Si Wu Tang (Four Treasure Decoction) , a treasure for women.

Si Wu Tang (Four Treasure Decoction) is a very basic yet very powerful formula.

The main function of Si Wu Tang is for tonifying blood.

Blood in the definition in TCM means more than what flows inside the blood vessels. In TCM our body runs on the dynamic reaction of Yin and Yang like moon and Sun. All the substance and functions in the body can all be categorized into these two aspects. Yin and Yang depends on each other and at the same time controls each other.

Blood falls on the yin side. “Women  belong to yin . The physiological function of the women is based on the blood.” Because of our physiology of pregnancy , labor and menstrual flow, we experience more “excess in Qi , but deficient in blood.”

Thus Si Wu Tang is considered a major formula for women.

First  we look at the menstrual flow and its physiology in TCM.  In the monthly course of menstruation, blood needs to fill in the Chong and Ren meridian. In the case of blood deficiency , which usually accompanies excess of Qi, the menses can  be scanty and in consistent. Because in TCM , blood is stored in the liver and can be easily stagnant because of its yin nature.

The composition of Si Wu Tang is Dang Gui (Angelica sinensis), Bai Shao(White Peony Root) , Di Huang (Chinese Foxglove Root), Chuan Xiong (Szechuan Lovage Roo). The main herbs in this formula is Dang Gui as the emperor herbs that dominates the whole formula. Dang gui also has the name of ” the herbs promotes the  qi in the blood.”

When the blood is not filling up the meridian and vessels , it can show as no lust on the skin , weakness and fatigue , scanty menstruation. When the blood is deficient in the channel , like not enough water filling up the water pipe, nutrients can’t be delivered to the organs and then stagnation can occur. Any stagnation can lead to pain. That’s why a lot of time , women with blood deficiency can present with menstrual cramps. PMS can be one of the indication for Si Wu Tang , as blood related closely to liver and spleen.  When blood is not filled and stored in the liver, liver’s function as unobstructed force can be compromised. The emotion  dominated by the Liver is anger. That’s why a lot of time, anger and irritability can be a major symptoms in PMS.

Over all, Si Wu Tang is a very basic yet versatile formula as in women’s problem. In the differentiation of blood deficiency or liver deficiency , this formula can be a good help.


*Disclaimer: this article is served as a reference for TCM practitioner and herbalists. If you have any questions on this formula, please consult your specialists  , or leave us a comment below.


Painful menstruation , the cause and the treatment, a TCM perspective.

I believe most of us wit X chromosome, have a love and hate relationship with our monthly flow. It represent the fertility and health of a woman. But it also brings a lot of discomfort and sometimes pain.

Painful menstruation, or dysmenorrhea , is one of the most common clinical symptoms and complaints I got among my patients.

Women during our reproductive years often experience certain level of discomfort related to our monthly flow. But painful menstruation is a term reserved to symptoms that are preventing women from normal activities and require medical attention.

With painful menstruation, you may experience pain before or during menstrual flow. The scale of pain can be high enough to cause you to be bed ridden. Also there might be times that you will have pain as well as nausea , fatigue or diarrhea.

What cause the painful menstruation?


There are three types of painful menstruation, primary with no organic cause, secondary with pathological cause and membranous cause with shedding of uterine membrane. There is also a type of painful menstruation caused by the IUD( intrauterine device) which needs immediate attention from your OB/GYN.

Studies have shown that for primary dysmenorrhea, the cause can be an increase of prostagladin. Prostaglandin can cause inflammatory response and  is stored in the uterine membrane , as the menstrual flow starts, prostaglandin can be released with shedding of membrane to the surrounding tissue like uterine muscle and blood vessel.

The increase level of prostaglandin can lead to abnormal contraction of uterine and decrease in blood flow which eventually lead to insufficient blood flow and oxygen to the uterine tissue.

When the prostaglandin enters the circulation of the body, it can cause systemic reaction like nausea, vomiting or diarrhea.

The  most common treatment  for painful menstruation is NSAIDs. There are times that your Ob/Gyn will prescribe you with antiprostaglandins , oral contraceptive or even suggest surgery to help with cervical dilation.

We know that acupuncture is effective for chronic pain , such as lower back pain and migraine headache. What’s the performance for acupuncture in treating painful menstruation?

An 2017 Australia based study[1] on manual acupuncture and electro-acupuncture in pain reduction for dysmenorrhea showed the manual acupuncture delivered the effect as peak pain reduction , and surprisingly showed a better outcome than electro-acupuncture.

The use of analgesic was not prohibited in this study, but this study also showed that both manual and electro-acupuncture provided a lower usage of pain medication.

In this study , the effect of acupuncture also showed a significant decrease in secondary menstrual symptoms which included mood changes, bloating and breast tenderness.

This finding is really encouraging because approximately 25% of women undergoing treatment of dysmenorrhea the conventional way has little to no relief.

For woman suffering from painful menstruation, without being dependent on medication, acupuncture can be a safe and effective treatment option.

[1]Armour, Mike, et al. “The role of treatment timing and mode of stimulation in the treatment of primary dysmenorrhea with acupuncture: An exploratory randomised controlled trial.” PloS one 12.7 (2017): e0180177.