Many women are experiencing "out-of-control" menstruation, periods like a bursting dam, with overwhelming, excessive flow, often lasting more than ten days with continuous spotting. Dizziness, fatigue, palpitations, and shortness of breath follow... This is not simply "irregular menstruation," but a severe imbalance of Qi and Blood called "Beng Lou" (Uterine Bleeding) in TCM! Are there any specific hemostatic formulas?
What causes Beng Lou (Uterine Bleeding)?
Singapore TCM Gynecology expert Dr. Que Poh Yuen Albert from Gong Fang Tang TCM explains that TCM terms sudden, massive, non-timely uterine bleeding as "Beng Zhong" (Flooding), and continuous, dripping bleeding as "Lou Xia" (Trickling). These two conditions often transform into each other and are collectively called "Beng Lou." Its occurrence is not due to a single cause but is a comprehensive manifestation of dysfunction of the internal organs and disharmony of Qi and Blood. It is mainly closely related to the following factors:
Spleen Qi Deficiency, Failure to Govern Blood: TCM believes "the Spleen governs blood." Overwork, dietary irregularities, and excessive worry damaging the Spleen lead to Spleen Qi deficiency, which weakens its ability to contain blood. Blood fails to follow its normal pathways and flows recklessly, making this the most common cause of Beng Lou. Patients often experience fatigue, shortness of breath, sallow complexion, and poor appetite.
Kidney Qi Deficiency, Failure to Secure and Store: "The Kidneys govern storage." Deficiency of Kidney Qi (especially Kidney Yang) is like a warehouse door that won't close tightly, making it difficult to contain menstrual blood. Congenital insufficiency, chronic illness, physical weakness, excessive sexual activity, or multiple childbirths can easily lead to this type. Symptoms often include soreness and weakness in the lower back and knees, aversion to cold with cold limbs, dizziness, and tinnitus.
Blood Heat Disturbing Internally, Forcing Blood Recklessly: Excessive consumption of spicy foods, emotional depression transforming into fire, or external contraction of heat pathogens can lead to excessive Yang heat internally. The fire-heat pathogen scorches the blood vessels, forcing blood to flow outside its normal pathways. Manifestations include heavy bleeding with dark red, thick blood; irritability; thirst; flushed face and red lips; and dry stools.
Blood Stasis Obstructing the Collaterals, Blood Failing to Return to its Pathways: Qi stagnation, cold congelation, heat scorching, or trauma can all lead to internal blood stasis. Stasis obstructs the Chong and Ren vessels and the uterine collaterals, preventing new blood from returning to its pathways and causing it to flow out. Manifestations include continuous dripping bleeding or heavy bleeding mixed with dark purple-black clots, and lower abdominal pain that is worse with pressure.
Damage to the Chong and Ren Vessels, Unstable Foundation: The Chong vessel is the "Sea of Blood," and the Ren vessel governs the uterus. Repeated miscarriages, gynecological surgeries, chronic pelvic inflammatory disease, etc., can directly damage the Chong and Ren vessels, leading to dysfunction of their securing ability and triggering Beng Lou.
Physician Qiu Baorun: "Beng Lou is not a minor ailment. It often hides risks of endocrine disorders, organic pathologies of the reproductive system (such as fibroids, polyps, adenomyosis), or even systemic diseases. Timely and accurate pattern differentiation is the key to successful treatment."
How does TCM regulate Beng Lou (Uterine Bleeding)?
Facing the complex and diverse presentations of Beng Lou, Physician Dr. Que Poh Yuen Albert, in years of clinical practice, particularly advocates for and skillfully uses the classic formula created by the renowned modern physician Zhang Xichun – An Chong Tang (Calm the Chong Vessel Decoction). This formula is exquisitely composed, combining attacking and tonifying strategies. Through multi-target regulation, it restores the securing function of the Chong and Ren vessels. It is especially suitable for Beng Lou due to Spleen Qi deficiency and Chong vessel instability (or combined with Kidney deficiency or blood stasis), with symptoms including heavy menstrual flow, prolonged periods, pale and thin blood, shortness of breath, fatigue, and lusterless complexion.
An Chong Tang consists of: Bai Zhu (Rhizoma Atractylodis Macrocephalae), Sheng Huang Qi (Radix Astragali), Sheng Long Gu (Os Draconis), Sheng Mu Li (Concha Ostreae), Da Sheng Di (Radix Rehmanniae Recens), Sheng Hang Shao (Radix Paeoniae Alba), Hai Piao Xiao (Endoconcha Sepiae), Qian Cao (Radix Rubiae), Chuan Xu Duan (Radix Dipsaci).
In the formula: Bai Zhu and Huang Qi fortify the Spleen and boost Qi to secure menstrual blood.
Long Gu, Mu Li, and Hai Piao Xiao astringe and stop bleeding.
