Abnormal Uterine Bleeding in Traditional Chinese Medicine

Understanding different abnormal uterine bleeding patterns according to TCM theory

Educational content • Consult qualified practitioners for medical advice

Condition Categories

Irregular or Abnormal Menstrual and Uterine Bleeding
10
TCM Patterns
50
Formulas
Overview
What causes it 10 TCM patterns documented
How to recognize Symptoms specific to each abnormal uterine bleeding pattern
Classical remedies 50 herbal formulas documented
Related conditions

Traditional Chinese Medicine (TCM) approaches abnormal uterine bleeding with a holistic lens, viewing it as a manifestation of imbalance within the body's energetic system. Unlike Western medicine, which often focuses on the symptom itself, TCM seeks to understand the root cause of the disharmony—be it Qi (energy), Blood, Yin, or Yang imbalances.

This diagnosis then informs a tailored treatment strategy aimed at restoring balance, emphasizing the importance of identifying the specific pattern of disharmony to effectively address the condition.

TCM Patterns for Abnormal Uterine Bleeding

Blood Stasis

Blood that is no longer flowing smoothly through the vessels

Causes: abnormal uterine bleeding, dysfunctional uterine bleeding, abnormal vaginal bleeding, atypical vaginal bleeding, bleeding between periods, intermenstrual bleeding, mid cycle bleeding, Hesitant periods, oligomenorrhea, long menstruation, long periods, prolonged menstrual bleeding, prolonged menstruation, prolonged periods, Irregular menstruation, Abnormal uterine bleeding

8 variations documented
Onset Gradual (trauma=sudden)
Location Often local, can be systemic
Features Fixed/stabbing pain • Purple/dark coloration • Masses/tumors • Pain worse at night

Blood Stasis represents blood that is no longer flowing smoothly through the vessels, either moving too slowly, pooling in certain areas, or congealing into clots. It's one of the most important pathological conditions in Traditional Chinese Medicine and can be both a result of disease and a cause of further illness.

Blood Stagnation
How it presents with abnormal uterine bleeding

abnormal uterine bleeding, dysfunctional uterine bleeding, abnormal vaginal bleeding, atypical vaginal bleeding, bleeding between periods, intermenstrual bleeding, mid cycle bleeding, Hesitant periods, oligomenorrhea

Along with: Dark face, Purple lips, Stabbing fixed pain, Abdominal masses, Purple nails, Menstrual cramps,

Qi And Blood Stagnation
How it presents with abnormal uterine bleeding

long menstruation, long periods, prolonged menstrual bleeding, prolonged menstruation, prolonged periods, Irregular menstruation

Along with: Chest distension, Chest pain, Stabbing fixed pain, Dark face, Purple lips, Purple nails,

Liver Blood Stagnation
How it presents with abnormal uterine bleeding

Irregular menstruation

Along with: Hypochondriac pain, Abdominal pain, Vomiting blood, Nosebleeds, Menstrual cramps, Irregular periods,

Blood Stagnation in the Lower Burner caused by Cold
How it presents with abnormal uterine bleeding

Abnormal uterine bleeding

Along with: Abdominal masses, Lower abdominal pain, Lower abdominal distension, Lower back pain, Menstrual cramps, Dark menstrual clots,

Traditional Herbal Formulas
Blood and Qi Deficiency with Blood Stagnation
How it presents with abnormal uterine bleeding

Irregular menstruation

Along with: Loss of appetite, Weak limbs, Lower back pain, Abdominal distention, Irregular periods, Red and white vaginal discharge,

Traditional Herbal Formulas
Blood Stagnation and Phlegm in the Uterus
How it presents with abnormal uterine bleeding

Irregular menstruation

Along with: Persistent uterine bleeding of purple or dark blood, Lower abdominal distension and pain that increases with pressure, Lower abdominal fibroids and cysts, Menstrual cramps, Irregular periods, Abdominal pain,

Traditional Herbal Formulas
Blood Stagnation in the Directing and Penetrating Vessels
How it presents with abnormal uterine bleeding

