Absence of menstruation according to Chinese Medicine
The information provided here is not a replacement for a doctor. You shouldn't use it for the purpose of self-diagnosing or self-medicating but rather so you can have a more informed discussion with a professional TCM practitioner.
Amenorrhoea, No periods, Blocked Menstruation, Blocked periods, Absence of periods and No menstruation redirect here
Absence of menstruation factsheet
Chinese name: 闭经
Pinyin name: Bì Jīng
Possible causes and remedies:
Symptoms: Anxiety Insomnia Tinnitus and nine other symptoms
Recommended formula: Tian Wang Bu Xin Dan
Symptoms: Nausea Oedema Fatigue and seven other symptoms
Recommended formula: Cang Fu Dao Tan Wan and two other formulas
Absence of menstruation is a condition where there is no monthly bleeding when there should be. It is referred to as amenorrhea in Western medicine term and it is called '闭经‘（Bi Jing) in Traditional Chinese Medicine. 'Jing' refers to menstruation while 'Bi' means 'closed', 'shut' or something that is blocked. As the name indicates, it is a pathological condition as opposed menopause which is not pathological. No periods is often developed from late menstruation or scanty menstruation. It is the opposite of flooding and Leaking.
Western medicine has divided amenorrhea into two categories: primary or secondary. This concept has been adopted by modern TCM. Primary Amenorrhea happens to these girls who have not yet menstruated by the time they've reached 18 years old. Secondary refers to women who have had periods but haven't any cycle for more than 3 months. Obviously, we rule out the special circumstances of pregnancy or breastfeeding after birth giving when it is absolutely normal not to have menstruation. Sometimes, sudden habit or environment change can also leads to absence of periods for 1 or 2 months and it should not be considered as pathological condition.
From a TCM point of view, two categories of patterns have to be distinguished for treating absence of periods. First are these Deficiency related patterns such as Qi and Blood Deficiency or Liver and Kidney Deficiency. In this case, the body doesn't produce enough Blood to fill the Uterus. The second category includes these Excess patterns such as Qi and Blood Stagnation or accumulation of Dampness and Phlegm. Under this circumstance, the free flow of Blood is restrained.
As you can see below we've detailed for you the seven "patterns of disharmony" associated with absence of menstruation. Chinese Medicine sees the body as a system, not a sum of isolated parts. A "pattern" is when the system's harmony is disrupted. It is not equivalent to a Western condition, as a matter of fact here absence of menstruation can be explained by seven different patterns.
Each of those patterns can be treated with one or several herbal formulas. Drinking herbal infusions is the most common remedy in Chinese Medicine, together with acupuncture. It is the Chinese Medicine equivalent to drugs, apart that it's 100% natural!
In total we detail below twenty one formulas that can help treat the various patterns that cause absence of menstruation, depending on which pattern fits your profile.
The seven "patterns of disharmony" associated with absence of menstruation
The Heart is a so-called "Zang" Organ. Learn more about the Heart in Chinese Medicine
Heart Yin Deficiency
Pulse type(s): Rapid (Shu), Empty (Xu)
Tongue coating: Complete absence of coating
Tongue color: Red
Recommended herbal formula: Tian Wang Bu Xin Dan
Symptoms: Anxiety Insomnia Tinnitus Dizziness Back pain Dry mouth Depression Dry throat Malar flush Poor memory Palpitations Night sweats
The Heart's main function in Chinese Medicine is to govern the flow of Blood, the Blood vessels and to house the Spirit/ Mind. It can be greatly influenced by emotional stress such as sadness, worry, grief and guilt.
The Heart connects to the Uterus and the Kidneys. These three Organs are closely related. Since Blood is a Yin elements, Heart and Kidney Yin Deficiency together can dry up the Blood and thus lead to an absence of menstruation.
The treatment principle is to nourish Heart and Kidney Yin, clear Empty Heat and calm the Mind. For this herbal formulas such as Tian Wang Bu Xin Dan can help.
