TCM Causes and Dietary Remedies for Bleeding During Intercourse

Bleeding during sexual intercourse refers to local bleeding in the female vagina or external genitalia during sexual activity. This condition can cause suffering to women, helps maintain them from experiencing pleasure and sexual satisfaction, affecting the harmony of sexual life, and leading to a gradual weakening of the marital bond.

Bleeding during sexual intercourse, if it occurs temporarily on the wedding night, before or after pregnancy, or after childbirth, is mostly caused by improper sexual intercourse. If bleeding during sexual intercourse occurs frequently, especially after the age of 40, a gynecological examination must be conducted to confirm whether there are conditions such as vaginitis, cervicitis, cervical erosion, cervical cancer, urethritis, urethral caruncle, etc.

I. Causes of bleeding during sexual intercourse

1.Inflammation or local organic lesions of the female reproductive system

(1) Vaginitis: Inflammation causes congestion and swelling of the vaginal mucosa. During sexual intercourse, excessive frequency and intensity of the penis’s thrusting and friction inside the vagina can lead to damage and rupture of the vaginal mucosa, resulting in bleeding.

(2) Urethritis: In females, the urethra is close to the vagina. Patients with urethritis often experience bleeding during sexual intercourse due to compression and damage to the inflamed area.

(3) Cervical erosion: The epithelium around the external orifice of the cervix undergoes exfoliation, exposing the subcutaneous tissue and forming an eroded surface. Bleeding can occur during sexual intercourse when the penis comes into contact with the eroded area.

(4) Urethral caruncle: Urethral caruncle is a benign fleshy tissue growth at the female urethral orifice, which is bright red in color, fragile and soft, and can easily cause bleeding upon slight contact during sexual intercourse. Electrocoagulation or surgical supports is appropriate for its management.

(5) The cervix is infiltrated by cancer cells, presenting with cauliflower-like, ulcerative, or nodular changes. The cells become fragile and are prone to bleeding upon contact during sexual intercourse. Therefore, sexual activity should be prohibited.

2. TCM understanding of the etiology of bleeding during sexual intercourse

In traditional Chinese medicine, it is believed that coital bleeding in women is related to Spleen, Liver, and Kidney deficiency as well as downward flow of damp-heat. Excessive worry or chronic wellness leading to physical weakness can damage the Spleen qi, resulting in a failure of the Spleen to control blood. If a person has a preexisting Yin Deficiency or engages in excessive sexual activity, Kidney yin will be depleted, leading to Yin Deficiency with excessive fire that injures the yin collaterals. Alternatively, downward flow of damp-heat from the Liver and gallbladder can cause heat stagnation in the lower energizer, burning and injuring the blood vessels.

II. Syndrome Differentiation and Dietary Therapy

1.Spleen failing to control blood

It is mostly caused by prolonged wellness leading to Spleen qi deficiency, excessive worry and overthinking, fatigue damaging the Spleen, or indulgence in spicy, fatty, and sweet foods, resulting in the loss of control due to qi deficiency. signs of imbalance include listlessness and fatigue, restlessness and excessive dreaming, soreness and discomfort in the lower back. The complexion is sallow, there is an abundant and foul-smelling leucorrhea, bleeding occurs during sexual intercourse, the tongue is pale with a thin white coating. The supports principle is to invigorate the Spleen and replenish qi, nourish yin and blood. Peanut and Lotus Seed Soup can be taken.

Formula and Preparation Method: Wash 30 grams of peanut kernels (with red skins) and 30 grams of lotus seeds (with skins). First, soak the lotus seeds in warm water for half an hour, then peel them and remove the bitter cores. Next, put them into a pot together with the peanuts, add two large bowls of cold water, and simmer over low heat for 1 hour. Add 1 spoonful of white sugar and continue to simmer for another half an hour. Remove from heat when tender and hot, and serve. It can be made into a snack and taken at any time.

The peanuts in the formula are rich in protein, vitamin K, and vitamin D. They have the effects of nourishing blood and resisting capillary fragility, showing good efficacy for various types of bleeding. Additionally, lotus seeds can tonify the Spleen and benefit the Kidneys. Therefore, this product is beneficial for nourishing the foundation in cases of sexual intercourse bleeding and physical weakness. Regular consumption yields good results.

One can also take Notoginseng Egg. Formula and preparation method: 1 egg, 3 grams of Radix Notoginseng powder, 50 grams of Chinese yam, and 50 milliliters of aged vinegar. Crack the egg and remove the shell, add the Radix Notoginseng powder, Chinese yam, and aged vinegar, then beat them together into a slurry. Next, steam it over boiling water until cooked. Consume it twice a day.