Irregular menstruation

Along with: Irregular periods, Brown vaginal discharge, Dark menstrual clots, Menstrual cramps, Dark menstrual blood, Prolonged lochia,

Traditional Herbal Formulas
Blood Deficiency and Stagnation
How it presents with abnormal uterine bleeding

Irregular menstruation

Along with: Dizziness, Blurry vision, Lackluster complexion and nails, Muscle tension, Insomnia, Palpitations,

Traditional Herbal Formulas

Heat

Intense, ascending pathogenic force that consumes body fluids, disturbs the mind, and accelerates all physiological processes

Causes: abnormal uterine bleeding, dysfunctional uterine bleeding, abnormal vaginal bleeding, atypical vaginal bleeding, Early periods, advanced menstruation, advanced periods, early menstruation, menstruation ahead of schedule, periods ahead of schedule, Trickling blood after period, bleeding between periods, intermenstrual bleeding, mid cycle bleeding, Irregular menstruation, Midcycle bleeding, Abnormal uterine bleeding, Shortened menstrual cycle in women

7 variations documented
Onset Can be sudden
Location Can be local or systemic
Features Red face/eyes • Thirst for cold drinks • Restlessness • Yellow/dark secretions

Heat is a major pathogenic factor in Traditional Chinese Medicine that can arise from external invasion or internal generation. Heat has the characteristics of burning intensity, rising upward, consuming qi and fluids, and generating wind and disturbing blood. In TCM philosophy, normal physiological warmth is called "minor fire" (少火) which maintains life functions, while pathological heat is "major fire" (壮火) which damages the body.

Heat in the Blood
How it presents with abnormal uterine bleeding

abnormal uterine bleeding, dysfunctional uterine bleeding, abnormal vaginal bleeding, atypical vaginal bleeding, Early periods, advanced menstruation, advanced periods, early menstruation, menstruation ahead of schedule, periods ahead of schedule, Trickling blood after period

Along with: Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia,

Damp-Heat
How it presents with abnormal uterine bleeding

bleeding between periods, intermenstrual bleeding, mid cycle bleeding, Irregular menstruation

Along with: Fever, Neck gland swelling, Headaches, Tight feeling in chest and stomach, Sticky taste in the mouth, Absence of thirst,

Traditional Herbal Formulas
Damp-Heat in the Liver
How it presents with abnormal uterine bleeding

Midcycle bleeding, Irregular menstruation

Along with: Hypochondrial fullness and distention with pain alleviated by warmth, Abdominal fullness, Lower abdominal fullness, Bitter taste in the mouth, Sticky taste in the mouth, Loss of appetite,

Traditional Herbal Formulas
Stagnant Liver Qi turning into Fire
How it presents with abnormal uterine bleeding

Irregular menstruation

Along with: Hypochondriac distention, Upper abdominal distension, Stifling sensation in the chest, Irritability, Melancholia, Depression,

Traditional Herbal Formulas
Liver Qi Stagnation with Spleen Qi Deficiency that transforms into Heat
How it presents with abnormal uterine bleeding

Abnormal uterine bleeding

Along with: Irritability, Spontaneous sweat, Eye hyperemia, Dry mouth, Palpitations, Lower abdominal oppression,

Traditional Herbal Formulas
Kidney and Liver Yin Deficiency causing Heat in the Blood
How it presents with abnormal uterine bleeding

bleeding between periods, intermenstrual bleeding, mid cycle bleeding

Along with: Dizziness, Tinnitus, Night sweats, Back pain, Dark urine

Heat Excess in the Liver or Gallbladder
How it presents with abnormal uterine bleeding

Shortened menstrual cycle in women

Along with: Hypochondriac pain, Headaches, Dizziness, Red and irritated eyes, Hearing loss, Ear swelling,

Traditional Herbal Formulas

Qi Stagnation

Blocked or disrupted flow of vital energy causing distending pain, emotional distress, and symptoms that worsen with stress

