Early menstruation according to Chinese Medicine

When early menstruation is caused by Heat in the Blood, the excessive Heat agitates the Blood and it leaks out of the vessels and therefore, periods come before the right time. There are two types of Blood Heat: Full or Empty. 

Full Heat in Blood has two sub-patterns: external 'Heat/Fire Evil invasion' or 'Stagnant Liver Qi turning into Fire".

For the first one, living or working in a hot environment may accumulate Heat in the body. Also, excessive amount of hot-spicy foods or alcohol can also be sources of external Heat invading the body. Typical symptoms are heavy periods with bright or dark red color, anxiety, mental restlessness, red-face, thirst, dark urine and dry stool. The treatment principle is to clear Heat, cool the Blood  and regulate the periods. Formulas such as Qing Jing San are recommended.

As for the pattern of  'Stagnant Liver Qi turning into Fire", emotional stress is typically the main cause. Feelings such as frustration, hatred, anger or resentment causes Liver Qi Stagnation. If untreated for a long time, it turns into Liver Fire. Since the Liver stores Blood, the Fire enters the vessels and push out the Blood before the normal schedule. Typical symptoms include heavy periods with dark red color and clots, abdominal pain, premenstrual breast distension, irritability, bitter taste in the mouth or dry throat. The treatment principle is to clear and pacify the Liver, move Qi, clear Heat, cool Blood and regulate the period. Formulas such as Jia Wei Xiao Yao Wan are recommended. It is derived from Xiao Yao Wan which moves Qi and pacifies the Liver. Mudan peony bark and Cape jasmine fruits are added on top to clear Heat.

As for the category of Empty Heat in Blood, the 'Empty' here refers to the 'Heat' caused by lacking of Kidney or Liver Yin which is a natural cooling material.  Chronic illness, overwork or having too many children too close together may cause Liver and Kidney Yin Deficiency which eventually results in Empty Heat. It is more likely to occur in older women. The treatment principle is to nourish Yin and for this formulas like Liang Di Tang are recommended. 

Read more about Heat in the Blood here

Qi Deficiency is one of the main causes of early menstruation according to Chinese Medicine. Looking into the details it can be further divided into Spleen Qi and Kidney Qi Deficiency. Concretely the issue is that Qi is deficient and therefore not firm enough to hold Blood inside the vessels. The most common underlying causes are lack of physical exercise, overwork, excessive worry or too much consumption of chilled or uncooked foods. 

Spleen Qi plays a major role in containing the Blood within its vessels. The Spleen Qi can be weakened by excessive amount of work or an unbalanced diet. If this situation lasts for a long period of time, the Kidneys will eventually fail to sustain and consolidate the Directing Vessel (Ren Mai 任脉), the Penetrating Vessel (Chong Mai 冲脉）and Kidney Essence. Then the Blood leaks out and the periods come before time.

The treatment principle is to strengthen the Spleen and Kidneys, tonify and raise Qi and consolidate the Penetrating Vessel. To tonify Spleen, Gui Pi Tan and Bu Zhong Yi Qi Tang are recommended herbal formulas. As for Kidney Deficiency, formulas like He Che Da Zao Wan are recommended. 

Read more about Spleen or Kidney Qi Deficiency here