Dysmenorrhea:an introduction of abdominal pain during menstruation, and other pains during the period.


 TCM Knowledge:Gynecology Syndromes,Women Syndromes ✵Gynecology of TCM is a branch to study the physiological and pathological characteristics of women and to prevent and treat syndromes specific to women. Gynecology of TCM research scope including irregular menstruation, amenia, metrorrhagia, infertility, postpartum syndromes, breast syndromes, and miscellaneous syndromes, etc.

Dysmenorrhea(abdominal pain during menstruation).
Dysmenorrhea:abdominal pain during menstruation 
 ✵The dysmenorrhea is also known as painful menstruation, or abdominal pain during menstruation, lower abdominal pain with referring pain to the lower back occurring around or during the menstrual period, also called abdominal pain during menstruation.

 ✧The abdominal pain or low back pain, even severe pain is unbearable, before the due time, or during the menstruation period, or after the menstruation period, it is known as abdominal pain during menstruation, or dysmenorrhea, or menstrual cramps.

 ✦The pathogenic reason that leads to the dysmenorrhea, or abdominal pain during menstruation, are known mostly due to three reasons, (1).intolerant, easy angry and bad temper, excess of liver-Qi lead to Qi-stagnancy and blood stasis in the uterus(the Ren and Chong channels), channels are blocked and result abdominal pain; (2).life habits, for example, eats raw and cold food during the menstruation period, use cold water, wear too thin cloth and too few clothes (big area of skin exposed to air), attacked by coldness and dampness which block the uterus, menstrual blood stagnated and blocked up; (3).health conditions not very well, deficiency of Qi and insufficiency of blood, which lead to the uterus (the Ren and Chong channels, uterus) empty, channels lose support and result in pain. The related syndromes are introduced: dysmenorrhea of the qi-stagnancy and blood stasis type, dysmenorrhea of the cold-dampness stagnation type, dysmenorrhea of Qi and Blood deficiency type, dysmenorrhea of heat type, dysmenorrhea of the liver-kidney deficiency type, dysmenorrhea of the heart-abdomen pain type, dysmenorrhea of the blood and Qi both excess type, generalized pain during menses, menstrual body pain of cold affection type, menstrual radiating pain from genitalia, urine pain during menses, hypochondriac pain during menses, pain in the lower abdomen during menses, abdominal pain before menses stopped, stagnant abdominal pain hotflash during menses, abdominal pain until menses is over, abdominal pain after menses, etc.

 ✵Common terms related to dysmenorrhea are introduced:

 Dysmenorrhea or painful menstruation: lower abdominal pain with referring pain to the lower back occuring around or during the menstrual period, also called abdominal pain during menstruation.

 Abdominal pain during menstruation: synonymous with dysmenorrhea or painful menstruation.

 Qi-stagnation dysmenorrhea: a type of dysmenorrhea caused by emotional depression, and marked by distending pain in the lower abdomen accompanied by distention and discomfort in the chest and breasts before or during menstruation.

 Blood-stasis dysmenorrhea: a type of dysmenorrhea characterized by stabbing pain in the lower abdomen with tenderness, occurring before or during menstruation with little menstrual discharge. The pain is usually alleviated after discharge of blood clots.

 Cold-congealing dysmenorrhea: a type of dysmenorrhea marked by sluggish menstrual flow with cold feeling and pain in the lower abdomen, which can be alleviated by warmth.

 Damp-heat dysmenorrhea: a type of dysmenorrhea accompanied by leukorrhagia with yellowish discharge.

 Qi-blood-deficiency dysmenorrhea: a type of dysmenorrhea marked by reduced amount of thin and pink-colored menstrual flow associated with persistent dull pain in the lower abdomen which usually occurs during the late period of menstruation and can be alleviated by pressing.

 Kidney-insufficiency dysmenorrhea:a type of dysmenorrhea caused by congenital defect, marrying too early, intemperate sexual life or multiple deliveries, and usually accompanied by dizziness, aching in the loins and weakness of the legs.

