhong |
| Semen Cuscutae |
Dodder seed |
Tu si zi |
| Radix Angelicae Sinensis |
Angelica root |
Dang gui |
| Herba Epimedii |
Epimedium |
Xian ling pi |
| Folium Artemisiae Argyi |
Artemisia leaf |
Ai ye |
Analysis: In this prescription, Monkshood, Epimedium, Cassia bark and deer horn glue cultivate the kidney yang and expel the internal coldness. They act as monarch herbs. Rhemannia root, cornelian cherry fruit, wolfberry fruit and Chinese yam, which are minister herbs, nourish the kidney yin and replenish the essence. Dodder seed and Eucommia bark invigorate the spleen and liver; Angelica root promotes blood production; and, Artemisia leaves warm the meridians and help to regulate the menses. The whole combination reinforces the kidneys, spleen and liver and resumes the yin yang balance at the same time. However, the formula predominately reinforces kidney yang in the end.
In TCM, when there is an inadequate source of yang, the usual approach is to use ingredients for nourishing yin and replenishing essence to firm up and tonify the kidney yang. Thus, a lot of the ingredients have been added in the prescription for this purpose.
Ex. Formula (2): Modified Kidney-Qi Bolus plus Four-Substance Decoction
Source: The Kidney-Qi Bolus is from Jinkui Yaolue (Synopsis of the Golden Chamber), and the Four-Substance Decoction is from Taiping Huimin Heji Jufang (Formulary of the Taiping Welfare Dispensary Bureau).
Composition:
| Radix Rehmanniae Praeparatae |
Rhemannia root (processed) |
Shu di huang |
| Radix Paeoniae Alba |
White peony root |
Bai shao |
| Radix Angelicae Sinensis |
Chinese angelica root |
Dang gui |
| Radix Ligustici Chuanxiong |
Szechuan lovage |
Chuan xiong |
| Fructus Corni |
Asiatic cornelian cherry fruit |
Shan zhu yu |
| Poria |
Poria |
Fu ling |
| Rhizoma Alismatis |
Oriental water plantain rhizoma |
Ze xie |
| Cortex Moutan Radicis |
Moutan bark |
Mu dan pi |
| Cortex Cinnamomi |
Cassia bark |
Rou gui |
| Radix Aconiti Praeparata |
Monkshood root (processed) |
Shu fu zi |
Analysis: In the prescription, the monarch herb is Rhemannia root, which nourishes the
kidney yin. Cornelian cherry fruit, angelica root, peony root and Szechuan lovage are the minister herbs, which fortify the spleen and liver to activate the blood circulation. Monkshood and cassia bark help the
vital gate to warm the body's yang and facilitate
. In addition, oriental water plantain and Poria expel the turbid
dampness; Moutan bark eliminates the
fire in the
liver. These three herbs act as buffers by clearing
evils and facilitating the actions of the main ingredients. The whole combination boosts kidney yang and recovers the vaporization function of the kidneys.
2. Kidney-yin deficiency
Therapeutic aim: Nourishes the kidneys and blood, aids the yin and clearing
heat.
Ex. Formula (1): Modified Zuogui Bolus
Source: Jingyue Quanshu (The Complete Work of Zhang Jingyue)
Composition:
| Fructus Lycii |
Chinese wolfberry fruit |
Gou qi zi |
| Fructus Corni |
Asiatic cornelian cherry fruit |
Shan yu rou |
| Colla Cornus Cervi |
Deer horn glue |
Lu jiao jiao |
| Semen Cuscutae |
dodder seed |
Tu si zi |
| Radix Achyranthis Bidentatae |
Achyranthes root |
Niu xi |
| Cortex Lycii |
Chinese wolfberry root-bark |
Di gu pi |
| Fructus Ligustri Lucidi |
Glossy privet fruit |
Nu zhen zi |
| Fructus Rosae Laevigatae |
Rosa fruit |
Jin ying zi |
| Herba Taxilli |
Chinese taxillus herb |
Sang ji sheng |
| Radix Rehmanniae Praeparatae |
Rhemannia root (processed) |
Shu di huang |
| Cortex Eucommiae |
Eucommia bark |
Du zhong |
|
Analysis: In the prescription, Rhemannia root is used in a large proportion, which replenishes kidney essence and acts as a monarch herb. Eucommia bark and Chinese taxillus herbs reinforce the liver and kidneys; cornelian cherry fruit nourishes the liver and consolidates the essence; wolfberry fruit and Glossy privet fruit promote the kidney and liver functions and replenish the essence. Deer horn glue acts as a strong booster in essence transformation while wolfberry root-bark expels excessive
virtual heat. All of them are minister herbs. Moreover, Rosa fruit consolidates essence storage, and, dodder seed and Achyranthes root benefit the liver and kidneys so as to strengthen the lumbar area and knees. These all act as assistant herbs. The whole combination nourishes kidney yin and replenishes kidney essence.
