Amenorrhea (no period) is called jing bi or bi jing in Chinese Medicine. Bi means blockage or something that is closed or shut. Jing refers to the menses. Bi Jing used together implies something is being closed or shut, meaning blood can not come out monthly during the menses. The term blocked menses is identified as a pathological absence of menses, which is distinct from menopause, as that is not pathological, it is part of life. There are two types of amenorrhea: primary and secondary. Primary amenorrhea is if a woman has not menstruated by 18. Secondary amenorrhea is when a woman experiences an established menstrual cycle but then it stops for 3 months or more. Blocked menses is often caused by a history of delayed menses and or scanty menses. It is essentially a problem of not bleeding or discharging blood when one should be.
Because blocked menses is not discharging blood when the body is suppose to, there are two mechanisms. One being there is not enough blood to fill the uterus on a regular basis, or there is something stopping the free flow of blood, thus preventing discharge. If there is insufficient blood, a practitioner must look at the heart, spleen and kidneys which all engender and transform blood. Emotional disturbances can cause the heart to fail in its function of circulating the blood. Overthinking, worry, lack of exercise, excessive fatigue, insufficient nutrition, can all hinder blood production. There is also congenital insufficiency, excess sex, prolonged and unremitting fatigue, disease, drug abuse, oral contraceptive use, and age factors that all attribute to the lack of production of blood in the body.
In terms of obstruction of free flow of menstrual blood there are three main types of blockage. The first is damp congealing and stagnating which results in blood stasis. This could be due to exposure to dampness and cold. Cold conceals and constricts the blood which causes blood stasis. Dampness is considered a yin element which also means it can obstruct and hinder the free flow of yang qi, which moves the blood. Dampness and cold may also be engendered by overeating uncooked or cold foods especially when one is expecting their menses to arrive. These foods include ice cream, frozen yogurt, and chilled refrigerated beverages. The second cause of bloackage and obstruction is due to qi stagnation and blood stasis. This can be caused by emotional upset, stress, and frustration, which all impact liver qi. The liver is in charge of moving blood in the body and if it cannot, qi stagnation and blood stasis can arise. Blood stasis can also be caused by trauma and chronic disease. The third and last cause is phlegm dampness. Dampness can obstruct the free flow of qi. Pheglm dampness can occur from a faulty diet, lack of exercise and some people are constitutionally predisposed to this condition.
Both vacuity and repletion patterns of blocked menses respond well to TCM treatment. However there are some patterns such as blood and yin vacuity, and phlegm dampness obstruction that can be harder and take longer to treat. Talk to your Acupuncturist or Herbalist to see how they can help!
