Late menstruation according to Chinese Medicine

Delayed periods, Delayed menstruation, Menstruation behind schedule, Late periods and Periods behind schedule redirect here

Late menstruation factsheet

Chinese name: 月经后期

Pinyin name: Yuè Jīng Hòu Qí

Possible causes and remedies:

Late periods are when periods are behind the expected due day for more than 7 days for at least three months in a row. Sometimes cycle can be as long as 40-50 days instead of the usual 28 days.

Sometimes late periods can happen due to change of environment or emotional stress. When this is the case it should not be categorized as a disease nor should it be treated medicinally because it is temporary. However, if there are other accompanying symptoms such as abdominal pain, it is worth considering treating it as well.

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

The five "patterns of disharmony" associated with late menstruation

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

Blood Deficiency

Blood Deficiency leads to an insufficient amount of Blood in the Directing (Ren Mai 任脉) and Penetrating (Chong Mai 冲脉) Vessels. As they're the Vessels directing and coordinating Blood to the Uterus, the sheer lack of Blood means the periods will fail to happen at the expected time and get delayed consistently.

There can be several underlying reasons for this pattern but chronic illnesses or excessive work are typically the major ones because they impair the Spleen's transforming function. The Spleen is the base of creating Gu Qi (or called Food Qi) and Food Essence which are essential for the creation of Blood. Also, long-term chronic excessive bleeding such as menorrhagia may also cause Blood Deficiency. Finally, breastfeeding for a long time may leads to this pattern as well because breast milk is also made from Blood and may therefore exhaust its supply. 

The treatment principle is to nourish Blood and Qi. Formulas such as Ren Shen Yang Rong Tang are recommended to supply both Blood and Qi. Da Bu Yuan Jian is to tonify Qi and Yang and nourishes Blood, Essence and Yin. Therefore it is for the most severe cases of the condition. 

Read more about Blood Deficiency here

Cinnamon Twigs (Gui Zhi) is the key herb for Wen Jing Tang, a formula used for Cold in the Uterus

Cold in the Uterus

Pulse type(s): Deep (Chen), Slow (Chi), Tight (Jin), Weak (Ruo), Full (Shi)

Tongue coating: Thick white coating

Tongue color: Pale

Recommended herbal formulas: Wen Jing Tang, Da Ying Jian, Si Wu Tang, Shao Fu Zhu Yu Tang

Symptoms: Tiredness Late period Scanty periods Painful period Feeling of cold Dark colored blood Lower abdominal pain Pain relieved with heat Dark clots in menstrual blood

Blood can congeal due to Cold invasion. Then new Blood can not be created and the Directing (Ren Mai 任脉) and Penetrating (Chong Mai 冲脉) Vessels are empty. They fail to fill the Uterus and thus the periods consistently come after the expected time. Other typical symptoms are a feeling of cold, scanty periods with dark blood and clots and abdominal pain which can be relieved with Heat. There are two types of Cold in the Uterus pattern that can cause delayed menstruation: Full or Empty. 

For the Full type, it often happens to women living in cold and damp countries or to women who spend large amount of time outdoor in cold weather. Young girls during their puberty are particularly vulnerable as their bodies are easily affected by external pathogenic factors such as 'cold evil'. Another source of Full Cold in the Uterus is diet. Excessive consumption of raw or cold foods can accumulate Cold in the body. The treatment principle is to warm the Uterus, disperse Cold and regulate the periods. Formulas like Wen Jin Tang are recommended. 

As for Empty Cold in Uterus, the 'Empty' here refers to the fact that the 'Cold' is caused by a lack of Yang which by nature is a warm substance. Apart from the typical symptoms mentioned above, patients may also feel tired under this Empty pattern. The treatment principle should rather focus on tonifying Yang instead of just warming the Uterus and dispersing Cold. Formulas such as Da Ying Jian are recommended. 

Read more about Cold in the Uterus here

Dong Quai (Dang Gui) is the key herb for Xiong Gui Er Chen Tang, a formula used for Phlegm

Phlegm

Whenever the body has Dampness or Phlegm, the Spleen is always the first Organ that should be checked since it controls body water metabolism. The Spleen transforms, transports, and distributes Body Fluids along with food Essence and Grain Qi. If its transforming ability is poor, the Body Fluids can congeal to create Phlegm and cause Edema. As a vicious cycle, Phlegm can further impair the Spleen's transforming function. Therefore, not enough new Blood can be created to overflow the Uterus and periods become consistently late. Phlegm can also block Qi movement and cause Qi or Blood Stagnation. 

The treatment principle is to strengthen the Spleen and disperse phlegm. In case there is also Blood Stagnation, invigorating the Blood should also be considered. 

