Abnormal uterine bleeding according to Chinese Medicine

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

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 pollen, Tienchi ginseng, Motherwort herbs, Safflowers or Peach kernels. 

Read more about Blood Stagnation here

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 fruits, Gypsum , Baikal skullcap roots, or Goldthread rhizomes are used to stop bleeding. To clear Heat and cool Blood, Unprepared Rehmannia, Red 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

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