Dysmenorrhea refers to cyclical abdominal pain which is
experienced during or before menstruation. It occurs most typically in young women two to three years after the onset of menstruation. Menstrual pain will take the form of cramping, lower abdominal pain, lower back pain or a pulling sensation in the inner thighs. Pain is often accompanied by headaches, dizziness, vomiting, nausea, diarrhea or constipation. This is a common health problem for women all over the world.

Conventional medicine uses the term “primary dysmenorrhea” for pelvic pain that is the normal result of having a period, and the term “secondary dysmenorrhea” for pain during menstruation which is caused by an abnormal condition such as endometriosis, fibroids, or pelvic inflammatory
disease. Ibuprofen or Naproxen are two of the over-the-counter pain relievers for menstrual pain which are commonly recommended by doctors. Birth-control pills and some stronger prescription medications also reduce menstrual pain, but
with these there can be unwanted side effects. The way conventional medicine manages menstrual pain is to block the formation of prostaglandins, a substance that is produced abundantly by the body during menstruation.

In Chinese medicine, menstrual pain, like other forms of pain, is caused by one or more of the following diagnostic patterns: blockage of Qi and Blood; deficiency of Qi and Blood; retention of Heat, Dampness or Wind; or imbalance of Kidney and Liver. The goal of treatment (both herbal and acupuncture) is to tonify the deficiencies, open the blockage, remove the excesses and regulate the internal organs.

Dysmenorrhea and Pain Management in Chinese Medicine.

In Chinese medicine, pain is the symptom 0f a deeper problem. The root cause of pain can be either an Excess (Shi)pattern or a Deficiency (Xu) pattern.
The blockage of Qi and Blood, or the retention of Heat, Dampness or Wind, are Excess patterns. Deficiency of Qi and Blood, or imbalance of Kidney and Liver are Deficiency patterns. Blockage of Qi and Blood causes pain; imbalances of the internal organs cause pain; blockage of the meridians causes pain. Figuring out the source of the pain is the key to diagnosis and treatment. Non-fixed pain is
attributed to a Wind pattern.

“Chilly” pain is associated with a Cold pattern. Heavy and swollen pain is associated with a Dampness pattern. Sharp pain is associated with a Blood Stasis pattern. Stomach pain and back pain are attributed to retention of Cold in the Middle. Dull pain is associated with a Blood Deficiency pattern. Pain with redness, swelling and heat is associated with a Heat pattern. Joint pain with leg soreness is attributed to Kidney Deficiency. Chinese medicine practitioners use acupuncture and herbal medicine to relieve pain through one or a few of the following strategies: expelling Wind; dissipating Cold; eliminating Dampness; moving Qi; invigorating Blood; nourishing the Blood; clearing the Heat; tonifying the Kidneys.

Differentiating the patterns of menstrual pain depends on
analyzing the timing, nature, location, intensity, color, volume and quality of
the menstrual cycle and discharge, and “reading” the tongue, pulse, and
associated symptoms. Generally speaking, menstrual pain before the period
indicates an Excess pattern, whereas menstrual pain after the period indicates a
Deficiency pattern. Aversion to pressure on the abdomen indicates an Excess
pattern, and feeling relief when pressure is applied to the abdomen indicates a
Deficiency pattern. Sticky menses with dark-red color indicates an Excess
pattern. Feeling relief after passing menstrual blood clots indicates a Blood
Stasis pattern. Abdominal pain with hypochondriac distention indicates a Qi
Stagnation pattern. Thin menses of a pale-red color, and experiencing pain after
the period indicates a Qi and Blood Deficiency pattern. Experiencing “cold”
abdominal pain, and passing small, dark blood clots indicates a Cold pattern.
Thin menses of a pale-red color, and experiencing back soreness indicates a
Kidney-Liver Deficiency pattern.

Treatment of Dysmenorrhea with Herbal Medicine
Dysmenorrhea is effectively treated with Chinese herbal medicine and acupuncture.
formula. Following are the most typical patterns of dysmenorrhea with the herbal formulas
most commonly prescribed to treat them:

Qi Stagnation and Blood Stasis Pattern: Abdominal pain before and during
menstruation; menses of a purple or dark color, with small volume and blood clots; decreased
pain after passing blood clots; purplish spots on the tongue; and a wiry-choppy-strong pulse.
One of the popular herbal formulas is BlockageEASE (Ge Xia Zhu Yu Tang).

Deficiency Cold Pattern: Abdominal pain during or after menstruation; feeling better
when pressure and/or warmth are applied to the abdomen; pale, watery menses with small volume; soreness
of the lower back and legs;long-drawn-out urination with a thin stream; a white tongue coating, and
a deep pulse. The widely used herbal formulas is “Warming Menses Formula” .

Cold Dampness Pattern: Abdominal pain before or during periods; application of warmth reduces pain;
dark-colored menses with blood clots; aversion to cold; cold limbs; white or white-sticky
tongue coating; and a wiry-tight or wiry-slippery pulse.
Stagnation EASE (Shao Fu Zhu Yu Tang) is a popular formula for this pattern.

Damp Heat Pattern: Abdominal pain before menstruation; aversion to heat;
soreness and distention of the lower back; a feeling of heat in the abdomen or a low grade fever;
menses that are sticky, with a dark red color and blood clots; a burning sensation when the
menses flow out; yellow and sticky vaginal discharge; scant urine; a red tongue
body, with a yellow-sticky tongue coating; and a wiry-rapid or slippery-rapid
pulse. “Heat-Clearing Blood-Regulating Decoction” (Qing Re Tiao Xue Tang) is a
very standard formula for this pattern of dysmenorrhea.

Qi Blood Deficiency Pattern: Abdominal pain after menstruation; dull abdominal pain; menses
that are thin, with a pale color and small volume; tiredness; loose stools; pale complexion; pale
tongue body; and a thin-weak pulse.
“Chi Blood Tonic” (Ba Zhen Tang) is a time-tested formula for the Qi Blood Deficiency pattern of disease.

Kidney Liver Deficiency Pattern: Dull abdominal pain after menstruation; sore back; menses that are pale, with small volume; dizziness;ringing in the ears (tinnitus); poor memory; insomnia; a flushed face; hot flashes; a dark-red tongue body; and a deep-thin pulse. “Liver Tonic” (Tiao Gan Tang)is recommended.

Treatment of Dysmenorrhea with Acupuncture: Besides using herbal formulas to treat dysmenorrhea, acupuncture is another viable way to treat menstrual pain. Acupuncture can open the blockage of Qi and Blood, balance the internal organs,
and clear the blockage of meridians.Scientific studies find the following mechanisms for pain relief: acupuncture stimulates the production of endorphins, blocks the transmission of pain signals, and increases adrenocorticotropic hormone. Let us find the right formula for you!



About the author: ChineseHerbalAdviser