Causes: long menstruation, long periods, prolonged menstrual bleeding, prolonged menstruation, prolonged periods, Irregular menstruation, irregular cycles, chaotic periods, irregular periods, unpredictable menstruation, unpredictable periods, irregular menstruation, Abnormal uterine bleeding

6 variations documented
Onset Gradual (can be sudden)
Location Can be local or systemic
Features Distending/moving pain • Emotional stress worsens • Sighing • Pain relieved by movement/burping

Qi Stagnation is a fundamental pathological pattern in Traditional Chinese Medicine where the smooth flow of vital energy becomes obstructed, creating areas of pressure, pain, and dysfunction throughout the body.

Qi And Blood Stagnation
How it presents with abnormal uterine bleeding

long menstruation, long periods, prolonged menstrual bleeding, prolonged menstruation, prolonged periods, Irregular menstruation

Along with: Chest distension, Chest pain, Stabbing fixed pain, Dark face, Purple lips, Purple nails,

Liver Qi Stagnation
How it presents with abnormal uterine bleeding

irregular cycles, chaotic periods, irregular periods, unpredictable menstruation, unpredictable periods, irregular menstruation

Along with: Hypochondriac distention, Chest distension, Upper abdominal distension, Abdominal distention, Sighing, Melancholia,

Qi Stagnation
How it presents with abnormal uterine bleeding

Irregular menstruation

Along with: General fullness, Moving pain, Depression, Irritability, Mood swings, Sighing

Stagnant Liver Qi turning into Fire
How it presents with abnormal uterine bleeding

Irregular menstruation

Along with: Hypochondriac distention, Upper abdominal distension, Stifling sensation in the chest, Irritability, Melancholia, Depression,

Traditional Herbal Formulas
Liver Qi Stagnation with Spleen Qi Deficiency that transforms into Heat
How it presents with abnormal uterine bleeding

Abnormal uterine bleeding

Along with: Irritability, Spontaneous sweat, Eye hyperemia, Dry mouth, Palpitations, Lower abdominal oppression,

Traditional Herbal Formulas
Blood and Qi Deficiency with Blood Stagnation
How it presents with abnormal uterine bleeding

Irregular menstruation

Along with: Loss of appetite, Weak limbs, Lower back pain, Abdominal distention, Irregular periods, Red and white vaginal discharge,

Traditional Herbal Formulas

Qi Deficiency

Insufficient vital energy causing fatigue, weakness, poor digestion, and reduced function of organs and protective systems

Causes: abnormal uterine bleeding, dysfunctional uterine bleeding, abnormal vaginal bleeding, atypical vaginal bleeding, Irregular menstruation, Abnormal uterine bleeding, Early periods, advanced menstruation, advanced periods, early menstruation, menstruation ahead of schedule, periods ahead of schedule

5 variations documented
Onset Gradual
Location Systemic
Features Fatigue • Weak voice • Shortness of breath • Spontaneous sweating • Poor appetite

Qi Deficiency is a fundamental pattern in Traditional Chinese Medicine where the body's vital energy is insufficient to maintain normal physiological functions, leading to weakness, fatigue, and various organ dysfunctions.

Qi Deficiency
How it presents with abnormal uterine bleeding

abnormal uterine bleeding, dysfunctional uterine bleeding, abnormal vaginal bleeding, atypical vaginal bleeding

Along with: General weakness, Weak voice, Generalized fatigue, Apathy, Dislike of speaking, Spontaneous sweat,

Liver Qi Deficiency
How it presents with abnormal uterine bleeding

Irregular menstruation

Along with: Dizziness, Blurry vision, Eye floaters, Nervousness, Timidity, Easily startled,

Heart and Spleen Deficiency
How it presents with abnormal uterine bleeding

Abnormal uterine bleeding

Along with: Palpitations, Insomnia, Loss of appetite, Generalized fatigue, Anxiety, Pale face,

Traditional Herbal Formulas
Liver Qi Stagnation with Spleen Qi Deficiency that transforms into Heat
How it presents with abnormal uterine bleeding

