Menstruation is essential for the renewal of the uterine lining in preparation for pregnancy. Major fluctuations in hormone levels precede a menstrual period, and it is normal to feel minor discomfort before and during menstruation. However, many women experience severe symptoms or painful menstruation. Painful menstruation, or dysmenorrhea, is more common in young women in their teens and twenties than in older women, and it can be secondary to an underlying condition such as endometriosis, pelvic inflammatory disease, ovarian cysts, or premenstrual syndrome (PMS). The symptoms of painful menstruation begin days before the onset of menstruation, and can continue throughout the cycle. Symptoms include lower abdominal cramping, a dull ache that often radiates to the lower back, heavy menstrual flow with or without clots, dull headaches, constipation or diarrhearhea, frequent urination, and mood changes including anxiety or depression. Stress, lack of exercise, and excess caffeine use can also cause menstrual discomfort and PMS. In Western medicine birth control pills or other hormonal agents, diuretics, and antidepressants are often prescribed.

In Chinese medicine, a healthy menstrual cycle relies on several factors, including the condition of the blood, the level of energy, and the proper functioning of the liver and kidneys. For example, if there is heat in the blood or a stagnation of energy resulting from emotional imbal­ance and stress, the menstrual flow becomes disrupted, causing pain and discomfort. Many women also suffer from a condition in which cold affects the uterus, causing severe menstrual cramps and pain. Stress and intense emotions, especially anger, frustration, and resentment, can easily depress the liver. Over time, the stagnation turns into heat, pushing the blood to flow out heavily with clots and pain.

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