Understanding Your Menstrual Pattern
What your period is telling you
"It's just cramps. Every woman gets them."
That's what we're told. That menstrual pain is normal. Expected. Something to endure with painkillers and heating pads.
But here's what traditional medicine has understood for thousands of years: pain is a signal, not a life sentence. It's your body communicating about a specific imbalance.
Not every woman experiences painful periods. In a truly balanced state, menstruation should be relatively comfortable—perhaps some mild sensation, but not debilitating cramps, not pain that makes you miss work, not symptoms that disrupt your life.
If you have severe period pain, it's not because you're unlucky. It's because your body is signaling a specific imbalance—one that can be addressed.
What a Healthy Period Actually Looks Like
A balanced menstrual cycle has these characteristics:
- Regular timing: 26-32 day cycles, consistent within 2-3 days
- Moderate flow: 3-7 days, not excessively heavy or light
- Minimal discomfort: Perhaps mild cramping on day 1, manageable without painkillers
- Healthy color: Fresh red blood, not dark purple or brown
- Smooth flow: No large clots (small ones are okay)
- Minimal PMS: Perhaps slight mood changes, but not severe symptoms
- Normal life continues: You can work, exercise, and function normally
If your period doesn't look like this, it's not "just how you are." It's a signal about a specific imbalance—one your body wants you to understand and address.
The Four Main Menstrual Patterns
Traditional medicine identifies four primary patterns of menstrual imbalance. Each has different causes, different symptoms, and—most importantly—different solutions.
Let's identify which pattern describes you.
Pattern 1: Blood Deficiency (血虛型)
Your imbalance: Insufficient blood reserves to support healthy menstruation
How This Works
Your body makes blood from food (through your digestive system) and stores it in the Liver. During menstruation, you release blood—if your reserves are already low, this monthly release depletes you further, causing pain and fatigue.
Think of it like a monthly payment from a bank account that's already too low. The payment hurts because you don't have enough in the account to cover it comfortably. The pain happens when you're depleted—during or after the period.
Key characteristic: Pain DURING or AFTER your period (not before)
What it looks like:
- Dull, achy pain (not sharp cramping) during or after period
- Light, scanty flow—sometimes only 2-3 days
- Pale, thin blood
- Fatigue that gets worse during period
- Dizziness or lightheadedness
- Pale complexion, pale lips
- Dry skin, brittle nails
- Sometimes blurry vision or spots
- Heart palpitations
Common in: Women with heavy periods (that depleted reserves), those with poor nutrition, people with digestive issues, very thin or underweight, after pregnancy/breastfeeding
Pattern 2: Energy Blockage + Blood Stasis (氣滯血瘀型)
Your imbalance: Stress creating circulation blockages
How This Works
Chronic stress creates tension in your Liver system, which controls the smooth flow of blood and energy. When this flow gets blocked, blood can't circulate properly—it gets stuck, creating pressure, pain, and clots.
Think of a river blocked by fallen logs. Water builds up behind the blockage, creating pressure. When your period comes, it's like forcing water through a partially blocked pipe—painful. The clots are the "stuck" blood finally breaking free.
Key characteristic: Pain BEFORE and DURING your period, especially first 1-2 days
What it looks like:
- Sharp, stabbing cramps before and during period
- Pain is worse with pressure (don't want anyone touching your belly)
- Dark, purplish blood with clots (sometimes large clots)
- Breast tenderness before period
- Severe PMS—irritability, mood swings, anger
- Period is heavy at first, then tapers off
- Bloating and distention before period
- Stress makes everything worse
Common in: High-stress jobs or lives, people who hold emotions in, perfectionists, those with a lot of frustration or anger
Pattern 3: Cold Pattern (寒凝型)
Your imbalance: Cold in the uterus impeding circulation
How This Works
Cold causes contraction and poor circulation. When your uterus and lower abdomen are cold, blood vessels constrict, blood flow slows, and cramping increases.
Think of trying to move oil in a cold engine—everything's sluggish and contracted. Warming up gets things flowing smoothly again. Same with menstruation—cold impedes the natural flow.
