Amenorrhea in Traditional Chinese Medicine

Understanding different amenorrhea patterns according to TCM theory

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12
TCM Patterns
74
Formulas
Overview
What causes it 12 TCM patterns documented
How to recognize Symptoms specific to each amenorrhea pattern
Classical remedies 74 herbal formulas documented

From the lens of Traditional Chinese Medicine (TCM), amenorrhea isn't just an isolated symptom; it's a signal of deeper imbalances within the body's energy systems. TCM delves into the harmony of Qi (vital energy), Blood, Yin, and Yang, seeing amenorrhea as a result of disharmony among these elements.

The TCM approach prioritizes understanding the individual's unique pattern of disharmony—be it a Deficiency in Blood, a Stagnation of Qi, or an imbalance in Yin and Yang—to tailor a treatment that addresses the root cause, not just the symptoms.

TCM Patterns for Amenorrhea

Blood Deficiency

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

Causes: absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods, Amenorrhea, delayed periods, late periods, No period, No menstruation by 18

9 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.

Qi and Blood Deficiency
How it presents with amenorrhea

absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods

Along with: General weakness, Generalized fatigue, Weak voice, Pale face, Shortness of breath, Palpitations,

Blood Deficiency
How it presents with amenorrhea

Amenorrhea, delayed periods, late periods

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

Liver and Heart Blood Deficiency
How it presents with amenorrhea

Amenorrhea

Along with: Palpitations, Dizziness, Insomnia, Vivid dreaming, Poor memory, Anxiety,

Liver Blood Deficiency
How it presents with amenorrhea

Amenorrhea

Along with: Blurry vision, Dull pale complexion, Scanty menstruation, Limb numbness, Pale lips, Muscle weakness,

Pericardium Blood Deficiency
How it presents with amenorrhea

Amenorrhea

Along with: Chest distension, Chest stiffness, Chest pain, Palpitations, Insomnia, Poor memory

Traditional Herbal Formulas
Spleen Blood Deficiency
How it presents with amenorrhea

Amenorrhea

Along with: Loss of appetite, Generalized fatigue, General weakness, Pale face, Weak limbs, Diarrhea,

Traditional Herbal Formulas
Liver Wind agitating Internally due to Liver Blood Deficiency
How it presents with amenorrhea

No period

Along with: Fine tremor, Facial tic, Dizziness, Blurry vision, Limb numbness, Tingling of limbs,

Liver Blood and Kidney Essence Deficiency
How it presents with amenorrhea

Amenorrhea, absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods, No menstruation by 18

Along with: Primary amenorrhea, Lower back pain, Generalized fatigue, Knee pain, Dizziness, Depression,

Blood Deficiency and Stagnation
How it presents with amenorrhea

Amenorrhea

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

Traditional Herbal Formulas

Yin Deficiency

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

Causes: absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods, Amenorrhea

5 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.

Lung Yin Deficiency
How it presents with amenorrhea

absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods

Along with: Hoarse voice, Itchy throat, Dislike of speaking, Thin chest

Traditional Herbal Formulas
Heart Yin Deficiency
How it presents with amenorrhea

absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods

Along with: Night sweats, Feeling of uneasiness, Feeling of heat, Heat sensation in palms, Hysteria, Neurasthenia

Traditional Herbal Formulas
Kidney and Liver Yin Deficiency
How it presents with amenorrhea

absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods, Amenorrhea

Along with: Dizziness, Tinnitus, Hearing loss, Lower back pain, Vertical headaches, Occipital headache,

Liver Yin Deficiency
How it presents with amenorrhea

Amenorrhea

Along with: Dizziness, Limb numbness, Tingling of limbs, Insomnia, Blurry vision, Eye floaters,

Kidney-Deficiency
How it presents with amenorrhea

Amenorrhea

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

Blood Stasis

Blood that is no longer flowing smoothly through the vessels

Causes: absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods, Amenorrhea, Absence of menstruation

5 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.

Qi And Blood Stagnation
How it presents with amenorrhea

absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods, Amenorrhea

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

Blood Stagnation
How it presents with amenorrhea

Absence of menstruation

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

Spleen and Liver Blood Deficiency
How it presents with amenorrhea

Amenorrhea

Along with: Loss of appetite, Slight abdominal distension after eating, Generalized fatigue, General weakness, Dull pale complexion, Weak limbs,

Blood Deficiency and Stagnation
How it presents with amenorrhea

Amenorrhea

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

Traditional Herbal Formulas
Heat and Blood Stagnation in the Lower Burner
How it presents with amenorrhea

Amenorrhea

Along with: Lower abdominal pain, Nighttime fever, Incoherent or confused speech, Irritability, Restlessness, Thirst,

Traditional Herbal Formulas

Qi Deficiency

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

Causes: absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods, Amenorrhea

3 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 and Blood Deficiency
How it presents with amenorrhea

absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods

Along with: General weakness, Generalized fatigue, Weak voice, Pale face, Shortness of breath, Palpitations,

