• The pain in the lower abdomen appears with the menstrual cycle
• The pain can spread over the whole abdomen, the lumbo-sacral region, or there 
• Is dragging pain in the vulva and anus. It varies in degrees and can be relieved when the
• menstrual blood flows smoothly.
• Pain beginning before or during the period suggests excess.
• Pain beginning at the end or after the period suggests deficiency.
• Pressure making the pain worse suggests excess.
• Pressure making the pain better suggests deficiency.

Differential Diagnosis :

1. Stagnation of Qi and Blood

Lower abdominal pain during, or one to two days before, the period, feelings of distention and tenderness in the abdomen and breasts, hesitant start of menstrual flow, pain relieved after passing clots, pre-menstrual tension and irritability.

Blood : Dark with clots

Tongue : Purple body with purple spots

Pulse : Wiry

2. Stagnation of cold

Lower abdominal pain several days before the period or during the period. Pain relieved by the application of heat, feelings of cold in the abdomen, and sore back.

Blood : Scanty, dark, with clots

Tongue : Bluish to bluish-purple

Pulse : Wiry

Damp Heat attacking the lower Jiao Hypogastric pain before or during the period, burning sensation extending to the sacrum, feeling of heat, vaginal discharge, scanty-dark urine.

Blood : Red with small clots

Tongue : Red with yellow-greasy coat

Pulse : Slippery

4. Deficiency of Qi and Blood.

Dull hypogastric pain toward the end of or after the period, dragging sensation in the lower abdomen, pain relieved by pressure and massage, fatigue, slight dizziness.

Blood : Scanty, red and thin

Tongue : Pale with thin white coat

Pulse : Thready and weak

5. Deficiency of Kidney and Liver

Dull hypogastric pain toward the end of or after the period, sore back, dizziness, pain relieved by pressure and massage, tinnitus, blurred vision, exhaustion.

Blood : Scanty

Tongue : Red with no coat

Pulse : Thread-weak or deep-thready

Treatment Principle:

1. Stagnation of Qi and Blood
   

   Move Qi and blood, eliminate stasis, stop pain.

2. Stagnation of cold

   Expel cold, warm the uterus, move blood, stop pain.

3. Damp Heat attacking the lower Jiao

   Clear heat, resolve dampness, eliminate stasis, stop pain.

4. Deficiency of Qi and Blood.

   Tonify Qi, nourish blood, move blood, stop pain.

5. Deficiency of Kidney and Liver

   Tonify Liver and Kidney, move blood, stop pain.

Point and Technique Prescription :

Sp 4 Confluent point of Chong Mai

Spleen 4 connects to the Chong Mai which is the Sea of Blood and is closely related to the menses. Thus, Spleen 4 can regulate blood in the uterus.

St 29 "Gui Lai" means "Return"

This point is used for the return of the menstrual cycle to normalcy. It can move blood and stop pain.

Ren 3

Regulates Chong and Ren channels (which both originate beneath Ren 3). This point is also the crossing point of the Ren and the three foot yin channels so it can regulate all four channels.

UB 32 Moves blood in the uterus, stops pain.

Sp 8 Xi cleft point of the Spleen channel regulates blood, stops pain.

Sp 6 Helps to move blood and stops pain.

1. For stagnation of Qi and Blood, add-

Liv 3 This Yuan source point regulates Liver Qi and blood, therefore, it stops pain

Ren 6 Sea of Qi moves Qi and hence, stops pain.

Sp 10 Sea of blood moves blood and thus, stops pain.

1. For Stagnation of cold, add-

   Ren 4with moxa, warms the uterus.

   Ren 6 with moxa, moves Qi and expels cold from the lower abdomen.

   Du 4 with moxa, expels cold, warm the uterus.

2. For Damp Heat attacking the lower Jiao, add-

   St 40 Resolves dampness

   Sp 9 Resolves dampness

   St 28 "Waterway" resolves dampness from the lower Jiao and uterus.

   Liv 2 Ying spring point of Liver, clears heat in the lower Jiao.

3. For Deficiency of Qi and Blood, add-

   Ren 6 Sea of Qi tonifies and moves Qi.

   UB 20

   St 36

   Both of the above two points strengthen the Spleen and tonify the Qi and blood

4. For Deficiency of Kidney and Liver, add-

   UB 23 Kidney shu tonifies Kidney

   UB 18 Liver shu tonifies Liver

   Ren 4 Strong point for tonification of Qi

   Kid 3 Tonifies Kidney

   St 36 A strong point for postnatal Qi and blood to assist the prenatal in the kidneys.