Erxian Decoction: A TCM Formula for Menopausal Syndrome and Various Diseases Caused by Aging and Weakness

Menopausal women often experience dizziness and headache, lightheadedness and vertigo, fatigue and weakness, sore lower back and weak legs, paroxysmal hot flashes (sometimes even with burning heat and sweating), occasional coldness, sometimes vexation and spontaneous sweating, a pale tongue, and a deep fine pulse. Dizziness with tinnitus, fatigue, and hot sweating are especially common. These symptoms are mainly caused by sex hormone disorders; men in their fifties and sixties often develop similar symptoms. Traditional Chinese medicine (TCM) can relieve such symptoms with the "Erxian Formula." This formula originates from Gynecology and Obstetrics and is commonly used in gynecology, but it can also treat many other diseases.

Composition of Erxian Decoction: Xianmao (Curculiginis Rhizoma) 10g, Xianlingpi (Epimedii Herba) 10g, Bajitian (Morindae Officinalis Radix) 10g, Danggui (Angelicae Sinensis Radix) 10g, Zhimu (Anemarrhenae Rhizoma) 5g, Huangbai (Phellodendri Cortex) 5g. This formula has the actions of tonifying the kidney and draining fire, and regulating the Chong and Ren meridians. Modern pharmacological studies have confirmed that this formula has sex-hormone-regulating effects: it promotes the secretion of plasma sex hormones, improves the subtype structure of spermatocytes and sperm, and delays aging. For this reason, breast cancer patients who are estrogen- and progesterone-positive, and prostate cancer patients in the recovery period, should not take this formula.

According to traditional TCM theory, Xianmao, Xianlingpi, and Bajitian all belong to kidney-yang-tonifying herbs and can relieve chills, sore lower back and weak legs, and frequent urination caused by kidney-yang deficiency. Danggui has the function of supplementing blood and activating blood. Zhimu and Huangbai are kidney-yin-nourishing herbs that can relieve dry throat and mouth, and vexing spontaneous sweating caused by kidney-yin insufficiency.

Taken together, Erxian Decoction is a tonifying formula that supplements both yin and yang, and can relieve a series of symptoms caused by progressive aging. It can be used not only for menopausal syndrome in both men and women, but also for aplastic anemia, osteoporosis, hyperosteogeny, leukopenia, thrombocytopenic purpura, insomnia, arthritis, and other conditions presenting with the above symptoms. It can also treat infertility, depression, and premature ovarian failure.

If the patient has five-center heat, severe hot flashes and night sweating, and needs stronger yin-nourishing and heat-clearing action, Digupi (Lycii Cortex), Baiwei (Cynanchi Atrati Radix), and Mudanpi (Moutan Cortex) may be added to nourish yin and clear heat. For kidney-yang deficiency with cold limbs and low libido, Lurong (Cervi Cornu Pantotrichum), Fuzi (Aconiti Radix Lateralis), and Suoyang (Cynomorii Herba) may be added to tonify kidney yang and strengthen the lower back and knees. For vexation, irritability, and depression, Chaihu (Bupleuri Radix), Xiangfu (Cyperi Rhizoma), Meiguihua (Rosae Rugosae Flos), Yujin (Curcumae Radix), and Hehuanpi (Albiziae Cortex) may be added to soothe the liver and resolve depression. Some menopausal women experience vaginal bleeding; in such cases, Huangqi (Astragali Radix) may be added to fortify the spleen and supplement blood, Duanmuli (calcined Ostre Concha), Wuzeiogu (Sepiae Endoconcha), and Shanzhuyu (Corni Fructus) to astringe and stop bleeding, and Xianhecao (Agrimoniae Herba), Qiancao (Rubiae Radix), and Fengweicao (Pteridis Semiflagellatae Herba) to cool blood and stop bleeding, jointly achieving the actions of fortifying the spleen, supplementing blood, and stopping bleeding. For infertility, Yiyiren (Coicis Semen), Shudi (Rehmanniae Praeparata Radix), Tusizi (Cuscutae Semen), Zhi Shouwu (processed Polygoni Multiflori Radix), and Lujiao Pian (Cervi Cornu slices) may be added to supplement essence and fill marrow; Yiyiren promotes ovulation and is especially suitable for infertile women. For aplastic anemia and thrombocytopenia presenting with the above symptoms, Ceyebiye (Platycladi Cacumen), Diyu Tan (charred Sanguisorbae Radix), Mohanlian (Ecliptae Herba), Sanqi (Notoginseng Radix), and Baiji (Bletillae Rhizoma) may be added to enhance coagulation and hemostasis. For erythrocyte reduction, Zhi Shouwu, Renshen (Ginseng Radix), and Huangjing (Polygonati Rhizoma) are suitable additions. For leukopenia, Sheng Huangqi, Nuzhenzi (Ligustri Lucidi Fructus), and Jixueteng (Spatholobi Caulis) are suitable.

Cancer patients often develop poor blood counts and fatigue after radiotherapy and chemotherapy; if the pattern differentiation matches the Erxian Decoction pattern, this formula can also be used. For poor blood counts, modifications may be made as described above. If liver function is impaired, Yinchen (Artemisiae Scopariae Herba), Wuweizi (Schisandrae Fructus), Chaihu, Lingzhi (Ganoderma), and Fuling (Poria) may be added as appropriate to promote liver function recovery. If diarrhea is severe after chemotherapy, this formula may be combined with Sishen Wan (Four-Miracle Pill) or Shenling Baizhu San (Ginseng-Poria-Atractylodes Powder).