Ex. Formula (2): Modified Zuogui Decoction
Source: Jingyue Quanshu (The Complete Work of Zhang Jingyue)
Composition:
| Herba Taxilli |
Chinese taxillus herb |
Sang ji sheng |
| Fructus Lycii |
Chinese wolfberry fruit |
Gou qi zi |
| Fructus Corni |
Asiatic cornelian cherry fruit |
Shan yu rou |
| Cortex Lycii |
Chinese wolfberry root-bark |
Di gu pi |
| Fructus Ligustri Lucidi |
Glossy privet fruit |
Nu zhen zi |
| Fructus Rosae Laevigatae |
Rosa fruit |
Jin ying zi |
| Radix Rehmanniae Praeparatae |
Rhemannia root (processed) |
Shu di |
| Radix Glycyrrhizae Praeparata |
Liquorice root (processed with honey) |
Jiu gan cao |
| Rhizoma Dioscoreae |
Chinese yam |
Shan Yao |
| Poria |
Poria |
Fu ling |
|
Analysis: In the prescription, the monarch herb is Rhemannia root, which nourishes the kidney yin and replenishes the essence. Cornelian cherry fruit enriches the liver and kidneys and
astringes the essence; Chinese yam benefits the spleen and aids the body's yin; Poria eliminates the dampness, and, Chinese taxillus herb and wolfberry fruit invigorate the kidneys and liver and replenish the essence. All of them are minister herbs. Glossy privet fruit and Rosa fruit benefit the kidneys and consolidate the essence storage; wolfberry root-bark expels the virtual heat. The liquorice acts as buffer. This combination is designed for individuals with a mild degree of kidney yin deficiency.
3. Blood and Qi weakness
Therapeutic aim: Powerfully reinforces both qi (vital energy) and blood and warms the kidneys as a subsidiary treatment.
Name of the Formula: Modified Yulin Pill
Source: Jingyue Quanshu (The Complete Work of Zhang Jingyue)
Composition:
| Radix Angelicae Sinensis |
Chinese angelica root |
Dang gui |
| Radix Rehmanniae |
Rhemannia root |
Sheng di |
| Radix Paeoniae |
Peony |
Shao yao |
| Radix Ligustici Chuanxiong |
Szechuan lovage |
Chuan xiong |
| Radix Codonopsis |
Pilose asiabell root |
Dang shen |
| Rhizoma Atractylodis Macrocephalae |
Large head atractylodes rhizome |
Bai shu |
| Poria |
Poria |
Fu ling |
| Radix Glycyrrhizae |
Liquorice root |
gan cao |
| Pericarpium Zanthoxyli |
Pepper tree |
Chuan jiao |
| Cortex Eucommiae |
Eucommia bark |
Du zhong |
| Semen Cuscutae |
Dodder seed |
Tu si zi |
| Colla Cornus Cervi |
Deer horn glue |
Lu jiao jiao |
Analysis: In the prescription, dodder seed, deer horn glue and Eucommia bark tonify the kidney and promote the transformation of essence. Pilose asiabell root, atractylodes root, Poria and liquorice are used for invigorating qi (vital energy). Angelica root, rhemannia root, peony and Szechuan lovage nourish the blood; pepper tree warms the
Governor vessel and assists the body's yang. The whole combination not only benefits the kidneys by replenishing essence, but also acts on the spleen to promote blood production. Moreover, it also contains ingredients to harmonize blood flow. When the blood and essence are abundant, the Conception and Thoroughfare Vessels are nourished and conception is ensured.
