Differentiation and Treatment

The most important differentiation is that between Full and Empty types of dysmenorrhoea. Full
types are much more common and clinically more important as they are characterized by more
intense pain than Empty types. Moreover, even in Empty types of dysmenorrhoea there is an
element of stasis of Blood as deficient Blood fails to move properly. For this reason, even for
Empty types of dysmenorrhoea, some Blood-moving herbs are added to the prescription used.

The general principle of treatment is to regulate Qi and Blood in the Penetrating and Directing
Vessels. On the basis of the main pattern, the treatment principle also includes moving Qi,
moving Blood, scattering Cold, clearing Heat or tonifying.

The treatment principle is often changed according to the time of the menstrual cycle. During the
period one concentrates on treating the Manifestation, i.e. move Blood and stop pain. At other
times of the cycle one treats the Root, i.e. according to the main pattern. In particular, if there is a
deficiency, this is best treated during the two weeks or thereabouts following the period.

The patterns discussed are:

EXCESS TYPE

Stagnation of Qi and Blood

Stagnation of Cold

Damp-Heat

DEFICIENCY TYPE

Qi and Blood Deficiency

Kidney and Liver Deficiency

Excess Types

Stagnation of Qi and Blood

Clinical Manifestations

Lower abdominal pain during, or one to two days before the period, a feeling of distension of the
abdomen and breasts, hesitant start to the period, menstrual blood dark with clots, pain relieved
after passing clots, pre-menstrual tension and irritability.