Period pain and PMS in TCM: why Chinese medicine talks about warmth and flow

Period pain is common, but in traditional Chinese medicine it is a sign that something in the body is out of balance. TCM explains the pain as blood and qi not flowing freely in the pelvis, often because of cold, stress or fatigue. Treatment aims to warm, get the flow moving and strengthen the body between periods. If your pain is severe or gets worse over the years, always have it checked by a doctor first.

This article explains how TCM sees period pain and PMS, what you can do yourself and how Dr. Tian works.

Three things to know straight away

• According to TCM, it hurts where things do not flow. The Chinese saying is 不通则痛, bu tong ze tong.
• Warmth is the first and simplest piece of TCM advice for period pain.
• PMS is seen as the same imbalance, showing itself in the week before your period.

Why it hurts, according to TCM

TCM sorts period pain into a few patterns. The same pain can have different causes, so treatment differs from person to person.

Cold

The pain is cramping and feels better with a hot-water bottle. The blood may be dark with clots. Your hands and feet get cold easily. According to TCM, cold makes the body contract, much as cold turns water into ice, and the blood then flows sluggishly.

Stress and tension

Your breasts are tender, you get irritable and your stomach feels bloated in the days before your period. The pain often comes at the start of the period. TCM calls this pattern stagnant qi and links it to the liver, which according to tradition keeps the flow in the body smooth and is affected by stress and suppressed anger.

Fatigue

The pain is a dull ache and often comes towards the end of the period or afterwards. You feel tired, pale or dizzy. According to TCM this is a shortage of qi and blood. The body simply has too little to move.

Many people have a mix. Someone can be both cold and stressed.

PMS: the imbalance shows before your period

Mood swings, tender breasts, sugar cravings, headaches and bloating in the week before a period are called PMS. TCM usually sees the same patterns here as in period pain, above all stagnant qi. That is why a TCM practitioner often treats PMS and period pain together, ideally across the whole cycle.

What you can do yourself

This advice comes from tradition. It is simple, cheap and suits most people.

• Keep your stomach and lower back warm. A hot-water bottle, a warm blanket or a bath helps many people straight away. In China it is common to avoid going bare-legged and getting cold feet around your period.
• Eat warm food. Soups, stews and porridge rather than cold, raw food, especially in the week before and during your period. Read more in the article on food as medicine.
• Try ginger with brown sugar. 红糖姜茶 is the classic Chinese period drink. Simmer a few slices of fresh ginger in water for ten minutes and stir in a teaspoon of brown sugar. TCM counts it as warming.
• Move gently. Walks and stretching keep the flow going. Hard training can wait until the pain has passed.
• Cut down on stress in the week before. Sleep and quiet evenings often make a difference.

This advice does not replace painkillers. If over-the-counter painkillers do not help, contact your GP, a midwife clinic or a gynaecology clinic.

What does the research say?

Research on acupuncture for period pain is not conclusive. A Cochrane review from 2016 went through the available studies. It concluded that it was not possible to say whether acupuncture or acupressure helps, because the studies were few and of low quality. Many women still seek acupuncture for period pain and feel that it helps. We think you should know both things.

When should you see a doctor first?

Have yourself examined if any of the following applies:

• The pain gets worse every year.
• It also hurts between periods or during sex.
• You bleed much more than usual.
• Over-the-counter painkillers do not help.

Pain like this can be caused by endometriosis or fibroids, for example, and then you need a gynaecological examination. Acupuncture can be a complement afterwards, but it does not replace the investigation.

How Dr. Tian can help

Dr. Fei Tian is a fourth-generation TCM practitioner. She qualified in medicine in China in 1985 and spent fifteen years in clinical work at Chinese hospitals, where she treated gynaecological complaints among other things. She holds a PhD from the Sahlgrenska Academy.

At the first visit she asks about your cycle, the pain, your mood and your sleep, and she examines your pulse and tongue. Based on the pattern she suggests a plan. Treatment is often given in the week before your period and continues over a few cycles. You also get advice on food and daily habits that suits your pattern.

• Health consultation, 550 SEK, 30 minutes. A TCM diagnosis and a plan.
• Acupuncture, first visit, 1,400 SEK, 60 minutes. Consultation and treatment in the same visit.
• Acupuncture, follow-up, 1,050 SEK, 50 minutes.

Book an appointment or first read about your first visit.

Frequently asked questions

When in my cycle is it best to come?

Many people start in the week before their expected period. You can also come during your period. Dr. Tian plans treatment around your cycle.

Can I have acupuncture if I have endometriosis?

Yes, as a complement. Keep up the treatment your gynaecologist has given you, and mention the diagnosis at your first visit.

How many treatments will I need?

It varies. For period problems, treatment is often needed over a few cycles, and you review progress together as you go.

Sources

• 1177 (Swedish national health service guide). Mensvärk (period pain).
• 1177. Endometrios (endometriosis).
• Smith CA et al. Acupuncture for dysmenorrhoea. Cochrane Database of Systematic Reviews, 2016.