Coco-Grass Rhizomes (Xiang Fu) is the key herb for Cang Fu Dao Tan Wan, a formula used for Damp-Phlegm in the Uterus
Damp-Phlegm in the Uterus
Pulse type(s): Slippery (Hua)
Tongue color: Normal (light red)
Recommended herbal formulas: Cang Fu Dao Tan Wan, Bu Zhong Yi Qi Tang, Xiang Sha Liu Jun Zi Tang
Symptoms: Nausea Oedema Fatigue Overweight Lack strength Chest fullness Vagina discharge Sore and weak limbs Feeling of heaviness Menstruation decreases gratually
Spleen Qi Deficiency is normally the fundamental cause of Phlegm. It is because the Spleen rules the transformation and transportation of Body Fluids. A dysfunction of the Spleen leads to an accumulation of these fluids and eventually Phlegm appears. It obstructs the Lower Burner and the Uterus so that Blood can not flow freely. Thus the secondary amenorrhoea develops.
Qi and Blood Stagnation often accompany Phlegm, which worsens the situation. This might also be paired with Qi and Blood Deficiency due to Spleen Deficiency.
Dampness and Phlegm is usually the result of an unhealthy diet such as an excessive consumption of cold or raw foods, dairy products or greasy foods.
The treatment principle is to resolve Dampness and Phlegm, tonify the Uterus, move Qi and penetrate the Connecting Meridians. Herbal formulas like Cang Fu Dao Tan Wan or Bu Zhong Yi Qi Tang are typically recommended.
Szechuan Lovage Roots (Chuan Xiong) is the key herb for Ge Xia Zhu Yu Tang, a formula used for Qi and Blood Stagnation
Qi and Blood Stagnation
Pulse type(s): Wiry (Xian)
Tongue color: Bluish-Purple
Recommended herbal formulas: Ge Xia Zhu Yu Tang, Tao Hong Si Wu Tang, Shao Fu Zhu Yu Tang, Wu Yao Tang, Jia Wei Xiao Yao San, Wei Jing Tang
Symptoms: Moodiness Dark face Dizziness Depression Chest pain Breast pain Irritability Abdominal pain Chest fullness Breast distention Abdominal fullness Menstruation decreases gratually Feeling of fullness in the chest
This is an Excess type of Amenorrhoea. This means that the periods are absent because Blood is stagnated rather than being insufficient.
Qi and Blood Stagnation discussed here typically occurs in the Liver. It normally results from emotional factors such as anger, frustration, resentment, irritation, worry or anxiety. If it is not treated for a long period of time, stagnated Blood can not flow freely from the Liver to fill the Penetrating Vessels and the Uterus. Therefore the menstruation stops.
The treatment principle is to pacify the Liver as well as move Qi and Blood. Formulas such as Tao Hong Si Wu Tang or Wu Yao Tang is recommended.
Cold in Uterus is another important cause for Qi and Blood Stagnation in the Uterus and in the Lower Burner. It eventually can also lead to secondary amenorrhoea. This type of absence of periods can last for more than a year. When the body is weak, Wind Cold or Damp Cold can invade the Lower Burner and injures the Directing and Penetrating Vessels which form the so-callled 'Sea of Blood'. Then the Blood gets Cold and stagnated. The Vessels and Channels connecting to the Uterus are blocked and the Uterus door is shut.
In this case the treatment principle is to expel Cold as well as move Qi and Blood. Formulas such as Shao Fu Zhu Yu Tang or Wen Jing Tang is recommended.
