Abnormal uterine bleeding according to Chinese Medicine

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Abnormal uterine bleeding factsheet

Chinese name: 崩漏

Pinyin name: Bēng Lòu

Possible causes and remedies:

In TCM, abnormal uterine bleeding is called 'Beng Lou' which is more precise than the Western term. 'Beng (崩)' means 'Flood' in Chinese and it refers to a sudden heavy periods, which often starts before the expected time. 'Lou(漏)' means 'trickling, dripping or leaking' and it indicates a continuous blood trickling even though the menstruation should have ended. In other words it means periods which start heavy and early and continue with an intermittent trickling of blood when they should have stopped.  

Abnormal uterine bleeding should be differentiated from other menstrual conditions such as heavy menstruation, early menstruation, abnormally long menstruation, irregular menstruation or intermenstrual bleeding. The patterns behind all those diseases are similar, but abnormal uterine bleeding is a much more severe gynecological condition and it takes a much longer time to recover. 

The pathology of abnormal uterine bleeding often varies according to patients' age. For post-puberty girls, hereditary Kidney Deficiency may be the main cause. For young women, Blood Heat created by Liver Fire is commonly seen. For premenopausal women, Liver and Kidney Yin Deficiency are the major reasons. 

As you can see below we've detailed for you the four "patterns of disharmony" associated with abnormal uterine bleeding. 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 abnormal uterine bleeding can be explained by four 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 twelve formulas that can help treat the various patterns that cause abnormal uterine bleeding, depending on which pattern fits your profile.

The four "patterns of disharmony" associated with abnormal uterine bleeding

Milkvetch Roots (Huang Qi) is the key herb for Bu Zhong Yi Qi Tang, a formula used for Qi Deficiency

Qi Deficiency

The pathology of abnormal uterine bleeding is a bit similar to that of spontaneous flow of breast milk. A key cause is that Qi is not strong enough to hold Body Fluids - be they breast milk or menstruation blood - so the Fluids flow out unwantedly. Since this is an Deficient type of bleeding, it is characterized by flooding at the beginning of the period, which then stops and continues with dripping after the periods end. A pale red blood color is a typical symptom. 

The Spleen is the major Organ involved in this pattern because its role is to 'transform and transport' food and drinks, extracting Grain Qi (Gu Qi) out of them, and distributing them to other Organs and Blood vessels. Malfunction of the Spleen causes general Qi Deficiency. It also controls the raising of Qi. In addition to the Spleen, the Lungs are also often involved in Qi Deficiency. Physical overwork and chronic illness can weaken both the Spleen and the Lungs.

Many herbs can tonify and strengthen Qi so as to stop bleeding. Astragalus is one of the most effective. The treatment principle is to tonify Qi, strengthen the Spleen, nourish Blood and stop bleeding.

Read more about Qi Deficiency here

Peach Kernels (Tao Ren) is the key herb for Tao Hong Si Wu Tang, a formula used for Blood Stagnation

Blood Stagnation

Pulse type(s): Choppy (Se), Wiry (Xian)

Tongue color: Reddish-Purple

Recommended herbal formulas: Tao Hong Si Wu Tang, Shi Xiao San

Symptoms: Dark face Hesitant periods Premenstrual pain Dark colored blood Dark clots in menstrual blood Abdominal distention and fullness

The Blood Stagnation type of abnormal uterine bleeding is characterized by dark clots and dark menstruation color. The periods are unpredictable as they seem to stop but then start again trickling for a while or even with a flood. There is often premenstrual pain as well.

The pathology is that the stagnant Blood accumulates in the Uterus and the vessels. Therefore the newly-created Blood has no place to go and spills out. Women just went through childbirth often experience Blood Stagnation and suffer from the above symptoms. 

The treatment principle is to invigorate Blood, eliminate Stagnation and stop bleeding. There are many herbs specializing in invigorating Blood and removing Stagnation. However, it is better to use the ones that also stop bleeding such as Cattail pollenTienchi ginsengMotherwort herbsSafflowers or Peach kernels

Read more about Blood Stagnation here

Goji Tree Root Bark (Di Gu Pi) is the key herb for Qing Jing San, a formula used for Heat in the Blood

Heat in the Blood

Pulse type(s): Overflowing (Hong), Rapid (Shu), Empty (Xu), Fine (Xi), Floating (Fu)

Tongue coating: Complete absence of coating, Yellow coating

Tongue color: Red

Recommended herbal formulas: Qing Jing San, Long Dan Xie Gan Tang, Liang Di Tang, Di Gu Pi Yin

Symptoms: Thirst Red face Dark Urine Dry stools Malar flush Constipation Restlessness Heavy periods Scanty periods Feeling of heat Dark colored blood Pale color periods Thick menstrual blood Thin and watery periods Trickling blood after period Flooding suddenly before schedule

There are two types of Heat in the Blood that cause abnormal uterine bleeding: Full or Empty. Full Heat in the Blood often derives from Liver Fire or an external Heat Evil invasion, while the Empty type is mainly due to a prolonged lack of Yin which is a naturally cooling, its absence therefore leading to Heat.

