Reviewed by Veena Angle, MBBS, MD and Physician Ng Qing Xiang
4 Types of Period Pain That You Should Be Aware of
Published | 7 min read
This article discusses the types of period pain or menstrual cramps, also known as dysmenorrhea, their causes, and prevention.
Period pain, menstrual cramps, or dysmenorrhea are common among women. Some experience mild symptoms, while others endure more discomfort and pain.
In Traditional Chinese Medicine (TCM), the colour of period blood can reveal a woman’s health condition. For example, a regular period comes with dark fresh blood without clots. Pale blood with a diluted texture indicates qi (vital life energy) deficiency, while light red with diluted texture means blood deficiency. For an accurate assessment, visit a TCM physician.
“The causes of menstrual cramps in TCM are cold pathogen (寒气), stagnation of qi (气滞), damp-heat (湿热), deficiency of the kidney (肾虚), and deficiency of qi and blood (气血不足),” TCM physician Ho Li Ying says.

4 Types of Period Pain
Generally, there are two kinds of dysmenorrhea (period pain) – primary and secondary.
Primary dysmenorrhea refers to common cramps in the abdomen occurring before or during menstruation without any disorder. Sometimes the cramps appear as intense spasms, while other times, women experience a dull and constant ache. In more severe cases, the pain can spread to the back and thighs. Some women may experience headaches and breast tenderness, too. Complaints of breast pain before menstruation are also common.
Secondary dysmenorrhea usually occurs in older women. This kind of period pain often gets worse over time. Causes of secondary dysmenorrhea include:
1. Endometriosis
One in ten women of reproductive age are affected by the condition and common symptoms of endometriosis. During menstruation, the lining of the uterus called the endometrium sheds through the vagina. In endometriosis, pieces of endometrium develop outside the inner lining of the uterus, such as on the ovaries, fallopian tubes, vagina, peritoneum, or the intestine. This condition makes it difficult for a woman to become pregnant and can cause other symptoms like chronic pelvic pain and pain during or after sexual intercourse.
2. Adenomyosis
Adenomyosis is a condition that causes the tissue from the lining of the uterus to grow into the uterine wall, causing the uterus to thicken and enlarge. Its symptoms include cramping, heavy periods, painful sex, and infertility. Hormonal therapies can ease symptoms, but for severe cases, surgically removing the uterus (hysterectomy) offers permanent relief.
3. Pelvic inflammatory disease (PID)
Pelvic inflammatory disease (PID) is an infection of the reproductive organs in women, including the uterus, fallopian tubes, or ovaries. It happens when sexually transmitted bacteria spread from the vagina to the upper reproductive organs. PID can produce mild signs and symptoms in some women, while others may not have any symptoms at all.
4. Fibroids (benign tumours)
Fibroids are non-cancerous or benign growths that develop in or around the uterus. The tumours can vary in size and consist of muscle and fibrous tissue. Many women with fibroids do not experience any symptoms.
Relieving Period Pain with Western Medicine
For mild period pain, you can take over-the-counter medications like ibuprofen or aspirin. However, these painkillers are not suitable for those with stomach, kidney, or liver diseases. Healthcare professionals may prescribe naproxen or codeine if mild painkillers don’t help. If you are not trying to get pregnant, doctors may recommend birth control hormones to reduce menstrual pain and lighten bleeding.
Medications aside, regular exercise, using a heat pad, warm baths, massages, and relaxation activities can help relieve period pain. In addition, you can also try dietary supplements, such as magnesium, vitamin B, Omega-3 fatty acids, Vitamin D and Vitamin E, and flavonoids.
Take note that if your period pain is due to a medical issue, you would have to treat its root cause. For instance, if fibroids are causing menstrual pain, you would need surgery. Always get a proper diagnosis before attempting to self-medicate.
Treating Period Pain with TCM

According to TCM, period pain arises from several internal conditions, which can be treated with different herbal remedies:
Cold-coagulation and blood stasis
Cold-coagulation and blood stasis are common in people with yang (active energy) asthenia constitution, who are frequently afraid of cold and have cold hands and feet. They experience cold pain in the lower abdomen before or during their period. During menstruation, their menstrual blood volume might be low and contain blood clots.
