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Author: Dr. Richard Zeng (Chinese medicine)

menstruation Chinese medicine

A typical menstrual cycle lasts between 24 and 35 days, with an average length of 28 days. The duration of menstrual bleeding usually ranges from 3 to 7 days, with a normal volume of 30 to 50ml.

However, Traditional Chinese Medicine has a more nuanced perspective on what constitutes a normal menstrual period.

Normal Menstrual Cycle and Traditional Chinese Medicine (TCM)

According to traditional Chinese medicine, a normal period should meet the following criteria:

  • the blood should be red in colour, not dark;
  • the flow should neither be too heavy nor too light;
  • there should be no presence of blood clots; and there should be no unusual odour.

In addition to these physical aspects, the absence of significant symptoms before and around menstruation is also considered indicative of a normal period. Such symptoms may include mood swings, sore or tender breasts, bloating, headaches, or migraines.

If a person’s period does not meet the aforementioned criteria, it may be seen as abnormal.

By examining various factors such as the menstrual cycle length, color, texture, volume, and odor, along with other general symptoms, one can gain insights into a woman’s overall health.

Menstrual Cycle Length

The menstrual cycle is measured from the first day of the period until its completion. If the cycle consistently starts 7 days earlier, or if there are 2 or more consecutive cycles with such early onset, it may indicate heat or blood deficiency. On the other hand, if the cycle is consistently delayed by more than 7 days, or if it lasts 40 to 50 days each time, it could suggest cold syndrome or Qi/blood deficiency (Qi/blood Xu).

Colour and Texture

The colour and texture of menstrual blood can provide clues about the underlying health conditions.

  • Light color or thin texture may indicate deficient syndromes such as qi/blood deficiency, spleen/kidney deficiency, or dampness.
  • Dark or purple color, thick texture, or the presence of clots may suggest heat, blood stasis, or Qi-energy stagnation.

For instance, the blood can be further classified as hot or cold. Hot blood is associated with a bright red color and a larger volume, while cold blood is characterised by a dark colour, small blood clots, and a cold appearance similar to black beans.

Flow

While the observation of menstrual flow is important, the volume of blood alone is not sufficient to determine the situation accurately. For example, a seemingly large amount of blood may actually be diluted by another component, indicating blood loss. Only when the colour is deep red and the texture is thick can it be considered hot. Similarly, when the flow is too light, considering the colour and texture in conjunction with the overall characteristics of the period can help determine the true state of Qi and blood.

Accompanying Symptoms

In addition to the nature of the period itself, the presence of symptoms such as dizziness, headaches, dysmenorrhea (painful periods), diarrhoea, mood swings, and others before and after menstruation can also provide valuable information. For example, experiencing dizziness before and after menstruation suggests deficiency. Observing the period can serve as a good indicator in such cases. Additionally, if dizziness is accompanied by pale gums, a pale tongue, palpitations, fatigue, and other signs of weakness and fatigue, it may also indicate Qi and/or blood deficiency.

If symptoms include chest tightness, a heavy sensation in the head, poor appetite, increased vaginal discharge, and the presence of phlegm, it could indicate spleen deficiency. On the other hand, if dizziness, a small amount of bright red menstrual flow, irritability, weakness in the lower back, dry mouth and throat, and redness of the cheeks are present, it may suggest involvement of the liver and kidneys.

Distinguishing the actual condition of dysmenorrhea is also possible. If the pain occurs before or during menstruation and is alleviated when blood clots are discharged, it is likely caused by blood stasis or liver Qi stagnation. However, if the pain persists throughout the menstrual period, worsens, and is accompanied by a feeling of restlessness or heat, it is more likely a result of kidney deficiency and virtual blood.

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