Abnormal uterine bleeding

Along with: Irritability, Spontaneous sweat, Eye hyperemia, Dry mouth, Palpitations, Lower abdominal oppression,

Traditional Herbal Formulas
Spleen or Kidney Qi Deficiency
How it presents with abnormal uterine bleeding

Early periods, advanced menstruation, advanced periods, early menstruation, menstruation ahead of schedule, periods ahead of schedule

Along with: Pale menstrual flow, Lower back pain, Dizziness, Chills, Nocturia, Thin menstrual blood,

Blood Deficiency

Insufficient blood to nourish the body, causing paleness, dizziness, and dryness throughout the system

Causes: oligomenorrhea, Abnormal uterine bleeding, Irregular menstruation

5 variations documented
Onset Gradual
Location Systemic
Features Pale face/lips/nails • Blurred vision • Dizziness • Scanty menses • Numbness

Blood Deficiency represents a fundamental lack of blood volume or quality in the body, resulting in organs, tissues, and the mind being undernourished. In Traditional Chinese Medicine, blood not only refers to the red fluid in our vessels but encompasses the body's entire nourishing and moistening functions.

Blood Deficiency
How it presents with abnormal uterine bleeding

oligomenorrhea

Along with: Dizziness, Scanty menstruation, Amenorrhea, Dull shallow face, Pale lips, Poor memory,

Traditional Herbal Formulas
Heart and Spleen Deficiency
How it presents with abnormal uterine bleeding

Abnormal uterine bleeding

Along with: Palpitations, Insomnia, Loss of appetite, Generalized fatigue, Anxiety, Pale face,

Traditional Herbal Formulas
Blood and Qi Deficiency with Blood Stagnation
How it presents with abnormal uterine bleeding

Irregular menstruation

Along with: Loss of appetite, Weak limbs, Lower back pain, Abdominal distention, Irregular periods, Red and white vaginal discharge,

Traditional Herbal Formulas
Blood Deficiency and Stagnation
How it presents with abnormal uterine bleeding

Irregular menstruation

Along with: Dizziness, Blurry vision, Lackluster complexion and nails, Muscle tension, Insomnia, Palpitations,

Traditional Herbal Formulas
Blood Deficiency with disharmony of Liver and Spleen
How it presents with abnormal uterine bleeding

Irregular menstruation

Along with: Chest distension, Chest pain, Anemia, Dizziness, Headaches, Dry mouth,

Traditional Herbal Formulas

Yin Deficiency

Depletion of cooling, moistening fluids causing dryness, false heat rising, and restless agitation throughout the body

Causes: long menstruation, long periods, prolonged menstrual bleeding, prolonged menstruation, prolonged periods, irregular cycles, chaotic periods, irregular periods, unpredictable menstruation, unpredictable periods, irregular menstruation, abnormal uterine bleeding, dysfunctional uterine bleeding, abnormal vaginal bleeding, atypical vaginal bleeding, oligomenorrhea, bleeding between periods, intermenstrual bleeding, mid cycle bleeding, Irregular menstruation

4 variations documented
Onset Gradual
Location Systemic
Features Night sweats • Dry mouth/throat • Heat in afternoon/evening • Malar flush

Yin Deficiency represents a fundamental pattern in Traditional Chinese Medicine where the body's yin fluids - blood, essence, and body fluids - become depleted, losing their ability to cool, moisten, and anchor the yang energy, resulting in relative hyperactivity of yang and internal heat manifestations.

