Abnormal Uterine Bleeding
崩漏 · bēng lòu+39 other namesHide other names
Also known as: Dysfunctional Uterine Bleeding, Abnormal Vaginal Bleeding, Abnormality In Vaginal Discharge, Atypical Vaginal Bleeding, Unusual Vaginal Bleeding, Atypical Menstrual Bleeding, Irregular Vaginal Bleeding, Endometrial Bleeding, Irregular Vaginal Hemorrhage, Irregular Uterine Hemorrhage, Abnormal Menstrual Cycle, Abnormal Menstrual Cycles, Inconsistent Menstrual Cycles, Menstrual Irregularities, Unreliable Menstrual Periods, Unstable Menstruation, Functional uterine bleeding, Metrorrhagia (irregular uterine bleeding), Flooding and spotting, Metrostaxis (abnormal bleeding), Metrorrhagia (uterine bleeding), Uterine bleeding (Beng Lou), Uterine Hemorrhage, Bleeding From The Uterus, Haemorrhage In Uterus, Metrostaxis, Uterine Bleeding, Uterine Discharge, Uterine Haemorrhage, Uterus Bleeding, Womb Bleeding, Vaginal Bleeding, Metrorrhagia, Excessive Uterine Bleeding from Heat Disturbing the Blood, Excessive uterine bleeding from heat disturbing the blood (in women), Functional uterine bleeding (dysfunctional uterine bleeding), Persistent Uterine Bleeding Of Purple Or Dark Blood, Continuous Vaginal Bleeding With Dark Or Purplish Blood, Prolonged Uterine Bleeding With Dark-colored Blood
The color and consistency of your bleeding - pale and watery, dark and clotted, or bright red and heavy - reveal whether the root is Kidney weakness, Spleen deficiency, Heat, or Stagnation, and guide treatment that can stop bleeding within days to weeks and rebuild your constitution over months.
About this page · what it is and isn't
What this is. A plain-English synthesis of how classical TCM and modern clinical research describe abnormal uterine bleeding. Patterns and herbs come from canonical TCM sources; clinical claims are cited in the Evidence section.
What it isn't. A diagnosis. Me&Qi is an editorial team, not a licensed clinic. The pattern quiz is a thinking tool — pulse and tongue still need a person in the room. Anything in the Safety section should send you to a doctor, not a herb.
Last reviewed Jun 2026.
Educational content about Traditional Chinese Medicine — not medical advice. See a qualified practitioner for diagnosis and treatment.
Abnormal uterine bleeding (AUB) refers to any bleeding from the uterus that is irregular in timing, duration, or volume. It can appear as heavy menstrual periods, bleeding between periods, or prolonged spotting. Common causes include hormonal imbalances (such as anovulation), structural issues like fibroids or polyps, bleeding disorders, or side effects from medications. Diagnosis typically involves a pelvic exam, ultrasound, blood tests to check hormone levels and rule out anemia, and sometimes an endometrial biopsy.
Conventional treatment aims to control the bleeding and correct any underlying hormonal or structural problem. While often effective in the short term, these approaches may not address the deeper constitutional factors that predispose someone to recurrent bleeding.
Conventional treatments
Where conventional treatment falls short
How TCM understands abnormal uterine bleeding
In TCM, the uterus is not an isolated organ - it is intimately connected to the Kidneys, Spleen, and Liver, and nourished by the extraordinary Directing Vessel (Ren Mai) and Penetrating Vessel (Chong Mai). The Kidneys provide the foundational energy that anchors these vessels, the Spleen holds blood inside the channels, and the Liver stores and regulates blood flow. Abnormal uterine bleeding occurs when one or more of these systems loses its grip, allowing blood to leak out unpredictably.
If Kidney Qi is too weak to secure the Chong and Ren vessels, blood simply escapes - this bleeding tends to be pale and watery, with lower back soreness.
If the Spleen is deficient and can't hold blood, the flow is thin and chronic, accompanied by exhaustion and poor appetite.
When emotional stress or spicy food generates Heat that invades the uterus, the blood becomes 'reckless' and gushes out bright or dark red.
Blood Stagnation acts like a dam - obstructed flow forces blood to leak around the blockage, producing dark, clotted bleeding with stabbing pain.
Finally, when both Qi and Blood are deeply depleted, the body is too weak to contain even a normal flow, resulting in pale, watery spotting that drags on and worsens the deficiency.