In the formula, Notoginseng contains panaxoside which can shorten prothrombin time. Compendium of Materia Medica (New Edition) describes it as a “miraculous medicine for stopping bleeding”. In addition, it also contains ginsenoside which has a good tonic effect on the Spleen and Kidney. Mature vinegar can disperse blood stasis, stop bleeding and detoxify. When these ingredients are used together, they have the effects of tonifying the Spleen and Kidney, replenishing blood and stopping bleeding.

In addition, one can also choose food therapy prescriptions that nourish qi and blood for consumption.

2.Liver and Kidney Yin Deficiency

It is mostly caused by excessive sexual activity, which depletes the yin essence of the Kidneys, leading to subsequent deficiency of Liver yin; or due to emotional injuries, excessive Liver yang, which over time consumes yin, resulting in insufficient Liver yin that then affects Kidney yin. signs of imbalance include sore and fatigued waist, dizziness and tinnitus, five-center heat, irritability and quick temper, dry mouth and constipation, bleeding during sexual intercourse, red tongue with scanty coating, and thin and rapid pulse. The supports principle is to nourish the Liver and Kidneys, and Shudi Hebao Dan (Rehmannia Glutinosa Poached Egg) can be taken.

Formula and Preparation Method: 30 grams of Rehmanniae Radix Praeparata, 15 grams of Agrimoniae Herba, and 3 eggs. First, decoct Rehmanniae Radix Praeparata and Agrimoniae Herba in water to obtain the decoction. Then, break the eggs into the decoction and cook them into poached eggs for consumption. Take it twice a day.

In the formula, Rehmanniae Radix Praeparata nourishes the yin of the Liver and Kidney. According to “Yao Pin Hua Yi” (Explanation of Medicinals), it is a “miraculous medicine” that can “soothe the five zang organs, harmonize the blood vessels, moisten the skin, nourish the true yin, and replenish the bone marrow”. Agrimoniae Herba has the function of astringent hemostasis. Coupled with eggs that nourish yin and replenish blood, this formula can supports coital bleeding of the Liver-Kidney Yin Deficiency type.

Taking Auricularia auricula stewed with jujubes is also effective. Formula and preparation method: 20 grams of Auricularia auricula, 15 grams of Lycium barbarum (Goji berry), and 20 grams of jujubes. Stew them together to make a decoction and take it once a day.

The black fungus in the formula contains protein, crude fiber, carotene, and riboflavin, and has the functions of nourishing blood, tonifying the Liver, harmonizing blood, and stopping bleeding. When combined with Chinese wolfberries that nourish the Liver and Kidneys, and red dates that replenish blood and stop bleeding, all the ingredients work together to nourish yin, tonify the Liver, and stop bleeding. Taking this formula can achieve the therapeutic effect of alleviating coital bleeding.

One can also consume dietary therapy prescriptions for nourishing yin and replenishing essence.

3. Exuberant Heat Agitating the Blood

This syndrome is mostly caused by Yin Deficiency in the constitutional body, exposure to the toxic heat, or emotional depression transforming into fire, which leads to intense internal heat-evil invading the blood phase and causing abnormal blood circulation. The signs of imbalance include bleeding during sexual intercourse, heavy menstrual flow, insomnia and restlessness, dry mouth and tongue, red tongue, and rapid pulse. The supports principle is to clear heat, nourish yin, cool blood, and stop bleeding. Fresh Imperata cylindrica and sugarcane decoction can be taken.

Formula and Preparation Method: 100 grams of fresh Imperatae Rhizoma, 30 grams of Citri Reticulatae Viride Pericarpium, and 300 grams of sugarcane. First, wash both the Imperatae Rhizoma and sugarcane to remove any dirt, then cut them into small sections. Place them into a small earthenware pot, add two large bowls of cold water, and simmer over low heat for half an hour until one large bowl of liquid remains. Strain the liquid to remove the dregs. After finishing the first decoction, add another large bowl of cold water and prepare a second decoction. When half a bowl of liquid remains, strain out the dregs and consume. This can be taken 2 to 3 times a day, with each dose being half a bowl, and can be consumed freely as a tea substitute.

In the formula, Imperatae Rhizoma (Bai Mao Gen) contains glucose, potassium salts, organic acids, gum, and vitamin K, and has the effect of nourishing yin and stopping bleeding; Sugarcane (Gan Zhe) is rich in sugar, water, and various amino acids, and has the effects of clearing heat, nourishing blood, and stopping bleeding. When used in combination, they have an even better effect in nourishing yin, clearing heat, and stopping bleeding.