Kidney Yin Deficiency
How it presents with abnormal uterine bleeding

long menstruation, long periods, prolonged menstrual bleeding, prolonged menstruation, prolonged periods, irregular cycles, chaotic periods, irregular periods, unpredictable menstruation, unpredictable periods, irregular menstruation

Along with: Excessive sweating, Back pain, Hearing loss, Dry mouth and throat at night, Lower back pain, Constipation,

Kidney-Deficiency
How it presents with abnormal uterine bleeding

abnormal uterine bleeding, dysfunctional uterine bleeding, abnormal vaginal bleeding, atypical vaginal bleeding, oligomenorrhea

Along with: Scanty menstruation, Pale menstrual flow, Back pain, Knee pain, Dizziness, Tinnitus,

Kidney and Liver Yin Deficiency causing Heat in the Blood
How it presents with abnormal uterine bleeding

bleeding between periods, intermenstrual bleeding, mid cycle bleeding

Along with: Dizziness, Tinnitus, Night sweats, Back pain, Dark urine

Deficiency of both the Kidney Yin and Yang
How it presents with abnormal uterine bleeding

Irregular menstruation

Along with: Menopausal symptoms, Hypertension, Irregular periods, Menopausal hot flashes, Excessive sweating, Irritability,

Traditional Herbal Formulas

Yang Deficiency

Insufficient yang qi causing coldness, fatigue, and diminished physiological functions throughout the body

Causes: irregular cycles, chaotic periods, irregular periods, unpredictable menstruation, unpredictable periods, irregular menstruation, bleeding between periods, intermenstrual bleeding, mid cycle bleeding, Irregular menstruation

3 variations documented
Onset Gradual
Location Systemic
Features Always cold • Fatigue • Pale face • Prefers warmth • Cold limbs

Yang Deficiency represents a fundamental weakness of the body's yang qi in Traditional Chinese Medicine. It manifests as an inability to warm the body, transform substances, and maintain normal physiological activities, resulting in various cold-type symptoms and functional decline.

Kidney Yang Deficiency
How it presents with abnormal uterine bleeding

irregular cycles, chaotic periods, irregular periods, unpredictable menstruation, unpredictable periods, irregular menstruation

Along with: Lower back pain, Dizziness, Tinnitus, Weak and cold knees, Lower back coldness, Chills,

Traditional Herbal Formulas
Spleen or Kidney Yang Deficiency
How it presents with abnormal uterine bleeding

bleeding between periods, intermenstrual bleeding, mid cycle bleeding

Along with: Abdominal pain that worsens with cold, Urinary dysfunction, Deep pain and heaviness in limbs, Dizziness, Heavy sensation in the head, Edema,

Traditional Herbal Formulas
Deficiency of both the Kidney Yin and Yang
How it presents with abnormal uterine bleeding

Irregular menstruation

Along with: Menopausal symptoms, Hypertension, Irregular periods, Menopausal hot flashes, Excessive sweating, Irritability,

Traditional Herbal Formulas

Dampness

Heavy, sticky moisture that obstructs body functions and creates sluggishness

Causes: bleeding between periods, intermenstrual bleeding, mid cycle bleeding, Irregular menstruation, Midcycle bleeding, oligomenorrhea

3 variations documented
Onset Gradual
Location Systemic, especially digestive
Features Heavy/foggy feeling • Sticky/turbid discharges • Poor appetite • Bloating

Dampness manifests as swelling, bloating, a feeling of heaviness in the head and limbs, and digestive issues. It's like having waterlogged tissues that make everything feel heavy and slow. Common signs include a thick, greasy tongue coating, sticky mouth sensation, and stools that are difficult to flush.

Damp-Heat
How it presents with abnormal uterine bleeding

bleeding between periods, intermenstrual bleeding, mid cycle bleeding, Irregular menstruation

Along with: Fever, Neck gland swelling, Headaches, Tight feeling in chest and stomach, Sticky taste in the mouth, Absence of thirst,

Traditional Herbal Formulas
Damp-Heat in the Liver
How it presents with abnormal uterine bleeding

Midcycle bleeding, Irregular menstruation

Along with: Hypochondrial fullness and distention with pain alleviated by warmth, Abdominal fullness, Lower abdominal fullness, Bitter taste in the mouth, Sticky taste in the mouth, Loss of appetite,

