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This patient is a teacher — a profession that demands long hours, mental focus, and emotional resilience. Over time, the combination of work-related stress and ongoing heavy periods took a toll on her body, gradually depleting her Qi and causing Blood stasis.
For over a year, she experienced prolonged menstrual bleeding with dark clots, dizziness, and fatigue. These symptoms, along with her tongue and pulse presentation, pointed to a diagnosis of Qi stagnation and Blood stasis — a common pattern in uterine fibroid cases according to Traditional Chinese Medicine (TCM).
We treated her using a carefully tailored Chinese herbal prescription aimed at promoting blood circulation, resolving stasis, and gently supporting fertility. Over several months, she took customised herbal formulas, adjusted at each stage to suit her changing condition, along with digestive support when needed.
After around five months of consistent treatment, her menstrual cycle became more regular, with reduced flow and minimal discomfort. Her dizziness, pain, and other premenstrual symptoms were significantly relieved — a clear example of how personalised, holistic care in TCM can support both gynaecological health and overall well-being.
Date of initial consultation: 18th June 2023
Patient: Mrs C, female, 36 years old, married
Main complaint: Heavy menstrual bleeding and prolonged periods for 1.5 years; uterine enlargement noted during a health check-up in the past 6 months.
Presenting History
Mrs C reported a previously regular menstrual cycle (7–8 days every 35–38 days), though periods were consistently heavy, with dark red blood and clots. She has one child and is hoping to conceive again.
Her last menstrual period was on 15th December 2022, lasting 8 days, again with heavy flow, dark blood with clots, dizziness, lower back ache, breast distension, and painful periods. The previous cycle began on 9th November 2022 and lasted 10 days.
Current symptoms included:
- Premenstrual breast distension and irritability
- Dizziness, occasional palpitations, fatigue worsened by exertion
- Cold hands and feet
- Aching and numbness in the lower back and knees
- Normal appetite but poor sleep (difficulty falling asleep and frequent waking)
Tongue: Pale and dark with thick, greasy coating
Pulse: Wiry and slippery
Ultrasound (2021) revealed uterine enlargement and thickened endometrium, with a solid mass in the mid-upper posterior uterine wall, suggesting a uterine fibroid.
Diagnosis
- Western Medicine: Uterine fibroid
- Chinese Medicine: Zheng Jia (癥瘕), excessive menstrual bleeding, prolonged menstruation
- Pattern Differentiation: Qi stagnation and blood stasis
- Treatment Principle: Promote blood circulation, resolve blood stasis, and dissolve masses
Herbal Prescription (initial 2 weeks) included:
Xiang Fu (Cyperus), Yu Jin (Curcuma), Tu Si Zi (Cuscuta), Bai Shao (Peony), Qing Pi (Unripe Tangerine Peel), Ju He (Tangerine Seed), Li Zhi He (Lychee Seed), Zao Jiao Ci (Gleditsia Spine), Dan Shen (Salvia)
As the patient wished to conceive, surgical removal (laparoscopic myomectomy) was not pursued at this stage.
First Follow-Up
Significant reduction in menstrual flow. Dizziness much improved. Still experienced dark menstrual blood with clots, backache, breast tenderness, and occasional dysmenorrhoea.
Prescription adjusted, maintaining core herbs with additions like Chai Hu (Bupleurum) and Yi Mu Cao (Motherwort).
Course: 3 weeks of herbal medicine.
Second Follow-Up
Overall symptoms much improved. Noted mild digestive discomfort in the past week – bloating and poor appetite.
Prescription continued with adjustments to suit her current state.
Herbal support for digestion was added.
Course: 3 weeks of herbal medicine.
Third Follow-Up
Menstrual flow within normal range (4–5 sanitary pads used during heavier days), lasting 6 days. No dizziness, darker blood persisted but with fewer clots. Backache, breast distension and period pain had all improved significantly.
Discussion
In Traditional Chinese Medicine, uterine fibroids fall under the category of Zheng Jia (癥瘕). They are understood to result from internal imbalances involving the kidney, liver, and spleen, with the formation of phlegm and blood stasis leading to the development of masses.
Treatment is tailored based on the individual’s constitution and the state of deficiency or excess. Throughout the course of the disease, blood stasis plays a central role—without clearing stagnant blood, new blood cannot be generated. Therefore, invigorating blood circulation and resolving stasis remains the cornerstone of therapy.
In this case, the patient underwent approximately 5 months of Chinese herbal treatment. Her menstrual irregularities and discomfort improved notably, and there was no further growth of the fibroid. Treatment is ongoing, with a focus on nourishing Qi and Blood to further support uterine health.
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