Treatment: Women with this condition can apply a hot towel or hot water bag on the lower abdomen when they experience period pain. In addition, ginger tea with brown sugar can help to relieve cold coagulation.
“They should avoid cold food and drinks, as well as cold weather or environment. When feeling cold, put on more clothes. A 15-min foot bath taken an hour before sleep would be beneficial. Use warm water and add argy wormwood leaf or lemongrass. These herbs will relieve cold-coagulation,” says physician Ho.
Additionally, Bak Foong Pills, a classic TCM formula containing over 20 types of Chinese tonic herbs, are known for its function to relieve period pain and disorders.
Qi stagnation and blood stasis
Qi stagnation and blood stasis are common in women who are usually stressed, impatient, depressed, or always stay up late. They experience pain in the lower abdomen before or during their period, accompanied by pain in the breasts or upper abdomen.
“They also report delayed menstruation or prolonged periods. During their period, they will have low blood volume, with dark blood colour and blood clots,” says physician Ho.
Treatment: Those with this condition should avoid staying up late, engage in activities to relieve stress and keep themselves in a good mood. They should also exercise regularly.
“Rose tea helps to relieve Qi Stagnation and Blood Stasis. Apart from this, a 15-min foot bath taken an hour before sleep can help. Use warm water, and add ligusticum wallichii cnidium (chuanxiong, 川芎) and spatholobus stem (jixueteng, 鸡血藤),” advises physician Ho.
Women undergoing menopause can also try Menoease Pills, a Bak Foong Pills-derived formula, to assist with alleviating post-menopausal symptoms. According to physician Ho, “herbal concoctions containing radix angelicae sinensis, rhizoma chunxiong, fructus jujubae can also help improve their well-being.”
Damp-heat
Damp-heat is common in women who are afraid of heat and easily develop ulcers in the mouth. They will feel lower abdomen pain and sometimes back pain before or during their period. They will also have high body temperature when they are menstruating.
“Their blood volume might be high during menstruation, with sticky blood and blood clots. In addition, there will be a large amount of vaginal discharge or yellowish vaginal discharge,” says physician Ho.
Treatment: It is important to have a balanced diet and reduce fat, sugar, and oily food in your daily meals. Regular exercise is essential as well.
“Women with this condition can also consume Rehmanniae Radix (Sheng di) soup, Chinese Yam porridge, and herbal tea containing cape jasmine, chrysanthemum, and honeysuckle” she notes.
Deficiency of the kidney
Deficiency of the kidney is common in women who have dizziness or tinnitus and lack of vaginal discharge. They may experience back pain before or during their period and a dull ache in the lower abdomen at the end of their period. During menstruation, they will have low blood volume, with pinkish or light red blood.
Treatment: Women with kidney deficiency should avoid staying up late and overworking. Beneficial food includes black beans, black sesame, mulberry, raspberry, goji berry, and more. Bak Foong Pills can also help with nourishing the kidney and liver.
Deficiency in qi and blood
Deficiency in qi and blood is common in women who always feel tired or sleepy or have insomnia and dizziness. When they have their period, they may notice low blood volume with pinkish or light red blood. Back pain before or during a period and dull ache in the lower abdomen after a period are also common symptoms.
Treatment: For women with this condition, a balanced diet and regular exercise are crucial. Consider taking ba zhen soup, qi and blood nourishing tea, and pure chicken essence to ensure better health.
Period pain is not something you just live with. You can take many steps to prevent it or lessen the discomfort. Eat well, exercise regularly, and practise a healthy lifestyle to improve your overall well-being.
References
- BMC Women’s Health. 2012. Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women. [Accessed on 25 November 2021]
- BMC Women’s Health. 2014. Impact of endometriosis on women’s lives: a qualitative study. [Accessed on 25 November 2021]
- F1000 Faculty Review. 2019. Recent advances in understanding and managing adenomyosis. [Accessed on 25 November 2021]
- Infection and Drug Resistance. 2016. Pelvic inflammatory disease: improving awareness, prevention, and treatment. [Accessed on 25 November 2021]
- NHS. 2019. Period Pain. [Accessed on 25 November 2021]
- HealthLinkBC. 2020. Relieving Menstrual Pain. [Accessed on 25 November 2021]
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