Menses ahead of schedule or early menses refers to the arrival of the menses before normally expected. Most Chinese gynecology texts define early menses as one that occurs eight to nine days ahead of schedule. If this is constant over a a long period of time it can be referred to as polymenorrhea. Since early menses means that the woman is discharging more blood that normally over a given length of time treatment should be focused on preserving yin blood and fluids and ultimately essence. According to TCM theory there are four mechanisms for pathological bleeding.
Heat making the blood move frenetically outside the pathways
Blood stasis forcing the blood outside its vessels
Insufficient qi that is unable to contain the blood within the vessels
Physical trauma or severing the channels and vessels
Patterns
Blood heat
Replete Heat - Excessive menses volume which is bright red or dark red in color. The blood may be purplish, clotty with possible odor. There can be lower abdominal pain and thirst with preference for cold drinks, red face, heat in the heart, and constipation. In severe cases there may be red eyes, sores in the mouth and nosebleeds. With this pattern the goal is to clear heat and cool the blood.
Formulas
Qing Jing San
Qin Lian Si Wu Tang
Xian Qi Tang
Depressive Heat - Early menses that is either red or purple, profuse or scanty, possible clots, breast, chest, ribside and lower abdominal distention and pain, agitation. One may also experience a dry mouth with a bitter taste.
Formulas
Dan Zhi Xiao Yao San
Hei Xiao Yao San Jia Wei
Qing Jing San Jia Jian
Xiao Chai Hu Tang
Phlegm heat - Early menses with either moderate or profuse blood flow. One may have a yellowish face, fullness in head, heavy limbs, dizziness, chest opression, tendency to profuse phlegm production. The goal is to fortify the spleen and disinhibit dampness, clear heat and transform phlegm
Formulas
Huang Lian Wen Dan Tang
Tao Hong Er Chen Tang Jia Wei
Damp Heat - early menses preceded by abnormally profuse vaginal discharge or mixed with dark red purplish discharge, possibly order, low back or hip pain, sciatica pain, swelling and redness, hot to touch, chronic lower abdominal pain. The goal is to clear heat and disinhibit dampness
Formulas
Jia Wei Er Chen Tang
Dang Gui Huang Tang
Wen Qing Yin
Vacuity heat - Menses ahead of schedule with scanty menses, red color, possibly sticky, lack of abdominal pain and distention, flushed cheeks, heat in centers of hands or feet, dry mouth, dizziness, heart palpitations, tidal fever, and night sweats. The goal is to Nourish yin and cool the blood
Formulas
Liang Di Tang
Di Gu Pi Yin
Yi Jian Jia Jian
Qi vacuity - Menses ahead of schedule, excess blood but pale red clear and watery, dizziness, heart palpitations, shortness of breath, spontaneous sweat, fatigue, pale white facial complexion. The goal is to boost the qi and nourish the blood, secure conserve and lift desertion.
Formulas
Gui Pi Tang
Bu Zhong Yi Qi Tang
Ba Zhen Tang
Er Xian Tang
Blood stasis - Menses ahead of schedule, scanty, purplish blood clots, abdominal pain that dissipates with passing of clots. The goal is quicken the blood and transform stasis.
Formulas
Tao Hong Si Wu Tang
