Vomiting that occurs during menstruation is called menstrual vomiting. If vomiting occurs once or twice occasionally during menstruation, it is not considered pathological.

bubble_chart Pattern Analysis

1. Liver-stomach Disharmony︰During menstruation, there is frequent acid swallowing, belching, and vomiting, accompanied by irritability, anorexia, mental fatigue, premenstrual chest tightness and breast distension, scanty menstruation with red color and clots, a red tongue with thin white coating, and a wiry-slippery pulse. This is caused by transverse rebellion of liver qi and disharmony of stomach qi, leading to frequent vomiting, acid swallowing and belching, menstrual distending pain of the breasts, and dysphoria with irritability. The treatment should focus on soothing the liver and harmonizing the stomach, regulating qi to stop vomiting. The recommended formulas are Four Seven Decoction combined with Left Metal Pill.
2. Spleen-stomach Weakness︰During menstruation, vomiting food, reduced appetite, abdominal distension and fullness, diarrhea, advanced menstruation with heavy flow and pale color. In cases of cold predominance, vomiting is mostly clear water, complexion is pale, limbs are cold, tongue texture is pale and tender, pulse is deep and thin; in cases of heat predominance, there is mostly retching, dry mouth and throat, gastric discomfort, tongue texture is red, coating is peeled and lacks moisture, pulse is thin and rapid. The cause is inherent spleen and stomach deficiency, impaired transportation and transformation. During menstruation, the qi of the spleen and stomach becomes even weaker, leading to sinking of clearing qi and rising of turbid qi, resulting in vomiting. The key diagnostic points are: vomiting food accompanied by diarrhea. Treatment should focus on strengthening the spleen, nourishing the stomach, and stopping vomiting. The recommended formula is Cyperus, Amomum and Six Gentlemen Decoction. For cold predominance, treatment should focus on warming dryness, strengthening the spleen, and stopping vomiting. The recommended formula is Middle-Regulating Decoction plus whitefruit amomim fruit and Villous Amomum Fruit. For heat predominance, treatment should focus on clearing heat, harmonizing the stomach, and stopping vomiting. The recommended formula is Tangerine Peel and Bamboo Shavings Decoction.
3. Retention of Phlegm-Fluid in the Stomach︰During walking, vomiting phlegm and saliva, accompanied by gastric stuffiness and fullness, sticky mouth, anorexia, vomiting upon drinking water, or dizziness and blurred vision, delayed menstruation, scanty and pale flow, pale red tongue texture, white and greasy coating, slippery pulse. Caused by phlegm-fluid retention lodging in the stomach, vomiting phlegm and saliva, obesity, vomiting upon drinking water, sticky mouth, anorexia. Treatment should focus on invigorating the spleen and harmonizing the stomach, resolving phlegm to stop vomiting. The selected formula is Inula and Hematite Decoction with modifications.

bubble_chart Documentation

1. Yizong Jinjian Gynecology Essentials．Menstrual Regulation Chapter: "Vomiting during menstruation is due to stomach weakness. If frothy fluid is vomited, it is due to fluid injury. If food is vomited, it is due to food injury (dyspepsia). However, those with food injury (dyspepsia) often experience pain and vomit food, while those with fluid injury vomit fluid without pain."