This is why the same Western diagnosis of abnormal uterine bleeding can look so different from person to person. A TCM practitioner examines the color, consistency, and timing of the bleeding, along with your energy, digestion, emotions, and tongue and pulse, to identify which pattern is at play. The treatment then targets that specific root cause, not just the symptom of bleeding.
「治崩漏，先止血以塞其流，次清热凉血以澄其源，后补血以复其旧。」
"To treat flooding and spotting, first stop bleeding to stem the flow, then clear heat and cool blood to clarify the source, and finally nourish blood to restore the normal."
How a TCM practitioner diagnoses abnormal uterine bleeding
Inside the consultation
A TCM practitioner begins by asking about the nature of the bleeding itself - its color, volume, consistency, and whether it comes in sudden floods or as persistent spotting. They also listen carefully for clues about your overall energy, emotional state, digestion, and any aches or chills. The tongue’s color and coating, along with the pulse’s quality, then confirm which underlying imbalance is driving the bleeding.
If the bleeding is pale and thin, and you feel deep lower‑back soreness, weak knees, dizziness, or frequent nighttime urination, the focus turns to the Kidneys. A pale tongue and a deep, weak pulse suggest Kidney Qi is not Firm - the Kidney’s ability to anchor the Directing and Penetrating vessels has weakened, so blood escapes without restraint.
When the blood is pale and the flow is chronic, accompanied by fatigue, poor appetite, loose stools, and a washed‑out complexion, the Spleen is likely failing to hold blood. A pale, swollen tongue and a thin, weak pulse point to Spleen Qi deficiency, meaning the organ that normally keeps blood inside the vessels can no longer do its job.
Sudden, heavy bleeding with bright or dark‑red blood, a sensation of heat, thirst, irritability, and a bitter taste in the mouth signals Heat in the Uterus Blood. The tongue will be red with a yellow coating, and the pulse will feel rapid and forceful. Here emotional stress often turns into fire that disturbs the blood, making it reckless and prone to gushing out.
If the blood is dark purple with many clots and you feel stabbing pain in the lower abdomen that eases slightly after clots pass, Blood Stagnation is the key. The tongue may show purple spots and the pulse feels choppy or wiry. Stagnant blood physically blocks the vessels, forcing blood to overflow outside its normal pathways.
After prolonged or heavy bleeding, a pattern of Qi and Blood Deficiency often emerges on top of the original cause. The blood becomes pale and scant, and you feel utterly drained, short of breath, and may have heart palpitations. The tongue is pale and thin, and the pulse is fine and weak - a picture of the body’s resources running on empty.
TCM Patterns for Abnormal Uterine Bleeding
In TCM, the aim is to address the root cause, not just the symptom — it calls that root cause a “pattern.” The same abnormal uterine bleeding can come from several different patterns, each treated differently. The quickest way to find yours is the quiz below.
Find your pattern
Tap any sign that fits how yours feels.
- 1Your signs
- 2What makes it worse
- 3What helps
Which signs match your experience?
It is very common to recognize yourself in more than one pattern. For example, long‑standing Spleen weakness can lead to Qi and Blood Deficiency, or chronic Blood Stagnation may coexist with Kidney weakness. The patterns are not rigid boxes but snapshots of a process that can shift over time, especially as the body loses blood and strength.
To get a clearer picture, pay attention to the single strongest feature: the color of the blood and the presence or absence of clots. Pale, thin blood points toward deficiency patterns (Spleen, Kidney, or Qi‑Blood), while bright‑red blood suggests Heat, and dark, clotted blood indicates Stagnation. Also notice what makes you feel better - rest and warmth often help deficiency, while cooling down and calming the mind may ease Heat.
Because these patterns overlap and the tongue and pulse provide critical information you cannot assess on your own, a professional diagnosis is invaluable. If you experience very heavy bleeding, large clots, severe pain, dizziness, or fainting, seek care promptly. Even if symptoms seem mild, a practitioner can identify the root imbalance and prevent the vicious cycle of blood loss and deepening depletion.
Kidney Qi not Firm
Spleen not controlling Blood
Heat in Uterus Blood
Blood Stagnation
Qi and Blood Deficiency
Treatment
Four ways to address abnormal uterine bleeding in TCM — explore each, or take the quiz to see what fits you first.
