Irregular Menstruation
Overview
Irregular menstruation covers abnormalities of cycle, duration, volume, color, and quality—early, late, or unpredictable periods, excessive or scant bleeding, or prolonged menses. Chinese medicine attributes it mainly to dysfunction of the liver, spleen, and kidney with failure to regulate qi and blood in the thoroughfare and conception vessels, related to emotions, diet, fatigue, cold, and constitution; common patterns are liver constraint, spleen deficiency, kidney deficiency, blood heat, blood deficiency, and stasis.
Pattern differentiation (clinical patterns)
Liver Constraint & Qi Stagnation
Unpredictable periods with variable volume and dark clotted blood, premenstrual rib-side/breast distension and pain, depression or irritability, normal or darkish tongue with thin coating, wiry pulse.
Soothe the liver and regulate qi; harmonize blood and regulate menstruation.
Spleen Deficiency (Insufficient Qi-Blood)
Late or scant pale periods, sometimes prolonged or trickling, with fatigue, poor appetite, loose stools, sallow face, pale tongue with white coating, slow weak pulse.
Tonify the spleen and boost qi; nourish blood and regulate menstruation.
Connections
Daily care & prevention
Keep regular hours; avoid crash dieting, sleep deprivation, and chronic stress. During menses avoid cold; eat a balanced diet, exercise moderately, and maintain a healthy weight—large weight swings also affect cycles. Track cycle dates, volume, and symptoms. Massage Sanyinjiao (SP6), Guanyuan (CV4), Xuehai (SP10), Zusanli (ST36), and Taichong (LR3). Seek evaluation for abnormalities when trying to conceive or during adolescence/perimenopause.
When to seek medical care
Seek prompt care for bleeding after menopause, heavy or unremitting non-menstrual bleeding, severe abdominal pain, fever, pain or bleeding during a possible pregnancy, or delayed first period in adolescence; sexually active people with a missed period should first rule out pregnancy.