Absence of menstruation according to Chinese Medicine

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Absence of menstruation factsheet

Chinese name: 闭经

Pinyin name: Bì Jīng

Possible causes and remedies:

Absence of menstruation is a condition where there is no monthly bleeding when there should be. It is referred to as amenorrhea in Western medicine term and it is called '闭经‘(Bi Jing) in Traditional Chinese Medicine. 'Jing' refers to menstruation while 'Bi' means 'closed', 'shut' or something that is blocked. As the name indicates, it is a pathological condition as opposed menopause which is not pathological. No periods is often developed from late menstruation or scanty menstruation. It is the opposite of flooding and Leaking

Western medicine has divided amenorrhea into two categories: primary or secondary. This concept has been adopted by modern TCM. Primary Amenorrhea happens to these girls who have not yet menstruated by the time they've reached 18 years old. Secondary refers to women who have had periods but haven't any cycle for more than 3 months. Obviously, we rule out the special circumstances of pregnancy or breastfeeding after birth giving when it is absolutely normal not to have menstruation. Sometimes, sudden habit or environment change can also leads to absence of periods for 1 or 2 months and it should not be considered as pathological condition. 

From a TCM point of view, two categories of patterns have to be distinguished for treating absence of periods. First are these Deficiency related patterns such as Qi and Blood Deficiency or Liver and Kidney Deficiency. In this case, the body doesn't produce enough Blood to fill the Uterus. The second category includes these Excess patterns such as Qi and Blood Stagnation or accumulation of Dampness and Phlegm. Under this circumstance, the free flow of Blood is restrained.

As you can see below we've detailed for you the seven "patterns of disharmony" associated with absence of menstruation. 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 absence of menstruation can be explained by seven 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 twenty one formulas that can help treat the various patterns that cause absence of menstruation, depending on which pattern fits your profile.

The seven "patterns of disharmony" associated with absence of menstruation

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

Heart Yin Deficiency

Pulse type(s): Rapid (Shu), Empty (Xu)

Tongue coating: Complete absence of coating

Tongue color: Red

Recommended herbal formula: Tian Wang Bu Xin Dan

Symptoms: Anxiety Insomnia Tinnitus Dizziness Back pain Dry mouth Depression Dry throat Malar flush Poor memory Palpitations Night sweats

The Heart's main function in Chinese Medicine is to govern the flow of Blood, the Blood vessels and to house the Spirit/ Mind. It can be greatly influenced by emotional stress such as sadness, worry, grief and guilt. 

The Heart connects to the Uterus and the Kidneys. These three Organs are closely related. Since Blood is a Yin elements, Heart and Kidney Yin Deficiency together can dry up the Blood and thus lead to an absence of menstruation. 

The treatment principle is to nourish Heart and Kidney Yin, clear Empty Heat and calm the Mind. For this herbal formulas such as Tian Wang Bu Xin Dan can help.

Read more about Heart Yin Deficiency here

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

Lung Yin Deficiency

Pulse type(s): Empty (Xu), Floating (Fu)

Tongue color: Red

Recommended herbal formula: Bai He Gu Jin Tang

Symptoms: Red lips Dry cough Depression Blood spit Chest pain Malar flush Frequent sighing Shortness of breath Hot palms and soles

An excessive amount of grief and sadness injures the Lung Qi and leads to a situation where the Lungs fail to circulate and disseminate Qi around the body. Qi is the driving force for the Blood flow in vessels and channels. This results in Blood Deficiency and the absence of menstruation.

It typically progresses from a Lung Qi Deficiency that is not treated for a while and degenerates into Lung Yin Deficiency.

The treatment principle is to moisten the Lungs, nourish Lung Yin and Liver Blood, calm the Mind and settle the Corporeal Soul.

Read more about Lung Yin Deficiency here

Qi and Blood Stagnation

This is an Excess type of Amenorrhoea. This means that the periods are absent because Blood is stagnated rather than being insufficient. 

Qi and Blood Stagnation discussed here typically occurs in the Liver. It normally results from emotional factors such as anger, frustration, resentment, irritation, worry or anxiety. If it is not treated for a long period of time, stagnated Blood can not flow freely from the Liver to fill the Penetrating Vessels and the Uterus. Therefore the menstruation stops. 

The treatment principle is to pacify the Liver as well as move Qi and Blood. Formulas such as Tao Hong Si Wu Tang or Wu Yao Tang is recommended. 

