Integrative Women’s Health Program
TCM OBGYN Fundamentals Part 1: Anatomy and Physiology
With: Dr. Daoshing Ni, co-founder of Yo San University
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- TCM Perspective
- Zi Gong – House of Fetus, Uterus
- Zi Gong and Kidney
- Zi Gong and Liver
- Zi Gong and Spleen
- Zi Gong and Stomach
- Zi Gong and Heart
- Zi Gong and Lung
- Bao Mai and Bao Luo
- Penetrating Channel: Chong Mai
- Conception Channel: Ren Mai
- Governing Channel: Du Mai
- Belt Channel: Dai Mai
- TCM OBGYN Physiology: Zang Fu
- Spleen and Stomach
- Women’s Reproductive Physiology
- Fecundity Rate by Age
- Summary: Physiology of Women in TCM
Welcome today we are going to continue with our learning on integrative women’s health program specifically in TCM OBGYN relating to anatomy and physiology. You see traditional Chinese medicine was built on the concept that activity inside of our body really reflects outward so therefore everything that we learn clinical observations signs and symptoms in traditional Chinese medicine thends to focus on this outward reflection. And due to also the taboos in opening and examining the human body anatomy was not just not as developed compared to the Western medicine counterpart. So even though there are mistakes as well as was generalizations in TCM OBGYN many of the TCM anatomical and physiological concepts and terminologies are still used extensively today. So as a student and a practitioner of Integrated Women’s Health Incorporating TCM OBGYN it is very important for us to really have a good grasp and understanding of these terminologies.
The very first one is Zi Gong. Zi Gong is translated as House of Fetus, or basically means Uterus. And there are other many Chinese terms that refer to this name Zi Gong such as Nu Zi Bao, Bao, Zi Zang, Zi Chu, Bao Zang, Tai Zang, Xue Zang, Bao Gong, etc. So there are many different terms that refer to the same thing as Zi Gong in TCM. Now Zi Gong’s main function as we know it is mostly in reproduction and that includes implantation , gestation, labor, delivery and the process of menstruation. This is a very important organ in fact there is some interesting cultural literature in the past saying and eluding something like when a woman’s uterus is strong and healthy, it usually means the woman is strong and healthy in some ways its a way to kind of pick your mate. Im not so sure you that’s a very good way to to to pick your mate but that is some of the mythology behind it.
Now Zi Gong in the proper functioning of Zi Gong requires three areas for shall we say popper function. One is Kidney qi and one is Tian Kui and one is Chong Ren. And since Zi Gong can both store essence and discharge menses it possesses the function of both Zang and Fu. It is therefore considered as an extraordinary fu organ extraordinary fu organ.
Now let’s take a look at some of the relationships Zi Gong has with different Zang organs or even Fu organs. The very first one the most intimate the most important one is the relationship between Zi Gong and Kidney. Now both have direct connections via Jing Luo via the channel and collaterals. And both have direct connections in working together for our reproductive function and processes. Zi Gong is connected to kidney or shall we say kidneys connected to Zi Gong via Bao Luo. Bao Luo means embryonic collaterals embryonic collaterals And Kidney stores Essence stores Jing and it is a source of reproduction growth and development And as you know Jing is the source for qi source for blood so blood is therefore extending into the Blood is the source for menstruation and reproduction. So Kidney as an organ of essence really plays a major role in the development and production of blood , of essence which in turn is a source of menstruation and reproduction.
Now let’s take a look at Zi Gong and the liver. Liver meridian and Ren Channel crosses at ren 2 Qu Gu point which is just right at our pubic symphysis area. Now in liver meridian and Du Channel also crosses at vertex of the head. Both as you know ren and du channel which will talk about little bit later they both really originate from the pelvis. And in woman it originates in and front of uterus therefore Liver Meridian has an indirect impact or indirect connection to the uterus via both ren and du channels.
Now if we look at liver as you know liver stores the blood. It’s a master over patency flow of Qi and blood evacuates sea of blood he has strong influences over the regulation of ovulation menstruation and fertility So liver and Zi Gong work intimately in making sure that patency flow process is proper.
