Do you have diarrhea before your period?

For many women, there will be many uncomfortable symptoms in the body before menstruation comes. Among them, abdominal pain is the most common, and some friends may also experience breast pain. In addition to these, some people also find that they have diarrhea before menstruation. Is this normal? In fact, it is normal to have diarrhea before menstruation. Traditional Chinese medicine calls this phenomenon menstrual diarrhea, while Western medicine calls it premenstrual syndrome!

Dialectical points

The key point of diagnosis of this disease is diarrhea occurring every time menstruation comes. Most patients with this disease present with deficiency syndrome. Those with diarrhea and abdominal distension present with spleen deficiency, those with sore waist and cold limbs present with kidney deficiency. There are also cases where strong liver attacks spleen, presenting with mixed symptoms of deficiency and excess.

Treatment principles

The principle of treatment is to warm the kidney and strengthen the spleen.

Syndrome and Treatment Classification

1. Spleen deficiency type

Main symptoms: diarrhea before or during menstruation, abdominal distension, fatigue, heavy menstrual flow, light-colored and thin-textured vaginal discharge, heavy, white and sticky vaginal discharge without odor, or puffy face and limbs, pale and fat tongue, greasy white tongue coating, and weak and slow pulse.

Symptom analysis: The spleen is originally weak. Before or during menstruation, Qi and blood are concentrated in Chong and Ren, which makes the spleen weaker and causes dysfunction of transportation and transformation. Water and dampness go down to the large intestine, causing diarrhea and abdominal distension. The spleen governs the limbs. When the spleen is weak, the mind is tired and the limbs are exhausted. Water and dampness overflow the skin, causing puffy face and swollen limbs. When the spleen is weak, it loses its control, and Chong and Ren are not solid. Therefore, the menstrual flow is heavy, light in color and thin in texture. When the spleen is weak, dampness is generated, which is concentrated in the lower part of the body and damages the belt meridian. The belt meridian fails to function properly, causing heavy vaginal discharge with white and sticky color. A pale and fat tongue, a white and greasy tongue coating, and a weak and slow pulse are also signs of spleen deficiency.

Treatment principles: tonify the spleen and replenish qi, remove dampness and stop diarrhea.

Representative prescription: Shenling Baizhu San.

Prescription: ginseng, atractylodes, lentils, poria, licorice, yam, rhubarb, platycodon, coix seed, and amomum.

If the liver is strong and dominates the spleen, the symptoms include abdominal pain and diarrhea during menstruation, which stops after diarrhea, or distension and pain in the chest and flanks, and irritability. The treatment should be to soften the liver and support the spleen, regulate qi and stop diarrhea, and use the prescription for pain and diarrhea (Dan Xi's Heart Method).

2. Kidney Yang Deficiency

Main symptoms: diarrhea before or during menstruation, especially in the morning, diarrhea at dawn, sore waist and weak legs, chills and cold limbs, dizziness and tinnitus, scanty and light-colored menstruation, usually heavy and watery vaginal discharge, dull complexion, pale tongue, white and slippery tongue coating, and slow and weak pulse.

Symptom analysis: The constitution is insufficient in kidney yang, and qi and blood flow downward before and during menstruation, which makes kidney yang more deficient. The vital fire cannot warm the spleen and earth, and the transportation and transformation are impaired, so water and dampness flow to the large intestine, resulting in diarrhea during menstruation; kidney yang deficiency cannot warm and nourish the external organs, so there is soreness and weakness in the waist and knees; kidney yang deficiency and yang qi are not distributed, so there is fear of cold and cold limbs; the sea of ​​marrow is not nourished, so there is dizziness and tinnitus; kidney yang deficiency, dampness and turbidity flow downward into Chong and Ren, so there is a lot of thin vaginal discharge; kidney deficiency and Chong and Ren are insufficient, and the blood fails to be warmed and transformed, so the menstruation is scanty, the color is light, the complexion is dull, the tongue is pale, the tongue coating is thin and white, and the pulse is deep, slow and weak, which are also signs of kidney yang deficiency.

Treatment principles: Warming yang and tonifying the kidney, strengthening the spleen and stopping diarrhea.

Examples of prescriptions: Jian Gu Tang (from "Fu Qingzhu's Gynecology"), He Si Shen Wan (from "Zheng Zhi Zhun Sheng").

Jian Gu Tang: ginseng, Atractylodes macrocephala, Poria cocos, Coix seed, and Morinda officinalis.

Si Shen Wan: Psoralea corylifolia, Evodia rutaecarpa, nutmeg, Schisandra chinensis, ginger, and jujube.

In the formula, Morinda officinalis and Psoralea corylifolia warm the kidney and boost yang; Evodia rutaecarpa warms the middle and harmonizes the stomach; Ginseng and Atractylodes macrocephala strengthen the spleen, replenish qi and stop diarrhea; Poria cocos and Coix seed strengthen the spleen and eliminate dampness; Nutmeg and Schisandra chinensis firm and stop diarrhea. The whole formula warms and solidifies the kidney qi, strengthens the spleen qi, transforms dampness and turbidity, and stops diarrhea.