Ginseng (Ren Shen) is the key herb for Ren Shen Yang Rong Tang, a formula used for Qi and Blood Deficiency
Qi and Blood Deficiency
Pulse type(s): Choppy (Se), Fine (Xi)
Tongue color: Pale
Recommended herbal formulas: Ren Shen Yang Rong Tang, Shi Quan Da Bu Tang, Bu Zhong Yi Qi Tang, Gui Pi Tang
Symptoms: Anxiety Fatigue Tingling Numbness Insomnia Dry skin Dry hair Dry eyes Dizziness Pale face Depression Low energy Poor memory Palpitations Poor appetite Blurred vision Pale menstrual blood Menstruation decreases gratually
Malfunction of the Spleen and the Stomach can often lead to Qi and Blood Deficiency and thus to the secondary amenorrhoea. It is because they are the Organs responsible for manufacturing the postnatal Qi and Blood from the food and drinks we intake.
This pattern is mostly caused by an unbalanced diet that lacks in Blood-nourishing ingredients. It happens often to women adopting a weight-loss or a vegan diet. Other factors that can impair the functions of the Spleen and Stomach are severe chronic diseases, repeated abortions or miscarriages, breastfeeding for a long period of time or long-term emotional stress such as sadness, worry or grief.
Heart Blood Deficiency can also cause secondary amenorrhoea because the Heart helps make menstrual Blood. It results either from a dysfunction of the Spleen and Stomach in making Blood, or from emotional stress such as sadness, worry or grief.
Finally, Liver Blood Deficiency can be a frequent cause of secondary amenorrhoea as the Liver stores Blood. Having sex too often can be a cause here as it impairs the Liver and exhaust Qi.
The treatment principle is to nourish Blood, tonify Qi and strengthen the Spleen, the Stomach, the Heart or the Liver as necessary.
The Lungs is a so-called "Zang" Organ. Learn more about the Lungs in Chinese Medicine
Lung Yin Deficiency
Pulse type(s): Empty (Xu), Floating (Fu)
Tongue color: Red
Recommended herbal formula: Bai He Gu Jin Tang
Symptoms: Red lips Dry cough Depression Blood spit Chest pain Malar flush Frequent sighing Shortness of breath Hot palms and soles
An excessive amount of grief and sadness injures the Lung Qi and leads to a situation where the Lungs fail to circulate and disseminate Qi around the body. Qi is the driving force for the Blood flow in vessels and channels. This results in Blood Deficiency and the absence of menstruation.
It typically progresses from a Lung Qi Deficiency that is not treated for a while and degenerates into Lung Yin Deficiency.
The treatment principle is to moisten the Lungs, nourish Lung Yin and Liver Blood, calm the Mind and settle the Corporeal Soul.
The Kidneys is a so-called "Zang" Organ. Learn more about the Kidneys in Chinese Medicine
Kidney and Liver Yin Deficiency
Pulse type(s): Rapid (Shu), Empty (Xu), Fine (Xi), Floating (Fu)
Tongue color: Red
Recommended herbal formulas: Tiao Gan Tang, Gui Shao Di Huang Tang, He Che Da Zao Wan, Zuo Gui Yin, Si Wu Tang
Symptoms: Fatigue Tinnitus Insomnia Dry eyes Dizziness Dry mouth Night sweats Blurred vision Lower back pain
Liver and Kidney Yin Deficiency are some of the most common Yin Deficiency pattern. Blood is a Yin elements and Yin Deficiency dries the 'Sea of Blood' of the Penetrating Vessel. Therefore the menstruation ceases. This pattern is the result of overwork, chronic disease or giving birth to too many children too close together. It happens more amongst women who are over 30 years old, in contrast to the patterns of Kidney Essence and Liver Blood Deficiency which happens more to younger girls.
The treatment principle is to nourish Liver and Kidney Yin, tonify the Uterus and nourish the Essence.
