Do you get headaches every time your period comes, like a tight band constricting your head, exploding from your temples to the back of your skull? Painkillers become less effective even as you take more and more. In Singapore's hot and humid environment, over 68% of women suffer from menstrual headaches. What can be done?
Why do headaches occur with menstruation?
TCM gynecology expert Dr. Que Poh Yuen Albert from Gong Fang Tang TCM Singapore explains that headaches occurring during a woman's menstrual period are mostly migraines. These are often caused by obstructed menstrual blood flow and blood stasis blocking the brain's collaterals. This type of headache can occur before, during, or after the period and is also called menstrual headache.
Three hallmark symptoms of "Blood-Stasis Type Headache":
Pain like being pricked by needles or awls, fixed in location.
Dark purple menstrual blood with clots, severe abdominal pain upon pressure.
Purplish-black, distended sublingual veins (check the two "black tendons" under your tongue in a mirror).
Why does blood stasis specifically act up during menstruation?
During menstruation, Qi and blood flow downwards to the uterus, leading to insufficient blood supply to the head.
Blood stasis takes advantage of this weakness to surge upwards, clogging the brain's microcirculation.
Singapore's hot and humid climate increases blood viscosity.
How does TCM regulate headaches that occur with menstruation?
Based on years of clinical experience, Physician Dr. Que Poh Yuen Albert has a unique treatment plan for menstrual headaches. He often uses Tongqiao Huoxue Decoction (Orifice-Opening Blood-Invigorating Decoction) for patient regulation. This formula originates from "Corrections of Errors Among Physicians" (Yi Lin Gai Cuo) by the renowned Qing Dynasty physician Wang Qingren.
Tongqiao Huoxue Decoction is composed of Chishao (Red Peony Root), Chuanxiong (Szechuan Lovage Root), Taoren (Peach Seed), Honghua (Safflower), Lao Cong (Old Scallion), Shengjiang (Fresh Ginger), Hongzao (Red Jujube), and Shexiang (Musk, which can be substituted with Shichangpu/Acorus Tatarinowii). It has the effects of invigorating blood, resolving stasis, opening the orifices, and relieving pain.
In the formula:
Taoren and Honghua invigorate blood and resolve stasis.
Chuanxiong is the Qi-moving herb within the blood; it ascends to the head and eyes, invigorating blood, moving Qi, and relieving pain.
Chishao assists in invigorating blood and resolving stasis.
Lao Cong, Shengjiang, and Hongzao harmonize Ying and Wei, unblock Yang, and open the orifices.
Shexiang (Shichangpu) is aromatic and penetrating, guiding the herbs into the collaterals and reaching the diseased area directly.
Physician Qiu will flexibly modify the Tongqiao Huoxue Decoction based on the patient's specific symptoms and tongue/pulse presentation for precise regulation.
Medical Case
Patient: Ms. Hu, 29 years old.
Chief Complaint: Menstrual migraines for 5 years, dark purple menstrual blood with many clots, abdominal pain that rejects pressure. In the past year, attacks were accompanied by blurred vision, requiring 2 days of bed rest. Repeated stomach pain from taking Western medicine.
Initial Consultation: Purple-dark tongue body with stasis spots on the edges. Headache localized to the right temple.
Diagnosis: Qi stagnation and blood stasis type menstrual headache.
Prescription: Modified Tongqiao Huoxue Decoction (added Dilong/Earthworm and Manjingzi/Vitex Fruit).
Medical Advice: Avoid mangoes, durians, and cold drinks during menstruation.
Result: After taking 7 doses, headache symptoms significantly reduced. After continuous regulation over three menstrual cycles, menstrual headaches basically disappeared, and menstrual color returned to normal.
