In TCM, dysmenorrhea may be caused by Blood and Qi stagnation, Qi and Blood deficiency, Damp Heat pattern, Kidney and Liver deficiency, depending to the differentiation.
Blood and Qi stagnation
1. Pain and tenderness in the lower abdomen before or during menstruation
In TCM point of view, pain and tenderness are caused by abnormal function of spleen in regulating the transportation of blood to the abnormal region as resulting of blood and qi stagnation. In Western point of view, they are caused by the inability of liver in essential fatty acid metabolism, leading to over production of certain hormones in the prostaglandins of family in controlling the movement of the uterus, causing pain and tenderness.
2. Hypochondrium and breast tenderness
Blood and qi stagnation in the body cause abnormal function of kidney in regulating the fluids in nourishing and moistening the reproductive organs, leading to water retention in the body, including the hypochodrium and breast tenderness. In Western point of view, it is caused by over production of prolactin hormone and abnormal lymphatic and kidney function in regulating the fluid in the body tissues.
3. Deep-purple blood with clots
Deep-purple blood with clots is caused by blood stasis as resulting of abnormal function of kidney in moistening the uterus and the liver function in regulating the blood flow to support the menstrual flow, leading to deep-purple blood with clots during menstruation.
4. Ecchymoses on the tongue edges
Ecchymose is defined as the end of tongue is covered with many small bluish-black spots. It is caused by blood stagnation as resulting of the inability of spleen in moving blood smoothly in the body and liver abnormal function in blood formation.
5. Wiry-choppy-strong pulse.
While there is blood and qi stagnation, blood can not move as normal, causing blood circulation irregularity as resulting of certain meridians being blocked, leading wiry-choppy-strong pulse.
Liver is important for blood formation and the lung. It helps to regulate the movement of qi in the body. Obstruction of blood in certain organs may also cause qi stagnation, leading to menstrual cramps and pain before, during and after menstruation. Causes of blood and qi stagnation include:
1. Chronic inflammation
The prolonged period of inflammation causes blood static as a result of increasing blood flow to inflammation regions and distorting the immune system in fighting against foreign bacteria and virus function, leading to blood stagnation.2. Liver function
Liver is vital for blood formation and waste removal. Abnormal function of liver causes old estrogen or other hormones as well as old blood remaining in the body's organs, leading to blood stagnation thus increasing the risk of menstrual irregularity and dysmenorrhrea.
3. Inability of respiratory function
If the lung is damaged for whatever reasons, it may affect the lung's ability to move qi in the pathway of the meridian, leading to blood stagnation in the reproductive region.
4. Stress and depression
Stress and depression caused by an unexpected event can affect the liver function in regulating the psychosocial symptoms of the nervous system and physical symptoms of blood formation, leading to liver qi and blood stagnation that contribute to symptoms of dysmenorrhrea.
5. Unhealthy diet
Unhealthy diet high in saturated and trans fat affect the blood and qi movement, because it causes the building up of cholesterol in the blood stream, thereby reducing the lung's function in regulating qi movement and the heart's function in blood circulation.
C.1. Herbs for qi stagnation
Qi stagnation can be classifies into 3 groups
A. Spleen and stomach qi stagnation
1. Mu Gua (quince fruit)
Besides helping to increase spleen function in food digestion, it increases the kidney function in qi and fluids regulation, thereby, reducing the dampness accumulated caused by kidney qi stagnation and preventing its the moving downward tendency, causing abdominal pain and spasms during menstrual cycle.
2. Chen Pi (tangerine peel)
Chen pi is Spleen and kidney tonic herb. It presentation besides improves the Spleen qi function moving downward, thereby, reducing spleen stagnation causes of abdominal distention, fullness, bloating and digestive disorder, it also increases of the function to dry dampness, thus decreasing the kidney congestion, leading to coughs with stifling sensation in the chest.
3. Zhi Shi (immature bitter orange)
Zhi shi has been used for thousand of years in traditional Chinese medicine in treating qi stagnation in kidney caused by accumulated of phlegm due to kidney deficiency, thereby reducing the dampness causes of abdominal cramps and pain and distention. Since it cool in nature, it helps to improve the abdominal pain and constipation caused by accumulation and stagnant qi.
1. Xiang Fu (nut grass rhizome)
It is one the herbs helped to regulate the qi flow by smoothing the liver and congestion of Spleen qi caused by excessive yin or yang, thus reducing qi stagnation caused by disharmonization of liver and Spleen causes of abdominal cramps and pain. It is said that xiang fu also has a function in promoting regular menstruation.
3. Wu Yao (lindera root)
Wu yao is one the warm with the main function of warming the kidney caused by kidney yang defieciency. It is only used for patient with evidence of liver qi stagnation caused by prolong intake of cold foods or working in a cold environment. Since its function is to restore the liver qi flow due to cold constraint, it reduces the blood stagnation causes of menstrual pain.
C.2. Lung qi stagnation.
1. Chen xiang (Aloeswood )
The herb is a warm her with bitter taste. According to traditional Chinese medicine, it works well to restore the lung qi stagnation caused by spleen, stomach and kidney channels dis-harmonization. By warming and regulating the lung qi downward movement pungent and bitter in flavour, and warm in nature, thereby reducing the upper and middle qi congestion ,thus eliminating hiccup, relieving asthma and abnormal cramps and pain caused by constipation.
2. Tan Xiang (sandalwood)
Tan xiang promotes lung qi movement, thus alleviating the pain caused by chest congestion and and abdomen pain caused by rebellion qi flow.
C.3. Herbs for blood stagnation
Normally blood stagnation is caused by qi stagnation or liver blood stasis. If the causes of blood stagnation is caused by qi stagnation, then by smoothing the qi flow, it will eliminate the blood stagnation. On the hand, if the blood stasis is caused by liver congestion, then the following herbs can be helpful
1. White Peony Root - (bai shao)
White peony root nourishes the blood and tones the uterus, it reduces the symptoms of yin deficiency causes of abdomen cramps and pain.
2. Ass-hide glue - (e jiao)
Ass-hide glue is a blood tonic herb that promotes the liver function in blood formation and lung dryness caused by yin deficiency. It is said that ass-hide glue also alleviates abnormal cramps and pain and stops abnormal bleeding during menstruation.
3. Wolfberry fruit - (gou qi zi)
Although wolfberry fruit is neutral herb, it has a function to promote yin and yang harmonization, thereby decreasing the dryness of lung qi which causes the blood stagnation causes of abdomen cramps and pain.
4. Polygonum multiflorum - (he shou wu)
Fleence is said to help improve the liver function by eliminating the liver toxin accumulation and expelling the "wind" from the skin, thereby increasing the liver function in blood formation and transportation.
5. Longan - (long yan rou)
Logan is warm in nature, it has been used in traditional Chinese medicine in treating yang deficiency causes of blood stagnation due to inability of the heart in blood circulation.
6. White mulberry fruit - (sang shen)
White mulberry fruit is a blood tonic herb, it helps to tonifies the blood as result of yin defieciency by promoting and generating body fluids, resulting in lessening the risk of blood stagnation causes of abdominal cramps and pain.
7. Angelica Root - (dang gui)
Angellica root is considered as a queen herb in TCM, beside helping to tonifies the blood and regulate the women menstruation, it also promotes blood flow to the abdomen, thus decreasing the risk of over active uterine muscles, causing dysmenorrhea.
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