"De Sheng Wan" (Fertility-Victorious Pill) for Dysmenorrhea and Benign Gynecological Tumors

"De Sheng Wan" (Fertility-Victorious Pill) is an empirical formula of contemporary TCM, from the Pharmacopoeia of the People's Republic of China, Part I, 2000 edition. Its composition is: Yi Mu Cao (Leonuri Herba) 600 g, Dang Gui (Angelicae Sinensis Radix) 200 g, Bai Shao (Paeoniae Radix Alba) 200 g, Chai Hu (Bupleuri Radix) 100 g, Mu Xiang (Aucklandiae Radix) 50 g, Chuan Xiong (Chuanxiong Rhizoma) 50 g.

Preparation: Crush the above 6 herbs into a fine powder, sift and mix; for every 100 g of powder add 190–210 g of refined honey, and make into large honey pills, each weighing 9 g. Take orally twice daily, 1 pill each time. This formula nourishes blood and resolves stasis, regulates menstruation and stops pain. It is indicated for blood stasis and qi stagnation, irregular menstruation, menstrual abdominal pain, and abdominal concretions and gatherings (i.e., benign gynecological tumors such as uterine fibroids).

Yi Mu Cao (Motherwort) is a commonly used gynecological herb. Its main actions are to invigorate blood and dispel stasis, promote urination and reduce swelling, and clear heat and resolve toxin. It is commonly used for irregular menstruation, dysmenorrhea, amenorrhea, postpartum abdominal pain, traumatic injuries, difficult urination, edema, sores and swellings. Motherwort has strong blood-activating, stasis-resolving, pain-stopping, and diuretic effects, and can improve symptoms in patients with nephritis and renal-tubule injury. This formula uses a large amount of Motherwort because it can both invigorate blood and dispel stasis and clear heat and promote urination, giving the pathogen an outlet. The large dose of Motherwort, together with blood-activating and liver-soothing herbs, gives this formula the additional effect of clearing pelvic effusion.

Dang Gui (Angelica) nourishes and invigorates blood, regulates menstruation and stops pain, and moistens the intestines to unblock the bowels. It is mainly used for sallow complexion due to blood deficiency, dizziness and palpitations, irregular menstruation, amenorrhea, dysmenorrhea, cold-deficiency abdominal pain, stasis pain, traumatic injuries, bi pain and numbness, boils and sores, and constipation due to blood deficiency and intestinal dryness.

Bai Shao (White Peony) nourishes and retains yin, softens the liver and stops pain, and levels liver yang. It is mainly used for irregular menstruation, dysmenorrhea, flooding and spotting, night sweating due to yin deficiency, spontaneous sweating due to exterior deficiency, pain in the chest, hypochondrium, stomach, and abdomen due to disharmony of liver qi, spasmodic pain of the limbs, and headache and vertigo due to liver-yang ascending.

Chuan Xiong (Chuanxiong) invigorates blood and moves qi, dispels wind and stops pain. It is mainly used for irregular menstruation, dysmenorrhea, amenorrhea, difficult labor, chest impediment and heart pain, chest and hypochondriac pain, headache, rheumatic bi pain, and postpartum abdominal pain. Chuanxiong is known as the "qi-herb within the blood"; it both invigorates blood and moves qi, so its most prominent action is activating blood and stopping pain.

This formula uses Angelica, White Peony, and Chuanxiong; it is actually Si Wu Tang (Four-Substance Decoction) minus the cloying Di Huang (Rehmannia). Si Wu Tang is the famous TCM formula for nourishing and invigorating blood and is also commonly used in gynecology. Di Huang is removed here mainly because it is overly cloying and is not good at stopping pain.

Chai Hu (Bupleurum) harmonizes the shaoyang, reduces fever and releases the exterior, soothes the liver and resolves stagnation, and raises yang qi. It is mainly used for shaoyang patterns with alternating chills and fever, high fever in colds, malarial chills and fever, and chest/hypochondriac pain, irregular menstruation, and dysmenorrhea caused by liver-qi stagnation. Bupleurum is one of the commonly used gynecological herbs, because TCM holds that women tend to have liver stagnation (i.e., the emotional problems of today); Bupleurum is an important herb for soothing the liver and resolving stagnation, and bodily pain often also causes emotional discomfort. Its use here is well placed.

Mu Xiang (Aucklandia) moves qi, stops pain, and harmonizes the center. It is mainly used for spleen-stomach qi stagnation with epigastric and abdominal distending pain, diarrhea with tenesmus, improper digestion, abdominal distension due to spleen deficiency, and epigastric/hypochondriac pain, jaundice, and hepatobiliary stones due to spleen dysfunction and liver failure to spread freely.

The combination of Bupleurum, Aucklandia, Chuanxiong, and White Peony is the main composition of Shu Gan San (Liver-Soothing Powder), a classic gynecological formula whose main indications are irregular menstruation and dysmenorrhea.

So overall this formula is essentially a combination of Si Wu Tang and Shu Gan San, plus Motherwort, the most commonly used gynecological herb. These are all classic gynecological formulas or herbs; combined together, their effect on gynecological diseases is even more marked.

Both dysmenorrhea and benign gynecological tumors require long-term treatment; pills are more convenient than decoctions and have fewer side effects. This formula has a strong blood-activating effect and is contraindicated in pregnancy.