What Is Metrorrhagia and Menorrhagia in Traditional Chinese Medicine?
Metrorrhagia and menorrhagia are TCM terms referring to sudden, excessive bleeding not occurring at regular menstrual intervals, or prolonged, irregular bleeding. The former is called "metrorrhagia" or "menorrhagia," while the latter is termed "leukorrhea" or "menstrual leakage." As stated in *Zhubei Yuanhou Lun*: "Bleeding that persists intermittently outside of menstruation is known as leukorrhea." "Sudden heavy bleeding is called metrorrhagia, which belongs to severe menstrual disorder." Although "metrorrhagia" and "leukorrhea" differ in meaning, they are interrelated: "Metrorrhagia is an extreme form of leukorrhea, and leukorrhea is a gradual progression toward metrorrhagia." In disease progression, the two often transform into one another, hence their combined clinical term—metrorrhagia and leukorrhea.
This condition is primarily classified into four types:
(1) Heat in Blood Type:
① Deficient Heat: Irregular bleeding with small amounts dripping continuously, or sudden heavy flow with bright red, thick consistency. Accompanied by irritability, hot flashes, red urine, constipation, thin yellow coating on the tongue, and fine rapid pulse;
② Excess Heat: Sudden, massive bleeding or persistent intermittent flow increasing suddenly, bright or deep red blood with thick consistency or clots. Thirst, restlessness, fever, lower abdominal pain, yellow stools, yellow or greasy tongue coating, and large rapid pulse.
(2) Kidney Deficiency Type:
① Kidney Yang Deficiency: Irregular menstruation with heavy flow or continuous light bleeding, pale color and thin consistency. Cold aversion, cold limbs, dull complexion, soreness in waist and legs, clear and long urination, pale tongue with thin white coating, and deep fine pulse.
② Kidney Yin Deficiency: Irregular bleeding with persistent light flow or heavy flow, bright red and thick consistency. Dizziness, tinnitus, soreness in waist and limbs, fatigue, insomnia, red tongue with little coating, and fine weak pulse.
(3) Spleen Deficiency Type: Irregular bleeding, starting with sudden heavy flow followed by continuous light flow, pale color and thin consistency. Shortness of breath, fatigue, facial and limb edema, poor appetite, pale tongue with thin white coating, and weak pulse.
(4) Blood Stasis Type: Irregular bleeding with intermittent onset and cessation, or persistent light flow, or sudden heavy bleeding after prolonged absence, followed by continuous light flow, dark purple blood with clots. Lower abdominal pain, dark purple tongue, thin white coating, and wiry pulse.