The typical symptoms of the Full Heat type are heavy menstruations as well as a dark or bright red blood color. It can lead to sudden flooding before the periods and/or a trickling of blood after the periods. Liver Fire is often caused by long term emotional stress and it is a main reason behind abnormal bleeding of the Excess type in gynecological problems. It is because the Liver stores Blood and it has great impact on the Directing and Penetrating Vessels as well as the Uterus. Apart from the Liver, emotional problems can also influence the Heart function and results in Heart Fire. The Heart governs the Bloods and it connects to the Uterus through the Uterus Channel. Heat in these two Organs agitates the Blood and it then becomes reckless and spills from the Blood vessels. 

Invasion of external Heat Evil is another reason for Full Blood Heat. It is mainly due to unhealthy diet such as over consumption of hot or spicy foods and alcohol. 

The typical symptoms of Empty Heat type are scanty menstruations before the starting time of the period and continuous dribbling after the periods end. The Blood color is a normal red or a light red. Possible causes are overwork or excessive sexual activity that can injure both Liver and Kidney Yin, resulting in Empty-type Blood Heat. Other reasons include long term Yin Deficiency or Yin injured by chronic Full Heat in the Blood which becomes Empty Heat eventually. If the latter is the case, the pathology is quite complicated as patients may have symptoms of both Full and Empty Heat. 

The treatment principle for Full Blood Heat is to clear Heat, cool Blood and stop bleeding. To clear Heat and drain Fire, Cape jasmine fruitsGypsum , Baikal skullcap roots, or Goldthread rhizomes are used to stop bleeding. To clear Heat and cool Blood, Unprepared RehmanniaRed peony roots, or Mudan peony bark are the most used. Qing Jing San and Long Dan xie Gan Wan are the most recommended formulas. 

For Empty Heat in the Blood, in addition to clearing Empty Heat, cooling Blood and stopping the bleeding, it is also important to nourish Yin. Eclipta herb and Sweet wormwood are the two herbs often used. Liang Di Tang and Di Gu Pi Yin are formulas that are typically recommended.

Read more about Heat in the Blood here

The Kidneys is a so-called "Zang" Organ. Learn more about the Kidneys in Chinese Medicine

Kidney Deficiency

Kidney Deficiency is one of the major causes of abnormal uterine bleeding. The Kidneys can be lacking of either Kidney Yang or Yin or both at the same time. Women who have experienced long childbirth and lost a large amount of blood are most susceptible to this pattern. 

In case of Kidney Yang (or Qi) Deficiency, the Directing and Penetrating Vessels can not contain Blood as they're supposed to and thus the Blood leaks. For younger girls, it can be due to hereditary Kidney weakness. While for older women, it is more due to the natural declining of Kidney Qi, especially during their menopause. The herbs most used to tonify the Kidney Yang and Qi are Japanese teasel root and Eucommia bark. The treatment principle is to tonify and warm the Kidneys, strengthen the Directing and Penetrating Vessels and stop bleeding.

As for Kidney Yin Deficiency, there are two reasons why it leads to abnormal uterine bleeding. The obvious one is that Kidney Yin is not able to hold Blood in the vessels and thus the Blood leaks out. The less obvious one is that Yin Deficiency can cause Empty Heat in the Blood, which makes Blood reckless and spill out of the vessels. The herbs often used for Kidney Yin Deficiency are Glossy privet fruits and Eclipta herb. The principle is to nourish Yin, strengthen the Kidneys and stop bleeding.

Read more about Kidney Deficiency here

The twelve herbal formulas that might help with abnormal uterine bleeding

Liang Di Tang

Source date: 1826 AD

Number of ingredients: 6 herbs

Key actions: Nourishes Yin. Cools Blood. Stop bleeding.

Why might Liang Di Tang help with abnormal uterine bleeding?

Because it is a formula often recommended to help with the patterns Heat in the Blood and Kidney Deficiency which are sometimes associated with abnormal uterine bleeding. 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).

Read more about Liang Di Tang here

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 abnormal uterine bleeding?