Then let’s take a look at Zi Gong and spleen. Spleen meridian and ren Channel crosses at Zong Ji, ren 3. Ren 3 as you know is one cun on the midline midsagittal line just right above ren 2 just right above the pubic symphysis. Now as well as scattering at the tongue when the basic ren channel comes up in the spleen meridian they meet actually in the tongue area. So the spleen meridian therefore has an indirect connection to Zi Gong. Now spleen Meridian as it crosses in ren 3 and as it connects the tongue, you know spleen governs the blood. You know it masters over transformation, the source of qi and blood. And it regulates it directly regulate menstruation in material nourishment to the fetus so without spleen there’s no nutrition. Without nutrition there will not be any blood production even if Kidney wills it without that nutrient you cant have it. So then nutrition is very important and spleen plays that role that nutritional role.
Now let’s take a look at the Zi Gong and stomach. Very similar the sense of spleen but stomach has his own unique influences as well. Stomach Meridian and ren Channel crosses ren 24 Chen Jiang area okay. If you look at the slide you’ll see the Chen Jiang area just right under your lower lip. Chong channel is composed from parts of the stomach and parts of the kidney. Chong and ren Channel both originate from Zi Gong therefore there is a direct connection and origination point between the stomach Meridian and Zi Gong. Now stomach and spleen a connected as Zang and Fu they are sister organs they both are the source of chi and blood. As you know the stomach is the sea of water and grains and masters over digestion. While spleen masters over simulation absorption. It is a fu organ with abundance of chi and blood. When this chi and blood is abundant then the blood in the Chong channel will be abundant. If that blood is abandon in the Chong channel the ovulations going to be strong that menstruation going to be strong and this guarantees the proper functioning of Zi Gong.
Zi Gong also has a relationship with the heart as well. that is Zi Gong and the heart has actually a direct connection. In the Huang Di Su Wen they talk about how Bao Mai originates from the heart. And how the heart directly controls and governs the proper functioning of the uterus. As you know heart governs spirit clarity and blood vessels the heart directly influences the proper function of Zi Gong so if you look at an expanse of the heart you recognize conventionally is not just a heart organ, conventionally it would be heart and the brain. And as you know especially with the HP all the hypothalamus pituitary ovarian axis you recognize that I’ll mid brain plays a huge major role in the initiation of ovulation and the proper functioning and proper regulation of the menstruation. Therefore obviously the heart has a very strong connection to Zi Gong.
Now let’s talk about Zi Gong and the Lung. Zi Gong and the Lung have indirect connections lung meridian enters the lung while the smaller collaterals spread into the throat this is where the collaterals of the lung Meridian meet the Ren channel at the throat as well as the Kidney Channel. Ren channel originates as you know as Zi Gong in the pelvis and the lung masters over the distribution and transportation of fluid, of Jing and blood. So lung is very important in helping Zi Gong to have the proper function because of its distribution action in the way it distributes the fluid the way it distributes the essence and the blood as well.
Let’s talk about Bao Mai and Bao Luo. Now Bao Mai and Bao Luo are channels and collaterals that connect to the Zi Gong. Their main function is to provide nourishment it’s a conduit they’re a vessel that’s a kind of transport nourishment to the Zi Gong such as essences such as qi such as blood to make sure to the Zi Gong is functioning properly. And Huang Di Su Wen has said very clearly now when there is cessation of menstruation, when menstruation stops, it is frequently from the blockage in the Bao Mai, blockage in this Bao channel and Bao Mai is governed by the heart. And as I said earlier has a direct connection from the heart to the Zi Gong. So if there is a qi blockage in the lung, for example, this can for example sadness some emotional sadness or melancholy this is going to affect the heart, causing blockage in the Bao Mai interfering with the proper functioning of menstruation. So this is when frequently you might have a patient that comes in with very strong sadness melancholy or a sudden loss of their mother or sudden or a loss of somebody important to the person all of a sudden you can see the cessation of menstruation. And this is the explanation for it. The reality is that in any situation where there’s any change in blood flow, in the body it can all have the potential to affect the menstruation
The Huang Di Su Wen also says that Bao Luo connects directly to the kidneys. And since Kidney in TCM denotes the reproductive system Bao Luo therefore is the connection between all the other reproductive system to Zi Gong it’s kind of like the tentacles to all the other areas. Chong, Ren, Du channels all have origination from Zi Gogn, and therefore they are considered a big part of this Bao Mai and Bao Luo system.
