According to Traditional Chinese Medicine (TCM), regular menstrual cycles not only indicate a proficient blood circulation, but also signify the entire being – physical, intellectual, emotional and spiritual – is well maintained.

Once a irregular menstruation occurs and is not taken care in time, the normal physiology inside the body will be disturbed. Then the individual is in risk of other problems such as emotional unstable, metabolic  disturbances, obesity or darkened and thin physique, premature aging and even infertility.

As the development of missed period (amenorrhea) is complicated, it may be hard to find the underlying causes sometimes. Also individuals usually have missed period alone, that can't identify other signs for evaluation. These cause problems for western doctors to treat, a process of trial and error leads to long treatment course.

TCM treatment is a suitable option for missed period. Physicians understand missed period development with a west and east approach, identify the internal disharmony based on syndrome differentiation and then design a proper treatment plan according to each individual. The treatment methods are flexible yet multiple. All of the therapies are aimed at regulating or balancing the endocrine system, so as to restore a normal menstrual cycle.

Dwarf lily-turf tuber	Pinellia tuber	Peony root bark

Below are TCM guidelines for missed period treatment:

• Deficient cases: replenishing blood along with invigorating spleen and stomach. In case if blood depletion is severe, nourishing liver and kidney;
• Excess cases: resolving blood stasis along with regulating qi. If there is cold obstruction, then add warming; phlegm and dampness obstruction, then add drying and resolving phlegm.

Some common syndrome patterns of missed period and their prescriptions are below:

Deficiency of kidney-qi

Therapeutic aim: reinforce kidney-qi, support Thoroughfare and Conception Vessels

Sample prescription: Cistanche and Dodder Seed Pill

In the prescription, cistanchi and dodder seed are the monarch herbs, which serve to reinforce the kidney-qi and support the Thoroughfare Vessel. The other herbs assist monarch herbs by enriching the blood and reinforcing the power of the kidneys. In addition, ingredients such as ledebouriella root and baical skullcap root are used for the elimination of pathogens, because the body can easily be attacked by pathogens such as wind-heat or wind-cold in this kind of deficiency.

Depletion of kidney essence

Therapeutic aim: nourish kidney, replenish essence and nourish blood

Sample prescription: Restore Kidney Pill

In the prescription, the processed rhemannia root acts as the monarch herb to nourish kidney yin; the eucommia bark, dodder seed, angelica root and wolfberry enrich blood and replenish essence; Chinese yam and poria promote the spleen to ensure the nutrient supply for blood and qi productions. The whole combination nourishes the yin and blood so as to replenish the essence and bone marrow.

Deficiency of blood and qi

Therapeutic aim: replenish blood and assist with boosting qi (vital energy)

Sample prescription: Sacred Healing Decoction

In the prescription, the first four ingredients make up the well-known combination known as the Four Herbs Decoction, which aids and regulates the blood. With the astragalus and ginseng, the prescription enriches both qi and blood and promotes circulation.

Blood stasis and cold coagulation

Therapeutic aim: warm meridians, disperse coldness, activate blood and dispel stasis

Sample prescription: Warm Meridian Decoction

This is a usual prescription for regulating menstruation. The medicinal evodia fruits and cassia twig are the monarch herbs, which warm the meridians and promote circulation. Angelica root and  Sichuan lovage rhizome remove blood stasis; donkey-hide gelatin, lily-turf tuber and white peony root nourish yin to produce blood; peony root bark clears virtual heat; ginseng, fresh ginger and pinellia tuber harmonize the stomach and promote blood and qi production. Liquorice root acts as the guide herb.

Platycodon root	Submature bitter orange	Achyranthes root

Stagnation of blood and qi

Therapeutic aim: sooth liver, regulate qi, activate blood and unblock stagnation

Sample prescription: Blood House Stasis Dispelling Decoction

In the prescription, the peach kernel and safflower flower are the monarch herbs that serve to activate blood and remove stasis. The angelica root, peony root and Sichuan lovage rhizome work together to nourish the blood. Platycodon root, bupleurum root, submature bitter orange and achyranthes root ensure the flow of qi and blood flow in the right direction. Also, the rhemannia clears heat in the blood; liquorice root acts as buffer. All the herbs work together to activate blood, dispel stasis, regulate menstruation and nourish blood.

Phlegm and dampness obstructions

Therapeutic aim: dispel phlegm, dry dampness, activate blood and unblock collaterals

Sample prescription: Atractylodes and Nutgrass Guide Phlegm Pill

In the prescription, the ingredients of Citrus & Pinellia Decoction resolve phelgm, dry dampness, harmonize the stomach and invigorate the spleen; the atractylodes rhizome dries dampness and invigorates the spleen; the nutgrass flatsedge rhizome and submature bitter orange regulate qi flow and unblock stagnation; arisaema with bile dries dampness and resolves phlegm; fresh ginger warms the middle burner and harmonizes the stomach. The whole prescription dispel phlegm and dampness so as to regulate menstruation.