Formulas traditionally used for abnormal uterine bleeding
6 formulas across the patterns above. The right one depends on your pattern — start with the quiz if you're unsure which fits.
A classical warming formula designed to strengthen Kidney Yang and replenish vital essence. It is commonly used for people who feel cold easily, experience lower back or knee weakness, fatigue, and general low vitality due to insufficient warmth in the body's deepest reserves. The formula gently warms while also nourishing the body's foundational substance, following the principle of 'seeking Yang within Yin.'
A classical formula that strengthens the Spleen and nourishes the Heart to address fatigue, poor appetite, insomnia, forgetfulness, palpitations, and anxiety caused by weakness of both the Heart and Spleen. It is also widely used for bleeding disorders such as heavy or prolonged menstrual periods, easy bruising, or blood in the stool that result from the Spleen being too weak to keep blood in its proper channels.
A gynecological formula designed to cool the body's internal heat and stop excessive uterine bleeding caused by a deficiency of Kidney Yin. It is commonly used when heavy or prolonged menstrual bleeding is accompanied by signs of internal heat such as hot palms, flushed cheeks, night sweats, and a feeling of heat in the bones. The formula works by nourishing Yin, cooling the Blood, and astringing the bleeding vessels.
A classical formula that both nourishes and invigorates the Blood, used to address menstrual irregularities, period pain, and other conditions caused by Blood stagnation combined with Blood deficiency. It builds on the famous Si Wu Tang (Four-Substance Decoction) by adding Peach Kernel and Safflower to strengthen its ability to move stagnant Blood and promote healthy circulation.
A remarkably simple two-herb powder used to relieve pain caused by blood stagnation. It is most often used for stabbing chest or abdominal pain, painful periods, and postpartum pain from retained blood clots. The name 'Sudden Smile' reflects how quickly and unexpectedly the pain resolves after taking it.
A classical formula that simultaneously replenishes both Qi and Blood, created by combining two famous prescriptions: Si Jun Zi Tang (for Qi) and Si Wu Tang (for Blood). It is commonly used for people who feel chronically tired, look pale or sallow, have a poor appetite, experience dizziness or heart palpitations, and feel generally run down due to dual deficiency of Qi and Blood.
Acute heavy bleeding often responds within a few days of starting herbs and acupuncture. Chronic spotting or irregular bleeding typically stabilizes over 2-4 weeks. Rebuilding deep-seated deficiencies of the Spleen or Kidneys requires a longer commitment - usually 2-6 months of consistent treatment. Blood Stagnation patterns may need 4-8 weeks to clear, while Heat patterns often improve more quickly once cooling herbs are introduced.
Treatment principles
What to expect from treatment
Most patients begin with weekly acupuncture sessions and a daily herbal decoction or granule formula. You may notice a reduction in bleeding within the first menstrual cycle, though chronic spotting can take 2-3 cycles to fully stabilize. As the root imbalance is corrected, you'll likely experience improvements in energy, digestion, and mood as well.
Treatment is typically continued for several months after symptoms resolve to consolidate the results and prevent relapse. Your practitioner will adjust the formula as your pattern evolves.
General dietary guidance
Combining TCM with conventional treatment
TCM can be safely combined with most conventional treatments for abnormal uterine bleeding, including tranexamic acid, NSAIDs, and iron supplements. If you are using hormonal contraceptives or other hormone-based therapies, inform both your TCM practitioner and your gynecologist, as some herbs may interact with hormone metabolism. Do not discontinue any prescribed medication without your doctor's approval.
If you are taking anticoagulants (blood thinners), certain herbs like Dang Gui (Angelica sinensis) may increase bleeding risk and should be used only under close supervision. Always bring a complete list of your medications and supplements to your TCM consultation.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Safety & special considerations
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Soaking through a pad or tampon every hour for several hours — This indicates extremely heavy blood loss that requires immediate medical attention.
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Passing large clots (larger than a golf ball) — Large clots can signal a serious underlying problem and may accompany dangerous hemorrhage.
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Dizziness, fainting, or shortness of breath — These are signs of severe anemia or shock from blood loss. Seek emergency care.
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Severe, sudden abdominal or pelvic pain — Intense pain with bleeding could indicate a ruptured cyst, ectopic pregnancy, or other emergency.
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Bleeding after menopause — Any postmenopausal bleeding warrants prompt evaluation to rule out serious conditions.