So let’s look at Chong channel or Chong Mai or as we call it the penetrating channel. Penetrating channel is also called a sea of 12 meridians and the Sea of blood. Origination of Penetrating Channel mainly runs longitudinally to as high as the head to as low as the bottom of the foot. It has direct and indirect connections to almost all 12 meridians. Sometimes this term, Chong penetrating can also be translated into critical or important. Why is it critically important? Because it regulates all 12 regular meridians, because it crosses over them it connects all of them in one way or the other. It runs throughout the entire body. Governs the flow and nourishment of chi and blood to all the meridians therefore it is frequently again call the Sea of 12 meridians. This channel is known to have three distinct origination points or areas. 1: it begins just below the kidneys along with collaterals from the kidney Meridian. It’s nourished by the essence from the Kidneys so that’s one area just right below the kidneys and it is kidney dominant. 2: it begins in the greater pelvis area so in the pelvis area it’s not focused on Zi Gong but anywhere in the pelvis area that is the second origination point. 3: the third origination point is that it begins actually in the Zi Gong especially in the gynecology of women in women situation it begins at the Zi Gong Fu extraordinary organ.
It regulates the Chong Channel regulates menstrual blood flow, therefore frequently recall this Chong channel is the sea of blood. And it also meets Qi Chong on stomach 30 this point with the stomach Channel. Where that the stomach channel provides this strong as you know the Yang Ming Channel stomach channel is abundance in chi and blood, without the abundance of of chi and blood it flows right into the Chong Channel where the Chong Channel flows right into the Zi Gong to help to replenish and allow the ovulation and menstrual process to take place properly in the uterus.
Now Chong Channel has a few branches in fact since this goes all over the place in the body it’s actually quite complicated and it encompasses five major branches. The first Branch would call it I called in the main branch originates from Zi Gong area down in the pelvis area and it tracks the ren channel down to the surface at the perineum, which is Ren one. And then it travels bilaterally to meet the stomach meridian at Qi Gong point just right above the inguinal area. Qi Gong is stomach 30 that’s around 5 cun below the belly button and 2 cun lateral to the midsagittal line. Then it continues to run upward tracking the kidney channel which is just very close parallel to the ren channel upward and it meets it meets all your kidney points the Henggui kidney 11 Dahe kidney 12 and Qixue kidney 13. And Siman kidney 14 and then Zhongzhu at kidney 15. So it meets all these points as it comes up. And then it converges at ren 7 in Yin Jiao point. That’s when the energy comes together again. And from that point from the Yin Jiao point then again it runs bilateral upward again and again meeting these Kidney Channel points again. Huang Shu kidney 16, Shang Qu kidney 17, Shi Guan kidney 18 and then Yin Du kidney 19 and Tang Gu kidney 20. And then this last one You Men kidney 21 point. After meeting all these kidney points just right below the xiphoid process is below the rib cags it now start to move upward to disperse in the chest region. In the chest region. So this is the main channel the main branch.
Then the next one is the second one is the extended upper branch which continues from the chest region and runs upward through the throat and circles around the lips and terminates at the upper throat and the sinus region is right behind this called Gang Sang in Chinese. This permeates into the yang meridians of the face head region and nourishes them with yin and blood. So this is where that if you have enough chi and blood from the Chong channel to nourish all the yang channels of the face then you won’t have withering. That’s a reason why later on when you read in Su Wen at 35 years old your face starts to wither. This is where the problem is the Chong channel is not having enough chi and blood at this point.
The third branch is the posterior branch of the Chong Mai. The posterior branch basically runs just like the Cu channel. Okay originates in the pelvis running backward to the Spine it tracks inside the spine upward like the Du channel and most likely ends at where the Du channel terminates. Truly there’s no termination point discussed in all the classics where really this branch where this branch terminates. I would presume that it takes on the energy of the Du channel and it moves and tracks just like the Du channel.
