Patient's question:
I have had my period coming 5 days earlier for 3 consecutive months, and it's accompanied by menstrual cramps. This has never happened before. Is there something wrong with me?Doctor's answer:
Hello:Being unable to work 5 days in advance does not necessarily indicate illness, but menstrual pain (dysmenorrhea) is considered a medical condition. In Traditional Chinese Medicine (TCM), dysmenorrhea is classified into the following patterns:
Qi Stagnation and Blood Stasis Pattern:
Symptoms: Lower abdominal pain before or during menstruation, resistant to pressure, reduced menstrual flow, sluggish flow, dark purple menstrual blood with clots, pain relief after clot expulsion, and pain disappearance after menstruation ends.
Treatment: Regulating qi and resolving stasis to relieve pain.
Formula: Modified Ge Xia Zhu Yu Tang (Gedeng Zhuyu Decoction).
Cold Congealing in the Uterus Pattern:
Subtypes:
- Yang Deficiency Internal Cold:
Symptoms: Lower abdominal cold pain before or during menstruation, relieved by pressure, alleviated by warmth, reduced menstrual flow, and dark pale menstrual blood.
Treatment: Warming the meridians and uterus to relieve pain.
Formula: Weng Jing Tang (Wenjing Decoction) with Fu Zi (Aconite), Ai Ye (Artemisia), and Xiao Huixiang (Fennel).
- Cold Dampness Congealing:
Symptoms: Lower abdominal cold pain before or during menstruation, pain relief with warmth, worsened by pressure, reduced menstrual flow, and dark pale menstrual blood with clots.
Treatment: Warming the meridians, dispelling cold and dampness, resolving stasis to relieve pain.
Formula: Shao Fu Zhu Yu Tang (Shaofu Zhuyu Decoction) with Cang Zhu (Atractylodes) and Fu Ling (Poria).
Damp-Heat Lowering Pattern:
Symptoms: Lower abdominal pain before menstruation, resistant to pressure, with a burning sensation, or worsened by regular abdominal pain during menstruation, dark red menstrual blood with clumps and a viscous texture.
Treatment: Clearing heat, resolving dampness, and resolving stasis to relieve pain.
Formula: Qing Re Tiao Xue Tang (Qingre Tiaoxue Decoction) with Hong Teng (Bistort) and Bai Jiang Cao (Poria).
Qi and Blood Deficiency Pattern:
Symptoms: Mild lower abdominal pain a day or two after menstruation, or a sense of emptiness in the lower abdomen and vulva, relieved by massage, reduced menstrual flow with pale, thin blood.
Treatment: Strengthening qi and blood to relieve pain.
Formula: Sheng Yu Tang (Shengyu Decoction) without Sheng Di (Rehmannia) and with Bai Shao (Paeonia), Xiang Fu (Angelica Sinensis), and Yan Hu Suo (Corydalis).
Liver and Kidney Deficiency Pattern:
Symptoms: Mild, lingering lower abdominal pain a day or two after menstruation, dark pale menstrual blood with reduced flow and thin texture.
Treatment: Nourishing the kidneys and liver to relieve pain.
Formula: Tiao Gan Tang (Tiaogan Decoction) with modifications.
However, TCM emphasizes syndrome differentiation and treatment. It is best to consult a TCM department and undergo the four diagnostic methods (inspection, auscultation/olfaction, inquiry, and palpation) for a tailored prescription.