Qi Deficiency
How it presents with amenorrhea

Amenorrhea

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

Traditional Herbal Formulas
Spleen Deficiency
How it presents with amenorrhea

Amenorrhea

Along with: Sticky vaginal discharge, Generalized fatigue, Depression, Cold extremities, Diarrhea, White vaginal discharge,

Essence Deficiency

Depletion of the fundamental substance governing growth, development, reproduction, and aging

Causes: Primary amenorrhoea, Amenorrhea, absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods, No menstruation by 18

2 variations documented
Onset Very gradual
Location Systemic, especially Kidney
Features Developmental issues • Premature aging • Weak bones/teeth • Poor growth/fertility

Essence Deficiency is a fundamental pattern category in Traditional Chinese Medicine involving insufficient Jing (精), the vital substance that governs human growth, development, reproduction, and the aging process. Jing forms the material foundation of life itself, stored primarily in the Kidneys, and manifests throughout the body as the source of constitutional strength and vitality.

Kidney Essence Deficiency
How it presents with amenorrhea

Primary amenorrhoea

Along with: Deafness, Decreased mental sharpness, Retardation, Osteomalacia, Hair loss, Lower back pain,

Liver Blood and Kidney Essence Deficiency
How it presents with amenorrhea

Amenorrhea, absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods, No menstruation by 18

Along with: Primary amenorrhea, Lower back pain, Generalized fatigue, Knee pain, Dizziness, Depression,

Qi Stagnation

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

Causes: absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods, Amenorrhea, delayed periods, late periods

2 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 amenorrhea

absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods, Amenorrhea

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

Qi Stagnation
How it presents with amenorrhea

delayed periods, late periods

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

Cold

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

Causes: No period, Amenorrhea, delayed periods, late periods

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 amenorrhea

No period, Amenorrhea, delayed periods, late periods

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

Empty-Cold
How it presents with amenorrhea

No period

Along with: Chills, Cold extremities, Pale face, Absence of thirst, Apathy, Excessive sweating,

Phlegm

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

Causes: absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods, Amenorrhea, delayed periods, late periods

1 variation 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 amenorrhea

absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods, Amenorrhea, delayed periods, late periods

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

Yang Deficiency

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

Causes: Absence of menstruation, delayed periods, late periods

1 variation 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 amenorrhea

Absence of menstruation, delayed periods, late periods

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

Traditional Herbal Formulas

Dampness

Heavy, sticky moisture that obstructs body functions and creates sluggishness

Causes: absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods, Amenorrhea, delayed periods, late periods

1 variation 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-Phlegm in the Uterus
How it presents with amenorrhea

absence of menstruation, amenorrhoea, no menstruation, no periods, absence of periods, Amenorrhea, delayed periods, late periods

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

Heat

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

Causes: Amenorrhea

1 variation 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 and Blood Stagnation in the Lower Burner
How it presents with amenorrhea

Amenorrhea

Along with: Lower abdominal pain, Nighttime fever, Incoherent or confused speech, Irritability, Restlessness, Thirst,

Traditional Herbal Formulas

Wind

Causes sudden symptoms, movement disorders, and serves as the vehicle for other pathogens

Causes: No period

1 variation documented
Onset Sudden
Location Often upper body/exterior
Features Rapid onset • Moving/migrating symptoms • Itching • Symptoms change location

Wind is the predominant pathogenic factor of spring in Traditional Chinese Medicine and is considered the leader of the six external pathogens. Wind is described as "the leader of the hundred diseases" (百病之长), serving as the primary factor in external pathogenic invasions. Wind represents a pathogen characterized by constant movement, changeability, and a tendency to affect the upper and outer portions of the body.

Liver Wind agitating Internally due to Liver Blood Deficiency
How it presents with amenorrhea

No period

Along with: Fine tremor, Facial tic, Dizziness, Blurry vision, Limb numbness, Tingling of limbs,

Herbal Formulas for Amenorrhea

Traditional Chinese Medicine formulas used to address amenorrhea

Si Wu Tang

Addresses these amenorrhea patterns:

Yin Deficiency Blood Deficiency Blood Stasis Wind Cold

Gui Pi Tang

Addresses these amenorrhea patterns:

Blood Deficiency Qi Deficiency Blood Stasis

Bu Gan Tang

Addresses these amenorrhea patterns:

Blood Deficiency Yin Deficiency Wind

Bu Zhong Yi Qi Tang

Addresses these amenorrhea patterns:

Blood Deficiency Qi Deficiency Phlegm Dampness

Liu Wei Di Huang Wan

Addresses these amenorrhea patterns:

Blood Deficiency Essence Deficiency Yin Deficiency

Suan Zao Ren Tang

Addresses these amenorrhea patterns:

Blood Deficiency Yin Deficiency

Zuo Gui Wan

Addresses these amenorrhea patterns:

Yin Deficiency Essence Deficiency

Chai Hu Shu Gan San

Addresses these amenorrhea patterns:

Blood Stasis Qi Stagnation

Dan Shen Yin

Addresses these amenorrhea patterns:

Blood Stasis Qi Stagnation