8 TCM Patterns and Herbal Teas for Preceded Menstruation

A menstrual cycle that advances by eight or nine days, or even results in two periods within one month, is termed “Preceded Menstruation”. If it only advances by three to five days without any other discomfort, it should be considered within the normal range. Preceded Menstruation often occurs together with heavy menstrual bleeding.

Traditional Chinese Medicine holds that the pathology underlying this condition primarily involves three types: Blood Heat, Yin Deficiency with Heat, and Qi Deficiency. Blood Heat may lead to abnormal bleeding, and Qi Deficiency may result in the Chong and Ren meridians failing to hold and secure. Therefore, the supports approach focuses on clearing internal heat, supporting healthy Qi, and securing the Chong and Ren meridians. However, when clearing heat, one should avoid using extremely bitter and cold substances to helps maintain harming the body’s healthy Qi. For individuals with Yin Deficiency Blood Heat and scanty menstruation, attention should be paid to supporting the nourishment of Yin and blood.

1. Blood Heat: This may result from a constitution with internal heat or Yin Deficiency with Yang Excess, a preference for spicy foods, excessive use of warming uterine herbs, or Liver Depression transforming into Fire.

2. Yin Deficiency with Heat: The etiology is the same as Blood Heat, but the constitution is of Blood Deficiency and insufficient Yin Fluids, resulting in the generation of internal Deficiency Heat.

3. Qi Deficiency: Overwork or improper diet leads to Spleen Deficiency and Middle Qi Insufficiency, which may affect the body’s ability to support normal blood regulation.

Key Points for Differentiation: Menstruation that comes early with heavy flow may involve heat or deficiency. Generally, heavy flow with purple, thick quality indicates Blood Heat; heavy flow with pale, thin, and clear quality indicates Qi Deficiency. Early menstruation with scanty flow and red color indicates Yin Deficiency with Heat, where Blood is insufficient and Fluids are depleted.

In traditional Chinese medicine, for individuals experiencing early onset of menstruation, pattern-based approaches are employed to support menstrual health, tailored to the specific underlying factors.

1. Blood-Heat with Reckless Extravasation: Menstrual period arriving early with copious flow, or prolonged menstruation beyond the expected period, purple sticky thick discharge, chest fullness and irritability, yellow urine, thin yellow tongue coating, slippery forceful or slippery rapid pulse. The supports principle supports the body’s natural cooling mechanisms and maintains healthy blood function (clearing heat and cooling blood).

2. Yin Deficiency with Blood Heat: Menstrual period arrives early with scanty volume, color red or purple, irritability, dry mouth, heat sensation in the five centers (palms, soles, and chest), red tongue with thin yellow coating, thin slippery or thin rapid pulse. The therapeutic approach is to nourish Yin and help clear internal heat, supporting the body’s natural cooling and moistening functions.

3. Spleen Qi Not Controlling Blood: Menstrual period may come early with heavy flow or extend beyond the normal duration, with pale and thin discharge like water; pale complexion; fatigue; palpitations and shortness of breath; empty and bearing-down sensation in the lower abdomen; pale tongue with teeth marks on the edges, thin white moist coating; weak pulse or large but foreeless pulse. supports principle: supports Qi and strengthens Spleen function, helps maintain normal containment and raising of Qi.

1.Yi Mu Xian He Cha (Motherwort and Agrimony Tea)

Ingredients: 12g Leonurus japonicus (Yimucao), 30g Agrimonia pilosa (Xianhecao), 12g vinegar-processed Cyperus rotundus (Xiangfu).

Preparation method: Grind the three ingredients into a coarse powder, place in a cup, and steep with boiling water. Drink as a tea. Take one dose daily.

Efficacy: helps maintain a balanced internal environment and supports healthy blood function, promotes regular menstrual cycles and harmonious qi flow, and supports the body’s natural hemostatic function. supports individuals experiencing occasional menstrual irregularity associated with a Blood-Heat pattern of reckless movement.

2.Lotus Leaf (Nelumbo nucifera) and Loofah Seed (Luffa cylindrica) Tea

Ingredients: 30g lotus leaf (Heye, *Nelumbo nucifera*), 10g Luffa seed (Sigua Zi, *Luffa cylindrica*), 20g rock sugar (Bingtang).

