Painful Menstruation

Dear women with debilitating menstrual pain.

We see you!

Often, when doctors cannot figure out what is wrong, it can feel very invalidating to be in extreme pain every month and not know why. While having painful menstruation is certainly all too common, too many of us have been told it’s just a “normal” part of being a woman and to suck it up and take an ibuprofen or naproxen. These medications can be beneficial for some women or even help you get to school or work on a bad day, but they are often like slapping a band-aid on a deeper issue. Quick fixes may aid temporary relief, but there is no such thing as a sustainable quick fix for chronic health issues and pain. 

Dysmenorrhea affects many women, with about 20% of women experiencing dysmenorrhea that is so severe it interferes with daily life and activities. Aside from lower abdominal pain, women may also experience low back pain, pain radiating down the inner legs, nausea, vomiting, fainting, headaches, weakness, and diarrhea.

There are many causes of dysmenorrhea, which is often just used as an umbrella term without further examining and differentiating potential root causes. 

Biomedicine states that in primary dysmenorrhea, cramping occurs when too many prostaglandins are released into the bloodstream, causing the blood vessels and muscles of the uterus to contract. Secondary dysmenorrhea is caused by a disorder in the reproductive organs and may more severe and occur at several different points in the menstrual cycle. 

This can be caused by conditions such as endometriosis, PCOS, fibroids, Adenomyosis, uterus or fallopian tube defects, or auto-immune diseases such as Crohn’s disease and irritable bowel syndrome, or urinary disorders. Pelvic Inflammatory Disease (PID) is another known culprit of dysmenorrhea as well as ectopic pregnancy. 

In Chinese medicine, several differential diagnoses can cause painful menstruation. 

It is written in the classical texts of Chinese medicine” Tong Ze Bu Tong, Bu Tong Ze Tong”. This points to a fundamental concept in Chinese medicine and is translated to “If there is free flow, there is no pain; if there is pain, there is lack of free flow.” Meaning, pain is usually due to some sort of stagnation and energy, blood and fluids not moving and circulating properly. 

According to Chinese medicine, our menstrual periods are like our fifth vital sign and give us many clues about our overall health. Even if we aren’t currently (or ever) trying to conceive- a healthy, regular, pain-free, and symptom-free menstrual cycle is a sign of good health. Because the menstrual cycle is seen and measured as a sign of overall health- Chinese medicine practitioners are trained to pay very close attention to blood flow color, viscosity- meaning how thick it is or if there are clots, the quality of the pain, and any form of blockage or stagnation impeding circulation to the uterus when treating painful menstruation. 

A healthy menstrual cycle is a cycle lasting from 28-30 days, with very minimal cramping, a dark red flow that is neither too light nor heavy and bleeding that lasts from 3-5 days. 

Below are some common causes of painful menstruation from a Chinese medicine perspective. 

Blood stagnation: Blood stasis is a lack of proper flow and circulation to the uterus. It often causes jelly-like menstrual blood or large clots, and often the menstrual period can be either early or late, or actually on time. The blood flow is often darker in color- being a very dark red, purple, brown, black. Sometimes the bleeding will occur much later after intense cramping, or the period may stop and start. 

Qi stagnation: Qi stagnation also occurs when things aren’t moving and circulating properly. It can be caused by any kind of emotional stress such as frustration, or unfulfilled desires. It can also be caused by weak digestion. Oftentimes, when dysmenorrhea is caused by qi stagnation- there will be alternating loose stools or constipation, or loose stools and nausea before menstruation. There will also usually be irritability or depression in the luteal phase, or tender breasts, bloating, headaches, etc.  

Damp stagnation:  Damp stagnation in the uterus will always occur due to weak digestion. Often, it occurs with Western diseases like PCOS. There will usually be pain that feels heavy and achy, and sometimes there will be excess vaginal discharge or mucous in menstrual blood.  

Heat (inflammation): What we call “heat” in Chinese medicine can be translated to mean inflammation. Heat can occur from bacterial or viral infections, long-standing stress, stagnation of blood or qi flow, or other lifestyle and dietary factors such as taking certain medications, consuming alcohol regularly, and over-eating processed, fried, or spicy foods. It will often cause insomnia and restlessness, anger and irritability, profuse bleeding of fresh red blood, and some patients may even feel very hot and feverish.

“Cold” in the uterus: Cold in the uterus can be caused by the stagnation of certain deficiencies of the body. It will often cause very painful menstruation, delayed cycles, or infertility. Sometimes patients will be very prone to feeling cold quite frequently or they will have red blood with very small dark clots. 

If you are suffering from dysmenorrhea, or painful periods, know that you should talk to your doctor about it. However, if you are left without answers or you want to get to the root of your painful menstruation without taking pain medication everything month, acupuncture and herbal medicine can likely help your pain! Call us or book an online appointment. We’re here to help!

This blog post was written by Samantha Kloss L.Ac