The onset of menstruation in one’s teenage years signifies her transition into womanhood, but for many, menstrual cramps can be a nightmare. Are painkillers the only way to relieve menstrual cramps? Traditional Chinese medicine (TCM) suggests otherwise, and with the proper treatment, menstruation can be a painless time of the month.
Three months ago, 28-year-old Mary Wong came to my outpatient clinic. It was summer, and everyone was wearing summer clothes, but Mary was wearing a thick sweatshirt with a jacket, sandals, and no socks.
The Causes of Menstrual Cramps in TCM
In TCM, menstrual cramps can be caused by both internal and external factors. The internal cause refers to emotions, and the external cause refers to wind, cold, heat, dampness, or dryness. After these pathogenic factors invade the thoroughfare meridian, conception meridian, and reproductive organs, menstrual cramps will result over time.TCM refers to the energy in the human body as “qi,” and the pathways of qi are called meridians. The thoroughfare and conception meridians originate from the lower abdomen and are connected to other meridians. Obstruction of these two meridians can lead to menstrual cramps and even infertility.
Qi circulates in the body and promotes blood circulation. If the circulation of qi and blood is blocked, diseases will occur. The liver is responsible for the motion of qi. If the liver meridian’s qi runs smoothly, the thoroughfare and conception meridians will be boosted by the liver meridian’s qi and also be full of energy and run smoothly, thus prompting regular menstruation.
Unblocking Liver Qi
The focus of Mary’s treatment was to unblock her liver qi. She was prescribed Decoction for Removing Blood Stasis and Normalizing Menstruation for three days. The decoction is from “Obstetrics and Gynecology” by Fu Qingzhu, a well-known Chinese medicine practitioner in the 17th century. It is composed of white peony, Angelica, and other herbs. Modern pharmacological studies have also found that these herbs can treat anemia, relieve pain, and fight inflammation.Mary had a follow-up appointment a week later. She was satisfied that after taking the herbal medicine, she only had pain for one day throughout her last menstruation.
The day of her follow-up appointment was a rainy day, and Mary was wearing sandals. She said she liked to wear sandals all year round. She used to work in an ice cream parlor in the United States and went to the freezer every day. Mary’s menstrual cramps were caused by cold, so the TCM physician recommended a warm remedy for her. She was cured in three months.
This type of menstrual cramps caused by cold is called “coagulated cold menstrual cramps,” which is characterized by a fear of cold, cold hands and feet in winter, crymodynia (pain aggravated by cold) in the abdomen (which can be alleviated by hot compresses), delayed menstrual periods, and light menstrual flow with dark red color and blood clots. Patients with this type of menstrual cramps can take a dietary remedy, ginger-jujube soup, to warm their abdomen so that the blood and qi work smoothly.

Ginger-Jujube Soup Recipe
- Ingredients: dry ginger, jujube (30 grams each), brown sugar.
- Preparation: Slice dry ginger, remove jujubes’ cores, and decoct them with brown sugar.
- Dosage: Eat it hot twice a day.