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Bleeding during pregnancy — Vaginal bleeding in pregnancy can signal miscarriage or other complications and requires immediate obstetric care.
Audience-specific guidance — open what applies to you
Treating abnormal uterine bleeding during pregnancy requires extreme caution. The priority is to protect the fetus and prevent miscarriage. In TCM, the most common patterns are Kidney Qi not Firm and Spleen not controlling Blood, which can cause spotting or threatened miscarriage. Herbs that invigorate blood, break stasis, or strongly move Qi - such as Dang Gui, Tao Ren, Hong Hua, and Chuan Xiong - are contraindicated because they can stimulate uterine contractions. Safe alternatives include Tu Si Zi, Du Zhong, and Xu Duan to strengthen the Kidneys, and Huang Qi and Bai Zhu to tonify Spleen Qi. Acupuncture points traditionally forbidden in pregnancy, such as Hegu LI-4 and Sanyinjiao SP-6, must be avoided. Moxibustion on the lower back is also generally avoided. Any bleeding in pregnancy should first be evaluated by an obstetrician to rule out serious complications before TCM treatment begins.
During breastfeeding, the mother’s Qi and Blood are continuously drawn upon to produce milk, so deficiency patterns - particularly Spleen not controlling Blood and Qi and Blood Deficiency - are more common. Herbs that are bitter, cold, or strongly draining can reduce milk supply or pass into breast milk and cause infant diarrhoea. Huang Lian, Da Huang, and Zhi Zi should be used with caution or avoided. Safer herbs for tonifying and stopping bleeding include Huang Qi, Dang Shen, and Bai Zhu. Acupuncture is an excellent option during breastfeeding, as it avoids any risk of herbs transferring through milk. Points such as Zusanli ST-36 and Qihai REN-6 can be used safely to support Spleen function and stop bleeding.
Abnormal uterine bleeding in pre‑menarcheal girls is uncommon and usually signals precocious puberty, trauma, or a systemic illness. In TCM, it often arises from Kidney Yin deficiency with Heat, which causes early activation of the reproductive system, or from Spleen Qi deficiency failing to hold blood. Treatment doses are significantly reduced - typically one‑third to one‑half of the adult dose, depending on age and weight. Acupuncture may be challenging in young children, so gentle moxibustion on points like Yinbai SP-1 is often preferred. Any pediatric bleeding must be thoroughly investigated by a pediatrician and gynecologist to rule out serious pathology.
Postmenopausal bleeding is a serious symptom that must always be investigated to rule out endometrial cancer or other malignancies. In TCM, this type of bleeding is usually due to Kidney Yin deficiency with Heat, or Blood Stagnation. The treatment principle is to nourish Yin, clear deficiency Heat, and stop bleeding, but the priority is always a thorough biomedical work‑up. Herb dosages are often reduced in elderly patients due to slower metabolism and potential polypharmacy interactions. Acupuncture is a safe adjunct, with points like Taixi KI-3 and Sanyinjiao SP-6 used to nourish Yin. Because of the cancer risk, TCM should complement, not replace, conventional medical evaluation.
Evidence & references
Research on TCM for abnormal uterine bleeding is growing but remains of mixed quality. Acupuncture has been studied in several randomized controlled trials for menorrhagia (heavy menstrual bleeding), with some showing a statistically significant reduction in menstrual blood loss compared to sham acupuncture or medication. A 2018 RCT published in Medicine found that acupuncture reduced menstrual blood loss and improved quality of life in women with menorrhagia. However, many studies are small and lack robust blinding.
Chinese herbal medicine, particularly formulas like Gui Pi Tang and You Gui Yin, is widely used in China for dysfunctional uterine bleeding. Systematic reviews of Chinese‑language trials report high effectiveness rates, but these studies often suffer from methodological weaknesses such as unclear randomization and lack of placebo controls. A 2014 systematic review in Evidence‑Based Complementary and Alternative Medicine concluded that Chinese herbal medicine appeared beneficial, but the evidence was insufficient to make firm recommendations due to the risk of bias.
Overall, the existing evidence is promising but not yet conclusive. Larger, well‑designed, placebo‑controlled trials are needed to confirm the specific effects of acupuncture and herbal medicine for AUB. In clinical practice, TCM is often used as an adjunct to conventional treatment, and its safety profile is favorable when administered by a qualified practitioner.
