Dysmenorrhea (painful menstruation) means that women have periodic pain during or prior to or after menstrual period in the lower abdomen or even faint in severe cases. It has been customary to classify cases of dysmenorrhea into two main groups: primary or functional dysmenorrhea referring to the one which is not caused by organic diseases, and secondary dysmenorrhea referring to the one caused by organic diseases in reproductive system.

Main Points of Diagnosis
1. The pain in the lower abdomen appears with menstrual cycle.
2. The pain can spread over the whole abdomen, lumbosacral region or there is dragging pain in the vulva and anus. It varies in degrees and can be relieved when the menstrual blood flows smoothly.
3. Gynecological examination: Those without organic diseases in the pelvic cavity are primary dysmenorrhea; those with organic diseases in the pelvic cavity are secondary dysmenorrhea.
Differentiation and Treatment of Common Syndromes
1. Blood Stasis due to Stagnation of Qi
Main Symptoms and Signs: Distending pain and tenderness in the lower abdomen one or two days prior to or during menstruation accompanied with fullness sensation in the chest, hypochondrium and breast, deep-purple blood with clots, relief of pain after discharge of clots, ecchymoses on the tongue edges, string-like pulse.
Therapeutic Principle: Regulating the flow of qi and removing blood stasis to alleviate the pain.
Recipe: Modified Decoction for Dissipating Blood Stasis Under Diaphragm.
Chinese angelica root
ligusticum root
red peony root
peach kernel
safflower
bitter orange
corydalis tuber
trogopterus dung
Sichuan chinaberry
lindera root
nutgrass flatsedge rhizome
All the above herbs are to be decocted in water for oral administration.
2. Stagnancy of Cold and Dampness
Main Symptoms and Signs: Distending pain in the lower abdomen several days prior to or during menstruation, which can be relieved by warmth, menstrual flow scanty in amount, dark in color and with clots, pale tongue with white and greasy fur, deep and tense pulse.
Therapeutic Principle: Warming the channels and expelling dampness to arrest pain.
Recipe: Modified Decoction for Removing Blood Stagnation in the Lower Abdomen.
common fennel fruit
cinnamon bark
red peony root
Chinese angelica root
ligusticum root
corydalis tuber
myrrh
cat-tail pollen
trogopterus dung
poria
All the above herbs are to be decocted in water for oral administration.
For those with lassitude in loins and legs and excreting copious clear urine, omit poria and add 6 grams of prepared aconite root and 9 grams of argyi leaf.
3. Deficiency of Both Qi and Blood
Main Symptoms and Signs: Vague pain in the lower abdomen during or 1-2 days after menstruation which can be relieved by pressing, scanty menstruation with reddish and thin blood, accompanied with lack of vitality and asthenia, pale tongue with white and thin fur, thready and weak pulse.
Therapeutic Principle: Invigorating qi and enriching the blood to alleviate pain.
Recipe: Modified Dysmenorrhea-Healing Decoction.
ginseng
astragalus root
Chinese angelica root
ligusticum root
prepared rehmannia root
white peony root
nutgrass flatsedge rhizome
corydalis tuber
Decoct the above herbs in water for oral administration.
Dr. Ming's TCM Medical Center,
Hua Xi Xiao Yuan, Hutian Developing Area,
Huaihua city, Hunan province
China