“On the first day of my period the pain floors me.”
The first day of her period
A pain she has always assumed is normal, concentrated in a few particular hours of the cycle rather than all of it.
- Patient
- Woman, 27
- Occupation
- Designer, eight hours seated
- Medication
- Ibuprofen on day one. No hormonal contraception.
- History
- Normal gynaecological ultrasound a year ago.
- Habits
- Swims twice a week in a heated pool.
- Vitals
- BP 118/72 · afebrile
1 · The consultation
You have 18 minutes. Each question or examination costs 2. Choose carefully what to ask.
Questions
Examination
2 · The tongue
3 · The pulse
Describe the pulse on each axis.
4 · The pattern
5 · Differential diagnosis
You're torn between two patterns. Which is it?
Which finding decides it?
6 · Case twist
Before finishing“«It has been the same since my periods started, no worse. Two days on ibuprofen and then I carry on as normal.»”
Mark the warning signs present:
What do you do?
7 · The treatment
Principle
Strategy
Points (choose 4)
Case solved
Reasoned solution
Pattern: Blood stasis in the Uterus. Supporting signs: Pain before and on day one, Dark clots that relieve as they pass, Fixed pain that refuses pressure, Purple tongue, Wiry, choppy pulse.
The deciding clue: Relief as clots pass: When a dark clot passes, the pain eases for a while. The defining sign of stasis..
Safety: Dysmenorrhoea that has been stable for years, with no abnormal bleeding or fever, is acupuncture's own ground.
Treatment: Move Blood, Break up stasis; Move in the days before the period. Points: SP10, SP6, CV6, LV3.
More patients are waiting in the app, with voice, a real timer and a history of your decisions.
See the solution without playing
Pattern: Blood stasis in the Uterus. Supporting signs: Pain before and on day one, Dark clots that relieve as they pass, Fixed pain that refuses pressure, Purple tongue, Wiry, choppy pulse.
The deciding clue: Relief as clots pass: When a dark clot passes, the pain eases for a while. The defining sign of stasis..
Safety: Dysmenorrhoea that has been stable for years, with no abnormal bleeding or fever, is acupuncture's own ground.
Treatment: Move Blood, Break up stasis; Move in the days before the period. Points: SP10, SP6, CV6, LV3.
Teaching case. Fictional patient for study purposes. If you have real symptoms, consult a healthcare professional.