One can also consume Water Chestnut and Lotus Rhizome Node Soup. Formula and preparation method: 250 grams of fresh water chestnuts (Eleocharis dulcis) and 100 grams of fresh lotus rhizome nodes (Nelumbo nucifera). Peel the water chestnuts, wash them together with the lotus rhizome nodes, cut both in half, place them in a casserole, add three large bowls of cold water, and simmer over low heat for half an hour. When about one and a half bowls of liquid remain, remove from heat, let it cool, and then consume. Take it twice a day, one small bowl each time. In addition to drinking the liquid, one can also eat the water chestnuts.

The lotus root nodes in the formula contain tannins and have a good effect of astringing and stopping bleeding. Water chestnuts are rich in sugars and various vitamins and have the function of clearing heat and detoxifying. Therefore, the combination of these ingredients can clear heat, calm the fire, and stop bleeding spontaneously.

4.Damp-heat pouring downward

In most cases, the patient suffers from damp-heat in the Liver and gallbladder flowing downward, which stagnates in the lower energizer, causing swelling, burning pain in the genital area, and damaging the blood collaterals, resulting in persistent bleeding during sexual intercourse. This is often accompanied by signs of imbalance such as restlessness, heat in the chest, flushed face and red eyes, bitter taste in the mouth, dry throat, dry stools, yellow and red urine, greasy yellow tongue coating, and slippery and rapid pulse. The supports principle is to clear heat, drain dampness, cool blood, and stop bleeding. The patient can take Mudanpi Wugui Decoction.

Formula and Preparation Method: 30 grams of Cortex Moutan (Mudanpi), 30 grams of Radix Gentianae (Longdancao), 2 soft-shelled turtles. Wrap Cortex Moutan and Radix Gentianae in gauze to make a medicinal bag. Place it in a casserole together with the soft-shelled turtles, add cold water to submerge them. After bringing it to a boil over medium heat, add 2 spoons of yellow rice wine and half a spoon of refined salt. Then, reduce the heat to low and simmer slowly for 2 to 3 hours until the turtle meat is tender and the turtle shell can be easily detached. Remove from heat and set aside for use. Take it twice a day, one small bowl each time, drinking the soup and eating the turtle meat, and discard the medicinal bag.

In the formula, Gentianae Scabrae Radix (long dan cao) clears and drains damp-heat from the lower energizer; Moutan Cortex (dan pi) cools the blood and stops bleeding; Turtle meat enters the Kidney meridian, nourishes yin and replenishes blood, and can guide the medicinal substances directly to the genital region, thereby resolving heat and eliminating dampness. The blood wellness resolve without specific supports.

One can also take “General Egg”. Formula and preparation method: 3 grams of powdered raw rhubarb and 1 raw egg. Make a small hole at the top of the egg, put the powdered rhubarb into it, then cover the hole with paper, add water and boil it. Consume it on an empty stomach, take 1 dose per day for 4 – 5 consecutive days.

In the formula, rhubarb is known as the “General” in traditional Chinese medicine. It functions to purge heat-toxin, break up accumulations and stagnation, promote blood circulation to remove blood stasis, and clear damp-heat. Eggs can nourish the Kidneys and moisten dryness. When used together, they have the effects of clearing and draining damp-heat from the lower energizer and cooling blood to stop bleeding.

III. External Folk and Proven Prescriptions

1. Burn a tuft of hair into ash, grind 10 grams of halloysitum rubrum and 10 grams of galla chinensis into powder respectively, wrap them with gauze, and insert into the vagina.

2. Coptis chinensis (Rhizoma Coptidis) 15 g, Achyranthes bidentata (Radix Achyranthis Bidentatae) 10 g, Glycyrrhiza uralensis (Radix Glycyrrhizae) 10 g. Decoct in water and use externally to wash the perineal region.

3.Sophora Flavescens (Kushen) 15g, Cnidium Monnieri Fruit (Shechuangzi) 15g, Phellodendron Bark (Huangbai) 9g, Platycladus Orientalis Leaf Charcoal (Cebai Tan) 15g. Decoct the herbs in water and use the decoction to rinse the vagina.

4.Fructus Cnidii 15 g, Zanthoxylum bungeanum 9 g, Alumen 6 g, Cortex Dictamni 9 g, Borax 15 g, Fructus Xanthii 9 g, Hairvein Agrimony and Burnt Radix Sanguisorbae 15 g. Decoct in water and use to rinse the vagina.