Chinese Medicine and Menstrual Pain

By Debra Wu, ND, LAc

Some studies estimate that 42% of women miss work because of menstrual pain. This costs an estimated 600 million in lost work hours. Many women routinely take an over the counter medication for their menstrual pain. From a Chinese medicine perspective, it is important to treat the cause of the pain since painful menses can sometimes be a precursor to other menstrual problems such as ovarian cysts or uterine fibroids.
The most common Chinese medicine pattern seen in women who present with painful menstrual cycles is Qi stagnation. Symptoms usually include some premenstrual tension (irritability, bloating, constipation, moodiness, headache) and cramping in the low back, thigh area or abdomen. Commonly used herbs to deal with this pattern are Chai Hu/Bupleurum, Bai Shao/White Peony and Dang Gui/Tang Kuei. These herbs help to move blocked Qi and to nourish the blood.
It is not unusual for a Chinese herbal formula to contain five to fifteen herbs. The use of herbs to treat menstrual irregularities is recommended because most patients have had a long history of menstrual problems and it may take several cycles to affect lasting change. In addition acupuncture is an excellent adjunct for treatment, particularly for pain during or before the cycle.
If a woman has excruciating, sharp or stabbing pain, then the Chinese medicine diagnosis is not just Qi stagnation but blood stagnation too. Blood stagnation often results after long term Qi stagnation since Qi helps to move the blood. The menstrual blood is usually a darkish red color with many blood clots. Some herbs to treat blood stasis are Tao Ren/ Persicae, Yu Jin/ Curcumae and Chuang Xiong/Ligusticum. The particular herbs used are based on the totality of the patients symptom picture. There is no single formula that works best for all individuals since every person has a unique presentation.
The kidneys are also intimately involved in reproductive health. According to Chinese medicine the kidney Qi is made up of the coming together of kidney Yin and Yang. Kidney Yin is the source of all fluids in the body, including blood and hormones. Kidney Yang regulates the circulation and transformative processes of fluids. Energetically, Yin is the water to Yangs fire. Both need each other to balance out.
A lack of kidney Yin is often associated with a functional decline in female hormones and blood. A blood deficiency (this does not necessarily mean anemia) can lead to more Qi stagnation since the liver stores blood and needs to be full/replete with blood in order to carry out its function of moving Qi.
A lack of kidney Yang can manifest as low body temperature or low thyroid, which can also affect menstrual cycles. Usually people present with a combination of both Yin and Yang deficiency since Yin transforms into Yang and vice versa.
Chinese medicine treats menstrual pain by looking at each individual and in particular, at how she experiences pain. An individualized plan that is based on finding and treating the Chinese medicine pattern will help to treat the cause of the pain, rather than simply treating the symptom.