Cramps, irregular cycles, cysts and PCOS: what TCM looks at
Physician Poh Yu Min (Joy) · 傅瑜敏医师
Period pain, a cycle that will not settle, an ovarian cyst found on a scan, and a PCOS diagnosis are four different situations. They get talked about together because they all involve the same part of the body, but they are not variations of one problem, and a TCM consultation approaches each of them differently.
The cycle is read as information
In TCM the menstrual cycle is not treated as an isolated event. Its timing, how it arrives, how long it lasts, what the days before it are like and how you feel afterwards are all read together, alongside sleep, digestion, appetite, temperature and stress.
That is why a consultation about period pain asks about your digestion. It is not idle curiosity and it is not a checklist — in TCM those things belong to the same picture, and the physician is reading the picture rather than the symptom.
The words a physician will use
What comes back to you will be in TCM's own vocabulary. Qi stagnation, blood deficiency, cold in the lower abdomen, damp accumulation. These describe a pattern — a way of organising what has been observed so that a treatment plan can follow from it.
They are not diagnoses in the medical sense, and they do not map onto one. Being told you have blood deficiency is not being told you are anaemic; those are two vocabularies describing different things, and a blood test is the only thing that settles the second.
Where a doctor's diagnosis fits
Polycystic ovary syndrome is a hormonal condition diagnosed by a doctor, usually from a combination of cycle history, blood tests and a scan. Ovarian cysts are fluid-filled sacs, most of which are found incidentally and many of which resolve without anything being done. Endometriosis and fibroids are different again. Each of these is a medical diagnosis, made with medical investigation.
TCM does not make those diagnoses and cannot confirm or rule one out. What it does is work alongside them. If you have one, bring the report — knowing what a doctor has found changes what the physician considers appropriate, and when.
It also matters in the other direction. A cycle that has changed markedly, or pain that is new and severe, is a reason to see a doctor even if you are already being seen here.
What a consultation involves
A first visit is mostly conversation. Cycle length and regularity, what the days before and during are like, and then the questions that seem unrelated — sleep, digestion, appetite, energy through the day, how you handle cold. Pulse and tongue examination sit alongside it.
Where the physician judges it appropriate, treatment combines acupuncture, moxibustion and herbal medicine, and is revised at each visit. What you report back about the weeks in between is most of what that revision is based on, which is why keeping a rough note of your cycle is more useful than it sounds.
Please see a doctor, not only a TCM physician, if you have unusually heavy bleeding, bleeding between periods or after sex, pain that stops you going about your day, a cycle that has changed suddenly, or if you are trying to conceive and have been for a year — six months if you are over 35. None of that is a reason to stop TCM treatment. It is a reason to have both.
This article is general information, not medical advice, and not a promise about what any treatment will do. What is appropriate for you is decided at consultation.