The 4th and the 5th branches are what we call the lower branch of the Chong Mai. Basically this is where the meridian the channel starts to move downward. The lower Branch originates again just below the kidney, meeting at Qi Chong stomach 30 point and runs down were alone the medial aspect of the thigh into the popliteal fossa. From there it then transverses to the medial margin of tibia downward to the posterior aspect of medial malleolus , basically your ankle bone and terminates in the bottom of your foot. Now that’s one of the lower Branch, the other lower Branch offshoots for the lower medial border of the medial malleolus which is from your ankle. This time instead of traveling to the bottom of the foot now it travels to to the big toe to meet with a foot Jue Yin liver Meridian. So as you can see the Chong Mai really has a lot of connections. And these two lower branches permeate and warm the yin meridians of the foot mainly deliver to the spleen and a kidney meridians.
So let’s talk about the function of Chong Mai. Chong means important or critical. I said earlier it is a critical channel because it governs the chi and blood flow of all regular 12 meridians. Therefore it’s frequently called The Sea of 12 meridians or the sea of blood Xue Hai. The penetrating channel connects directly with both Ren and Du channels. It further regulates all yin blood in yang chi of the body. Chong Mai again connects with the kidney and stomach meridians which supply Jing and blood to the Zi Gong, to allow regular ovulation and menstrual process. Therefore if Chong Mai is weakened it affects the body tremendously in so many ways. First of all the period will weaken the period will stop. And it can affect the youthfulness of your body as well. So in women really focusing on treating Chong Mai it’s very important in providing good health and the consideration of longevity.
Let’s go to the next vessel the Conception Channel or what we call Ren Mai. The conception channel encompasses three branches: the main branch originates from Zi Gong moving downward to the surface of Hui Yin, Ren 1 this is just like the Chong Channel moving upward tracking the midsagittal line through the throat and winds around the mouth and terminates into both eyes. That is your main branch of the Ren channel okay. And the second branch just like the posterior branch of the Chong Channel it originates from Zi Gong again moving backward to the spine then moving upward inside the spinal cord tracking the Du channel just like Du Channel there and terminates by this time terminates around the mouth region around the mouth region. Just like it’s main branch terminates around the mouth region and the eye region,
The third branch is actually a collateral branch. It’s a Luo channel of the Ren Channel which begins at the xiphoid process spreading downward into the epigastric region. So that’s the reason why if there is abdominal fullness if there are indigestion in the epigastric region, the treatment of balancing the Ren Mai Conception channel can be very helpful in treatment of that particular condition. Let’s talk about the function: Ren means supporting and nourishing. The channel traverses through the yin portion of body it’s all in this area this is the yin portion of the body. It governs all the yin channels. And no wonder we frequently call this channel the Sea of Yin Channels, Sea of Yin. The Ren channel begins in Zi Gong and therefore it governs over gestation so it’s responsibility is to ensure a proper pregnancy all the way until delivery. So most conditions of the Ren Channel, including but not limited to hernia, vaginal infections, irregular menstruation, infertility, dysuria, incontinence and conditions of the genitals condition of the genitals.
Let’s talk about the Du channel, Du Mai. As you know Du Mai is basically the spinal cord and it originates in the pelvis. In men it is the pelvis in a woman most likely Zi Gong. It descends downward to the genitals. So in a woman it actually descends down to the vaginal meatus so the opening of the urethra and the opening of the vagina area that’s where it surfaces. Then it tracks backward through the perineum area to touching the Ren 1 Point. And then it enters the spine and rises upward to the top the vertex of the head. Then it then descends downward through the front of a face on the midline and terminates at the tip of the nose and philtrum. And philtrum so this is where it ends. Some people in some writings considered that termination point is in that upper palate right inside not just on the surface it’s a little bit inward.
