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Period Problems and the Liver

For starters, lets get this straight, menstruation should really be called womenstruation.


Okay, no more intended period puns.

Reportedly 16% - 81% of women experience dysmenorrhea (period pain), and 43–91% women under 20 years of age have period pain. (1)

They are bad odds, and that's just pain alone, it doesn't even include heavy and irregular periods, or amenorrhea (no periods). So I'll take the liberty to theorize that most women have some form of period problemo.

Why though?

When one of my Traditional Chinese Medicine (TCM) tutors said to our class:

"Periods aren't supposed to be painful - your uterus is just a muscle doing its job and that shouldn't hurt..."

...I thought it was pretty profound, and it totally makes sense. So lets look at some technical Western Medicine and TCM comparisons of why on earth our big ole uterus muscles do us over once (or for unlucky ones more than once) a month.

Liver-Blood, Irritability and Histamines

In TCM, most period problems get blamed on the Liver's energy (Qi).

This is because the Liver-Blood regulates menstruation in TCM.

Now you may thinking, ... "oh, I thought progesterone and estrogen had that job" ... and you're mostly right. And yes, those hormones do come from (mostly) the ovaries. But bear with me!

Liver Blood

The Liver receives all of the nutrients from your gut before your heart gets that blood. The Liver adds its magic to the blood by cleaning out random things you've eaten (finger nails), as well as toxins.

The Liver turns these nutrients and fats into a bunch of useful things like cholesterol, proteins, and bits that help your blood to clot (stop bleeding).

So the Liver adds magic bits to the watery part of your blood, and these bits generally can't dissolve in the blood.

So when we say "Liver Blood" in TCM, now you know what we're on about. The magic bits in your blood that the Liver helps to make.

Clotting Factors

The bits in the blood that help stop bleeding.

Now you might be starting to see why the Liver is important in period problems. Or you might not.

Let Dr Keown, a Western Medical Doctor and TCM Acupuncturist explain further. From his book, The Spark in The Machine:

"Clotting factors are the most obvious link between Liver-Blood and menstruation. Produced in the liver, these are critical for normal blood clotting and a disturbance in them can cause heavy bleeding. However, it is unusual to find any serious abnormality when tests are done on women with heavy bleeding. Instead, when doctors treat abnormal menstrual bleeding the first line is invariably to use hormones to take control over the menstrual cycle. If this doesn't work with the 'Pill' then they will use progressively stronger hormones until they induce an artificial menopause. Sledgehammers and nuts come to mind." (2)

So, it could be the Liver not producing enough clotting factors (Heavy, long periods, spotting between periods), or producing too much clotting factor (clotted, painful periods).

It may also be another culprit related to the Liver...


The liver has a lot to do with histamine. If you want to know more about the specifics of that then have a look over here.

Who has been accused of being irritable when you happen to have your period? Maybe even accused of being ANGRY! All hands up I bet, but with a defensive look on your face, suggesting they should shove their accusation up their you-know-what because "I AM NOT IRRITABLE!".

Histamine makes you irritable.

Most people associate histamine with hay fever (AKA Allergic Rhinitis which, by the way, acupuncture is good at treating (3)). But histamine has more roles in the body than just making you sneeze when male pine trees do their biz everywhere!

  • During menstruation, histamine causes the womb to be more leaky, allowing red blood cells and fluid to flow.

  • "Around 50% of a women's 'blood' loss is not blood at all: it is actually fluid that has leaked out, and histamine makes this worse." (2) (This 'leakiness' is similar to the runny nose in hay fever.)

  • Women with dysfunctional uterine bleeding have raised levels of histamine in their wombs.

  • PMS symptoms (headaches, tiredness, diarrhea etc) have also been linked to an intolerance of histamine.

  • Histamine increases progesterone levels.

  • Antihistamines do not necessarily work (they also don't very well for histamine induced asthma).


So what does acupuncture have to do with all this biz?

Now that you (hopefully) get the concept of 'Liver-Blood regulating Menstruation' through clotting factors and histamine, lets look at some period symptoms and what they correlate to in TCM. I'll show you some pressure points you can massage to help too.

Liver Qi Stagnation Symptoms

  • PMS - Bloating, temporal headaches, irritability, tender breasts

  • Pain - Aching/cramping on day 1-2 of period, the pain is bearable though

  • Clotted blood

  • Generally feel better after day 1-2 of you period

Massage in a circular motion with you thumb or finger for 5-10 mins, if its achy you're in the right spot!

Liver Blood Stasis Symptoms

  • Simillar symptoms of Liver Qi stagnation, but the pain is unbearable

  • Dark red - black blood, clotted/congealed

  • Pain - Stabbing, drilling cramps, make you want to curl up and maybe throw up. The kind of pain that Paracetamol doesn't kill :(

Massage in a circular motion with you thumb or finger for 5-10 mins, if its achy you're in the right spot!

Liver Blood Depletion

  • Very light period, 1-3 day bleed, light flow

  • Watery, light coloured blood

  • May have dizziness, lethargy, poor sleep, difficulty concentrating, headaches behind the eyes

Liver Yang Rising

  • You might be an angry lady when you have your period...

  • Symptoms are usually worse before the period

  • Hot flushes, red irritated eyes, really irritable, temporal/vertex/behind the eye headaches.

You can massage both these points at the same time with your thumb and third finger.


Now the thing is, you can have more than one of these conditions. You might have Liver-Blood Depletion and Stasis making for really painful periods that hardly seem worth it because there's hardly any blood.

The good thing is though that (from a Western Medical View) there is nothing wrong with you physical Liver. We are talking about the energetic jobs of the Liver here. Check out 'What's this 'Qi'?' to learn more about this.

There are also other organs in the body that, if not working correctly, can affect the menstrual cycle. These will be covered these in future blogs.

Hopefully these tips will provide you with some relief - otherwise go seek out your local acupuncturist. ...Please don't try sticking stitching needles in at home!


1. Armour, M. (2015) The effectiveness of acupuncture in the treatment of primary dysmenorrhea: A mixed methods study.

2. Keown, D. (2014) The Spark in the Machine. Singing Dragon. UK

3. McDonald J, Janz S. (2017). The Acupuncture Evidence Project: Plain English Summary.

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