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 | Severe menstrual pain (stabbing), dark menstrual blood with clots, abdominal distension |
| Associated Symptoms | Irritability, chest tightness, frequent sighing, pain worse with stress |
| Tongue and Pulse | Purple-dark tongue with petechiae, wiry or hesitant pulse |
| Pathogenesis | Liver Qi stagnation causing Blood stasis in the uterus |
| Etiology | Chronic stress, emotional distress, sedentary lifestyle, cold exposure |
Acupuncture Point Prescription
| Point | Location | Function |
|---|---|---|
| Ganshu (BL18) | Lower back, 1.5 cun lateral to T9 | Back-Shu point of Liver meridian; soothes Liver Qi |
| Taichong (LR3) | Dorsum of the foot, between the 1st and 2nd metatarsals | Source point of Liver meridian; soothes Liver Qi |
| 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 |
| Ciliao (BL32) | In the second sacral foramen | Treats lower back 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
- Gynecology of TCM (New Century 4th Edition) - Dysmenorrhea Pattern Differentiation.
- Xiong Jibai Pattern Correspondence: Qi Stagnation with Blood Stasis.
- 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.