Syndrome differentiation and treatment
Dysmenorrhea usually occurs before and during menstruation. Lower abdominal cold pain or colic may be due to cold coagulation and blood stasis if it gets improved with warmth. Lower abdominal distending pain complicated by distending pain in the breasts is due to cold coagulation and blood stasis. Prolapsing pain in the lower abdomen with scanty and light-colored menses as well as lassitude is due to qi asthenia and blood stasis. The treatment usually concentrates on resolving abdominal mass. If it is due to cold coagulation and blood stasis, the treatment should be warming the meridians to disperse cold; if it is due to qi stagnation and blood stasis, the treatment should be promoting qi flow and activating blood; if it is due to qi asthenia and blood stasis, the treatment should be nourishing qi and activating blood.

(1) Syndrome of cold coagulation and blood stasis
Main symptoms: Lower abdominal cold pain or colic worsened by pressure, or lower abdominal mass, profuse or scanty menses with purplish color and blood clot, alleviation of abdominal pain after removal of blood clot, cold limbs, purplish and blackish tongue with ecchymosis and whitish and slippery fur, deep and taut or deep and tense pulse before menstruation.Therapeutic methods: Warming meridians and dispersing cold, resolving stasis and eliminating mass.

(2) Syndrome of qi stagnation and blood stasis
Main symptoms: Unbearable lower abdominal pain before and during menstruation, or lower abdominal mass, profuse menses with deep-red color and blood clot,slight alleviation of pain after removal of blood clot, premenstrual dysphoria and susceptibility to rage, distending pain in chest, hypochondria and breasts, blackish tongue or tongue with ecchymosis and taut pulse.Therapeutic methods: Promoting qi flow and activating blood, resolving stasis and dissipating nodules.

(3) Syndrome of qi asthenia and blood stasis
Main symptoms: Unbearable and prolapsing pain in the lower abdomen, profuse or delayed menstruation with light color and thin texture menses, or lower abdominal mass, lassitude, anorexia, grayish tongue or tongue with ecchymosis, thin and unsmooth pulse. Therapeutic methods: Nourishing qi and activating blood, resolving stasis and dissipating abdominal mass.