Preparation: Grind lotus leaf (He Ye) into coarse powder, crush luffa seeds (Sigua Zi) and rock sugar, put them together into a thermos mug, pour in boiling water, cover and steep for 30 minutes, then drink as tea. One dose daily.

Efficacy: helps maintain a balanced internal environment and normal moisture levels, and supports the body’s natural hemostatic function. It supports individuals with the pattern of Blood-Heat with Reckless Movement (Xue Re Wang Xing) in maintaining a regular menstrual cycle.

3.Two-Earth White Peony Tea (Sheng Di Huang, Di Gu Pi, Bai Shao)

Ingredients: Rehmannia glutinosa (Shengdi) 12 g, Lycium chinense (Digupi) 10 g, Paeonia lactiflora (Baishao) 12 g, Scrophularia ningpoensis (Xuanshen) 10 g, Ophiopogon japonicus (Maidong) 10 g, Asini Corii Colla (Ejiao) 15 g, Eclipta prostrata (Hanliancao) 10 g.

Preparation: Decoct the above herbs with water twice. Combine the decoctions, mix well. Drink as a tea, taking separately in the morning and evening. One dose per day.

supports yin nourishment and helps maintain internal balance. helps maintain a normal menstrual cycle for individuals with the Yin Deficiency and Blood Heat pattern.

4.Qingpi Shanzha Cha (Green Tangerine Peel and Hawthorn Tea)

Ingredients: Citrus reticulata (Qingpi) 6g, Crataegus pinnatifida (Shanzha) 9g, white sugar 30g.

Preparation method: Grind the first two ingredients into coarse powder, place them together with white sugar into a cup, steep with boiling water, and drink as tea. One dose daily.

supports Liver function and helps with occasional discomfort, promotes the smooth flow of Qi and blood circulation. This formula supports individuals with a pattern of Liver Qi Stagnation transforming into Heat, which may be associated with early menstrual cycles characterized by red or purple blood, variable flow with small clots, distending discomfort in the breasts, chest and rib sides, and lower abdomen, irritability, red tongue with yellow coating.

5.Mentha haplocalyx (Bohe) and Atractylodes macrocephala (Baizhu) Tea

Ingredients: Mentha haplocalyx (Bohe) 30 g, Atractylodes macrocephala (Baizhu) 15 g.

Preparation method: Grind the above two ingredients together into a coarse powder. Place in a cup and steep with boiling water. Drink as tea. One dose daily, take for 7 consecutive days.

Actions: Clears heat and disperses wind, strengthens the Spleen and tonifies qi. supports normal menstrual cycle regularity in cases of Liver Qi Stagnation transforming into Heat.

6.Er Huang Cha (Two-Yellow Tea)

Ingredients: Rehmannia glutinosa (Shengdihuang) 30 g, Polygonatum sibiricum (Huangjing) 30 g.

Preparation: The two ingredients are coarsely ground together, placed in a thermos, infused with boiling water, covered, and steeped for 30 minutes, then taken as a tea. One dose daily.

supports Spleen and Lung function, and helps maintain a balanced internal environment. This formula is intended to promote healthy menstrual regularity, particularly for patterns involving Spleen Qi failing to govern blood.

7.Rehmannia glutinosa (Dihuang) Tea

Ingredients: 30 grams of Rehmannia glutinosa (Shengdi).

Preparation: Grind Rehmannia glutinosa (Shengdi) into coarse powder, place in a thermos, pour in boiling water, cover and steep for 30 minutes. Drink as tea. One dose daily.

Functions: supports yin nourishment and helps maintain a balanced internal environment, while supporting healthy blood heat balance. Formulated for individuals with Yin Deficiency and blood heat tendencies to support normal menstrual cycles.

8.Dan Gao Baishao Cha (White Peony Root Tea)

Ingredients: 15g Danpi (Cortex Moutan, Paeonia suffruticosa), 20g Qinghao (Artemisia annua, Sweet Wormwood), 20g Baishao (Radix Paeoniae Alba, Paeonia lactiflora).

Preparation: Grind the above three ingredients into coarse powder, place in a cup, and steep with boiling water. Drink as tea. One dose daily.

Function: supports clearing heat and cooling the blood, and helps astringe yin and helps with occasional tension. This formula supports a normal menstrual cycle in individuals with a pattern of Blood Heat with Reckless Movement.