Sheng Di and Bai Shao nourish Yin and blood, cool blood, and clear heat.
Xu Duan tonifies the Kidneys and secures the Chong vessel.
Qian Cao invigorates blood and dispels stasis, removing stasis so new blood can return to its pathways. The entire formula is brilliantly combined to achieve the effects of fortifying the Spleen and tonifying the Kidneys, securing the Chong vessel and containing blood, nourishing blood and cooling blood, transforming stasis and stopping bleeding. It fundamentally regulates menstrual Beng Lou and restores normal menstruation.
Modifications and Clever Applications:
Significant Damp-Heat (Yellow, greasy tongue coating): Add Chao Yi Yi Ren (Stir-fried Semen Coicis) 30g, Mian Yin Chen (Herba Artemisiae Scopariae) 15g to fortify the Spleen, drain dampness, and clear heat.
Heavy, Rapid Bleeding: Add Xian He Cao (Herba Agrimoniae) 30g, Zong Lü Tan (Petiolus Trachycarpi Carbonisatus) 12g to enhance astringency and stop bleeding.
Prominent Blood Stasis (Abdominal pain worse with pressure, many clots): Add San Qi Fen (Notoginseng Powder) 3g (taken infused), Chao Pu Huang (Stir-fried Pollen Typhae) 12g (wrapped in decoction) to transform stasis and stop bleeding.
Kidney Yang Deficiency (Cold lower back, aversion to cold): Add Pao Jiang Tan (Blast-fried Ginger Carbonisatus) 6g, Ai Ye Tan (Mugwort Leaf Carbonisatus) 10g, Lu Jiao Shuang (Cornu Cervi Degelatinatum) 15g to warm the Kidneys and secure the Chong vessel.
Kidney Yin Deficiency (Tidal fever, irritability): Add Nü Zhen Zi (Fructus Ligustri Lucidi) 15g, Han Lian Cao (Herba Ecliptae) 15g to nourish Kidney Yin, cool blood, and stop bleeding.
Severe Qi and Blood Deficiency (Fatigue, pale face): Add E Jiao Zhu (Gelatinum Corii Asini) 10g (melted), Dang Shen (Radix Codonopsis) 15g to enhance Qi and blood tonification.
Medical Case
Patient: Ms. Gao, 31 years old.
Chief Complaint: Menstrual irregularities for the past year. Each period lasts over 10 days or even half a month, with flooding-like heavy flow, pale red, thin blood. Abdominal pain slightly reduced after passing large clots. Accompanied by significant dizziness, fatigue, palpitations, shortness of breath, pale complexion, poor appetite, soreness, and weakness in the lower back and knees.
Initial Visit: Pale, swollen tongue with teeth marks, thin white coating, deep, thin, weak pulse.
Pattern Differentiation: Spleen and Kidney dual deficiency, Chong and Ren vessel instability, with concomitant stasis.
Treatment Principle: Boost Qi and fortify the Spleen, tonify the Kidneys and secure the Chong vessel, assisted by transforming stasis to stop bleeding.
Prescription: Modified An Chong Tang.
Herbs: Zhi Huang Qi (Honey-fried Radix Astragali) 30g, Chao Bai Zhu (Stir-fried Rhizoma Atractylodis Macrocephalae) 15g, Duan Long Gu (Calcined Os Draconis) 30g (decocted first), Duan Mu Li (Calcined Concha Ostreae) 30g (decocted first), Hai Piao Xiao (Endoconcha Sepiae) 15g, Xu Duan (Radix Dipsaci) 15g, Shu Di Huang (Radix Rehmanniae Praeparata) 15g, Chao Bai Shao (Stir-fried Radix Paeoniae Alba) 15g, Qian Cao Tan (Rubia Root Carbonisatus) 10g, Xian He Cao (Herba Agrimoniae) 30g, Pao Jiang Tan (Blast-fried Ginger Carbonisatus) 6g, San Qi Fen (Notoginseng Powder) 3g. 7 doses. Decocted in water, one dose daily, taken morning and evening.
Second Visit: After taking 3 doses, bleeding significantly reduced. Bleeding stopped after finishing 7 doses. Spirit and appetite improved; dizziness and palpitations lessened. Based on her Qi and Blood deficiency condition, the prescription was adjusted. Subsequent cycles focused on preventive regulation before menstruation (fortifying Spleen, tonifying Kidneys, securing Chong vessel) and replenishing Qi and Blood after menstruation (e.g., Gui Pi Tang, Ba Zhen Tang, etc.).
Result: After continuous regulation over 3 menstrual cycles, Ms. Gao's menstrual cycle returned to 28-30 days, with periods lasting 6-7 days and ending cleanly. Menstrual flow became moderate. Discomfort symptoms basically disappeared. Complexion became rosy, and physical strength and energy significantly improved.
