Dysmenorrhea - Qi Stagnation with Blood Stasis Pattern

TCM differentiation and treatment for dysmenorrhea with Qi

Dysmenorrhea · Qi Stagnation with Blood Stasis Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Pelvis


Pattern Overview

Qi Stagnation with Blood Stasis is a common pattern in dysmenorrhea,

characterized by **elevated prostaglandin F2α, severe menstrual pain,

dark menstrual blood with clots, and abdominal distension**. The core

pathogenesis is **Liver Qi stagnation leading to Blood stasis in the

uterus**, causing uterine spasm, ischemia, and severe pain.


Key Symptoms and Differentiation Points

Differentiation Dimension Manifestations
Primary Symptoms

menstrual blood with clots, abdominal distension |

Associated Symptoms

sighing, pain worse with stress |

Tongue and Pulse

hesitant pulse |

Pathogenesis

uterus |

Etiology

lifestyle, cold exposure |


Acupuncture Point Prescription

Point Location Function
Ganshu (BL18) Lower back, 1.5 cun lateral to T9

of Liver meridian; soothes Liver Qi |

Taichong (LR3)

metatarsals | Source point of Liver meridian; soothes Liver Qi |

Sanyinjiao (SP6) 3 cun above the medial malleolus

for gynecological conditions; regulates menstruation |

Diji (SP8)

meridian | Xi-Cleft point of Spleen; treats acute menstrual pain |

Ciliao (BL32) In the second sacral foramen

and pelvic pain |

Clinical Recommendation: Filament needle, reducing method; may

combine with moxibustion on Ciliao to warm the uterus.


Herbal Formula

Base Formula: Chai Hu Shu Gan San (柴胡疏肝散) + Shi Xiao San

(失笑散)

Composition:

Bupleurum (Chai Hu), White Peony (Bai Shao), Immature Bitter Orange (Zhi

Ke), Chuanxiong (Chuan Xiong), Cyperus (Xiang Fu), Trogopterus Dung (Wu

Ling Zhi), Pollen Typhae (Pu Huang), Licorice (Gan Cao)

Action: Soothes Liver Qi, invigorates blood, resolves stasis, and

relieves pain.

Modifications

Associated Symptoms Additions/Subtractions
Severe pain Add Yan Hu Suo, Ru Xiang to relieve pain
Dark blood clots Add Tao Ren, Hong Hua to invigorate blood
Irritability Add Zhi Zi, Dan Pi to clear Liver Heat
Abdominal distension Add Mu Xiang, Sha Ren to regulate Qi

Western Mechanism Reference

Elevated prostaglandin F2α causing uterine smooth muscle spasm,

ischemia, and pain, with abnormal hemorheology and microcirculatory

disturbance. Qi Stagnation with Blood Stasis corresponds to primary

dysmenorrhea with severe pain, where elevated prostaglandin levels and

uterine ischemia contribute to cramping and pain.


References

1. Gynecology of TCM (New Century 4th Edition) - Dysmenorrhea Pattern

Differentiation.

2. Xiong Jibai Pattern Correspondence: Qi Stagnation with Blood Stasis.

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


Explore More

Personalized herbal protocols and acupressure tools for menstrual

health.

research papers and clinical case studies on TCM women's health.


Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM | Content updated: Monthly

Disclaimer: This guide is for educational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any treatment.