In my clinic, I once treated a patient who had been experiencing prolonged menstrual bleeding for nearly two months. After diagnosis, I determined it was due to qi stagnation and blood stasis, and prescribed a qi-regulating and blood-activating formula with motherwort as the main ingredient. The patient hesitated, saying, "I'm already bleeding non-stop—won't blood-activating herbs make it worse?" Only after repeated reassurance did she feel comfortable taking the medication.

During her follow-up visit, she reported heavier bleeding on the first day after taking the medicine, but by the second day, her menstrual period had completely stopped.

Why can blood-activating medications stop bleeding when there's continuous dripping of menstrual blood? Let's discuss this issue today.

First, it's important to clarify that bleeding outside the menstrual period isn't necessarily prolonged menstruation.

Normally, menstruation should end within 7 days. If it persists beyond 7 days or occurs irregularly, regardless of the flow, it is considered prolonged menstruation, known in Traditional Chinese Medicine as "metrorrhagia." Additionally, if intermittent bleeding continues for more than 3 days after menstruation ends and before the next period, it is also classified as metrorrhagia. However, physiological ovulation bleeding (midcycle spotting) doesn't count as metrorrhagia—in women with regular cycles, occasional light bleeding or blood-streaked discharge lasting 1-3 days around days 12-16 of the cycle is considered normal.

So why does blood stasis cause prolonged menstrual dripping?

Poor blood circulation can lead to blood stasis. If the stagnation occurs in the meridians and blood vessels, preventing normal qi and blood flow, they will "find alternative pathways" and flow out at irregular times, causing prolonged menstrual bleeding. In this case, blood-activating herbs are needed to dredge the meridians, completely expel stagnant blood, and thereby stop the bleeding.

If blood stasis remains stagnant in the uterus for a long time, it may lead to the formation of cysts or nodules, triggering issues such as mammary gland hyperplasia, uterine fibroids, and ovarian cysts. It could even result in pigmentation, dark circles under the eyes, and infertility.

If you mistakenly treat prolonged spotting of blood stasis type as a deficiency syndrome and only focus on tonification, it will only worsen the stagnation and produce opposite effects. You can determine whether you have a blood stasis constitution through a self-assessment checklist for body constitution and tongue examination.

For those struggling with spotting due to blood stasis, Chinese angelica root (Danggui) and motherwort (Yimucao) are excellent traditional remedies. Chinese angelica root, with its warm nature and sweet-pungent flavor, targets the heart, liver, and kidney meridians. It excels at promoting blood circulation, nourishing blood, regulating menstruation, and relieving pain with its strong warming and unblocking properties. Particularly suitable for women with internal blood stasis accompanied by cold constitution, it can be prepared as steamed chicken with Danggui, Danggui steamed eggs, or Danggui herbal soup for therapeutic benefits.

Motherwort has a pungent taste and slightly warm-cool nature, capable of dispelling wind, resolving stasis, and promoting regeneration. Neither as strongly warming as Angelica sinensis nor obviously cold in nature, it suits women with blood stasis and a constitution leaning towards heat. A simple bowl of Motherwort Lean Pork Soup can effectively activate blood circulation and expel stasis.

Here we recommend "Motherwort and Tangerine Peel Boiled Eggs":

Take 50g fresh motherwort (or 15g dried), 6g tangerine peel, and 2 eggs. Boil together in water. After the eggs are cooked, remove shells and continue boiling briefly. Drink the broth and eat the eggs.

Women with heat-leaning constitutions, internal blood stasis, prolonged menstrual spotting accompanied by constipation, dry mouth, or a red tongue may consume this dish before menstruation. During persistent post-menstrual dripping, consume for 2-3 consecutive days (once daily), discontinuing when bleeding stops.

To keep away from a blood stasis constitution, there are two key points to note in daily life:

Firstly, maintain a pleasant mood. Holding in anger, losing temper, or experiencing frequent emotional fluctuations can harm liver fire, affect the liver qi's free flow, and lead to qi stagnation and blood stasis

Second, avoid cold drinks and crop tops. Regularly consuming cold foods, exposing yourself to chilly water, or living in cold environments for prolonged periods can slow down or even stagnate blood circulation. Those with blood stasis constitutions should protect their waist, abdomen, and legs by eating fewer raw/cold foods and minimizing crop top attire.

Finally, it's important to note that apart from blood stasis, "deficiency failing to contain blood" can also cause prolonged menstruation. In such cases, tonifying deficiency is needed rather than promoting blood circulation – careful differentiation of constitution is required. If menstrual bleeding persists for an extended period with heavy flow, it may deplete qi and blood leading to mixed deficiency-excess conditions. We recommend timely clinical consultation to avoid delaying treatment.