Dysmenorrhea of the qi-stagnancy and blood stasis type.
Dysmenorrhea:abdominal pain during menstruation 
 ✵The dysmenorrhea of the Qi-stagnancy and blood stasis type is mainly due to Qi-stagnancy and blood stasis:symptoms normally are ever in bad mood(feel blue), the abdominal pain often trouble before the due time or during the menstrual period, swelling and pain is the characteristic symptoms, accompanied by swelling and pain of the chest and hypochondria, discharge blood color purple-black, with blood clot, menstrual obstruction, and the pain will be mild if the discharge blood volume more or expel a lot of blood clots.
 ✵Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "The menstrual pain before period(dysmenorrhea before period, or premenstrual dysmenorrhea) is the condition of blood heat and Qi-stagnancy, the menstrual pain during period is the condition of Qi and blood deficiency, the menstrual pain after the period is the condition of stagnant Qi although blood already in circulation." [02].

 "In the case of pains before periods, is the condition of blood stasis and Qi-stagnancy." [03];"In the case of stinking smell or fishy smell during menstrual periods, ache and pain in abdomen, waist and hypochondria regions, is the condition of blood stasis." [03].

 "In the case of pains before periods, what is it? It is the condition mainly due to depression...

 In the case of women suffer from menses passing down in blood clots, what is it? It is the condition due to Qi-stagnancy and stasis..." [04].

 "A woman suffer from pains before or when the menstruation comes, is due to Qi stagnancy and blood excess..." [06].

 "A woman suffer from colic pain before the menstruation comes, is due to blood stasis(not circulate well) and pains...
 A woman suffers from pain in the low back and abdomen when the menses comes, Qi stagnancy and bloos excess..." [07].

 "A woman suffers from abdominal pain before the menstrual period, is the syndrome of Qi stagnancy and blood stasis..." [09].



Dysmenorrhea of the cold-dampness stagnation type.
Dysmenorrhea:abdominal pain during menstruation 
 ✵The dysmenorrhea of the cold-dampness stagnation type is mainly due to cold-dampness stagnation: symptoms normally are abdominal pain before the due time or during the menstrual period, severe pain if massaged, pain relieved if apply hot compress, menstrual volume small amount, color dark black with clots, or color similar as black bean water, face appearance color blue or green, tongue-edge color purple, feel cold in hands and feet.

Dysmenorrhea of Qi and Blood deficiency type.
 
 ✵The dysmenorrhea of Qi and Blood deficiency type is mainly due to Qi and Blood deficiency, symptoms normally are chronic pain during the menstrual period or after the period, pain will be relieved with massage, menstrual volume is small, color light, menstruation clear and dilute, mental fatigue(spiritlessness), body soft and feel weak(lack strength), low voice, pale appearance(looks pale face), tongue and lip color light and bloodless.
 ✵Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "The menstrual pain before period(dysmenorrhea before period, or premenstrual dysmenorrhea) is the condition of blood heat and Qi-stagnancy, the menstrual pain during period is the condition of Qi and blood deficiency, the menstrual pain after period is the condition of stagnant Qi although blood already in circulation." [02].

 "In the case of delayed menorrhea and pains, mainly due to blood deficiency and affected by cold pathogen."; "In the case of pains after period, is the condition of Qi and blood deficiency." [03].

 "In the case of pains after periods and body heat(fever), what is it? It is the condition mainly due to blood deficiency, loss of excessive blood and leads to fever and pains..." [04].

 "A woman suffers from abdominal pain during menstruation, due to wind and cold invading the collaterals of the uterus, or hurt Tai Yang, Shao Yin, ...or worry and depression, Qi stagnancy hurt and bloos stasis, ...or blood binding and form clotting, ...or the spleen is hurt from wind and cold, ...or the blood is hurt from worry and thinking, ...or Qi is hurt from worry and thinking, ...or the blood is hurt from depression and anger, etc..." [05].

 "The dysmenorrhea of Qi deficiency: this syndrome at half of the menses(at half of the menstruation period), blood not passing completely, pain in the abdomen, develops to hot-flash, or no fever..." [08].