Because it is a formula often recommended to help treat Qi Deficiency, a pattern sometimes associated with abnormal uterine bleeding. If it looks like you might suffer from Qi Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Bu Zhong Yi Qi Tang here

Tao Hong Si Wu Tang

Source date: 1291 AD

Number of ingredients: 6 herbs

Key actions: Tonifies Blood and regulates the Liver. Moves Qi and Blood in the lower abdomen. Stops pain.

Why might Tao Hong Si Wu Tang help with abnormal uterine bleeding?

Because it is a formula often recommended to help treat Blood Stagnation, a pattern sometimes associated with abnormal uterine bleeding. If it looks like you might suffer from Blood Stagnation, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Tao Hong Si Wu Tang here

Gui Pi Tang

Source date: 1529 AD

Number of ingredients: 12 herbs

Key actions: Tonifies and nourish Qi and Blood. Tonifies Heart and Spleen.

Why might Gui Pi Tang help with abnormal uterine bleeding?

Because it is a formula often recommended to help treat Qi Deficiency, a pattern sometimes associated with abnormal uterine bleeding. If it looks like you might suffer from Qi Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Gui Pi Tang here

Gu Ben Zhi Beng Tang

Source date: 1826 AD

Number of ingredients: 6 herbs

Key actions: Tonifies Qi and Yang.

Why might Gu Ben Zhi Beng Tang help with abnormal uterine bleeding?

Because it is a formula often recommended to help treat Qi Deficiency, a pattern sometimes associated with abnormal uterine bleeding. If it looks like you might suffer from Qi Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Gu Ben Zhi Beng Tang here

Shi Xiao San

Source date: 1108 AD

Number of ingredients: 2 herbs

Key actions: Invigorates Blood. Dispels Blood Stagnation. Eases pain.

Why might Shi Xiao San help with abnormal uterine bleeding?

Because it is a formula often recommended to help treat Blood Stagnation, a pattern sometimes associated with abnormal uterine bleeding. If it looks like you might suffer from Blood Stagnation, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Shi Xiao San here

Qing Jing San

Source date: 1826 AD

Number of ingredients: 7 herbs

Key actions: Clears Blood-Heat. Stops bleeding.

Why might Qing Jing San help with abnormal uterine bleeding?

Because it is a formula often recommended to help treat Heat in the Blood, a pattern sometimes associated with abnormal uterine bleeding. If it looks like you might suffer from Heat in the Blood, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Qing Jing San here

Long Dan Xie Gan Tang

Source date: 1682 AD

Number of ingredients: 10 herbs

Key actions: Clears Heat and Fire from the Liver and Gallbladder. Clears and drains Damp-Heat from the Lower Burner.

Why might Long Dan Xie Gan Tang help with abnormal uterine bleeding?

Because it is a formula often recommended to help treat Heat in the Blood, a pattern sometimes associated with abnormal uterine bleeding. If it looks like you might suffer from Heat in the Blood, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Long Dan Xie Gan Tang here

Di Gu Pi Yin

Source date: 1742 AD

Number of ingredients: 6 herbs

Key actions: Clears Heat. Stops bleeding.

Why might Di Gu Pi Yin help with abnormal uterine bleeding?

Because it is a formula often recommended to help treat Heat in the Blood, a pattern sometimes associated with abnormal uterine bleeding. If it looks like you might suffer from Heat in the Blood, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Di Gu Pi Yin here

You Gui Wan

Source date: 1624 AD

Number of ingredients: 10 herbs

Key actions: Warms and tonifies Kidney Yang. Replenishes the Essence. Tonifies the Blood.

Why might You Gui Wan help with abnormal uterine bleeding?

Because it is a formula often recommended to help treat Kidney Deficiency, a pattern sometimes associated with abnormal uterine bleeding. If it looks like you might suffer from Kidney Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about You Gui Wan here

Zuo Gui Wan

Source date: 1624 AD

Number of ingredients: 8 herbs

Key actions: Nourishes the Yin. Strengthens the Kidneys. Fills the Essence. Augments the marrow.

Why might Zuo Gui Wan help with abnormal uterine bleeding?

Because it is a formula often recommended to help treat Kidney Deficiency, a pattern sometimes associated with abnormal uterine bleeding. If it looks like you might suffer from Kidney Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Zuo Gui Wan here

Er Zhi Wan

Source date: 1534 AD

Number of ingredients: 2 herbs

Key actions: Nourishes Liver Yin. Nourishes Kidney Yin.

Why might Er Zhi Wan help with abnormal uterine bleeding?

Because it is a formula often recommended to help treat Kidney Deficiency, a pattern sometimes associated with abnormal uterine bleeding. If it looks like you might suffer from Kidney Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Er Zhi Wan here