30 days, menstrual period 5 days. Last menstrual period was:

30 days, menstrual period 5 days. Last menstrual period was: May 10, 2017, with scanty flow and dark color, blood clots (+), lumbago (+), abdominal distension and pain (+++). Physical examination: tongue body purple-dark, white greasy coating, pulse沉细. Color Doppler ultrasound shows: normal uterine size, retroverted position, right ovarian cystic change (2.8 cm x 2.0 cm). [Western medical diagnosis] Endometriosis. [Treatment principle] Activate blood circulation and regulate qi, regulate menstruation and relieve pain. [Prescription] Guizhi 15g, Fuling 15g, Danpi 15g, Chishao 15g, Taoren 15g, Sanleng 15g, Ezhushi 15g, Fuzi 6g, Shanyao 10g, Shanyurou 6g, Danpi 6g, Fuling 12g, Yanhusuo 10g, Xiangfu 6g. 10 doses, decocted in water and taken orally, one dose per day. Second consultation: May 30, 2017. The patient reported that after taking the medicine, lower abdominal distension and pain were relieved compared with before, chest and flank distension and pain, and lumbago were alleviated, mood was significantly improved, aversion to cold markedly improved, sleep and bowel movements were normal. In the original prescription, Fuzi and Danpi were removed, and Sanqi 3g and ShuiZhi 3g were added. 10 doses, decocted in water and taken orally. Lifestyle adjustments remained the same as before. Third consultation: June 10, 2017. The patient reported that today her menstruation has come, with normal amount and color, no blood clots (-), no lower abdominal distension (-), no lumbago (-), happy mood, good appetite and sleep, and normal bowel movements. Follow-up color Doppler ultrasound showed: right ovarian cystic change (1.8 cm x 1.2 cm). It is advised to increase ShuiZhi in the above formula to 6g and continue taking it. After 3 months of treatment, dysmenorrhea symptoms have not recurred, and color Doppler ultrasound shows that the mass has disappeared. VIII. Discussions by ancient and modern physicians on endometriosis Endometriosis is one of the modern medical disease names; in traditional Chinese medicine, there is no specific disease name for it. According to clinical symptoms, it is classified under conditions such as dysmenorrhea, infertility, and tumor fatigue. In "Jin Gui Yao Lue," the description of dysmenorrhea symptoms is: "If vaginal discharge and menstrual flow are obstructed, and there is fullness and pain in the lower abdomen, with menstruation reappearing after a month, then Tuigua Gen San should be used." In "Zhu Bing Yuan Hou Lun," it is said: "When blood accumulates and causes pain, it leads to lumbago that makes it impossible to bend or straighten, with accumulated qi below the pubic bone, hard as stone, causing urgent and painful sensations in the lower abdomen, back pain that extends deep into the waist and abdomen, and cramping in the lower yin region. If wind and cold invade, the uterus becomes blocked, menstrual flow comes irregularly, sometimes arriving and sometimes not, which can lead to childlessness." In "Liu Xuan Si Jia Yi An," it is written: "Dysmenorrhea lasting for several years, unable to conceive, with abdominal pain occurring three days before menstruation, and a mass forming in the abdomen... After inquiring about the woman's condition before marriage, it was found that she had no such illness, but developed it after getting married." All these described conditions share many similarities with dysmenorrhea, abdominal pain, and infertility caused by endometriosis. "Zhen Jiu Zi Sheng Jing" believes that "when evil blood in the organs surges upward, the abdominal pain becomes unbearable," which is similar to the modern medical theory of retrograde menstruation. "Yi Lin Gai Cuo" proposes that "any abdominal pain that cannot be moved at all is due to blood stasis," providing theoretical ideas for later physicians to study the pathogenesis of endometriosis-related dysmenorrhea. Tang Rongchuan stated in "Xue Zheng Lun" that "all blood that has left the meridians is completely separated from the blood that nourishes the whole body... Even if it is clear blood or fresh blood, it is still blood stasis." "Blood that has left the meridians" flows outside the channels, accumulates as stasis, blocks the Chong and Ren channels and the uterus, affecting the overflow and discharge of menstrual blood. When blockage occurs, pain arises. Over time, blood stasis hinders the normal ascending and descending movement of qi, causing qi stagnation and inability to circulate freely. As time goes on, blood stasis and qi stagnation interact and combine, gradually becoming harder and forming scars. Modern physician Professor Xia Guicheng believes that this disease is often caused by yang deficiency in the constitution, or by neglecting health preservation in daily life, drinking cold beverages during menstruation, leading to damage of yang energy and stagnation of qi and blood, thus causing blood coagulation. Over time, this coagulation turns into stasis. He considers yang deficiency and blood stasis as the basic pathological characteristics of this disease, along with qi deficiency, qi stagnation, phlegm-dampness, and damp-heat. Professor Zhou Shiyuan believes that the main cause of this disease is kidney deficiency or insufficient kidney yang, possibly combined with cold evil and liver depression, leading to failure of the Chong channel to contain qi, chaos of qi and blood, blood stasis blocking the channels, and blood entering the channels, thus forming stasis. He believes that kidney deficiency is the fundamental pathogenesis of endometriosis, with blood stasis blocking the channels being the hallmark; Professor You Zhaoling believes that the main pathogenic factors of endometriosis are "stasis, deficiency, and phlegm," and the key lies in weak righteous qi, imbalance of qi and blood, and mutual obstruction between phlegm and stasis. Professor Chai Songyan believes that the pathogenesis of endometriosis is the interplay of dampness and stasis, blocking the Chong and Ren channels and the sea of blood. Professor Han Bing believes that blood stasis is the basic pathogenesis, and from the perspective of "qi, blood, and phlegm," he discusses the mechanism of endometriosis, proposing that endometriosis has the characteristic of "stasis accumulating over time with phlegm, gradually forming tumor fatigue." Section 5: Menopausal Syndrome — Western medical etiology and pathology The most obvious change around menopause is the decline of ovarian function, followed by the degeneration of hypothalamic-pituitary function.

1. Estrogen The earliest sign of ovarian function decline is the decreased sensitivity of follicles to FSH; follicles gradually become more resistant to gonadotropin stimulation.
2. Androgen The androgens produced after menopause are testosterone and androstenedione. 3. Gonadotropins During the menopausal transition, women who still ovulate often have elevated FSH levels in most cycles, while luteinizing hormone (LH) remains within the normal range, but the FSH/LH ratio is still high. After menopause, both FSH and LH rise significantly, with FSH increasing more markedly, resulting in an FSH/LH ratio > 1.
3. Gonadotropin-releasing hormone