TCM believes that the pathogenic factors include six exogenous pathogenic factors, seven emotions, inlproper diet, overstrain, excessive sexual intercourse, incised wound and wound due to insects and animals attack. The pathogenic factors responsible for woman diseases are also included in the factors mentioned above. Among these pathogenic factors, some are very easy to cause gynecological diseases.

  

(1) Six Exogenous Pathogenic Factors 

Wind, cold, summer-heat, dampness, dryness and fire are the normal climatic changes in the four seasons. If they are excessive, insufficient or appear in the season that they should not exist, they become exogenous pathogenic factors. In gynecology, cold, heat and dampness frequently lead to woman diseases. 

    

Cold is either exogenous or endogenous. Exogenous cold, one of the six exogenous pathogenic factors, pertains to yin and tends to contract and coagulate by nature, often affecting the circulation of qi and blood. In gynecological diseases, the attack by cold is usually due to sudden catching of wind and rain during menstruation and after delivery or due to work in cold water or excessive intake of uncooked and cold food, leading to invasion of cold into the body. 

The invasion of cold will stagnate qi and blood as well as impair the thoroughfare and conception vessels, resulting in delayed menstruation, scanty menstruation, dysmenorrhea, amenorrhea and abdominal mass, etc. Endogenous cold is usually caused by weakness of the body and asthenia of spleen and kidney yang which fail to warm the viscera and lead to insufficiency and unsmooth circulation of qi and blood.     

Heat is either exogenous or endogenous. Exogenous heat means exogenous pathogenic heat and fire. Heat,fire and summer-heat are of the same nature. Heat pertains to yang pathogenic factors and tends to develop upwards, accelerating the circulation of blood. If pathogenic heat impairs blood and drives blood to flow abnormally, the thoroughfare and conception vessels will be weakened, leading to such problems like early menstruation, profuse menorrhea, metrorrhagia and metrostaxis, reddish leukorrhea, uterine bleeding during pregnancy and lochiorrhea. Endogenous heat is usually caused by excessive intake of hot or pungent foods, or by yin asthenia and blood heat that drive blood to flow abnormally and damage the thoroughfare and conception vessels, resulting in the symptoms mentioned above. 

Dampness is a pathogenic factor of yin nature. It is heavy, turbid, greasy and stagnant by nature, tending to stagnate qi. Dampness is caused by attack of exogenous pathogenic dampness or asthenia of spleen and kidney yang which fails to transform and transport water and dampness. Since dampness is stagnant, it is difficult to be eliminated. Dampness tends to mix up with other pathogenic factors. It may mix up with heat or transform into neat due to stagnation, leading to damp-heat; it may mix up with cold and produce cold-dampness; it may accumulate into phlegm and cause phlegm-dampness. 

If dampheat attacks qi and blood or damages the thorougthfare and conception vessels, it will lead to profuse menorrhea, metrorrhagia and metrostaxis as well as lochiorrhea; when it attacks the conception and belt vessels or the liver meridian, it may lead to leukorrhagia and pudendal pruritus. If cold-dampness attacks the thoroughfare and conception vessels, it stagnates qi and blood, leading to dysmenorrhea, amenorrhea and sterility. When phlegm-dampness stagnates in the thoroughfare and conception vessels, it may lead to amenorrhea, leukorrhea and sterility, etc. 

Wind is the leading factor in causing diseases. Wind is either endogenous or exogenous. Exogenous wind, one of the six exogenous pathogenic factors, often combines with other pathogenic factors to cause diseases, such as wind-cold and wind-heat. Wind pertains to yang and tends to change. In gynecology, wind often mixes up with cold to damage the thoroughfare and conception vessels and causes various diseases. Clinically gynecological diseases due to wind and cold attacking qi and blood as well as damaging the thoroughfare and conception vessels are also commonly encountered. 

Endogenous wind refers to a series of symptoms during the course of a disease, such as tremor of limbs, convulsion, dizziness, distorted face,coma and abnormal sensation of skin that are caused by dysfunction of the viscera, adverse flow of qi and blood or deficiency of liver blood. Such symptoms are known as interior disturbance of liver wind, interior stirring of wind or generation of wind due to blood asthenia. The problems caused by endogenous are dizziness during pregnancy,premonitory signs of eclampsia gravidarum and eclampsia gravidarum as well as numbness of limbs and formication over skin and pudendal pruritus during menopause. 

 

Seven emotions refer to joy, anger, anxiety, contemplation, sorrow, fright and terror, excessive changes of which may lead to imbalance of yin and yang, disharmony between qi and blood as well as dysfunction of the viscera. In clinical treatment, hematemesis, hemorrbage and dizziness during pregnancy are commonly encountered. These problems are usually caused by blood circulating upward with the adverse flow of liver due to impairment of the liver by rage. Excessive contemplation impairs the spleen. If spleen qi is stagnated, transformation and transportation cannot be properly carried out, leading to insufficiency of transformation and deficiency of blood in the uterus, consequently resulting in delayed menstruation, scanty menstruation and amenorrhea. 

(3) Intemperance in Life 

Apart from the seven emotional factors, gynecnlogical diseases may be caused by intemperance in life which affects the normal functions of the viscera, the thoroughfare and conception vessels as well as qi and blood. The following are some of the most commonly encountered ones. 

Improper habit in taking food: Excessive intake of pungent, hot and yang-invigorating foods accumulates heat in the thoroughfare and conception vessels and drives blood to flow abnormally, leading to profuse menstruation, metrorrhagia and metrostaxis. Excessive intake of cold foods may coagulate blood or impair spleen yang, accumulate dampness into phlegm and obstruct the thoroughfare and conception vessels, resulting in dysmenorrhea, amenorrhea and leukorrbagia. Crapulence or hunger or partiality to certain kind of food may damage the viscera and lead to disorder of qi and blood as well as disturbance of the thoroughfare and conception vessels which further lead to gynecological diseases. 

Uneven allocation of work: Proper physical work is helpful for strengthening constitution and preventing diseases. However, woman should be careful about the allocation of work during menstruation, pregnancy and breast-feeding, avoiding heavy physical work lest profuse menstruation, metrorrhagia and metrustaxis, abortion, premature labor and prolapse of the uterus be caused. So during menstruation,  pregnancy and breast-feeding,woman should properly rest but also take appropriate activities, because excessive rest affects the circulation of qi and blood and gives rise to the occurrence of various diseases. And therefore to do some proper physical work is beneficial to health. 

Multiparity and excessive coitus: Frequent delivery or sexual activity during menstruation or after delivery tends to consume qi and blood, impair the liver and kidney as well as damage the thoroughfare and conception vessels, consequently leading to menstruation disorder, leukorrhea problems, abortion, premature delivery and prolapse of uterus. Early marriage and multiparity not only impairs the physique of gravida, but also affects the development of fetus. So proper sexual life and family planning are important measures for preventing woman disease.