My friend Dr. Paul Reynolds, AP (who now practices in Clearwater, FL) phoned for a consultation for one of his patients in 2008. The patient was a 60 year old female who had been diagnosed with leukoplakia vulvae the previous month. The main symptoms the patient reported were itching in her vulva and genital area, burning pain with dryness in her vulva without vaginal discharge and pain during sexual intercourse. She had hot flashes that got worse in the afternoons and evening, and reddish color her face at night sometimes, night sweating and fatigue, weakness of body; she had poor sleep and wake up 3 to 4 times per night due to itching and painful sensations in the vulva and her genital area; she also had stress and anxiety from her diagnosis at leukoplakia vulvae. She was overly worried, and often nervous. Her appetite was normal without acid reflux or constipation. She had bowel movements once a day and normal urine; her menstruation ended 10 years ago, and her libido was decreased. There was no more information about the condition of her tongue and pulse by phone, and no examination of local genital and vulva.

Based on TCM principles, the condition of the patient was due to yin deficiency in the liver and kidney with heat; the plan of treatment was to tonify and nourishing yin in kidney and liver, clear heat and reduce itching, and calm shen to help her stress, anxiety and poor sleep. This condition suggests the use of the acupuncture points RN2, 3, 6, Zigongxue, ST36, SP 6, 10, 11, LV3, KI3 and LI4; the points of electro-acupuncture stimulation include DU20, Yintang, RN12 and 14. The patient underwent acupuncture treatment once a week. The Chinese herbal formula used in this case was one modified from Zhi Bai Di Haung Wan. The herbs include Huang Bai, Zhi Mu, Sheng Di Huang, Shan Yao, Shan Zhu Yu, Mu Dan Pi, Xuan Shen, Ze Xie, Dang Gui, Han Lian Cao and Xian Mao. The formula was a 50g power of an herb Rx for one week, to be taken orally three times a day, 2g per time, mixed with about 2-3oz warm water. These herbs were given in combination with a Chinese herbal formula to be made into a cream to apply topically in area of vulva two to three times a day.

The patient’s symptoms of itching and burning pain in the vulva showed improvement in the first week after treatment; dryness and pain in the vulva improved after one month of treatment; the white color of the vulva was much improved after three months of treatment.