It’s estimated that up to 90% of women in reproductive age experience some degree of menstrual pain. About 25% of this population have moderate to severe pain that requires long term management from health care providers.

Painful menstruation shows up in ways that are more than just pain. If you suffer from painful menstruation, the duration of pain can start from before your period to a few days after your period, in some cases the pain can radiate to your back. Sometimes you may even have nausea, vomiting, headache, cold sensation, diarrhea and even fainting.

There are two types of dysmenorrhea: primary and secondary

In primary dysmenorrhea, doctors usually can’t find any structural abnormality in the reproductive organs. Mostly, it’s caused by the overproduction of prostaglandin PGF2a after ovulation. Prostaglandin is an inflammatory mediator that is associated with pain. 

PGF2a stimulates the uterine wall to shed off the endometrial lining, but the overproduction of PGF2a results in over contraction of the uterus which leads to painful menstruation.

Primary dysmenorrhea is more prevalent in the first few years of menstrual cycles. Often we can see an improvement of symptoms when girls turn 18 to 20 years old. 

In secondary dysmenorrhea, we can find some abnormality in the uterine structure such as uterine fibroids, endometriosis, chronic pelvic inflammation, or adenomyosis. 

These structural abnormalities and pathological changes can lead to reduced blood flow, and over contraction of the uterus.

Menstruation is a regular monthly flow of vitality, it reflects the health of women’s reproductive systems. Although in conventional medicine, there is no difference in the type of pain in dysmenorrhea, TCM pays close attention to it. We can basically differentiate pain with the type of pain that you have.

Pain occurs before the menstruation with profuse flow and clots = heat 

Pain after menstruation with scanty flow or pale color blood = deficiency

Pain with resistance of pressure = excessity  

Pain with dull aches type and prefer pressure = sufficiency 

Pain prefer cold = heat and vice versa 

Stabbing pain, relief after clots discharge = blood stasis

Distending pain = Qi stagnation

Pain in the hypochondria = liver qi stagnation

Pain radiates to the lower back = Kidney Qi deficiency.

Each pattern requires a different type of treatment. Instead of a one size fits all approach, TCM practitioners first identify the pattern and the channels affected. Because of the different patterns, the treatments would be different accordingly. 

If the pain is deficient, we tonify. If the pain is excessive, we reduce. 

These treatment principles can be applied to both Chinese herbs and acupuncture.

Although the treatment plan is highly customized in TCM, there are a few rules we can follow in daily practice.

Avoid: Caffeine around menstruation. 

Avoid: High calories, low nutrient density food. 

Eat: Food that is rich in potassium, such as potato, brown rice, kiwi and spinach. This can help your body to retain less sodium and reduce the discomfort

Last but not least, resting is the best way to restore your body during menstruation. Avoid staying up too late, and make sure you sleep a good 7 to 8 hours at night to reduce the inflammation in the system.