4. Qi and blood stagnation
Therapeutic aim: Activates the blood and remove stasis, soothes the liver so as to regulate the qi movement.
Name of the Formula (1): Modified Xiaoyao Power
Source: Furen Daquan Liangfang (The Complete Book of Efficacious Prescriptions for Women)
Composition:
| Cortex Moutan Radicis |
Moutan Bark |
Mu dan pi |
| Herba Menthae |
Peppermint |
Bo he |
| Radix Bupleuri |
Chinese tororwax root |
Chai hu |
| Rhizoma Atractylodis Macrocephalae |
Large head atractylodes rhizome |
Bai shu |
| Poria |
Poria |
Fu ling |
| Radix Paeoniae Alba |
White peony root |
Bai shao |
| Rhizoma Corydalis |
Corydalis tube |
Yuan hu |
| Radix Angelicae Sinensis |
Chinese angelica root |
Dang gui |
| Pericarpium Citri Reticulatae Viride |
Green Tangerine peel |
Qing pi |
| Radix Glycyrrhizae |
Liquorice root |
Gan cao |
| Faeces Trogopterorum |
Trogopterus dung |
Wu ling zhi |
| Radix Cudraniae |
Tricuspid Cudrania root |
Chuan po shi |
| Fructus Gardeniae |
Cape jasmine fruit (charred) |
Jiao zhi zi |
| Rhizoma Zingberis Preparata |
Ginger |
Wei jiang |
| Fructus Meliae Toosendan |
Szechuan Chinaberry |
Chuan lian zi |
Analysis: In the prescription, Chinese tororwax root is the monarch herb, which dispels the liver stagnation. White peony root soothes the liver and nourishes the blood; angelica root nourishes the blood and harmonizes its flow. These two herbs are the minister herbs. Atractylodes root, Poria and liquorice fortify the spleen and aid in qi (vital energy). Moutan bark, peppermint and Cape jasmine fruit clear the excessive heat; Szechuan chinaberry, corydalis tube and green Tangerine peel activate the qi flow and relieve pain. Trogopterus dung removes the stasis and eases pain. Cudrania root expels dampness and
wind evils to promote blood flow and menstruation; the pungent flavor in ginger helps to disperse the stagnation. This formula is usually used in irregular menstruation due to liver stagnation and blood deficiency.
Ex. formula (2): Decoction for Removing Blood Stasis in the Lower Abdomen
Source: Yilin Gaicuo (Correction of Errors in the Medical Circles)
Composition:
| Rhizoma Zingiberis |
Fried ginger |
Gan jiang |
| Ramulus Cinnamomi |
Cassia twig |
Gui zhi |
| Resina Commiphorae Myrrhae |
Myrrh |
Mo yao |
| Fructus Foeniculi |
Fennel |
Xiao hui xiang |
| Radix Ligustici Chuanxiong |
Szechuan lovage |
Chuan xiong |
| Radix Angelicae Sinensis |
Chinese angelica root |
Dang gui |
| Radix Paeoniae |
Peony root |
Shao yao |
| Rhizoma Corydalis |
Corydalis tube |
Yuan hu |
| Pericarpium Citri Reticulatae Viride |
Green Tangerine peel |
Qing pi |
| Faeces Trogopterorum |
Trogopterus dung |
Wu ling zhi |
| Squama Manitis |
Pangolin scales |
Chuan shan jia |
| Spina Gleditsiae |
Gleditsia spine |
Zao jiao ci |
| Pollen Typhae |
Sweet flag |
Chang pu |
Analysis: In the prescription, angelica root, Szechuan lovage and peony root activate the blood flow and expel the stasis. Green Tangerine peel promotes qi flow and eases pain. Ginger, cassia twig, myrrh, fennel and corydalis tube dissipate the liver stagnation and move the qi flow, warm the meridians and relieve pain. Sweet flag and trogopterus dung dissolve the stasis and relieve pain. Pangolin scales and Gleditsia spine remove the obstruction in the meridians and dissolve the accumulated masses. The formula is designed for infertility associated with regular menstrual pain.
5. Liver-qi stagnation
Therapeutic aim: Soothes the liver so as to move the qi (vital energy) and nourish the blood.
