In Traditional Chinese Medicine, the evaluation of the color, consistency, and flow of menstrual blood is considered a diagnostic tool that provides extremely valuable insights about a woman's overall health. While particularly telling of the state between her Blood and Qi (vital energy) balance, menstrual blood is distinct from the blood that flows throughout the rest of the body. Though still seen as a vital substance, it is more closely connected to Jing, one of our Three Treasures. Jing, or “Essence” (often referred to as primal energy or original life force), is crucial for birth, development, fertility, and longevity. A healthy menstrual cycle and the quality of menstrual blood are often seen as direct reflections of a woman’s Jing and overall vitality.
Understanding what menstrual blood represents, we can assess it for important clues about patterns of deficiency and excess toward the ultimate goal of restoring balance. When Jing is abundant and strong, menstrual blood tends to be healthy and regular. In TCM, the ideal menstrual cycle is 28 to 32 days with a moderate, fresh red flow for 3-6 days. Slight variations to these parameters can still be considered healthy if the cycle is consistent and free of the common but ultimately abnormal PMS symptoms. Typical PMS symptoms like emotional upheavals, headaches, acne, breast tenderness, and bloating are an indication of Qi stagnation, circulation issues, or compromised internal organ function (especially of the Spleen, Kidneys, and/or Liver).
So, what can we learn from the color of menstrual blood?
Crimson: This color is considered normal and healthy in TCM, suggesting that the blood is fresh and there is good circulation.
Associated with: Balanced Qi and Blood.
Dark Red / Maroon: Indicates Blood and Qi stagnation. There is a classic adage in TCM that “where Qi flows, Blood follows,” highlighting the importance of unobstructed, robustly flowing Qi.
Associated with: Liver Qi stagnation or cold in the uterus.
Pale / Pink: A sign of Blood deficiency, which may mean that the body is not producing enough blood or that the blood is lacking the necessary nutrients.
Associated with: Qi deficiency, often related to the function of the Spleen or Heart.
Bright Scarlet: This is a clue that there’s excess heat or dampness in the body, especially when viscous like mucous.
Associated with: Damp-heat conditions, possibly related to the Liver or Spleen, and Yin deficiency.
Purple / Dark Clotted: This is alerting to severe blood stasis or cold in the uterus, leading to more serious stagnation.
Associated with: Conditions like cold-damp stagnation or Liver Qi stagnation.
Brownish: Indicates compromised circulation and Qi stagnation, leading to PMS symptoms (anger, irritability, headaches, and breast tenderness). It’s often old blood that was not expelled during the last cycle.
Associated with: Poor circulation, weak Kidney Qi, or Yang deficiency.
The consistency of menstrual blood is also revelatory…
Watery or Thin: Indicates Blood or Qi deficiency, where the blood lacks substance and nutrients. This can be accompanied by fatigue, frequent urination, and a feeling of coldness.
Associated with: Weakness in the Spleen or Heart and/or Kidney Yang deficiency.
Thick or Mucousy: A sign that the pathogenic factors of Dampness and/or Phlegm are present. It can express as bloating, loose stools, brain fog, and fatigue.
Associated with: Speen-Qi Deficiency, inflammation, Damp-Heat imbalance.
Clotted: An indication that there’s Blood Stasis (prolonged stagnation), it’s typically accompanied by symptoms such as sharp, stabbing, or cramping pain, which may be severe.
Associated with: Poor circulation, cold in the uterus, Qi stagnation or deficiency, excess heat in the Blood. Large dull clots indicate Blood stagnation due to Cold, while big, fresh clots are a sign of Blood stagnation due to Heat.
Finally, the flow of menstrual blood helps complete the diagnostic picture—both in terms of duration and whether it is heavy or scanty. Heavy flow can be the result of Qi deficiency (not being able to hold the Blood in the vessels) or excess heat / inflammation causing the speed of the flow to quicken. Scanty flow can be a sign of Blood deficiency, Kidney deficiency, or Qi stagnation. TCM practitioners can offer individualized support, piecing together all of the aforementioned symptoms and clues with other diagnostic tools like pulse and tongue reading. However, there are some surefire ways to support healthy menstrual cycles, like prioritizing warming foods / herbs before and during menstruation, incorporating Jing tonics like He Shou Wu, and minimizing stress.
To dive deeper, check out our free eBook on Women’s health.
