TCM diagnosis Based on Syndrome Differentiation:
Traditional Chinese Medicine prefers to look at dysfunction of the part as a manifestation of imbalance of the whole. One cannot be separated from the other. Therefore, within the broad categories of patterns of disharmony, attention must be paid to the individual details of the person’s disease signs, symptoms and history. Although western differential and laboratory diagnoses can help in determining a prognosis for individual cases of POF – i.e., a patient with POF secondary to chromosomal disorders such as Turner’s Syndrome will be more difficult to help than someone with POF secondary to hypothyroidism – the TCM differential diagnosis is the guiding factor in developing a treatment strategy.

1. Kidney and Liver Yin and Blood Deficiency
Symptoms: The above-mentioned kidney and liver yin deficiency signs plus: irritability, premenstrual ten-sion, breast tenderness, irregular menses (if they come at all), frequent sighing, constipation, ovulatory pain (if there is ovulation), work-related stress, symp-toms worse with stress and emotional lability, patient may have diagnosed pituitary microadenoma/prolactinemia, hypochondriac feeling of distension.
Tongue: Dusky or reddish with dark edges and possible liver stagnation spots. 

2. Kidney Yang and Essence Deficiency 
Symptoms: Low back pain, subjective feeling of cold when others are warm, preference for warm weather, cold extremities (particularly the feet and ankles), fatigue, an appearance of being prematurely aged, primary amen-orrhea, underdeveloped sexual characteristics (small hips and breasts), low libido, withdrawn personality, pale/wan complexion, history of delayed onset of puberty.
Tongue: Pale and dry and tender in appearance.
 
3. Kidney and Liver Yin Deficiency
Symptoms: Hot flushing, night sweats, insomnia, thirst, malar flush, tidal fever, low back pain, tinnitus, vaginal dryness, amenorrhea, scanty menses, dry skin and eyes, joint pain.
Tongue: Dry, Red, with little or no coat-ing. Possible cracked.

4. Kidney and Liver Yin and Blood Deficiency
Symptoms: The above men-tioned Kidney and liver yin deficiency signs plus, painful menses possibly with clotting (if there are menses), dark and lusterless complexion, spider nevi on the liver and kidney meridians, pain at ovulation (if there is ovulation), amen-orrhea, possible history of ovarian cysts,
endometriosis or PID, joint pain.
Tongue: Red or Pale, and dry with pronounced sublingual distension.