Patient's question:
When menstrual flow is heavy, it may appear as clots-like menstruation, piece by piece. Is there something wrong? Moreover, my period lasts for 6 days to be completely clean, and the last day has brownish discharge. Is this still menstruation? Does it indicate that it's clean? Or is there something abnormal? First follow-up question: On the first day of my period, my abdomen and waist hurt a lot (but it's fine by the second day), and my legs feel weak. Many times, I get dizzy when I take the bus to work in the morning! Is my problem very serious?Doctor's answer:
Hello, in Traditional Chinese Medicine theory, menstrual pain is divided into: Qi stagnation and blood stasis syndrome. Symptoms: Lower abdominal pain before or during menstruation that is resistant to pressure, reduced menstrual volume, difficult menstruation, dark purple menstrual blood with clots, pain relief after clot expulsion, and pain disappearance after menstruation ends. Treatment should focus on regulating qi, resolving stasis, and relieving pain. Prescription: Modified Ge Xia Zhu Yu Decoction.Cold congealing in the uterus syndrome:
- Yang deficiency internal cold: Symptoms: Lower abdominal cold pain before or during menstruation, relieved by pressure, and relieved by warmth, reduced menstrual volume, and dark dull menstrual blood. Treatment should focus on warming the meridians and warming the uterus to relieve pain. Prescription: Warming the Meridians Decoction with aconite, mugwort, and fennel.
- Cold dampness stagnation: Symptoms: Lower abdominal cold pain before or during menstruation, pain relief when warmed, increased pain upon pressure, reduced menstrual volume, and dark dull menstrual blood with clots. Treatment should focus on warming the meridians, dispelling cold and dampness, resolving stasis, and relieving pain. Prescription: Modified Sha Fu Zhu Yu Decoction with atractylodes and poria.
Damp-heat lower jiao syndrome: Symptoms: Lower abdominal pain before menstruation that is resistant to pressure and has a burning sensation, or abdominal pain worsening during menstruation, dark red menstrual blood with a viscous consistency and clots. Treatment should focus on clearing heat, removing dampness, resolving stasis, and relieving pain. Prescription: Clearing Heat and Regulating Blood Decoction with rhubarb, polygonum, and coix seed.
Qi and blood deficiency syndrome: Symptoms: Lower abdominal pain before or after menstruation, or a sense of emptiness and heaviness in the lower abdomen and vulva, relieved by massage, reduced menstrual volume, pale and thin menstrual blood. Treatment should focus on replenishing qi and blood to relieve pain. Prescription: Holy Recovery Decoction with modified rehmannia, white peony root, safflower, and croton.
Liver and kidney deficiency syndrome: Symptoms: Lower abdominal pain before or after menstruation that is dull and persistent, dark dull menstrual blood, reduced volume, and thin consistency. Treatment should focus on tonifying the kidneys and nourishing the liver to relieve pain. Prescription: Liver-Regulating Decoction with modifications.
However, Traditional Chinese Medicine emphasizes syndrome differentiation and treatment. It is best to consult a TCM department and combine the four diagnostic methods (inspection, auscultation/olfaction, inquiry, and palpation) for a tailored prescription to achieve the best results. Wishing you a speedy recovery!