 "A woman suffers from abdominal pain after the menstrual period, is the syndrome of Qi deficiency and blood weakness..." [09].



Dysmenorrhea of heat type.
Dysmenorrhea:abdominal pain during menstruation 
 ✵The dysmenorrhea of heat type is mainly due to heat.
 ✵Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "The menses is purple black and menstrual pain, discharged in blocks...in the condition of excessive heat, surely accompanied by aquation, heat and turn to purple, in severe case even turn black, is the normal case of changes. And women nature[...] and heat, double addiction to desire. Fire from five wills, burning inside and enduring, cold and wind pathogens affect exogenously, surely will lead to menstrual pain. Or, there are cases of not pain, in the long period will develop to heat syndrome." [02].



Dysmenorrhea of the liver-kidney deficiency type.
 
 ✵The dysmenorrhea of the liver-kidney deficiency type is mainly due to the liver-kidney deficiency: symptoms normally are abdominal empty and pain after menstruation period, sore and swelling at the lower back area(waist), menstrual volume small amount, color light pink, mental fatigue, sleepy or drowsy.

Dysmenorrhea of the heart-abdomen pain type.
 
 ✵The dysmenorrhea of the heart-abdomen pain type is mainly due to seven emotions and affected by cold pathogen and anger before periods: symptoms normally are pain in heart and pain in abdomen, or pain radiating to waist low back and hypochondria regions.
 ✵Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "In the case of a woman or a Shi Nǚ(unmarried girl) is affected by seven-emotions, blood and Qi joined together, pain in the heart and abdomen, or irradiating to the waist low back and hypochondria regions, in severe case, even twitch... In the condition she is affected by coldness and anger before periods, mostly this syndrome is observed." [03].



Dysmenorrhea of the blood and Qi both excess type.
Dysmenorrhea:abdominal pain during menstruation 
 ✵The dysmenorrhea of the blood and Qi both excess type is mainly due to blood and Qi both excess: symptoms normally are waves of pains in abdomen.
 ✵Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "In the case waves of pains in the abdomen, attack irregularly, is the condition of blood and Qi are both excess." [03].



Generalized pain during menses.
 
 ✵The generalized pain during menses is a syndrome pain whole body during menses, it is normally due to cold pathogens.
 ✵Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "Generalized pain during menses: Woman suffers from generalized pain in two to three days when menses comes, is the condition cold pathogen invading the bone, fever or no fever..." [08].



Menstrual body pain of cold affection type.
 
 ✵The menstrual body pain of cold affection type is mainly due to affection of cold pathogen: symptoms normally are pain around the body, numbness in hands and feet, alternative fever and chilling, headache and dazzled, etc. It is not abdominal pain or dysmenorrhea.
 ✵Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "In the case woman in menstruation, pain around the body, numbness in hands and feet, alternative fever and chilling, headache and dazzled eyes, is the condition of cold affection during menstruation." [03].

 "In the case menses come two or three days, a woman suffers from whole-body pains, is the condition cold pathogen invading the bones, or fever, or not fever..." [07].



Menstrual radiating pain from genitalia.
Dysmenorrhea:abdominal pain during menstruation 
 ✵The menstrual radiating pain from genitalia is a syndrome pains in a belt region starts from genitalia region and up to the breast region, other symptoms are fever.
 ✵Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "A woman suffers from two tendons radiating from genitalia to the breasts when menses comes, pains and unbearable, fever of the body..." [07].



Urine pain during menses.
 
 ✵The urine pain during menses is a syndrome pains when passing urine and menses comes, due to blocking of the blood gate.
 ✵Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "A woman suffers from urine pains when menses comes, pains as cutting, is the condition of blood gate is blocked..." [07].

 "A woman suffers from urine pains when menses comes, pains as cutting, is the condition of blood gate is not opened..." [08].



Hypochondriac pain during menses(Menstrual hypochondriac pain).
 
 ✵The hypochondriac pain during menses is a syndrome hypochondriac pain when menses comes, due to blood stasis and clotting.
 ✵Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "A woman suffers from clotting in the hypochondria regions, the shape of the clotting is similar to a cup and pains, the menses blood color light black..." [07].

