bubble_chart Concept

Pale menstrual color refers to the symptom where the color of menstruation is lighter than normal. Danxi Xinfa discusses this condition in the context of women's health, stating: "Irregular menstruation with pale, watery blood." Later, Nyuke Zhengzhi Zhunsheng and Jiyin Gangmu provided more detailed explanations on the mechanism of disease and treatment principles for this condition.

bubble_chart Pattern Analysis

1. Blood Deficiency︰The menstrual flow is pale red, delayed with scanty amount, accompanied by lingering pain in the lower abdomen, dull complexion, dizziness, blurred vision, palpitations, insomnia, brittle nails, pale tongue, and thin pulse. The deficiency primarily lies in "blood," resulting from frequent pregnancies or miscarriages, metrostaxis, or blood loss, leading to insufficient blood in the Chong and Ren meridians with nothing left to discharge. The main symptoms are characterized by delayed menstruation (third stage), pale and scanty flow, along with signs of deficient nourishment due to insufficient nutrient-blood, such as lingering pain in the lower abdomen, brittle nails, pale lips and tongue, and thin pulse. The treatment focuses on nourishing blood, supplemented by tonifying qi, so that yin can be uplifted by yang, enabling endless generation and transformation.
2. Qi Deficiency︰The menstrual blood is pale red in color and thin in quality, with early onset and heavy flow during the menstrual period, or prolonged bleeding, or metrostaxis dripping, complexion pale, shortness of breath and physical fatigue, spontaneous sweating and aversion to wind, or a sensation of emptiness and sagging in the lower abdomen, tongue texture pale and tender, with tooth marks on the edges, thin and moist coating, and a deep and weak pulse. The deficiency primarily lies in "qi," resulting from dietary overstrain, which depletes middle qi. The main symptoms are characterized by pale red menstrual blood, thin quality, early onset with heavy flow during the menstrual period, or prolonged bleeding, or metrostaxis dripping, etc. Qi deficiency fails to perform its warming function, hence accompanied by symptoms such as a pale complexion, physical fatigue and reluctance to speak, spontaneous sweating and aversion to wind, and a sensation of emptiness in the lower abdomen. A pale and tender tongue texture with tooth marks on the edges and a deep and weak pulse are also important indicators of qi deficiency. The treatment focuses on tonifying qi, supplemented by harmonizing blood, so that yang receives support from yin and the source of transformation remains unexhausted. For blood deficiency, use Four Ingredients Decoction with Astragalus Root and Longan Aril; for qi deficiency, use Original-Qi Preserving Decoction with Chinese Angelica and Peony Root; for dual deficiency of qi and blood, Eight Precious Ingredients Decoction or Ginseng Nutrient-Nourishing Decoction is recommended.
3. Spleen-kidney Yang Deficiency︰The menstrual blood is dull in color, thin in texture, or mixed with clots, with most periods delayed. The hands and feet are cold, the lips are blue and the face is pale, and there is cold pain in the lower abdomen, possibly accompanied by soreness and weakness in the lower back and knees, thin and clear leukorrhea, or loose stools and frequent urination. The tongue is pale, swollen, and tender, with thin white and slippery coating, and the pulse is deep, thin, and slow. This condition may arise from spleen yang being impaired first, eventually affecting the kidneys, or from kidney yang declining first, failing to warm the middle jiao. As yang qi weakens, yin blood fails to generate, leading to deficiency and cold in the Chong and Ren meridians. Thus, the main symptoms include dull and thin menstrual blood, delayed periods, or clots. With yang unable to warm, coldness in the lower body becomes pronounced, resulting in cold hands and feet, blue lips and pale face, cold pain in the lower abdomen, loose stools, frequent urination, and a preference for warmth and aversion to cold. The treatment should focus on warming and tonifying kidney yang, supporting fire to generate earth. The recommended formula is Right-Restoring Decoction with added Poria and Dried Ginger.
4. Damp Phlegm︰The menstrual flow is pale in color and sticky in texture, with delayed periods. The leukorrhea is thick and sticky, accompanied by chest tightness, epigastric distension, a sticky mouth with a bland taste, frequent nausea, or vomiting of phlegm and saliva. There may also be dizziness, a heavy body, a sallow complexion, a white and greasy tongue coating, and a wiry-slippery pulse. This condition is often caused by dietary overexertion, which injures the spleen and stomach, impairing their transport function and leading to dampness accumulation and phlegm production. The dampness and phlegm then descend to the Chong and Ren channels, obstructing the uterine vessels. The obstruction of the uterine vessels results in delayed menstruation (third stage), scanty and sluggish flow, pale and sticky menstrual blood mixed with turbid discharge, which are the main clinical features. Additional symptoms may include a plump and pale physique, a sticky mouth with a bland taste, nausea, poor appetite, dizziness, a heavy body, a greasy tongue coating, and a slippery pulse. The treatment principle is to invigorate the spleen, resolve dampness, disperse phlegm, and promote circulation. The modified Chuanxiong and Danggui Two Old Ingredients Decoction is recommended.

The symptom of pale menstrual color is mostly attributed to deficiency pattern and cold pattern, as water is clear and fire is turbid. Therefore, the treatment generally focuses on warming and nourishing. Even in cases of phlegm-dampness descending, it is still a condition of root deficiency with superficial excess. Treatment should carefully assess the urgency and severity of the root and superficial aspects to determine the priority and order of therapeutic methods.

bubble_chart Documentation

1. Nyuke Jinglun．menstruation Gate: "Irregular menstruation with pale discharge indicates qi deficiency, and remedies such as Ginseng, Atractylodes, Angelica, Peony, Astragalus Root, and Cyperus should be used...", "The heart governs blood, hence red color is normal. Even if the timing is irregular, if the color is normal, it is easier to regulate... Pale color indicates deficiency, possibly mixed with phlegm and retained fluid. Chuanxiong and Angelica Decoction with Ginseng, Astragalus, Peony Root, and Cyperus should be added..."