Managing Nocturia: A Traditional Chinese Medicine Approach

by Andy Wong | Feb 14, 2026 | Chinese Medicine

In healthy individuals, diurnal urine production typically exceeds nocturnal output. Following sleep onset, most individuals maintain continence throughout the night without requiring micturition. This physiological pattern of reduced nocturnal urine production is considered normal and serves to preserve uninterrupted sleep in healthy adults.

Nocturia demonstrates increased prevalence among the geriatric population. In elderly males, benign prostatic hyperplasia of varying severity is commonly observed. In elderly females, progressive weakening of detrusor musculature and pelvic floor support structures frequently occurs. Consequently, both older men and women typically experience increased urinary frequency compared to younger adults.

When nocturia becomes pronounced—particularly when accompanied by increased daytime frequency—yet urinalysis reveals dilute, clear, and non-painful urination, Traditional Chinese Medicine (TCM) pathophysiology attributes this presentation to Kidney Qi deficiency with cold pattern, resulting in impaired bladder sphincter control. Herbal pharmacotherapy has demonstrated favorable therapeutic outcomes in such cases.

The author’s formulation, “Modified Suo-quan Pill 縮泉丸 (Jia-wei Suo-quan Wan 加味縮泉丸),” represents an efficacious treatment protocol comprising:

Formula Composition:

• 30 g each: Alpinia oxyphylla (Yizhi Ren), Dioscorea opposita (Huai Shan), Astragalus membranaceus (Huangqi), Atractylodes macrocephala (Baizhu), Codonopsis pilosula (Dangshen)
• 15 g each: Cistanche deserticola (Rou Cong Rong), Cornus officinalis fructus (Shan Zhu Yu), Eucommia ulmoides (Duzhong), Dipsacus asper (Xuduan), Ziziphus jujuba seed (Suan Zao Ren), Schisandra chinensis (Wuweizi)
• 20 g each: Calcined Os Draconis (Longgu), Calcined Concha Ostreae (Muli)

Preparation Method: The thirteen ingredients are moistened with dilute saline solution, subjected to thorough steam processing, desiccated, pulverized into fine powder, and combined with refined honey to form pills approximately 6-8mm in diameter (mung bean size).

Dosing Regimen:

• Adult dose: 10 grams twice daily, administered orally with warm water
• Pediatric dose (under 8 years): 5 grams twice daily

Therapeutic Action: Modified Suoquan Pill functions to tonify Kidney Yang, supplement essence (Jing), and strengthen bladder sphincter control.

Clinical Experience: The author has employed this formulation extensively over multiple years in treating geriatric patients presenting with Kidney Qi deficiency-cold pattern, nocturnal polyuria, and urinary incontinence, achieving significant therapeutic efficacy. For cases where pill preparation is impractical, the formula may be administered as a decoction at 50% of the stated dosage quantities, yielding comparable clinical outcomes.

Cystourethritis Risk During Hot Weather

by Andy Wong | Nov 11, 2025 | Chinese Medicine

High ambient temperatures combined with excessive perspiration and reduced urinary output may predispose individuals to lower urinary tract inflammation. Common presenting symptoms include:

• Dark yellow urine
• Dysuria (burning sensation during or after urination)
• Increased urinary frequency
• Suprapubic discomfort

These findings are consistent with lower urinary tract infection (UTI) involving both the bladder and urethra—clinically referred to as cystourethritis.

Clinical Classification

• Urethritis: Pain localized to the urethral tract
• Cystitis: Suprapubic or lower abdominal pain

These conditions frequently co-exist and are collectively termed cystourethritis.

Acute Cystourethritis: Key Symptoms

• Frequency: Voiding every 30–60 minutes, occasionally more often
• Urgency: Sudden, compelling need to urinate
• Dysuria: Burning pain post-micturition, possibly radiating to the perineum or suprapubic region
• Pyuria or microscopic haematuria: Cloudy urine or presence of red blood cells on urinalysis
• Systemic signs: Fever is typically absent

Chronic Cystourethritis

• Symptoms are less intense
• Daytime polyuria and nocturia (3–4 episodes nightly)
• History of recurrent acute flares
• Urinalysis may reveal proteinuria, haematuria, and pyuria

Traditional Chinese Medicine (TCM) Interpretation

In TCM, this condition is classified as Re Lin (熱淋)—a heat-induced urinary disorder attributed to damp-heat accumulation in the lower burner.

TCM symptom profile:

• Painful, difficult urination
• Burning sensation
• Dark yellow, concentrated urine
• Frequent and urgent voiding

Herbal Protocol: “Huo Fu Dan” (火府丹)

This formula is designed to:

• Clear internal heat
• Eliminate dampness
• Detoxify
• Promote diuresis

It is considered safe for short-term use during acute episodes.

Base Composition

Formula Modifications

• For severe urethral pain: Add Spora Lygodii (海金沙 Hai Jin Sha) – 10g
• For pyuria or haematuria: Add Herba Cirsii (小薊 Xiao Ji) – 12g and Rhizoma Imperatae (白茅根 Bai Mao Gen) – 15g

This protocol is also applicable to post-coital cystitis, commonly referred to as “honeymoon cystitis.”

Supportive Lifestyle Measures

• Maintain adequate hydration
• Consume a light, easily digestible diet
• Ensure sufficient rest and recovery

These interventions aid symptom resolution and reduce recurrence risk.

Menopausal Syndrome in Women and the “Geng-Nian-Kang Decoction”

by Andy Wong | Oct 19, 2025 | Chinese Medicine

When women reach the ages of 45 to 52, natural cessation of menstruation occurs, which in medicine is called “menopause.”