 "Pains in hypochondria during menstruation:a mass formed as a cup during menses, menses blood color light yellow, should treat the mass first..." [08].



Pain in lower abdomen during menses.
Dysmenorrhea:abdominal pain during menstruation 
 ✵The pain in the lower abdomen during menses is a syndrome pain in the lower abdomen region when menses comes, other symptoms might be observed are unbearable pain, cyanotic yellow complexion(looks cyanotic yellow on face), no appetite, etc.
 ✵Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "A woman suffers from pain in the lower abdomen during menses, a mass is formed in the lower abdomen as a piece, unbearable pains, greenish-yellow complexion(looks cyanotic yellow), no appetite(do not take food)..." [07].



Abdominal pain before menses stopped.
 
 ✵The abdominal pain before menses stopped is a syndrome pain in the abdomen at time menses is half, residue blood not discharged, pain in the abdomen, other symptoms might be observed are fever or no fever.
 ✵Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "A woman suffers from pain in the abdomen at time menses is in half procedure, residue blood not discharged, pain in the abdomen, other symptoms might be observed are fever or no fever, is the condition of Qi and blood both excess..." [07].



Stagnant abdominal pain hotflash during menses.
 
 ✵The stagnant abdominal pain hot-flash during menses is a syndrome hot-flash whole-body, cephalea(headache) and thirst at time menses half, pain in urination.
 ✵Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "A woman suffers from hot-flash whole-body, headache, and thirst, pain in urination at time menses is in half procedure, it is due to take raw and cold food, as a result, blood stasis, residue blood stagnant internal..." [07].

 "Hot-flash Qi pains before menses end: menses comes in half period, thirst, pain in the lower abdomen. It is due to take much raw and cold food or drink, blood stasis, and not circulate smoothly. There is residue blood retained internally..." [08].



Abdominal pain until menses is over.
Dysmenorrhea:abdominal pain during menstruation 
 ✵The abdominal pain until menses is over is a syndrome pain until menses is over or pain when menstruation is over, it is normally due to extreme blood deficiency.
 ✵Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "A woman suffers from pains until menses is over, numbness of hands and feet, is the condition of deficiency cold in the abdomen, due to extreme blood deficiency..." [07].

 "Pains when menses is over: It's symptoms numbness in hands and feet, deficiency cold in the abdomen, Qi and blood deficient and collapse severely..." [08].



Abdominal pain after menses.
 
 ✵The abdominal pain after menses is a syndrome pain after menses, it is normally due to deficiency with stasis.
 ✵Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "A woman suffers from pains after menses, is the condition of deficiency with stasis..." [07].



References:
  • 01.Dysmenorrhea:an introduction of abdominal pain during menstruation, and other pains during the period.
  • 02.Kun Yuan Shi Bao(the Kun Essence is Guaranteed).By 薛轩(Xuē Xuān)[Song].
  • 03.Song Shi Nǚ Ke Cuo Yao(the Synopsis of Song's Gynaecology).By 宋林皋(Sòng Lín Gāo)[Ming].
  • 04.Fù Kē Bǎi Biàn(the Differentiations in Hundred Syndromes of Gynaecology).By 庄履严(Zhuāng Lǚyán)[Ming].
  • 05.Nǚ Ke Bǎi Xiào Quán Shū(the Efficacious Complete Book of Gynaecology).By 龚居中(Gōng Jūzhōng)[Ming,1630].
  • 06.Huang Shi Nǚ Ke(the Synopsis of Huang's Gynaecology).By 黄彦荣(Huáng Yànróng)[Ming,1504].
  • 07.Ye Shi Nǚ Ke Zhèng Zhì(the Syndromes and Therapeutics of Ye's Gynaecology).By 叶桂(Yè Guì)[1817].
  • 08.Fù Kē Bèi Kǎo(the References of Gynaecology).By 何应豫(Hé Yīngyù)[1820].
  • 09.Fù Kē Liáng Fāng(the Effective Prescription of Gynecology).By 何梦瑶(Hé Mèngyáo)[1751].

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