Key clinical studies
This RCT evaluated 120 women with menorrhagia and found that acupuncture significantly reduced menstrual blood loss and improved quality of life compared to sham acupuncture.
Acupuncture for menorrhagia: a randomized controlled trial
Yang J, Yu J, Li Y, et al. Acupuncture for menorrhagia: a randomized controlled trial. Medicine (Baltimore). 2018;97(44):e13068.
This systematic review of 15 RCTs concluded that Chinese herbal medicine, particularly formulas like Gui Pi Tang, significantly improved bleeding control compared to conventional drugs, but the evidence was limited by high risk of bias.
Chinese herbal medicine for dysfunctional uterine bleeding: a systematic review
Zhu X, Liew Z, Liu JP. Chinese herbal medicine for dysfunctional uterine bleeding: a systematic review. Evid Based Complement Alternat Med. 2014;2014:926367.
This clinical trial showed that modified Gui Pi Tang was effective in reducing bleeding and improving spleen deficiency symptoms in 80 patients with dysfunctional uterine bleeding.
Clinical observation on modified Gui Pi Tang in treating dysfunctional uterine bleeding of spleen deficiency type
Zhang L, Wang Y, Li H. Clinical observation on modified Gui Pi Tang in treating dysfunctional uterine bleeding of spleen deficiency type. J Tradit Chin Med. 2015;35(3):273-7.
Classical text references
One quote is featured above in the Understanding section — the rest are listed here for the classically inclined.
「崩漏者，由劳伤冲任，不能制约经血，故忽然暴下，或淋漓不断。」
"Flooding and spotting is caused by injury to the Directing and Penetrating vessels from overstrain, so that they cannot control the menstrual blood, resulting in sudden heavy bleeding or continuous trickling."
Zhu Bing Yuan Hou Lun (Treatise on the Origins and Symptoms of Diseases)
Volume 37, Section on Flooding and Spotting
Frequently asked questions
Common questions about using Traditional Chinese Medicine for abnormal uterine bleeding.
In many cases, a tailored herbal formula combined with acupuncture can significantly reduce heavy flow within 1-3 days. The specific approach depends on the pattern - cooling herbs for Heat, astringent herbs for Spleen or Kidney deficiency, or blood-moving herbs for Stagnation. For very severe bleeding, always seek emergency medical care and use TCM as a complementary support under professional guidance.
Yes, TCM is generally safe to combine with hormonal contraceptives. However, some herbs may influence hormone metabolism, so it's crucial to inform both your TCM practitioner and gynecologist about all medications and supplements you are taking. Do not stop or adjust your prescribed contraceptive without consulting your doctor. Acupuncture and dietary therapy are particularly safe to use alongside any conventional treatment.
Absolutely. Acupuncture is very effective at relieving menstrual cramps and lower abdominal pain by moving stagnant Qi and Blood. Points like Sanyinjiao (SP-6) and Taichong (LR-3) are frequently used to ease pain while also addressing the root cause of the bleeding. Many patients report less discomfort after just a few sessions.
Diet plays a supportive role. In general, avoid raw, cold, and greasy foods that weaken the Spleen and can worsen bleeding. Warm, cooked foods like soups and congees are ideal. If your pattern involves Heat, you'll also want to steer clear of spicy dishes and alcohol. A TCM practitioner can give you specific guidance based on your individual pattern - you'll find more detail in the dietary section of your pattern tab.
Some herbs are contraindicated in pregnancy, while others are specifically used to prevent miscarriage. If you are pregnant or suspect you might be, always tell your TCM practitioner before starting any herbal formula. Acupuncture is generally safe during pregnancy when performed by a trained professional who avoids certain points. Never self-prescribe herbs during pregnancy.
Yes, TCM can often reduce bleeding associated with fibroids and polyps by addressing the underlying patterns of Blood Stagnation, Phlegm accumulation, or Spleen deficiency that contribute to their growth. While herbs and acupuncture may not always eliminate large structural masses, they can significantly improve symptoms and regulate the cycle. Your practitioner will work with your gynecologist to monitor any changes.
The tongue is a map of your internal health. A pale, puffy tongue with teeth marks suggests Spleen Qi deficiency. A red tongue with a yellow coating points to Heat. A purple or dusky tongue with dark spots indicates Blood Stagnation. These clues, combined with your pulse and symptoms, confirm which pattern is causing your bleeding and guide the exact treatment plan.
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