By: Qing Chen, Professor

Dysmenorrhea indicates woman pain occurring before, during or after menstruation. The pain may occur in lower abdomen or sacral region, even radiates to anus and external genital area. Medical doctors usually prescribe painkiller for this case. It can stop pain temporarily but does not treat the reasons to cause pain. Chinese medicine is good at treating this pain, as well as the roots of dysmenorrhea. Here introduced the comprehensive Chinese medical treatment methods for dysmenorrhea carried from ancient Chinese doctors knowledge, also from the author’s own special clinical experience. The author invents a new Chinese herbal formula Yin qiao qin lian sini simiao san, which is very effective for dysmenorrhea duo to woman’s endometriosis, myoma (uterus tumor) and pelvic inflammatory disease. From the point of Chinese medicine, emotional strain (such as anger, frustration, resentment and hatred) is a very important etiological factor that leads to body’s Qi and blood stagnation. Excessive cold-damp and damp-heat cause stasis of blood in the uterus, therefore painful menses period. On the other hand, physical overwork, chronic illness, excessive sexual activity and too frequent childbirth can give rise to malnourishment of uterus that makes painful period happen. The general treatment principles of Chinese medicine for dysmenorrhea are: to remove stagnation to stop pain at severe painful time and 3-7 days before menses period; to treat etiological roots of pain at other time of menstrual cycle by reducing excess or tonifying deficiency of body. So no fixed treatment is given to patient throughout her menstrual cycle. Here Dysmenorrhea is divided into 7 types with 7 kinds of treatment methods, which are more than the 4-5 types in ordinary Chinese medical books. 1. Kidney deficiency with blood stasis: Painful abdomen at the first day of period, soreness of lower back, post-dated menstrual cycle, or irregular cycle after onset of menses, scanty amount of blood, red or dark color with clots, slight red tongue, thready wiry pulse, Treatment principle: remove blood stasis, eliminate stagnation, stop pain, and tonify kidney. Herbal formula: Ge xia zhu yu tang. Herbs: wuyao (Rx. Lubderae Strychnifoliae), yanhusuo (Rx. Corydalis Yanhusuo), danggui (Rx. Angelicae Sinensis), chuanxiong (Rx. Ligustici Chuanxiong), chishao (Rx. Paeoniae Rubrae), taoren (Se. Persicae), honghua (Fl. Carthami Tinctorii), wulingzhi (Ex. Trogopteri Seu Pteromi), mudanpi (Cx. Moutan Radicis), xuduan (Rx. Dipsaci Asperi). Acupuncture points: Ren3, Ren4, Liv3, Li4, Sp8, and sedation needling method on these points expects Ren4.

2. Qi and blood stagnation: Lower abdomen pain during or one to two days before her period, a feeling of distention in abdomen and breast, hesitant start to period, menstrual blood dark with clots, pain relieved by passing clots pre-menstrual tension, irritability, purple tongue, choppy or wiry pulse. Treatment principle: move Qi and blood, eliminate stasis, and stop pain. Herbal formula: Chai hu shu gan san. Herbs: chaihu (Rx. Bupleuri), wuyao (Rx. Linderae Strychnifoliae), xiangfu (Rz. Cyperi Rotundi), muxiang (Rx. Aucklandiae Lappae), qingpi (Pc. Citri Reticulatae Viride), chenpe (Pc. Citri Reticulatae), danggui (Rx. Paeoniae rubrai), shanzha (fr. Crataegi), yimucao (hb. Leonuri Heterophylli). Acupuncture points: zigongxue, Liv3, Sp6, Ren3, Ub32. Sedation needling method.

3. Accumulatin of liver fire: Lower abdominal pain before and during the period, distending and burning pain of abdomen and nipples, heavy amount of blood with dark clot, bitter taste in mouth, thirst, irritability, red tongue, yellow coating, wire rapid pulse. Treatment principle: clear liver heat, sooth liver Qi, eliminate stasis, stop pain. Herbal formula: dan zhi xiao yao san. Herbs: mufsnpi (Cx. Moutan Radicis), zhizi (Fr. Gardeniae Jasminoidis), xiangfu (Rz. Cyperi Routundi), yujin (Rx. Curcumae), danggui (Rx. AnelicaeSinensis), chishao (Rx. Paeoniae Rubrae), baoshao (Rx. Paeoniae Lactiflorae), wulingzhi (Ex. Trogopteri Seu Pteromi), huangqin (Rx. Scutellariae Baicalensis). Acupuncture points: Li4, Liv3, Liv2, Liv5, Ub18, ren3. Sedation needling method.

4. Stagnation of cold: Abdominal pain at the first day of period, pain relieved by the application of heat, post-date menstrual cycle, scanty and dark blood with clots, feeling cold, purple tongue, white greasy coating, deep wiry pulse. Treatment principle: warm uterus, expel cold, move blood, and stop pain. Herbal formula: shao fu zhu yu tang. HerbsL rougui (Cx. Cinnamomi Cassiae), paojiang (Rz. Zingberis Officinalis), yanhusuo (Rz. Coryfalis Yanhusuo), wulingzhi (Ex. Trogopteri Seu Pteromi), moyao (Myrrha), danggui ( Rx. Angelicae Sinensis), puhuang (Pl. Typhae), cangzhu (Rz. Atractylodis), chishao (Rx. Paeoniae Rubrae). Acupuncture points: Ub23, Ren3, Ren6 Sp6. Moxibustoin and sedation needling method.

