Why is my menstrual cycle irregular, painful, or constantly changing?
There’s rarely just one simple answer. From a Traditional Chinese Medicine perspective, your cycle is often seen as a reflection of your overall health, lifestyle, stress levels, nourishment, and internal balance. Chinese Herbal Medicine aims to look deeper at the root cause of these imbalances and gently support the body back toward a more regular, balanced cycle.
Chinese Herbal medicine can help regulate your menstrual cycle and can be a great adjunct to acupuncture. There are many possible reasons why our cycle can be long, short, irregular or sporadic. Common menstruation conditions include:
Early menstruation, delayed menstruation, or irregular menstruation
Menorrhagia (heavy/prolonged periods) or hypomenorrhea (scanty periods)
Dysmenorrhea (painful periods) or amenorrhea (absence of periods)
Traditional Chinese medicine assesses patients in a wholistic manner, to identify the root cause and patterns of imbalance and prescribe herbal formulas to help regulate the body back to balance to regulate the menstrual cycle.
Chinese herbal medicine has been used since the Zhou Dynasty 3000 years ago. It mainly consists of plants but may also include minerals or animal substances (FYI I personally choose not to use any animal products in herbal formulars). Chinese herbal medicine is given in formulas, which are a combination of different herbs that work in synergy to help regulate the body, and needs to be tailored to fit the person’s disease pattern and constitution.
Herbal formulas can be prescribed in different forms, such as:
Raw herbs to be decocted at home
Concentrated instant herbal granules
Herbal powders or premade patent pills
Each has their own variation of strength and weakness.
Common conditions from an eastern medicine perspective that can impact regular cycle are blood deficiency, blood stagnation, Spleen qi deficiency, Liver qi stagnation, Kidney yin and /or yang deficiency, heat or cold in the blood, and phlegm obstruction. These pattern diagnoses are based on Traditional Chinese Medicine theory and are not equivalent to biomedical diagnoses used in Western medicine.
There are often overlapping disharmonies and be quite complex to peel back the layers, due to each person’s history, background and constitution, therefore it recommended to see a qualified Chinese medicine herbalist practitioner to assess and give the appropriate herbal prescription. The ultimate aim is to help regulate the body to enable a continuous regular menstrual cycle naturally.
Some common TCM patterns that may affect the menstrual cycle include:
Blood deficiency – the lack of blood quality and quantity, which can manifest as delayed or scanty menstruation. The menstruation may be very short in length, bleed may appear very light or even drop like spotting, and pale in colour and light consistency. Patients tend to have a pale complexion, be low in iron, and suffer from dizziness.
Blood stagnation – poor circulation of blood throughout the body, leading to blood stasis or clotting. This can manifest in distending period pain in the lower abdomen, darker coloured bleeding, visible blood clots during menstruation, and pain before or at the start of the period. Patients may also have dry skin, especially on the legs.
Liver qi stagnation – the qi pertaining to the Liver not flowing smoothly, which can hinder blood flow. This may manifest as irregular menstruation, painful periods, hormone imbalances, and significant PMS symptoms such as headaches, breast distention, emotional irritability or instability. Patients may also experience temporal headaches, rib-side discomfort, bitter taste in the mouth, and frustration.
Cold in the blood – often caused by environmental, dietary, medication, or lifestyle factors that impede the smooth flow of blood. This can manifest as delayed or absent menstruation, painful periods, darker bleeding, and a desire for warmth for pain relief. Patients often feel the cold easily and may have cold limbs.
Heat in the blood – may arise from lack of yin, constitution, lifestyle, or surrounding factors. Excess heat can manifest as early menstruation, heavy or prolonged bleeding, flushed faces, thirst, and a preference for cold. There are also different sub-types of heat patterns which require proper diagnosis for appropriate management.
Spleen qi deficiency – the lack of qi to transform and transport nutrients and hold qi and blood in its right place, often due to improper diet or over-fatigue. This may manifest as early, delayed, irregular, prolonged and/or heavy menstruation. Patients may also experience chronic fatigue, shortness of breath, poor appetite, digestive issues, and loose stools.
Phlegm or dampness accumulation – often developing over time from inadequate Spleen qi. This sticky, retentive substance can obstruct qi and blood flow, manifesting as delayed or scanty menstruation, painful periods, vaginal discharge, heaviness of limbs, profuse phlegm, or sticky stools.
Kidney yin and/or yang deficiency – depletion of one’s lifeforce and essence, strongly associated with reproductive reserves and the ability to sustain regular menstruation. This can manifest as scanty or irregular menstruation due to inadequate regular hormones. Patients may also experience lower back aches, dizziness, frequent urination, tinnitus, or a dragging sensation in the lower abdomen.
It is common to have a mix of overlapping patterns at varying degrees, especially in chronic conditions these patterns can be intertwined, which can be complex to unravel. Herbal formulas prescribed by your TCM practitioner will aim to address the root cause of your condition, such as to tonify and/or circulate blood, move blood stasis, tonify qi, soothe Liver qi, tonify the Kidney yin or yang, or move phlegm/dampness.
Herbal formulas are often amended throughout the menstrual cycle, to support the particular stage of the cycle and as conditions improve. Therefore, it is important to seek a qualified practitioner who can tailor herbal formulas to suit your condition.
This is for general information only, please seek for registered eastern herbalist practitioner for further personal advice.
Any further enquires or if you would like to discuss your case further, please book through Womb to World.
References:
Ji, H. R., et al. (2020). Herbal medicine (Taohong Siwu Tang) for the treatment of primary dysmenorrhea: A systematic review and meta-analysis. Explore, 16(5), 297–303. https://doi.org/10.1016/j.explore.2020.05.013
Kaptchuk, T. J. (2000). The web that has no weaver: Understanding Chinese medicine (2nd ed.). McGraw-Hill.
Maciocia, G. (2015). The foundations of Chinese medicine: A comprehensive text for acupuncturists and herbalists (3rd ed.). Elsevier.
The Zhejiang College of Traditional Chinese Medicine. (1991). A handbook of traditional Chinese gynecology (2nd ed.). Blue Poppy Press.
Zhang, Y., et al. (2023). Chinese herbal medicine for primary dysmenorrhea: A systematic review and network meta-analysis of 54 randomized controlled trials. European Journal of Integrative Medicine, 63, 102293. https://doi.org/10.1016/j.eujim.2023.102293
Zhu, X., Proctor, M., Bensoussan, A., Wu, E., & Smith, C. A. (2008). Chinese herbal medicine for primary dysmenorrhoea. Cochrane Database of Systematic Reviews, (2). https://doi.org/10.1002/14651858.CD005288.pub2
Written by Teresa Huynh.