Dysmenorrhea - Cold with Blood Stasis Pattern

Dr. Li Wei, DACM

Dysmenorrhea · Cold with Blood Stasis Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Pelvis

Pattern Overview

Cold with Blood Stasis is a common pattern in dysmenorrhea, characterized by cold-induced uterine vasoconstriction, menstrual pain relieved by warmth, cold extremities, and dark menstrual blood with clots. The core pathogenesis is Cold invading the uterus causing Blood stasis, leading to uterine vasoconstriction, ischemia, and severe cramping pain.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Cramping menstrual pain, relieved by warmth, cold extremities |

| Associated Symptoms | Dark menstrual blood with clots, pale complexion, cold lower back |

| Tongue and Pulse | Pale tongue with white coating, deep and tense pulse |

| Pathogenesis | Cold invading the uterus causing Blood stasis |

| Etiology | Cold food intake, cold exposure during menstruation, constitutional Cold |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Guanyuan (RN4) | 3 cun below the umbilicus | Warms the uterus and supplements Yuan Qi |

| Qihai (RN6) | 1.5 cun below the umbilicus | Tonifies Qi and warms the lower abdomen |

| Sanyinjiao (SP6) | 3 cun above the medial malleolus | Master point for gynecological conditions; regulates menstruation |

| Diji (SP8) | 3 cun above the medial malleolus, on the Spleen meridian | Xi-Cleft point of Spleen; treats acute menstrual pain |

| Shiqizhui (EX-B8) | On the lower back, below the spinous process of L5 | Extra point for painful menstruation |

Clinical Recommendation: Filament needle, even method; heavy moxibustion is strongly recommended to warm the uterus and disperse Cold.

Herbal Formula

Base Formula: Wen Jing Tang (温经汤) or Shao Fu Zhu Yu Tang (少腹逐瘀汤)

Composition (Shao Fu Zhu Yu Tang):

Fennel Seed (Xiao Hui Xiang), Dried Ginger (Gan Jiang), Myrrh (Mo Yao), Angelica (Dang Gui), Chuanxiong (Chuan Xiong), Cinnamon (Rou Gui), Trogopterus Dung (Wu Ling Zhi), Pollen Typhae (Pu Huang)

Action: Warms the uterus, disperses Cold, invigorates blood, and resolves stasis.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe cold pain | Add Fu Zi, Gui Zhi to warm Yang and disperse Cold |

| Dark blood clots | Add Tao Ren, Hong Hua to invigorate blood |

| Cold extremities | Add Gui Zhi, Sheng Jiang to warm the meridians |

| Weakness | Add Huang Qi, Dang Shen to supplement Qi |

Western Mechanism Reference

Cold-induced uterine artery vasoconstriction causing ischemia and hypoxia, with increased uterine artery resistance and decreased blood flow. Cold with Blood Stasis corresponds to dysmenorrhea with cold sensitivity, where cold-induced vasoconstriction and reduced uterine blood flow contribute to ischemia and pain.

References

  1. Gynecology of TCM - Dysmenorrhea with Cold Coagulation and Blood Stasis.

  2. Zang-Fu Pattern Differentiation: Cold Coagulation belongs to Excess Pattern - Clearing and Warming.

  3. WHO. (2023). Women’s health. World Health Organization.

Explore More

  • Find your solution at MendGod.com – Personalized herbal protocols and acupressure tools for menstrual health.

  • Deepen your knowledge at TcmCIO.com – Full research papers and clinical case studies on TCM women’s health.