Another branch of Du Mai governing channel arises from the pelvis basically tracks the Ren Channel upwards going around the lips and ending up in the middle of the eyes. So you can see both Ren and Duo channels that come how connected together really sister channels they track each other their branch attract each other’s main channel. Now this channel has a very strong connection with the Ren channel as I said earlier. And also most other regular channels especially the yang meridian since it is running in the back and it connects all the different yang meridians. And it governs all the chi flow of these yang meridians of the body. Therefore it’s frequently called The Sea of Yang Meridians of yang channels. It regulates and has a more intimate relationship with all the regular yang channels. And it has a very strong regulating function for the brain development for the brain function as well as bone marrow.
The last channel I want to talk about in TCM OBGYN and it and it does not mean the other channels such as Yang Qiao Yin Qiao are not important, they are. They just have less to do with TCM OBGYN compared to these four channels.
So let’s go to the Belt channel the Dai Mai. The Belt channel is basically like your belt I think we all know this from our schooling that it runs horizontally crossing the top of hip bone to the abdomen. It really originates around liver 13 area and moves forward to meet gallbladder 26 Dai Mai. And it continues to gallbladder 28 way way down and it goes through gallbladder 27 and then terminates in the level it terminates in the umbilicus area. Now another branch of the belt channel runs from Dai Mai gallbladder 26 backward and upward to meet bladder 23 Shen Shu point and terminates at L2 spine reaching out to the spine region. And Dai Mai it’s main function is to control and to regulate all the longitudinal channels of the body. And the condition of Dai Mai can include but are not limited to abdominal pain, back pain, vaginal infection and lower limb atrophies lower limb atrophies.
So as an overview Chong, Ren, Du, Dai these 4 ordinary channels have a direct connection to each other. They affect each other strongly especially in OBGYN conditions. They regulate many of the bodily functions in women, they specifically regulate over reproduction, gestation and lactation. And Chong Mai provides chi and blood nourishment to the reproductive organs. It regulates the proper functioning of ovaries and uterus while Ren Mai dominates over gestation it regulates and is responsible for proper growth and development of the baby. And Daqi Mai governs over the floor chi and blood to the reproductive system it’s a belt Channel. It also regulates all the fluid moving of the fluid metabolism and strengthens immunity and fights infection especially vaginal infections. Du Mai governs the Mingmen the Gate of Life of yang functions. It regulates hormones and endocrine system and the HPO hypothalamus pituitary ovarian axis. So each one of them supports each other. And each one of them has a specific function as well as general functions.
Zi Men is the fetal gate, it is the opening to the uterus commonly known as the cervix. Yin Dao is the yin way, it is where the in fluids menstruation and where the sperm travels and the fetus is being born – it’s the vagina.
Zi Chang is fetal intestines, well it’s basically a combination of Zi Gong and the vagina. Then you have Yin Men, or Chan Men, which means vaginal opening. Yin Hui means female external genitalia. Yin Qi means external genitalia. So these turns you will see sprinkled trough the different classics of TCM OBGYN. It’s important for you to understand some of these terms in a historical perspective so that when you go back and do some research or study you will not be surprised by them.
Now we’re going to take a look at TCM OBGYN. We are going to take a look at Zang Fu and how that relates to TCM OBGYN. The uniqueness of TCM OBGYN is that in women the body is dominated by blood and led by chi and it is nourished by Yin and fortified by Yang. The female body has the unique physiological processes of menstruation, pregnancy, labor, and breastfeeding with lactation.
Monthly menstrual cycles correctly respond to the rise and fall of the tide and moon. So this is the uniqueness of a woman.
Now kidney we talked about earlier stores essence. Essence or Jing transforms into chi. Jing and chi the source of yang and yin respectively. It is also commonly named as kidney yin and kidney yang. It is the source of yin and yang for the entire body.
Kidney is also the source of Tian Kui, the heavenly water. It is the foundation of Chong and Ren channel dominant over reproduction, body fluid, connects with the brain. Liver and kidney share the same foundational essence sourcen And while spleen and kidney nourish each other and lung and kidney govern together the chi flow in the channel so therefore kidney is a very important organ. It’s the source of the source of essence, source of chi, and the blood. It is also known to be the foundation for growth development and reproduction.
