Differentiation of syndromes should concentrate on revealing the nature of dysmenorrhea in light of the time, location and degree of pain; the quantity, color and texture of menses; and complications, tongue and pulse conditions. Usually pain occurring before and during menstruation is of sthenia; pain occurring after menstruation is often of asthenia. Unpressable pain is of sthenia; while dull pain with preference for pressure is of asthenia.
Pain alleviated with warmth is due to cold, while pain worsened with warmth is due to heat. Pain severer than distension is due to blood stasis, while distension severer than pain is due to qi stagnation. Colic pain and cold pain are due to cold, while burning pain is due to heat. Pain in the sides of abdomen is due to liver disorder, while pain involving the loins is due to kidney disorder.
Four therapeutic methods for painful menstruation in TC
Syndrome of qi stagnation and blood stasis
Therapeutic methods: Soothing the liver to regulate qi and resolving stasis to stop pain.
Syndrome of coagulation of cold dampness
Therapeutic methods: Warming meridians to disperse cold and draining dampness to eliminate stagnation.
Syndrome of qi and blood asthenia
Therapeutic methods: Strengthening the spleen and nourishing qi, invigorating blood and stopping bleeding.
Syndrome of liver and kidney asthenia
Therapeutic methods: Nourishing blood and regularing the liver, replenishing the kidney and enriching essence.