The onset of menopause leads to physiological changes. Some women, due to constitutional weakness or psychological influences, may not be able to adapt promptly. This imbalance of endocrine function may result in obvious dysfunction of internal organs, known medically as “menopausal syndrome.”

In the early stages, symptoms may include insomnia, dizziness, headache, fatigue, tachycardia or bradycardia, loss of appetite, reduced work capacity, lumbago or joint pain, obesity, excessive sweating, and various vague complaints. As the condition progresses, women may develop prominent neuropsychiatric symptoms such as anxiety, depression, suspicion, or hysteria.

These symptoms may involve the neuropsychiatric system, sensory disturbances, vasomotor symptoms, musculoskeletal complaints, digestive system issues, or urinary system problems. All of these arise from endocrine imbalance and hence are categorized as “menopausal syndrome.” Naturally, symptoms vary among individuals due to differences in physical and psychological conditions. Therefore, treatment must be individualized according to syndrome differentiation. Importantly, despite these neurasthenic-like manifestations, there is no substantial organic pathology in the internal organs.

Although Traditional Chinese Medicine (TCM) does not have a specific name for this condition, it has long recognized the physiological and pathological states of women during menopause. It is attributed to declining Kidney-Chi, exhaustion of Tian-Gui (reproductive essence), and disharmony of the Chong and Ren meridians. Based on syndrome differentiation, many treatment principles have been established, summarized as “nourishing the heart, replenishing yin, calming the spirit, and subduing hyperactivity.”

Following these principles, the author has formulated the prescription “Geng-Nian-Kang Decoction” for treatment:

• Radix Scrophulariae (Xuan Shen) – 10 g
• Radix Salviae Miltiorrhizae (Dan Shen) – 10 g
• Radix Codonopsis (Dang Shen) – 10 g
• Radix Ophiopogonis (Mai Dong) – 5 g
• Radix Asparagi (Tian Dong) – 5 g
• Rehmanniae Radix, raw and prepared (Sheng Di, Shu Di) – 20 g each
• Semen Platycladi (Bai Zi Ren) – 10 g
• Semen Ziziphi Spinosae (Suan Zao Ren) – 10 g
• Radix Polygalae (Yuan Zhi) – 5 g
• Radix Angelicae Sinensis (Dang Gui) – 3 g
• Poria (Fu Ling) – 10 g
• Fructus Tritici Levis (Fu Xiao Mai) – 10 g
• Radix Paeoniae Alba (Bai Shao) – 10 g
• Radix Corydalis (Yan Hu Suo) – 6 g
• Os Draconis (Long Gu) – 15 g
• Concha Ostreae (Mu Li) – 15 g
• Fructus Schisandrae (Wu Wei Zi) – 5 g
• Radix Platycodi (Jie Geng) – 5 g

The herbs are decocted in water for oral administration. A course consists of 16 doses.

This formula has shown favourable therapeutic effects in menopausal women presenting with emotional depression, irritability, palpitations, insomnia, low-grade fever, decreased body fluids, suspicion, excessive worrying, musculoskeletal aches resembling “flu-like” symptoms, dizziness, and headaches.

Rosa chinensis

by Andy Wong | Sep 10, 2025 | Chinese Medicine

“A Year Long Like Spring in All Seasons”
「一年長作四時春」

“This flower alone blooms without end — all year round, it turns the seasons into spring.”

This faithful flower blooms with grace, Springtime lingers in its place《惟有此花開不厭，一年長作四時春。》— This is high praise for the chief herb in the Chinese medicinal formula 《勝春湯》(Spring-Surpassing Decoction): 月季花 Rosa chinensis (Chinese rose).

Chinese rose (月季) is also known as “Eternal Spring”「四時春」、 “Surpassing Spring”「勝春」、“Crimson Rivalling the Snow”「斗雪紅」、“Delicate Companion”「瘦客」. Its flowers come in shades of deep red and light red, truly a feast for the eyes, graceful in fragrance and colour, pleasing in both scent and taste.

The petals of Chinese rose (月季) are sweet and aromatic. Pharmacologically, they regulate qi, activate blood, regulate menstruation, dispel stasis, reduce swelling, and relieve pain. Among edible petals, it is one of the best for consumption. Even putting aside its processed forms, take the painted depiction of “Eternal Spring”「四時春」, for example: Lingnan painters often used it as a subject in their artworks. In spring’s faint, yearning embrace,
Grief lingers in the evening rain. “無力春懷裡，多愁暮雨中” — I’ve seen many paintings centered on Chinese rose (月季), with lush blossoms and verdant leaves, swaying gracefully. Who would have known it’s also a low-cost Chinese medicinal herb?

In clinical practice, the formula Spring-Surpassing Decoction《勝春湯》 is used to treat women’s amenorrhea or scanty, pale-colored menstrual flow with lower abdominal pain, accompanied by low spirits and constipation. If a woman experiences such symptoms during her period, consider this prescription:

• 月季花 (Chinese rose flower) 5g
• 當歸 (Angelica sinensis) 10g
• 丹參 (Salvia miltiorrhiza) 10g
• 白芍 (White peony root) 10g
• Appropriate amount of 紅糖 (brown sugar)
• Decoction in water for oral administration

This remedy is fragrant and sweet, unlike typical medicine. Taken a few doses before each period, and boiled together with one egg, it is indeed a wonderful formula for regulating menstruation, qi, and activating blood.

Chinese rose flower月季花 can also be cooked with 蜜糖 (honey) and 紅棗 (red dates), in a remedy called 「勝紅湯」Winning Red Decoction, which treats low-grade fever during menstruation and has a delicious flavor. Adding a few petals of 月季花 into a health tea not only promotes blood circulation and nourishes the complexion, but also keeps youthfulness long-lasting. Calling it 「一年長作四時春」 (a year long like spring in all seasons) is truly no exaggeration!