Traditional Herbal Formulas
Damp-Phlegm in the Uterus
How it presents with abnormal uterine bleeding

oligomenorrhea

Along with: Late menstruation, Amenorrhea, Scanty menstruation, Lower abdominal pain, Abdominal heaviness, Stifling sensation in the chest,

Phlegm

Thick, sticky pathological fluid that obstructs body functions and can manifest anywhere in the body

Causes: oligomenorrhea, Irregular menstruation

2 variations documented
Onset Gradual
Location Local or systemic
Features Nodules/lumps • Heavy sensation • Mucus/expectoration • Mental confusion (if affecting mind)

Phlegm is both a pathological product and a pathogenic factor in Traditional Chinese Medicine. It results from impaired fluid metabolism when the body's transformative functions fail, particularly affecting the Spleen, Lungs, and Kidneys. Classical texts emphasize that "the Spleen is the source of phlegm production, while the Lungs are the storage vessel for phlegm."

Damp-Phlegm in the Uterus
How it presents with abnormal uterine bleeding

oligomenorrhea

Along with: Late menstruation, Amenorrhea, Scanty menstruation, Lower abdominal pain, Abdominal heaviness, Stifling sensation in the chest,

Blood Stagnation and Phlegm in the Uterus
How it presents with abnormal uterine bleeding

Irregular menstruation

Along with: Persistent uterine bleeding of purple or dark blood, Lower abdominal distension and pain that increases with pressure, Lower abdominal fibroids and cysts, Menstrual cramps, Irregular periods, Abdominal pain,

Traditional Herbal Formulas

Cold

Congeals body fluids, damages Yang Qi, and causes pain with fixed location

Causes: Irregular menstruation, Abnormal uterine bleeding

2 variations documented
Onset Sudden
Location Can be local or systemic
Features Aversion to cold • Prefers warmth • Pain relieved by heat • Tight/contracted feeling

Cold is the predominant pathogenic factor of winter in Traditional Chinese Medicine. Cold represents an environmental pathogen that, when excessive, causes disease characterized by its cold, congealing, and contracting nature. While Cold is the main pathogen of winter, it can cause illness in any season through exposure to cold temperatures, getting caught in rain, sweating followed by wind exposure, or excessive air conditioning.

Cold in the Uterus
How it presents with abnormal uterine bleeding

Irregular menstruation

Along with: Diarrhea, Loss of appetite, Generalized fatigue, General weakness, Thin vaginal discharge

Blood Stagnation in the Lower Burner caused by Cold
How it presents with abnormal uterine bleeding

Abnormal uterine bleeding

Along with: Abdominal masses, Lower abdominal pain, Lower abdominal distension, Lower back pain, Menstrual cramps, Dark menstrual clots,

Traditional Herbal Formulas

Herbal Formulas for Abnormal Uterine Bleeding

Traditional Chinese Medicine formulas used to address abnormal uterine bleeding

Xiao Yao San

Addresses these abnormal uterine bleeding patterns:

Qi Stagnation Blood Stasis Qi Deficiency Blood Deficiency

Chai Hu Shu Gan San

Addresses these abnormal uterine bleeding patterns:

Blood Stasis Qi Stagnation

Liang Di Tang

Addresses these abnormal uterine bleeding patterns:

Heat Yin Deficiency

Shao Fu Zhu Yu Tang

Addresses these abnormal uterine bleeding patterns:

Blood Stasis Cold Qi Stagnation

Si Wu Tang

Addresses these abnormal uterine bleeding patterns:

Blood Stasis Qi Stagnation Blood Deficiency Qi Deficiency

Bu Zhong Yi Qi Tang

Addresses these abnormal uterine bleeding patterns:

Qi Deficiency

Er Zhi Wan

Addresses these abnormal uterine bleeding patterns:

Yin Deficiency Heat

Ge Xia Zhu Yu Tang

Addresses these abnormal uterine bleeding patterns:

Blood Stasis Qi Stagnation

Gui Pi Tang

Addresses these abnormal uterine bleeding patterns:

Qi Deficiency Blood Deficiency