Acupuncture for Painful Menstrual Periods

In the West, symptoms surrounding menstruation such as pain, heavy bleeding, premenstrual tension (PMT), and headaches are often considered a normal part of the menstrual cycle. These symptoms can range from mildly annoying to utterly debilitating, affecting every area of life. Traditional Chinese Medicine (TCM) sees it differently. While common, these symptoms are viewed as signs of imbalance and can be addressed effectively with acupuncture and other treatments.

Acupuncture has been shown to reduce the intensity and duration of menstrual cramps. Unlike painkillers, it does not just treat the symptoms but works to lessen pain over future cycles by addressing underlying causes.

Qi Stagnation

This is one of the most common patterns. Qi stagnation, particularly of the liver and heart, disrupts the natural flow of energy and blood, especially at ovulation and before menstruation. It can lead to breast and abdominal distension, moodiness, irritability, depression, and even diarrhea before the period. Menstrual blood may appear darker, and cycles can be irregular or delayed. Pain tends to be worse before and during menstruation and is aggravated by pressure. The flow may stop and start, reflecting poor qi circulation. Emotional stress and oral contraceptive use are common triggers.

Blood Stagnation

If qi stagnation is left untreated, it may progress to blood stagnation. Pain becomes more severe, fixed, and stabbing. Relief may come with the passing of clots. Blood is typically dark and clotted. Periods can be light due to poor flow or heavy as the body tries to expel stagnant blood. The cycle may be irregular or absent, with possible spotting. A purple tongue with distended veins and a wiry pulse are common. Blood stagnation often appears after childbirth or surgery and in conditions like endometriosis and fibroids. It may also result from cold, phlegm-damp, or qi deficiency.

Heat

Heat can arise from prolonged qi or blood stagnation or from yin deficiency. It may lead to shorter cycles due to early ovulation. Heat causes blood to move recklessly, often producing heavy bleeding with bright red blood. If fluids are injured, blood may be thick and dry. If heat comes from yin deficiency, bleeding may be scanty. Other symptoms can include irritability, headaches, nosebleeds, insomnia, palpitations, red eyes, mouth ulcers, acne, and reflux. A red tongue tip and rapid pulse are typical signs. Heat can also result from overwork, poor rest, heated foods, or emotional stress.

Cold

In TCM, a warm uterus is essential for healthy menstruation and fertility. Cold is a common pattern and can result from internal deficiency or external exposure. It often causes delayed cycles and cramping that improves with warmth. Blood may appear red with small clots or pale depending on the source of cold. A pale tongue and slow pulse are common. Cold can enter through cold environments, cold food and drink, swimming, or exposure of the lower abdomen. Walking barefoot or exposing legs to cold can also allow cold to invade. Postpartum women are especially vulnerable and benefit from warming herbs and moxibustion.

Yang Deficiency

Yang is responsible for warmth and transformation in the body. Deficiency can result in problems during the luteal phase, such as low progesterone and spotting before the period. Other symptoms include diarrhea at onset of menses, low back pain, late or absent ovulation, swelling, low libido, cold limbs and abdomen, a pale and wet tongue, and a slow pulse. Hypothyroidism is a classic example. Yang deficiency can stem from chronic illness, overwork, lack of rest, cold exposure, or even a history of yin deficiency.

Phlegm-Damp

A diet high in greasy, sweet, or dairy foods or impaired fluid metabolism can cause phlegm-damp. This pattern often settles in the lower abdomen and disrupts menstruation. Symptoms may include long or absent cycles, mucus in menstrual blood, thick discharge, swelling, heaviness, weight gain, acne, sinus issues, or a phlegmy cough. Conditions like PCOS are often linked to this pattern. The tongue is swollen with a thick coating, and the pulse feels full and slippery.

Qi Deficiency

Spleen qi holds the blood in place. When it is weak, periods may come early, last long, or involve heavy bleeding. Blood is often brown, pale, and watery. Additional signs include bruising, fatigue, poor appetite, and loose stools. The tongue is pale, and the pulse is weak. Qi deficiency often leads to blood deficiency and is commonly caused by overthinking, poor nutrition, and lack of rest.

Blood Deficiency

Blood deficiency can result from frequent menstruation, childbirth, blood loss, or poor diet. Periods may be delayed, absent, or light. Blood is pale and dilute. Other signs include anemia, pallor, dizziness, dry skin and nails, and insomnia. The tongue is pale, and the pulse is thin.

Jing Deficiency

Jing, or essence, governs reproductive development. Severe deficiency may cause delayed puberty or primary amenorrhea. Milder cases involve irregular cycles, early menopause, or fertility issues. Jing deficiency can be inherited or result from excessive stress, drug use, poor rest, or multiple pregnancies close together. It also naturally declines with age and menstruation. A person born to older parents or the youngest of many siblings may be more prone to this condition.

Acupuncture offers a way to support menstrual health by treating the root causes behind each of these patterns. By improving blood flow, regulating hormones, and restoring balance, it provides lasting relief that extends beyond each cycle.