5. Accumulation of damp-heat: Lower abdomen and sacral region pain before or during the period, pain aggravated by pressure, feeling of heat, menstrual blood heavy, dark red with clots, vaginal discharge thick and smelly , dark urine, red tongue, yellow greasy coating, wiry slippery rapid pulse. Treatment principle: clear heat, drain damp, eliminate stagnation, stop pain. Herbal formula: yin qiao qin lian si ni si miao san invented by myselfL jinyinhua (Fl. Lonicerae Japonicae), lianqiao ( Fr. Forsythiae Suspensae), huangqin (Rx. Scutellariae Baicalensis), huanglian (Rz. Coptidis), chaihu (rx. Bupleuri), zhishi (Fr. Citri Aurantii)m chishao (Rx. Paeoniae Rubrae), huangbai (Cx. Phellodendri), niuxi (Rx. Cyathulae Officinalis), wulingzhi (Ex. Trogopteri Seu Pteromi). Acupuncture points Gb34, Li11, Liv2, St29, Ub32. Sedation needling method.

6. Qi and blood deficiency: Dull abdominal pain towards the end of or after the period, dragging and empty sensation in abdomen, pain relieved by pressure, scanty blood, pale complexion, tireness, pale tongue, weak thready pulse. Treatment principle: tonify Qi, strengthen spleen, nourish blood, stop pain. Herbal formula: shen yu tang. Herbs: renshen (Rx. Ginseng), huangqi (rx. Astragali Membranacei), danggui (Rx. Angelicae Sinensis), chuanxiong (Rx. Ligustici Chuangxiong), shudihuang (Rx. Rehmanniae Glutinosae Conquitae), baishao (Rx. Paeoniae Lactifloraea), chishao (Rx. Paeoniae Rubrae). Acupuncture points: St36,Sp6, Ren6, Ub17, ub18. Tonifying needling method and moxibution.

7. Kidney and liver deficiency: Dull abdominal pain towards the end of or after abdominal pain to towards the end of or after the period, sore and weak low back, pain relieved by pressure and massage, scanty blood, or bleeding in med-cycle, dizziness, tinnitus, blurred vision, exhaustion, scanty tongue coating, thrady pulse. Treatment principle: nourish kidney and liver, tonify Chong and Ren meridian, and stop pain. Herbal formula: tiao gan tang. Herbs: shudihuang (rx. Rehmanniae Glutinosae Conquiate), shanyao (Rx. Dioscoreae Oppositae), danggui (Rx. Angelicae Sinensis:)), baishao (Rx. Paeoniae Lactiflorae), goujizi (Fr. Corni Officinalis), bajitian (Rx. Morindae Officinalis), zhigancao (Rx. Glycyrrhizae Uralensis). Acupuncture points: Ub18, Ub23, Ren4, Kid 3, Kid12. Tonification of needing method. Typical case treated by my new formula yin qiao qin lian si ni si miao san: Wang, female, 32 years old, suffering from dysmenorrhea ever since her first menstruation started. The pain occurred one ay befor and first two days during her period. 2 years ago she was diagnosed endometriosis with 3.3cm mass in her left ovary called chocolate cyst. Every month he has abdominal and sacral pain along her period. Two weeks ago she got acute pelvic inflammatory disease. When she visited my clinic, it was her first day of period, very severe distending pain with burning sensation in abdomen and back, pain relieved after passing blood clots, but aggravated by pressure and walking, menstrual blood dark red, heavy with clots, restlessness, constipation, red tongue with purple spots, yellow greasy coating thick at the root of tongue, wiry slippery raped pulse. Diagnosis: dysmenorrhea due to Qi and blood stagnation, and damp heat in lower jiao. Treatment principle: eliminate stagnation, move Qi an blood, drain damp heat, remove mass, stop pain, Herbal formula: yin qiao qin lian si ni si miao san. Herbs: jinyinhua (Fl. Lonicerae Japonicae) 20g, lianqiao (Fr. Forsythiae Suspensae) 20g, huanglian (Rx. Coptidis) 6g, huangqin (Rx. Scutellariae Baicalensis) 10g, huangbai (Rx. Phellodendri) 8g, chanihu (Rx. Bupleuri) 12g, zhishi (Fr. Citri Aurantii) 10g, chishao (Rx. Paeoniae Rubrae) 12g , chuanniuxi (Rx. Cyathulae Officinalis) 10g, cangzhu (Rz. Atractylodis) 8g, yanhusuo (Hb. Leonuri Heterophylli) 10g, ruxiang (Gm. Olibanum) 6g, hupo ((Succinum) 3g, Acupuncture treatment: Li4, Li11, Liv2,3, Gb34, St29, Ren3, Ren17. Sedation needling technique was applied. Cupping therapy was used on point Ub32. Result: After first treatment and first bag of herbal tea, the pain was 80% reduced. She continually took this tea for one month (14 bags). When the next period came, there was much less pain than before, only mild pain for one day. After drinking the tea modified from formula yin qiao qin lian sini simiao san for 5 months, she is free from pain and the endometriosis cyst in her ovary went away thoroughly.