Cold in Uterus is another important cause for Qi and Blood Stagnation in the Uterus and in the Lower Burner. It eventually can also lead to secondary amenorrhoea. This type of absence of periods can last for more than a year. When the body is weak, Wind Cold or Damp Cold can invade the Lower Burner and injures the Directing and Penetrating Vessels which form the so-callled 'Sea of Blood'. Then the Blood gets Cold and stagnated. The Vessels and Channels connecting to the Uterus are blocked and the Uterus door is shut. 

In this case the treatment principle is to expel Cold as well as move Qi and Blood. Formulas such as Shao Fu Zhu Yu Tang or Wen Jing Tang is recommended.

Read more about Qi and Blood Stagnation here

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

Liver Blood and Kidney Essence Deficiency

According to TCM Kidney Essence is the origin of menstrual Blood. Also TCM believes that the Liver stores Blood. The malfunction of these two Organs together causes the emptiness of the Penetrating and Directing Vessels, in charge of directing Blood to the Uterus. Kidney Essence Deficiency can also cause Kidney Yang Deficiency which leads to the pattern of Cold in the Uterus and amenorrhoea as a symptom.

This pattern is seen more often among young women, especially for the primary amenorrhoea cases (when there never was any menstruation). For those young women, hereditary Kidney weakness is often one of the main reason. For the others, overwork or having too many kids too close to each can be another cause for this pattern. 

The  treatment principle is to tonify the Kidneys, nourish the Liver and regulate the periods, with appropriate herbal formulas.

Read more about Liver Blood and Kidney Essence Deficiency here

Phlegm in the Uterus

Spleen Qi Deficiency is normally the fundamental cause of Phlegm. It is because the Spleen rules the transformation and transportation of Body Fluids. A dysfunction of the Spleen leads to an accumulation of these fluids and eventually Phlegm appears. It obstructs the Lower Burner and the Uterus so that Blood can not flow freely. Thus the secondary amenorrhoea develops. 

Qi and Blood Stagnation often accompany Phlegm, which worsens the situation. This might also be paired with Qi and Blood Deficiency due to Spleen Deficiency. 

Dampness and Phlegm is usually the result of an unhealthy diet such as an excessive consumption of cold or raw foods, dairy products or greasy foods. 

The treatment principle is to resolve Dampness and Phlegm, tonify the Uterus, move Qi and penetrate the Connecting Meridians. Herbal ormulas like Cang Fu Dao Tan Wan or Bu Zhong Yi Qi Tang are typically recommended.

Read more about Phlegm in the Uterus here

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

Kidney and Liver Yin Deficiency

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

Tongue color: Red

Recommended herbal formulas: Tiao Gan Tang, Gui Shao Di Huang Tang, He Che Da Zao Wan, Zuo Gui Yin, Si Wu Tang

Symptoms: Fatigue Tinnitus Insomnia Dry eyes Dizziness Dry mouth Night sweats Blurred vision Lower back pain

Liver and Kidney Yin Deficiency are some of the most common Yin Deficiency pattern. Blood is a Yin elements and Yin Deficiency dries the 'Sea of Blood' of the Penetrating Vessel. Therefore the menstruation ceases. This pattern is the result of overwork, chronic disease or giving birth to too many children too close together. It happens more amongst women who are over 30 years old, in contrast to the patterns of Kidney Essence and Liver Blood Deficiency which happens more to younger girls. 

The treatment principle is to nourish Liver and Kidney Yin, tonify the Uterus and nourish the Essence.

Read more about Kidney and Liver Yin Deficiency here

Ginseng (Ren Shen) is the key herb for Ren Shen Yang Rong Tang, a formula used for Blood and Qi Deficiency

Blood and Qi Deficiency

Malfunction of the Spleen and the Stomach can often lead to Qi and Blood Deficiency and thus to the secondary amenorrhoea. It is because they are the Organs responsible for manufacturing the postnatal Qi and Blood from the food and drinks we intake.

This pattern is mostly caused by an unbalanced diet that lacks in Blood-nourishing ingredients. It happens often to women adopting a weight-loss or a vegan diet. Other factors that can impair the functions of the Spleen and Stomach are severe chronic diseases, repeated abortions or miscarriages, breastfeeding for a long period of time or long-term emotional stress such as sadness, worry or grief. 