Now Kidney also secretes and develops Tian Kui. Tian Kui can only be secreted when there’s an abundance of Kidney Chi. And the balance between Kidney yin and yang. Only when there is an abundance of kidney chi Chong and Ren channel begin to properly fill out the sea of blood and then function. When Chong Channel and when Ren Channel is abundant ovulation and menstruation can occur regularly. Therefore Kidney Zang is probably the most important organ in the study of TCM OBGYN.
Liver. let’s talk about liver. Liver stores blood and masters over patency of flow. Liver blood not only nourishes the body it also fills the sea of blood the Xue Hai. Where the sea of blood provides the foundation for menstruation. Liver Channel runs around the external genitalia the stomach the pelvic the breast and the top of the head. Provides nourishment and regulation for growth of external genitalia hair, for example. Proper development of menstruation and also breast milk production, breast milk production. So liver is an important organ.
Now let’s move on to spleen and stomach. Spleen is the source of chi and blood transforming food essence, the proper function of ovulation, menstruation, gestation, and lactation all depends on the normal function of Spleen. You can say spleen and stomach brings the nutrition to the table. Stomach is a Fu organ with abundance of chi and blood. Stomach Channel and Chong Channel meet in the pelvis where the stomach provides the blood and chi to the Chong channel. While the stomach Channel also provides direct nourishment to the breasts, therefore the production of breast milk is directly related to the strength of the stomach. Okay again the production of breast-milk is directly related to the strength of stomach. Now both ovulation and menstruation and the lactation process require the nourishment from spleen and stomach. Without it we would have a cessation of menstruation.
Now let’s talk about the heart, let’s go on to the heart. Heart masters over the blood and has a direct connection to Bao Mai and Zi Gong. It insures that Bao Mai is functioning properly which affects the proper ovulation and menstruation. We know the heart dominates over Spirit or what we call Shen, and connects with the Kidney. Along with Kidney they regulate both spirit and essence of the body. Heart is important it’s not justs a governor, it’s actually a director or leader or a dictator that dictates whether or not actually the menstruation is going to be happening or not.
Now let’s go to Lung. Lung Masters over chi, over the transformation and transportation of chi throughout the body. Lung also dominates all the waterways of the body making sure the fluids are well distributed throughout the body. Lung also has the function of ensuring that Qi flow in all channels and collaterals are proper. And this proper flow and abundance of chi affects the female physiology, female physiological functions of menstruation, gestation, and lactation.
If we look at the woman’s reproductive physiology you know we can trace back as far back as in the Huang Di Nei Jing, the book of the yellow emperor’s, written about some people say is about 5000 years ago. Some people say is about 4000 years ago which discusses the development and the growth and decline of female life in seven year cycles. For men it is eight year cycles. So Su Wen starts in chapter 1. Chapter one gives you some idea of the importance of reproductive endocrinology in Chinese medicine. It states like this, Huang Di asks “when one grows old one can not have children. Is it because once energy has already been exhausted or due to a natural environment?” And Qi Bo replies, he starts to reply about all the differentiation of the 7 year cycle. So he talks about the seven year of cycle the 14 year 21 – 28 – 35 – 42 and 49.
So he starts with the seven year cycle the seven year old. Qi Bo replies, “for a for girl, her kidney chi,her kidney energy becomes prosperous when she’s seven and kidneys determine the condition of the bones and the teeth.” In which they are the teeth is the surplus of bones so therefore in this situation when her kidney energy becomes abundant her milk teeth or her first teeth her baby teeth fall out. And then the permanent teeth emerge when her kidney energy becomes really strong it becomes prosperous at the time of 7 years old. And as you know the hair is an extension of blood therefore the blood is transformed from the kidney essence her hair will start to grow at a rapid rate when the kidney is prosperous. And this is happening at around seven years old seven years old, so we call that 7 times 1 cycle.