Name of the Formula (1): Conceptive Decoction by Soothing the Liver
Source: Fuqingzhu Nuke (Obstetrics and Gynecology of Fu Qingzhu)
Composition:
| Radix Angelicae Sinensis |
Chinese angelica root |
Dang gui |
| Rhizoma Cyperi |
Nut grass |
Xiang fu |
| Rhizoma Atractylodis Macrocephalae |
Large head atractylodes rhizome |
Bai shu |
| Fructus Ligustri Lucidi |
Glossy privet fruit |
Nu zhen zi |
| Cortex Moutan Radicis |
Moutan bark |
Mu dan pi |
|
Pollen |
Hua fen |
| Radix Curcumae |
Curcuma root |
Yu jin |
| Flos Albiziae |
Albizia flower |
He huan hua |
| Poria |
Poria |
Fu ling |
| Radix Paeoniae Alba |
White peony root |
Bai shao |
Analysis: In the prescription, angelica root and white peony root sooth the liver and nourish the blood; glossy privet fruit reinforces the liver and enriches the kidney yin. Nut grass, curcuma root and Albizia flower disperse the stagnation in the liver to facilitate qi movement; Moutan bark cools and activates the blood; Atractylodes root and Poria promote spleen and stomach functions so as to ensure the nutrient support. Pollen clears the heat and promotes body fluid production. The whole combination acts on soothing the liver, regulating the spleen and nourishing the blood, so as to regulate menstruation.
Ex. formula (2): Decoction for Regulating Menses and Conception.
Source: Gujin Yijian (Ancient and Contemporary Mirror of Medicine)
Composition:
| Radix Angelicae Sinensis |
Chinese angelica root |
Dang gui |
| Rhizoma Cyperi |
Nut grass |
Xiang fu |
| Cortex Cinnamomi |
Cassia bark |
Rou gui |
| Poria |
Poria |
Fu ling |
| Cortex Moutan Radicis |
Moutan bark |
Mu dan pi |
| Radix Rehmanniae Praeparatae |
Rhemannia root (processed) |
Shu di |
| Rhizoma Zingiberis Recens |
Fresh ginger |
Sheng jiang |
| Rhizoma Zingiberis |
Fried ginger |
Gan jiang |
| Radix Paeoniae Alba |
White peony root |
Bai shao |
| Radix Ligustici Chuanxiong |
Szechuan lovage |
Chuan xiong |
| Pericarpium Citri Reticulatae |
Dried tangerine peel |
Chen pi |
| Folium Artemisiae Argyi Praeparatae |
Artemisia leaves (processed) |
Shu ai |
| Rhizoma Corydalis |
Corydalis tube |
Yuan hu |
| Fructus Corni |
Asiatic cornelian cherry fruit |
Shan yu rou |
Analysis: In the prescription, angelica root, rhemannia root, white peony root and Szechuan lovage are the four main ingredients for nourishing blood and regulating menstruation. Cassia bark, cornelian cherry fruit and ginger are used for warming and removing the obstruction in the meridians. Poria and tangerine peel enhance and harmonize the spleen and stomach functioning. Nut grass, Moutan bark and corydalis tube regulate the qi (vital energy) and dispel the stasis. Artemisia leaves warm the meridians. The whole combination nourishes and activates the blood so that regular menstrual cycles can resume and make conception possible.
6. Interior struck by phlegm and dampness
Therapeutic aim: Warms and tonifies the spleen and kidneys, eliminates the dampness and phlegm and nourishes the blood.
Name of the Formula (1): Atractylode and Nut-grass Decoction for Phlegm Elimination
Source: Guangsi Jiyao (Essential Discipline for Spreading Progeny)
Composition:
| Rhizoma Atractylodis |
Atractylodes rhizome |
Cang zhu |
| Rhizoma Cyperi |
Nut grass |
Xiang fu |
| Poria |
Poria |
Fu ling |
| Arisaema cum Bile |
Arisaema with bile |
Dan nan xing |
| Pericarpium Citri Reticulatae |
Dried tangerine peel |
Chen pi |
| Fructus Aurantii |
Orange fruit |
Zhi qiao |
| Rhizoma Pinelliae |
Pinellia tuber |
Ban xia |
| Herba Lycopi |
Hirsute Shiny Bugleweed herb |
Ze lan ye |
| Radix Angelicae Sinensis |
Chinese angelica root |
Dang gui |
| Radix Ligustici Chuanxiong |
Szechuan lovage |
Chuan xiong |
| Radix Glycyrrhizae |
Liquorice root |
Gan cao |
Analysis: In the prescription, Arisaema and Pinellia tuber dry the dampness and expel the phlegm, which serve as monarch herbs. Atractylodes root, Poria and tangerine peel fortify the spleen to enhance fluid metabolism. Nut grass and orange fruit regulate the qi movement; angelica root, Szechuan lovage and Bugleweed herb nourish and activate the blood. Liquorice acts as a buffer.