Read more about Phlegm here

Bupleurum Roots (Chai Hu) is the key herb for Xiao Yao San, a formula used for Qi Stagnation

Qi Stagnation

Qi Stagnation here mainly refers to Liver Qi Stagnation which is often caused by long-term emotional stress like worry or fear. If untreated for a long period of time, it can lead to Blood Stagnation and thus the Directing (Ren Mai  任脉) and Penetrating Vessels become blocked and periods come behind schedule. 

Heart or Spleen Qi Deficiency can also be caused by these emotions and be responsible for delayed periods. Take the Spleen as example, its function is to transform and transport food and drinks, extracting Grain Qi (Gu Qi) and food Essence out of them, and distributing them to other Organs. It is the foundation of Blood making. In case of Spleen Qi Deficiency, the transforming function will not work properly and thus not enough Blood can be produced to send to the Uterus. It can lead to either scanty periods or late periods. 

The treatment principle is to pacify the Liver, move Qi, eliminate Stagnation, invigorate Blood and therefore regulate the periods. Of course it goes without saying that treatment can only work long term if the patient deals with their emotional stress as well, if it continues the patterns will keep from coming back again and again.

Read more about Qi Stagnation here

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

Kidney Yang Deficiency

Pulse type(s): Deep (Chen), Weak (Ruo)

Tongue color: Pale

Recommended herbal formula: Shen Qi Wan

Symptoms: Sore back Dizziness Late period Scanty periods Pale color periods Nocturnal emissions

Kidney Yang is considered the 'primary Yang'. It is the root of Yang for all other Organs and all the Yang energies of the entire body. In the case of Kidney Yang Deficiency, this results in a situation where there is not be enough Kidney Essence to create Blood, nor sufficient Qi to move Blood to the Lower Burner. Then the Directing (Ren Mai 任脉) and Penetrating (Chong Mai 冲脉) Vessels are not nourished and the Sea of Blood fails to fill the Uterus, hence the delayed periods. Long-term Kidney Yang Deficiency can also cause Empty Cold in the Uterus pattern. 

Many reasons can lead to this pattern, such as hereditary Kidney weakness, chronic disease, overwork, excessive sex, recreational drugs, poor sleep, aging or giving birth to too many children too close together. The treatment principle is to tonify Yang, strengthen the Kidneys and warm the Uterus. A typical herbal formula is Shen Qi Wan

Read more about Kidney Yang Deficiency here

The fourteen herbal formulas that might help with late menstruation

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 late menstruation?

Because it is a formula often recommended to help with the patterns Blood Deficiency and Cold in the Uterus which are sometimes associated with late 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 Si Wu Tang here

Xiong Gui Er Chen Tang

Source date: 1575 AD

Number of ingredients: 7 herbs

Key actions: Resolves Damp-Phlegm. Nourishes Blood.

Why might Xiong Gui Er Chen Tang help with late menstruation?

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

Read more about Xiong Gui Er Chen Tang here

Xiao Yao San

Source date: 1107 AD

Number of ingredients: 6 herbs

Key actions: Harmonizes the function of Liver and Spleen. Relieves Liver Qi stagnation. Nourishes the Blood.

Why might Xiao Yao San help with late menstruation?

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

Read more about Xiao Yao San here

Shen Qi Wan

Source date: 220 AD

Number of ingredients: 8 herbs

Key actions: Tonifies and warms Kidney Yang.

Why might Shen Qi Wan help with late menstruation?

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

Read more about Shen Qi Wan 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 late menstruation?

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

Read more about Ren Shen Yang Rong Tang here

Da Bu Yuan Jian

Source date: 1624 AD

Number of ingredients: 8 herbs

Key actions: Tonifies Yin and Blood. Nourishes Qi and Yang.

Why might Da Bu Yuan Jian help with late menstruation?

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

Read more about Da Bu Yuan Jian 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 late menstruation?

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

Read more about Liu Wei Di Huang Wan 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 late menstruation?

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

Read more about Gui Pi Tang here

Wen Jing Tang

Source date: 220 AD

Number of ingredients: 12 herbs

Key actions: Warms the Uterus and vessels. Nourishes Blood. Dispels Cold. Dispels Blood Stagnation.

Why might Wen Jing Tang help with late menstruation?

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

Read more about Wen Jing Tang here

Da Ying Jian

Source date: 1624 AD

Number of ingredients: 7 herbs

Key actions: Tonifies Qi and Blood. Expels Cold.

Why might Da Ying Jian help with late menstruation?

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

Read more about Da Ying Jian 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 late menstruation?

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

Read more about Shao Fu Zhu Yu Tang 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 late menstruation?

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

Read more about Xiang Sha Liu Jun Zi Tang here

Chai Hu Shu Gan San

Source date: 1602

Number of ingredients: 7 herbs

Key actions: Disperses Stagnant Liver Qi and Blood. Alleviates pain. Harmonizes Blood.

Why might Chai Hu Shu Gan San help with late menstruation?

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

Read more about Chai Hu Shu Gan San 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 late menstruation?

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

Read more about Wu Yao Tang here