Now let’s go to the seven times 2 which is 14 years old. At this time her Tian Gui or what we call heavenly water appears at the age of 14. Now at this time her Ren Mai, her conception channel begins to put through. And her Chong Mai, her penetrating channel becomes prosperous. And her menstruation begins to appear as all her physiological conditions become mature she can now be pregnant and bear a child. Now if you can imagine, this is written somewhere around 3 to 4,000 years ago my God the time of of menarche has not changed too much. I mean in this day and age in the United States I think last time I checked the average mean age is about 12.8 or 12.9 years. So 14 years old might be a little bit late but it’s not that much earlier today. So in some way this concept still applies quite well even in this day and age.
Let’s go to 7 times 3, or 21 years old. At 21 years of age the growth of kidney energy reaches the normal status of an adult, by the age of 21. Her wisdom teeth are starting to show and have grown up by this stage and her teeth are completely developed. So her kidney energy is becoming very abundant, very abundant
And that brings us to seven times 4, 28 years old. Because at 28 years old this is when the peak Kidney energy exists or occurs. Actually if you look at reproduction, it is still a very prime age of fertility, but it’s not exactly the peak anymore. In fact, I would say somewhere around 24 – 25 is actually the peak more. 28 – 29 is actually starting to decline a little bit.
But nevertheless at 28 years old at 4 x 7 the vital energy in blood becomes substantial. Her extremities become strong. The development of tissues and hair of her whole body is flourishing. In this stage her body is in the strongest strongest condition.
Now if we talk about 7 times 5 it is 35 years old, that’s the next stage At 35 you know your fertility and reproductive function is starting to decline a little bit. Actually quite a bit. The physique of a woman turns gradually from prosperity to decline. So by this time her Chong channel is starting to decline a little bit and we talked about that earlier before that the Chong channel supplies the Jing and the blood to the yang channel of the face. So her Yang Ming turns to debility, her face is starting to become withered they’re starting to have wrinkles there’s a little bit of lines here and there may not be so severe but you start to see that. And her hair begins to fall just a little bit more.
That brings us to 7 x 6, 42 years old. By the time a woman reaches 42 years old her three yang channels of the face or even the body, the Taiyang, the Yangming, and Shaoyang channels begin to decline. So her facial complexion becomes wane and what we will be seeing is a lot more lines and wrinkles. And her hair begins, you start to see some graying in a woman. Now they don’t see much graying because most women dye their hair. So you can’t really tell but you’ve got to ask them and they will tell you when they start having greying.
Now if you look at this chart over here you will find that the fecundity rate by age really changes drastically through time. You can see the peak is between 20 to 24 years old. And it gradually declines. But between 40 to 50 year old it’s a very dramatic drop a very dramatic drop. So if we are counseling or advising a patient to get pregnant, we really want to see if they can get pregnant before the age of 30 if it’s possible. And also women need to be counseled in the sense to understand what their fertility rate is going to be when they’re passing 30 year old when it get to 35 and when you get to 40 and when you get to 45. So these are Sounder age times that they really need to see.
Not the least is 7 x 7 or 49 years old. At the age of 49 her Ren and Chong channels are depleting and her menstruation really ceases as the Tian Gui has been exhausted. As her physical body turns old and feeble and she can no longer conceive. this is the menopause time. So in the old days, the mean age of menopause is 49. But today with nutrition, with the good nutrition we can see the menopausal time is advancing a little bit to somewhere around 51 years old. So there is a little increase but I think that’s due to the nutritional status that’s really quite helpful.
So in general as an overview summary: blood is the basis for women chi for the men. And during the reproductive years there’s a superabundance of chi and blood. At the same time blood is released monthly via menstruation. Or during a possible pregnancy it nourishes the fetus and after birth it’s transformed into breast milk. So the blood transforms into breast milk. And through time the blood is slowly decreasing. And since the Yangming channel is abundant with chi and blood it will be the first one to exhibit any kind of signs of decline, it is very sensitive. That’s why you start to see it on the face and hair first. Slowly starting at age 35, the onset of perimenopause, you can actually see some of it at age 42, and you can definitely see some perimenopause starting. And age 49 is the average when menopause arrives.
Okay so in the next lecture will get into more aspects of the physiology especially in reproduction. So we’ll stop here today and I’m looking forward to share more of my experience in our next lecture, continuing onward in the study of TCM OBGYN physiology. Thank you very much