Understanding the Exact Causes of Menstrual Pain

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“My menstrual pain recurs every month, and now even medication doesn’t help much…” This is a story I often hear in the consultation room. Menstrual pain is a common symptom experienced by many women, but it is by no means ‘pain that must be endured.’ In fact, menstrual pain can be a signal of uterine abnormalities and can arise from various causes such as blood stasis (瘀血), coldness (冷症), or deficiency of Qi and blood in the body.

In Korean medicine, menstrual pain is not simply suppressed with painkillers; rather, treatment focuses on identifying and resolving the root cause by examining the body’s constitution and uterine condition. Is the uterus cold, obstructing circulation? Is there blood stasis? Or is the uterine function weakened? Only by correcting these underlying causes can menstrual pain disappear and uterine health be maintained.

In this article, we will explain the specific causes of menstrual pain and how Korean medicine approaches and treats it in detail.

Menstrual pain (dysmenorrhea) is an uncomfortable symptom experienced by many women, characterized by pain that occurs periodically in sync with the menstrual cycle. Dysmenorrhea is a common symptom affecting approximately 50% of women of reproductive age, divided into primary and secondary dysmenorrhea. Primary dysmenorrhea occurs when prostaglandins, produced in the endometrium after ovulation, cause strong contractions of the uterine muscles.

It typically begins within 1-2 years after menarche and is common in women in their teens and twenties. Painkillers (NSAIDs) are effective. Secondary dysmenorrhea arises from pathological causes within the pelvis, such as endometriosis, adenomyosis, or intrauterine devices.

It can begin several years after menarche and may occur independently of ovulation. Therefore, primary dysmenorrhea is mainly related to hormonal changes, while secondary dysmenorrhea is associated with pelvic abnormalities. In Korean medicine, menstrual pain is explained by various internal imbalances such as Qi (氣), Blood (血), Cold (寒), Heat (熱), and Dampness (濕).

Treatment methods vary according to the different causes, and the main causes are as follows: *Deficiency of Qi and Blood If the circulation of Qi and Blood is not smooth, the uterus may not receive sufficient blood supply, leading to pain. This occurs when Qi and Blood are deficient due to fatigue, stress, irregular lifestyle habits, etc.

*Coldness (寒氣) If cold energy accumulates in the uterus, blood circulation is reduced, which can lead to menstrual pain. This is especially common in women exposed to cold environments in winter or those with accumulated cold energy in their bodies. *Qi Stagnation (氣滯)

In Korean medicine, Qi stagnation is considered a major cause of menstrual pain, which can arise from stress or emotional imbalance. When Qi stagnates, energy becomes blocked in various organs, including the uterus, causing pain. *Blood Stasis (血瘀) If blood does not circulate normally, blood stasis occurs, leading to pain.

This is a common cause, especially in pathological conditions such as endometriosis or adenomyosis. Premenstrual Syndrome Self-Diagnosis (If 3 or more apply, seek a diagnosis!) 1. Tenderness is felt in the breasts.

2. Suddenly experience indigestion, nausea, and sometimes vomiting. 3. Become irritable and easily angered.

4. Frequently overeat due to noticeable changes in appetite. 5. Experience excessive sleep or, conversely, insomnia.

6. Migraines occur. 7. Muscle pain appears in various places, such as the shoulders and lower back.

8. The body swells easily, and weight increases. 9. Feel restless and tense without reason.

10. Concentration decreases and fatigue sets in without reason. Accurate identification of the cause of menstrual pain is essential for proper treatment.

Root Cause Treatment for Menstrual Pain with Korean Medicine 1. Coldness (冷症) – A state where the uterus is cold, obstructing the circulation of Qi and Blood – Through warm acupuncture, moxibustion treatment, and warming herbal medicine, warmth is brought to the uterus, and circulation is restored. 2. Blood Stasis (瘀血) – When menstrual blood stagnates, causing pain – Herbal medicine to remove blood stasis helps facilitate the discharge of menstrual blood, reducing pain.

3. Deficiency Syndrome (虛證) – When uterine function is weak and Qi and Blood are deficient – The function of the uterus and ovaries is strengthened with restorative herbal medicine that replenishes Qi and Blood.

Accurate identification of the cause of menstrual pain is essential for proper treatment. Menstrual pain can be a sign that blood stasis (瘀血) is accumulating within the uterus, and if not improved, it could lead to more serious conditions such as uterine fibroids, endometriosis, or ovarian abnormalities. In Korean medicine, the focus is on resolving blood stasis and promoting uterine health through personalized treatment tailored to the individual’s constitution.

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This post was written directly by the medical staff of Sunyujae Korean Medicine Clinic to provide medical information, in compliance with Article 56(2) and Article 57(3) of the Medical Service Act. The duration and outcome of treatment may vary from person to person, so please consult a qualified practitioner before beginning treatment.