Menstruation is dark in color and the amount is less, what is the reason?

Patient's question:

Menstruation becomes black and the amount is less, what is the reason?
Menstruation becomes black and the amount is less with a smell, with blood clots, sometimes lower back pain during the period

Doctor's answer:

Traditional Chinese Medicine (TCM) believes that dark-colored menstruation is caused by qi stagnation and blood stasis, where menstrual blood accumulates in the uterus for an extended period, leading to menstrual cramps. This is considered menstrual irregularity and can be regulated by TCM using herbal medicine.
The etiology and pathogenesis of menstrual irregularity primarily involve emotional distress (seven emotions), external pathogens (six evils), or congenital deficiency of kidney qi. Factors such as multiple births, excessive sexual activity, or overexertion can damage the zang-fu organs, disrupt the functions of the kidneys, liver, and spleen, lead to imbalances in qi and blood, and ultimately injure the Chong and Ren meridians, resulting in menstrual irregularity.

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