Key characteristic: Pain improves with heat and gets worse with cold
What it looks like:
- Cramping pain that feels better with heating pad or hot water bottle
- Lower abdomen feels cold to the touch
- Dark, clotted blood (from poor circulation)
- Pain that gets worse in cold weather
- Late periods (cold slows everything down)
- Scanty flow at first, then increases
- Lower back ache
- Cold hands and feet, especially during period
- Clear, watery vaginal discharge
Common in: People who love iced drinks, those who wear crop tops in cold weather, people who've gotten very cold during a period, those with weak digestion or low metabolism
Pattern 4: Damp-Heat Pattern (濕熱型)
Your imbalance: Inflammation in the reproductive system
How This Works
Damp-heat is inflammation and excess moisture in your reproductive system—often from infection, diet, or environmental factors. This creates a hot, sticky environment that affects menstruation and causes uncomfortable symptoms.
Think of a swamp—hot, humid, stagnant, with bacteria potentially thriving. That's what damp-heat is like internally. Everything's inflamed and stuck.
Key characteristic: Heavy flow with heat symptoms and unusual discharge
What it looks like:
- Heavy, gushing periods (soaking through pads/tampons quickly)
- Bright red or dark, sticky blood
- Burning or hot sensation in pelvis
- Yellow vaginal discharge with odor
- Lower abdominal pain and heaviness
- Period comes early
- Fever or feeling hot during period
- Thirst, bitter taste in mouth
- Constipation or dark, smelly urine
Important: This pattern often requires medical evaluation. If you have unusual discharge, odor, or fever, see a doctor to rule out infection, endometriosis, fibroids, or other conditions.
Common in: People with or after infections, those with endometriosis/fibroids/PCOS, people who eat a lot of greasy/spicy foods, those in hot/humid climates
Which Pattern Are You?
Use these checklists to identify your primary pattern:
Blood Deficiency Checklist
- □ Pain during or after period (not before)
- □ Light, scanty flow
- □ Pale blood
- □ Fatigue worse during period
- □ Dizziness or lightheadedness
- □ Pale face, dry skin
3+ checks? Likely Blood Deficiency
Energy Blockage + Blood Stasis Checklist
- □ Sharp cramps before/during period
- □ Dark blood with clots
- □ Severe PMS (irritability, mood swings)
- □ Breast tenderness
- □ Pain worse with pressure
- □ Stress makes it worse
3+ checks? Likely Energy Blockage pattern
Cold Pattern Checklist
- □ Pain improves with heat
- □ Lower abdomen feels cold
- □ Worse in cold weather
- □ Late periods
- □ Cold hands/feet during period
- □ Love for iced drinks
3+ checks? Likely Cold pattern
Damp-Heat Checklist
- □ Very heavy flow
- □ Yellow discharge with odor
- □ Burning sensation in pelvis
- □ Feeling hot during period
- □ Early periods
- □ Dark, smelly urine
3+ checks? Likely Damp-Heat (see doctor to rule out infection)
Mixed Patterns Are Common
Many women have combinations:
Blood Deficiency + Cold: Light, painful periods with cold symptoms. Both depleted AND cold.
Energy Blockage + Cold: Stress creates tension, cold makes circulation worse. Clots + pain that improves with heat.
Blood Stasis + Damp-Heat: Old stuck blood creates inflammation. Heavy flow with clots and pain.
Your Body's Wisdom
Here's what's important to understand:
Period pain isn't random. It's your body communicating about a specific imbalance.
Understanding your pattern is the first step to addressing it—not just managing symptoms with painkillers, but actually supporting your body to restore balance.
Blood Deficiency: You need to build reserves → Menstruation becomes comfortable
Energy Blockage: You need to release tension → Blood flows smoothly → Pain resolves
Cold: You need to restore warmth → Circulation improves → Cramping releases
Damp-Heat: You need to clear inflammation → System balances → Symptoms resolve
Your body is designed for comfortable, healthy periods. The pain is a signal about what needs support—not a permanent condition you have to endure.
Your period pain is communication, not condemnation.
Your body is telling you what it needs to restore balance.
Understand the message, and comfortable periods become achievable.