Menstrual diarrhea refers to diarrhea that occurs during the menstrual period and resolves after menstruation, presenting as a cyclical condition. This condition can generally persist for several years and is difficult to self-heal without treatment, having a certain impact on physical health.

If certain gastrointestinal diseases occur during menstruation, causing diarrhea, or if the diarrhea is unrelated to the menstrual cycle, these cases are not within the scope of this discussion.

bubble_chart Pattern Analysis

1. Spleen Qi Deficiency︰During menstruation, there is loose stool, increased frequency, or slight abdominal distension and fullness pain, advanced menstruation, heavy flow with pale color, complexion shallow yellow, facial and limb puffiness, bland taste in mouth with reduced appetite, leukorrhea lingering, tongue texture pale and swollen, thin and greasy coating, soggy pulse. Treatment should focus on tonifying the spleen and replenishing qi, warming the middle and astringing the intestine. The prescription used is Cyperus, Amomum and Six Gentlemen Decoction.
2. Spleen-kidney Yang Deficiency︰During menstruation, there is loose stool, thin or watery, with cold pain and a sinking sensation in the lower abdomen. The complexion is pale or dull, accompanied by cold intolerance and cold limbs, delayed menstruation with scanty flow, soreness in the lower back and weak legs, clear and abundant urine, and thin, clear leukorrhea. The tongue is pale and swollen with a thin coating, and the pulse is deep and thin. The treatment should focus on tonifying qi and warming the kidneys, strengthening the spleen to stop diarrhea. The recommended formula is Aconite Middle-Regulating Decoction with the addition of Alisma and common fenugreek seed.
3. Liver and Spleen Disharmony︰Before menstruation, there is diarrhea, pain leading to the urge to defecate, relief of pain after defecation, chest and hypochondriac distension and oppression, belching, reduced food intake, nausea and vomiting, menstrual distending pain of breasts, lower abdominal distension and fullness during menstruation, thin and greasy tongue coating, wiry or soggy pulse. This is caused by excessive liver wood, rebellious liver qi attacking spleen qi. Its characteristics include pain leading to the urge to defecate, relief of pain after defecation, menstrual distending pain of breasts, and chest and hypochondriac distension and oppression. Treatment should focus on soothing liver and regulating spleen, supporting earth and draining wood. The prescription used is Pain and Diarrhea Vital Formula with the addition of Cyperus and Villous Amomum Fruit.

bubble_chart Documentation

1. "Shi's Medical Book Series. Chinese Gynecology": "Menstrual diarrhea: Treatment: For those with cold, Xiangsha Stomach Poria Decoction; for those with heat, Pueraria, Skullcap and Coptis Decoction; for those with deficiency, Ginseng, Poria and White Atractylodes Powder; for those with excess, Immature Orange Fruit Daozhi Decoction."
2. "Ye Tian-shi Gynaecology Complete Book": "During menstruation, diarrhea before dawn, like infant urine, this is kidney deficiency, do not treat the spleen, take Middle-Regulating Decoction seven doses."