Heart Blood Deficiency can also cause secondary amenorrhoea because the Heart helps make menstrual Blood. It results either from a dysfunction of the Spleen and Stomach in making Blood, or from emotional stress such as sadness, worry or grief. 

Finally, Liver Blood Deficiency can be a frequent cause of secondary amenorrhoea as the Liver stores Blood. Having sex too often can be a cause here as it impairs the Liver and exhaust Qi. 

The treatment principle is to nourish Blood, tonify Qi and strengthen the Spleen, the Stomach, the Heart or the Liver as necessary.

Read more about Blood and Qi Deficiency here

The twenty one herbal formulas that might help with absence of menstruation

He Che Da Zao Wan

Number of ingredients: 11 herbs

Key actions: Tonifies the Kidneys. Strengthens the Directing and Penetrating Vessels. Regulates the periods.

Why might He Che Da Zao Wan help with absence of menstruation?

Because it is a formula often recommended to help with the patterns Liver Blood and Kidney Essence Deficiency and Kidney and Liver Yin Deficiency which are sometimes associated with absence of menstruation. 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 He Che Da Zao Wan 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 absence of menstruation?

Because it is a formula often recommended to help with the patterns Phlegm in the Uterus and Blood and Qi Deficiency which are sometimes associated with absence of menstruation. 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 Bu Zhong Yi Qi Tang here

Tian Wang Bu Xin Dan

Source date: 16th century

Number of ingredients: 14 herbs

Key actions: Nutritive tonic: Nourishes Yin, Blood and Vital Essence of the Heart and Kidney. Clears away pathogenic Heat, clears Deficient Heat. Sedative.

Why might Tian Wang Bu Xin Dan help with absence of menstruation?

Because it is a formula often recommended to help treat Heart Yin Deficiency, a pattern sometimes associated with absence of menstruation. If it looks like you might suffer from Heart Yin Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Tian Wang Bu Xin Dan here

Bai He Gu Jin Tang

Source date: 1573 AD

Number of ingredients: 10 herbs

Key actions: Nourishes Lung and Kidney Yin. Lubricates the Lung and clears phlegm.

Why might Bai He Gu Jin Tang help with absence of menstruation?

Because it is a formula often recommended to help treat Lung Yin Deficiency, a pattern sometimes associated with absence of menstruation. If it looks like you might suffer from Lung Yin Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Bai He Gu Jin Tang here

Ge Xia Zhu Yu Tang

Source date: 1830 AD

Number of ingredients: 12 herbs

Key actions: Invigorates Blood. Eliminates Blood Stagnation below the diaphragm. Stops pain. Promotes Qi movement.

Why might Ge Xia Zhu Yu Tang help with absence of menstruation?

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

Read more about Ge Xia Zhu Yu 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 absence of menstruation?

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

Read more about Tao Hong Si Wu Tang here

Shao Fu Zhu Yu Tang

Source date: 1830 AD

Number of ingredients: 10 herbs

Key actions: Expels Cold and warm the menstruation Blood. Stops pain. Invigorates Blood. Dispels Blood stagnation.

Why might Shao Fu Zhu Yu Tang help with absence of menstruation?

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

Read more about Shao Fu Zhu Yu Tang here

Wu Yao Tang

Source date: 1336 AD

Number of ingredients: 9 herbs

Key actions: Pacifies the Liver. Moves Qi. Stops pain. Nourishes Liver Blood. Eliminates Stagnation.

Why might Wu Yao Tang help with absence of menstruation?

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

Read more about Wu Yao Tang here

Jia Wei Xiao Yao San

Source date: Ming dynasty

Number of ingredients: 10 herbs

Key actions: Clears Liver and Spleen Qi Stagnation. Tonifies Spleen. Clears Deficient Heat. Nourishes the blood.

Why might Jia Wei Xiao Yao San help with absence of menstruation?

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

Read more about Jia Wei Xiao Yao San here

Wei Jing Tang

Source date: 627 AD

Number of ingredients: 4 herbs

Key actions: Clears heat from the Lungs. Transforms Phlegm. Drives out Blood-Stagnation. Discharges pus.

Why might Wei Jing Tang help with absence of menstruation?

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

Read more about Wei Jing Tang here

Dang Gui Di Huang Yin

Source date: 1640 AD

Number of ingredients: 7 herbs

Key actions: Nourishes Blood. Tonifies Kidney and Liver Yin. Regulates the menstrual cycle.

