This patient is a lawyer, whose profession involves extensive speaking and interaction with people from all over the world — a lifestyle that can deplete Qi(vital energy of body).

During the past year, her periods were heavy; this substantial blood loss further drained her Qi, manifesting in weakness, shortness of breath, and fatigue. Based on the four diagnostic methods (inspection, listening and smelling, inquiry, and pulse-taking), we determined her condition to be deficient in both Qi and Blood with accompanying stagnation.

Therefore, we treated her with Chinese herbal medicine to boost Qi, resolve stagnation, and nourish the Blood. The patient took the herbs for about 3 weeks, alongside acupuncture treatments to enhance circulation and ease stasis.

As a result, her painful periods were almost completely resolved, yielding a dramatic improvement in her condition — a testament to the power of this tailored, holistic approach.

Initial Consultation (23rd December 2024)

A 45-year-old woman presented at our clinic for the first time on 23rd December 2024. She had been experiencing increasingly painful periods for nearly a year, which were affecting both her work and daily life.

Her periods were previously regular and without significant pain. She is married and has children. After the onset of symptoms, she consulted several hospitals and was prescribed the contraceptive pill, but this made her dizzy and her breasts tender, and she chose to discontinue it. An IUS (Mirena coil) was subsequently recommended, but the patient declined and chose to pursue Traditional Chinese Medicine (TCM) instead.

Her last period was on 7th December 2024. The pain was rated 9/10 on a Visual Analogue Scale (VAS). Her flow was heavy and lasted for 7 days, with clots present. She took painkillers, but this provided little relief. She also experienced vomiting, headaches during her period, upper body sweats, lower body chills, persistent spotting, weakness, shortness of breath, poor sleep, a pale and darkish tongue with a slightly greasy coating, and deep, thin, slippery pulse.

Past medical history: She has a history of anaemia and is currently taking iron supplementation. A follow-up for anaemia has not been performed recently.

Gynecological ultrasound (within the last 3 years) shows an enlarged uterus with a painful nodule on the back wall. She has multiple uterine fibroids, a thickening of the endometrial stripe (about 8.5 mm), and a suspected endometriotic (chocolate) cyst in the right ovary.

Chinese Medicine Diagnoses:
Dysmenorrhea; “Zheng-Jia” (Mass formations) — Qi and blood deficiency with blood stasis.

Western Medicine Diagnoses:

1. Adenomyosis
2. Pelvic Endometriosis
3. Right ovarian chocolate cyst
4. Uterine fibroid
5. Anaemia

Traditional Chinese Medicine treatment:
To tonify Qi, resolve stasis and nourish the blood. Herbs were prescribed, including Codonopsis, Atractylodes, Bupleurum, Tabania, and Magnolia.
(Non-professionals should not use these herbs without proper supervision).

Second Consultation:

Her upper body sweats, lower body chills, weakness, shortness of breath, and poor sleep had all improved.
The main treatment remained the same — strengthening Qi and removing stasis.
Acupuncture points were added to aid this, including Zusanli (ST36), Baliao, and Pishenshu (Bladder 20 and 23).

Third Consultation:

The patient reported that this period was much less painful — rated 1/10 on the VAS — although the flow remained heavy and there were still some small clots. Her period has now finished, and she reports feeling warm in her lower body and less fatigued overall.

Summary — Dysmenorrhea in Traditional Chinese Medicine

Dysmenorrhea is a very common gynaecological condition. It occurs due to a range of factors, including lifestyle, emotions, and external influences (such as Cold, Heat, Damp, and Wind), and it’s closely related to a woman’s constitution and the unique physiology of menstruation.
As described in the classical text Jing Yue Quan Shu, “menstrual pain may be excess or deficiency; excess is often due to stagnation — Cold, Heat, Qi, or Blood — while deficiency predominantly results from weakness of Qi or Blood.”
This highlights the principle: “Where there is blockage, there is pain; where there is insufficiency, there is weakness and discomfort.”

Dysmenorrhea predominantly involves the Uterus and the Chong and Ren meridians. The main treatment principle is to regulate Qi and Blood flow — clearing stagnation in cases of excess and tonifying when there is weakness — alongside addressing related symptoms.
Some key points in treatment:

• If there is excess, we resolve and move; if there is deficiency, we nourish and tonify.
• We treat the symptoms during menstruation and the root afterwards.
• It’s often helpful to combine herbs with acupuncture to aid circulation and ease pain.
• Support is tailored to each patient’s constitution and symptoms.