Ex. formula (2): Decoction for Eliminating Phlegm and Turbid-fat.
Source: Zhongzi Yaofang (Important Formulae for Conception)
Composition:
| Arisaema cum Bile |
Arisaema with bile |
Dan nan xin |
| Fructus Aurantii |
Orange fruit |
Zhi qiao |
| Rhizoma Pinelliae Praeparatae |
Pinellia tuber (processed) |
Zhi ban xia |
| Radix Saposhinkoviae |
Fang feng |
Fang feng |
| Pulvis Talci |
Talci |
Hua shi fen |
| Rhizoma Seu Radix Notopterygii |
Incised Notopterygium rhizome and root |
Qiang huo |
| Rhizoma Zingiberis Recens |
Fresh ginger |
Sheng jiang |
| Radix Ligustici Chuanxiong |
Szechuan lovage |
Chuan xiong |
| Poria |
Poria |
Fu ling |
| Exocarpium Citri Grandis |
Red tangerine peel |
Ju hong |
| Semen Plantaginis |
Asiatic Plantain seed |
Che qian zi |
Analysis: In the prescription, Arisaema and Pinellia tuber dry the dampness and expel the phlegm, which serve as monarch herbs. Poria, red tangerine peel and orange fruit invigorate and harmonize the spleen and stomach. Talci and plantain seed clear the heat and expel dampness; Fang feng and Notopterygium eliminate wind and dampness. Szechuan lovage activates blood and qi flows and disperses the wind to ease pain. Ginger assists in buffering.
Chinese angelica root, combined spicebush root & epimedium
B. Herbal Regulations Based on Menstrual Cycle
Long ago, TCM realized that menstruation was not simply just womb bleeding, but a surface phenomenon resulting from the physiological fluctuations inside the body. Menstruation occurs about every 28 days in women. Cyclic changes inside the body are mainly related to the kidney functions and blood and qi (vital energy) supplies. They regulate the production of tian-gui and the activities of the extra meridians, and lead to a natural rhythm of the menstruation cycle.
TCM physicians have identified those changes and incorporate specialty skills in identifying particular segments of the four-phase period surrounding menstruation. When the phases happen normally, the body is in its best condition to produce high quality eggs and allow an embryo to implant easily.
General guidelines for each phase are:
- Proliferation (6th to 10th day): This period ensures the growth of the uterine membrane and development of the ovum (egg). TCM usually focuses on fortifying the liver and kidneys, invigorating the spleen and stomach in order to replenish blood and kidney essence and activate their circulation.
- Ovulation (11th to 16th day): This period is when typically the ovum is released from the ovary. TCM usually focuses on fortifying the liver and kidneys to ensure appropriate nutrient supply, warming yang and unblocking meridians to activate the local blood flow and remove any stasis.
- Secretion (17th to 25th day): This period ensures the further ripening of the released follicle inside the ovary and facilitates a fertilized egg's implantation in the thickened lining of the uterus. TCM usually focuses on warming the yang and fortifying the kidneys to nourish the Conception and Thoroughfare Vessels.
- Menstruation (25th to 5th day): This period usually does not need special management; however, when there are symptoms like non-smooth flow and painful menstruation, TCM will focus on harmonizing the blood and promoting qi (vital energy) movement.
The above techniques are used when treating ovarian or uterine problems. Herbal therapies generally have less adverse effects than conventional drug therapies and show no inhibited effect on ovary functioning for long-term use. Overall improvement on body health is attained too.
** Please keep in mind that if you are under hormone therapy or artificial insemination, you should report this to your physician to avoid interferences with herbal medicines.
