Dysmenorrhea is a common issue for many women during menstruation. However, severe menstrual pain may signal underlying health issues rather than being just a “normal phenomenon.” Nikki Zhang, a Chinese medicine practitioner in New York specializing in gynecology, believes that “where there is pain, there is stagnation.” Dysmenorrhea is often associated with poor blood circulation or blood stasis, and through traditional Chinese medicine (TCM) treatments, menstrual pain can be fundamentally alleviated.

What is Dysmenorrhea?

Dysmenorrhea refers to pain in the lower abdomen, lower back, or even legs during menstruation, typically lasting no more than three days. Other symptoms may include headaches, fatigue, and nausea. Depending on the cause, dysmenorrhea can be categorized into two types:

1. Primary Dysmenorrhea

• Mainly caused by prostaglandins produced by the endometrium, leading to uterine contractions.

• Often occurs within 1-2 years after menarche and may improve after childbirth.

2. Secondary Dysmenorrhea

• Caused by gynecological conditions such as endometriosis, uterine fibroids, or adenomyosis.

• The pain is usually more severe and may worsen over time.

Main Causes of Dysmenorrhea

1. Excessive Uterine Contractions

During menstruation, the uterus contracts to expel menstrual blood. High levels of prostaglandins can cause excessive contractions, leading to severe pain.

2. Poor Blood Circulation

TCM believes that "QI" stagnation and blood stasis can make it difficult for menstrual blood to flow smoothly, forming clots and causing severe pain. If menstrual blood appears dark with clots, it indicates blood stasis.

3. Gynecological Conditions

• Endometriosis: Endometrial tissue grows outside the uterus, causing severe menstrual pain.

• Adenomyosis: Endometrial tissue grows into the uterine muscle, leading to heavy bleeding and dysmenorrhea.

• Uterine Fibroids: Some fibroids, especially those in the uterine wall, may cause menstrual pain.

4. Lifestyle and Psychological Factors

• Excessive stress and anxiety can worsen menstrual pain.

• Lack of sleep and overwork can disrupt hormonal balance, increasing the risk of dysmenorrhea.

• Unhealthy diet: High-fat, high-salt, caffeine, and cold foods may aggravate menstrual pain.

Traditional Chinese Medicine (TCM) Treatments for Dysmenorrhea

1. Acupuncture and Moxibustion

• Acupuncture: Stimulates meridians, improves blood circulation, and regulates uterine function.

• Moxibustion: Warms the uterus and alleviates menstrual pain caused by cold stagnation.

2. Herbal Medicine Therapy

TCM practitioners prescribe different herbal formulas based on the type of dysmenorrhea:

• Qi stagnation and blood stasis type (severe pain, blood clots): Common prescriptions include Tao Hong Si Wu Tang and Shao Fu Zhu Yu Tang.

• Cold stagnation and blood stasis type (cold limbs, aggravated pain in cold weather): Common prescriptions include Wen Jing Tang and Dang Gui Si Ni Tang.

• Qi and blood deficiency type (light flow, dizziness, fatigue): Common prescriptions include Ba Zhen Tang and Gui Pi Tang.

3. Dietary Adjustments

• Consume foods rich in iron and nutrients, such as red dates, black sesame, walnuts, and spinach.

• Avoid cold foods (ice drinks, cold fruits) to prevent worsening menstrual pain.

• Drink warming beverages like ginger red date tea or brown sugar ginger water to warm the uterus.

4. Lifestyle Adjustments

• Maintain a regular sleep schedule and avoid staying up late.

• Engage in moderate exercise like yoga and brisk walking to promote blood circulation.

• Keep a positive mindset and reduce stress to minimize the impact on menstruation.