Period Pain (Dysmenorrhea)
★Overview
Dysmenorrhea is cyclical lower-abdominal pain during or around menstruation that may radiate to the lower back, sometimes severe enough to cause fainting, often with pallor, cold sweat, or nausea. Chinese medicine locates it in the thoroughfare and conception vessels and the uterus, centered on qi and blood: emotional constraint causes qi stagnation and blood stasis, while cold exposure during menses causes cold congelation and stasis; deficiency pain arises from weak qi and blood failing to nourish the uterine vessels. Excess patterns reflect "pain from obstruction," deficiency patterns "pain from lack of nourishment."
Pattern differentiation (clinical patterns)
Cold Congelation & Blood Stasis
Cold, fixed lower-abdominal pain before or during menses that rejects pressure and improves with heat; scant dark clotted blood with pain relief after clots pass; cold limbs, greasy white coating, deep tight pulse.
Warm the channels and disperse cold; transform stasis to stop pain.
Qi Stagnation & Blood Stasis
Distending premenstrual lower-abdominal pain that rejects pressure, with breast and rib-side fullness/pain, inhibited flow of dark clotted blood, depression or irritability, purple dark tongue or stasis dots, wiry pulse.
Regulate qi and move stagnation; transform stasis to stop pain.
Qi-Blood Deficiency
Dull lower-abdominal pain during or after menses that prefers pressure, scant pale thin blood, fatigue, dizziness, palpitations, lusterless face, pale tongue with thin coating, fine weak pulse.
Boost qi and nourish blood; regulate menstruation to stop pain.
Connections
Daily care & prevention
Keep the lower abdomen, lower back, and feet warm during menses; avoid cold exposure, iced drinks, swimming, and strenuous exercise. Keep regular hours, manage emotions, and reduce caffeine and salt premenstrually. Apply heat to the lower abdomen, use moxibustion at Guanyuan (CV4), Sanyinjiao (SP6), and Diji (SP8), and massage Hegu (LI4) and Taichong (LR3). Use painkillers as directed; seek evaluation for severe pain to rule out endometriosis.
When to seek medical care
Sudden severe pelvic pain, fainting, fever, abnormal vaginal bleeding, or abdominal pain after a missed period can signal an ectopic pregnancy emergency. Seek gynecologic care for progressively worsening pain, markedly heavy periods, or non-menstrual bleeding.