Why is it still painful after drinking Chinese medicine for three months to treat dysmenorrhea, and what should I do?

Generally, if menstrual pain persists despite three months of taking traditional Chinese medicine (TCM), it may be due to incorrect medication for the condition, poor lifestyle habits, endometriosis, adenomyosis, or sequelae of pelvic inflammatory disease. Depending on the specific situation, improvements can be achieved through adjusting medication, lifestyle modifications, pharmacological treatment, or surgical intervention. Detailed analysis is as follows:

1. Incorrect Medication for the Condition

In TCM, dysmenorrhea is classified into different patterns. If a patient with cold stagnation and blood stasis is mistakenly treated with liver-soothing and qi-regulating herbs, the treatment may counteract the intended effect and fail to relieve pain. It is important to revisit a healthcare provider for timely adjustment of the prescription, with a qualified physician re-evaluating the pattern and reformulating the herbal combination accordingly.

2. Poor Lifestyle Habits

Exposure to cold, staying up late, and emotional anxiety during menstruation can worsen blood and qi stagnation or cold accumulation, thereby negating the effects of medication and triggering pain. During menstruation, maintain warmth, avoid raw and cold foods, follow a regular sleep schedule, and engage in light activities such as walking to help ease emotions.

3. Endometriosis

Ectopic endometrial tissue undergoes cyclic bleeding, stimulating surrounding tissues and causing adhesions, which cannot be effectively cured by TCM alone. Follow medical advice to take medications such as drospirenone and ethinyl estradiol tablets, dienogest tablets, or naproxen sodium tablets. In severe cases, laparoscopic excision of ectopic lesions may be required.

4. Adenomyosis

This occurs when endometrial tissue invades the uterine muscle layer, leading to abnormal contractions of the myometrium during menstruation and resulting in severe pain. Under medical guidance, treatments may include gestrinone capsules, danazol capsules, or ibuprofen sustained-release capsules. In some cases, surgical removal of adenomyotic lesions may be necessary.

5. Sequelae of Pelvic Inflammatory Disease

Pelvic tissue adhesions and scar formation impair normal circulation of qi and blood, contributing to dysmenorrhea. Treatment requires prescribed antibiotics such as cefuroxime axetil tablets, azithromycin dispersible tablets, and metronidazole tablets, along with pelvic physical therapy to promote recovery.

During TCM treatment, strictly adhere to medical instructions and do not adjust dosages independently. If pain continues to worsen or is accompanied by abnormal menstrual flow, promptly undergo gynecological ultrasound examinations. Practice proper menstrual care in daily life and attend regular gynecological check-ups to identify the underlying cause early and enable targeted treatment.