Types and Causes of Menstrual Cramps – Part Five of PMS and Menstrual Irregularities

Estimated read time... 3 minutes

Menstrual cramps range in severity from an inconvenient ache to a nauseating pain.  I used to suffer from debilitating cramps, to put it mildly: it was the pits.  If you are in the menstrual cramp boat, you know how they put a damper on your whole day and limit what you are able to do.  In this post, I will review the common types and causes of menstrual cramps so that you can identify which cause (pattern) is most suited to your unique situation – if you aren’t sure, wait until your next cycle and write down how you feel. In the next post, I’ll share techniques and ideas to help get you started on a path to a more comfortable menstrual cycle.

Northern Spicebush


Here is a brief list of the most common types and causes of menstrual cramps, and their signature signs and symptoms.

In Part Three, I discussed some signs and symptoms in relation to PMS; these signs and symptoms are just as applicable to the causes of menstrual cramps as they are to PMS.

Stagnant Liver Qi (or Stagnant Qi)

While I discussed Stagnant Liver Qi in a previous post, Stagnant Liver Qi is so very common in modern society and is relevant to both PMS and menstrual cramps. Remember that the Liver controls the smooth flow of Qi (vital energy) and if that is interrupted, then things are bumpy and uneven.

Signs of Stagnant Liver Qi:

  • Menstrual pain feels better after movement
  • Menstrual pain is over the lower abdomen and occurs during the period and up to two days before menses begins
  • Menstrual blood is dark, and the flow starts “hesitantly”
  • Menstruation is irregular
  • Bloating/distention associated with menstruation


Blood Stagnation

In the same way the Qi/energetic flow of the body can be stagnated or clogged in the Liver’s filtration system, our Blood can also be stagnated. When this happens, the stagnated area tends to have stabbing, throbbing or boring type pain that does not move from one menstrual cycle to the next. Fixed pain that does not move means that you may always have cramps that are worse on the right or left side, but the cramps don’t move to the other side the next month or within menstruation that month.

Signs of Blood Stagnation:

  • Pain that is fixed in location
  • Pain that is intense and stabbing, throbbing, or boring (like a needle)
  • Pain occurs before or during menses
  • Pain that is not relieved by movement, but is relieved when menstrual clots are passed
  • Menstrual blood has clots

Cold Stagnation

When there is Cold that has stagnated, the only thing that seems to relieve that Cold is a lot of heat – that part of the body might also feel cold when you press into the body a bit (not so much that it hurts, but just enough so you are feeling at a layer of the body that is deeper than the surface skin.) Where does Cold Stagnation come from? Swimming in a cold pool or the ocean while menstruating, standing on cold/damp surfaces for extended periods of time, and even getting the abdomen wet repeatedly during the day (think: leaning against the sink while doing dishes, then walking around with a wet shirt instead of changing.)

Signs of Cold Stagnation:

  • You feel cold! Cold over your belly and cold over your lower back, especially.
  • Pain is relieved with heat – hot baths, hot pads, hot water bottles
  • Menstrual pain occurs before or after menstruation
  • Your back is sore during menstruation
    Menstrual blood is bright red, can be scanty, and has small dark clots


Blood Deficiency

General Blood Deficiency manifests with the following signs: dizziness, blurry vision, numbness (in fingers, toes, etc), dry skin/hair/nails, to name a few. Blood Deficiency is fairly common in women as we lose blood every month and need to ensure that we rebuild our Blood every month.

Signs of Blood Deficiency:

  • Scanty menses/amenorrhea
  • Dull pain after menstruation
  • Pain that improves with pressure


To review: write down how you physically feel during your menses, and see which pattern (or patterns) most apply to you.  Refer back to the PMS posts (particularly Part Four) to confirm which pattern most describes you.  Everyone is different, and your particular presentation may not mesh with the patterns listed above – that is okay!  You can still make positive changes if you are not yet working with a herbalist.

Up Next: Remedies for Menstrual Cramps!