The Kidneys is a so-called "Zang" Organ. Learn more about the Kidneys in Chinese Medicine
Liver Blood and Kidney Essence Deficiency
Pulse type(s): Deep (Chen), Weak (Ruo)
Tongue color: Pale
Recommended herbal formulas: Dang Gui Di Huang Yin, Liu Wei Di Huang Wan, He Che Da Zao Wan
Symptoms: Fatigue Dry skin Knee pain Dizziness Dark face Dry mouth Depression Amenorrhea Low energy Dry throat Night sweats Lower back pain Feeling of cold No menstruation by 18
According to TCM Kidney Essence is the origin of menstrual Blood. Also TCM believes that the Liver stores Blood. The malfunction of these two Organs together causes the emptiness of the Penetrating and Directing Vessels, in charge of directing Blood to the Uterus. Kidney Essence Deficiency can also cause Kidney Yang Deficiency which leads to the pattern of Cold in the Uterus and amenorrhoea as a symptom.
This pattern is seen more often among young women, especially for the primary amenorrhoea cases (when there never was any menstruation). For those young women, hereditary Kidney weakness is often one of the main reason. For the others, overwork or having too many kids too close to each can be another cause for this pattern.
The treatment principle is to tonify the Kidneys, nourish the Liver and regulate the periods, with appropriate herbal formulas.
Read more about Liver Blood and Kidney Essence Deficiency here
The twenty one herbal formulas that might help with absence of menstruation
Bu Zhong Yi Qi Tang
Source date: 1247
Number of ingredients: 10 herbs
Key actions: Tonifies Qi of the Spleen and Stomach (Middle Burner). Raises the Yang. Detoxifies. Lifts what has sunken.
Why might Bu Zhong Yi Qi Tang help with absence of menstruation?
Because it is a formula often recommended to help with the patterns Damp-Phlegm in the Uterus and Qi and Blood Deficiency which are sometimes associated with absence of menstruation. If any of these patterns look like something you might suffer from, this formula might help (although please seek confirmation with a professional practitioner beforehand).
He Che Da Zao Wan
Number of ingredients: 11 herbs
Key actions: Tonifies the Kidneys. Strengthens the Directing and Penetrating Vessels. Regulates the periods.
Why might He Che Da Zao Wan help with absence of menstruation?
Because it is a formula often recommended to help with the patterns Kidney and Liver Yin Deficiency and Liver Blood and Kidney Essence Deficiency which are sometimes associated with absence of menstruation. If any of these patterns look like something you might suffer from, this formula might help (although please seek confirmation with a professional practitioner beforehand).
Tian Wang Bu Xin Dan
Source date: 16th century
Number of ingredients: 14 herbs
Key actions: Enriches the Yin. Nourishes the Blood. Clears Heat. Calms the Mind.
Why might Tian Wang Bu Xin Dan help with absence of menstruation?
Because it is a formula often recommended to help treat Heart Yin Deficiency, a pattern sometimes associated with absence of menstruation. If it looks like you might suffer from Heart Yin Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).
Ge Xia Zhu Yu Tang
Source date: 1830 AD
Number of ingredients: 12 herbs
Key actions: Invigorates Blood. Eliminates Blood Stagnation below the diaphragm. Stops pain. Promotes Qi movement.
Why might Ge Xia Zhu Yu Tang help with absence of menstruation?
Because it is a formula often recommended to help treat Qi and Blood Stagnation, a pattern sometimes associated with absence of menstruation. If it looks like you might suffer from Qi and Blood Stagnation, this formula might help (although please seek confirmation with a professional practitioner beforehand).
Bai He Gu Jin Tang
Source date: 1573 AD
Number of ingredients: 10 herbs
Key actions: Nourishes Lung and Kidney Yin. Lubricates the Lung and clears phlegm.
Why might Bai He Gu Jin Tang help with absence of menstruation?
Because it is a formula often recommended to help treat Lung Yin Deficiency, a pattern sometimes associated with absence of menstruation. If it looks like you might suffer from Lung Yin Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).
Symptoms related to absence of menstruation
Depression Dizziness Fatigue Insomnia Night sweats Dry mouth Menstruation decreases gratually Palpitations Malar flush Anxiety