Why might Dang Gui Di Huang Yin help with absence of menstruation?

Because it is a formula often recommended to help treat Liver Blood and Kidney Essence Deficiency, a pattern sometimes associated with absence of menstruation. If it looks like you might suffer from Liver Blood and Kidney Essence Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Dang Gui Di Huang Yin here

Liu Wei Di Huang Wan

Source date: 1119 AD

Number of ingredients: 6 herbs

Key actions: Nutritive tonic for the Liver and Kidney Yin Essence (nourishes the parasympathetic nervous system).

Why might Liu Wei Di Huang Wan help with absence of menstruation?

Because it is a formula often recommended to help treat Liver Blood and Kidney Essence Deficiency, a pattern sometimes associated with absence of menstruation. If it looks like you might suffer from Liver Blood and Kidney Essence Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Liu Wei Di Huang Wan here

Cang Fu Dao Tan Wan

Source date: 1817 AD

Number of ingredients: 8 herbs

Key actions: Resolves Dampness and Phlegm.

Why might Cang Fu Dao Tan Wan help with absence of menstruation?

Because it is a formula often recommended to help treat Phlegm in the Uterus, a pattern sometimes associated with absence of menstruation. If it looks like you might suffer from Phlegm in the Uterus, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Cang Fu Dao Tan Wan here

Xiang Sha Liu Jun Zi Tang

Source date: 1675 AD

Number of ingredients: 9 herbs

Key actions: Tonifies Spleen and Stomach Qi. Removes Dampness. Moves Qi. Alleviates pain.

Why might Xiang Sha Liu Jun Zi Tang help with absence of menstruation?

Because it is a formula often recommended to help treat Phlegm in the Uterus, a pattern sometimes associated with absence of menstruation. If it looks like you might suffer from Phlegm in the Uterus, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Xiang Sha Liu Jun Zi Tang here

Tiao Gan Tang

Source date: 1827 AD

Number of ingredients: 7 herbs

Key actions: Nourishes Kidney and Liver Yin.

Why might Tiao Gan Tang help with absence of menstruation?

Because it is a formula often recommended to help treat Kidney and Liver Yin Deficiency, a pattern sometimes associated with absence of menstruation. If it looks like you might suffer from Kidney and Liver Yin Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Tiao Gan Tang here

Gui Shao Di Huang Tang

Source date: 1706 AD

Number of ingredients: 8 herbs

Key actions: Nourishes Blood. Nourishes Yin.

Why might Gui Shao Di Huang Tang help with absence of menstruation?

Because it is a formula often recommended to help treat Kidney and Liver Yin Deficiency, a pattern sometimes associated with absence of menstruation. If it looks like you might suffer from Kidney and Liver Yin Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Gui Shao Di Huang Tang here

Zuo Gui Yin

Source date: 1624 AD

Number of ingredients: 6 herbs

Key actions: Nourishes the Yin. Tonifies the Kidneys.

Why might Zuo Gui Yin help with absence of menstruation?

Because it is a formula often recommended to help treat Kidney and Liver Yin Deficiency, a pattern sometimes associated with absence of menstruation. If it looks like you might suffer from Kidney and Liver Yin Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Zuo Gui Yin here

Si Wu Tang

Source date: 846 AD

Number of ingredients: 4 herbs

Key actions: Restores and nourishes Blood. Stimulates Blood circulation.

Why might Si Wu Tang help with absence of menstruation?

Because it is a formula often recommended to help treat Kidney and Liver Yin Deficiency, a pattern sometimes associated with absence of menstruation. If it looks like you might suffer from Kidney and Liver Yin Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Si Wu Tang here

Ren Shen Yang Rong Tang

Source date: 1174 AD

Number of ingredients: 14 herbs

Key actions: Tonifies Qi and Blood. Nourishes the Heart. Calms the spirit.

Why might Ren Shen Yang Rong Tang help with absence of menstruation?

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

Read more about Ren Shen Yang Rong Tang here

Shi Quan Da Bu Tang

Source date: 1180 AD

Number of ingredients: 10 herbs

Key actions: Warms and tonifies Qi. Warms and tonifies Blood.

Why might Shi Quan Da Bu Tang help with absence of menstruation?

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

Read more about Shi Quan Da Bu 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 absence of menstruation?

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

Read more about Gui Pi Tang here