Lets go through a case together.  Start to highlight all of the symptoms and pair with a organ system and substance (qi,blood,yin,yang). Then produce a diagnosis based on what you see.  This diagnosis will guide you in identifying the best acupuncture points and herbal prescriptions.  Remember don’t get distracted with all of the symptoms and focus on the main concern.

A 33 year old woman sought treatment for possible secondary infertility: She had not had any tests or investigations but she had not been able to conceive after trying for 1 year. Patient had a history of cycles that were 21 days in length, for over 2 years, she described her bleed as pale and dilute at the time. Her cycles for the last 6 months have been very different and she has found that her periods were every 6 weeks apart now. Her menstrual blood still continued to be pale and she suffered from slight pre-menstrual tension. Her bowels were usually loose with undigested food, complained of fatigue, back-ache, dizziness and occasional tinnitus. Her tongue was pale with a sticky, white coating and her pulse was weak on the right rear position.

Assessment and Diagnosis: Lets break down the meaning of each of the symptoms and it’s cause according to TCM.

Secondary infertility
Previous cycles: 21 day cycles caused by Qi Deficiency
Bleed: Pale and dilute = (yang issue)
Current Cycles: 6 weeks apart = Late
PMS present = Qi stagnation (liver)
Bowels: Loose, undigested food=SP Qi Deficiency + SP Yang Def
Energy: Fatigue = Qi Deficiency
Backache = Kidney Def
Dizziness = qi/blood def
Tinnitus = Kidney def
Tongue: Pale, sticky = Qi Deficiency with damp maybe cold
Pulse: Weak right rear Kidney Yang

TCM Diagnosis and Treatment Principles: Based on the above lets diagnose and provide treatment protocols.  

TCM Diagnosis: Late Periods
Pattern Differentiation: Spleen Yang Deficiency with Kidney Yang Deficiency
Herbs: Wen Jing Tang
Acupuncture: CV4, CV6, KD3,7, SP6,SP4, ST36, Du20, LV8

Treatment plan: Acupuncture once a week for 3-6 months

Herbal Teas: Once a day for 3-6 months

Goals: to see cycle length and quality to normalize, should see noticeable changes within 3 months/3 cycles.