Missed or Irregular Periods After COVID? Doctor Luo Dalun: Rest First, Calm Your Emotions, Then Tonify Qi and Blood, Warm Yang or Nourish Yin — and Clear Blood Stasis Slowly
💬 Note from Doctor Luo: Dear friends, good morning, everyone. Today we continue our discussion of the lingering effects of COVID. This series has been going on for a while, because you have so many questions. Today’s topic is menstrual irregularity in women after COVID — and this is basically the final lecture of this series. After this we will return to the classical medical cases.
One question on Weibo, hundreds of replies: menstrual problems have been badly overlooked
What is the symptom everyone mentions most often after COVID? Doctor Luo says that when he asked on Weibo what symptoms people had after COVID, almost no one wrote about their periods — everyone wrote about fatigue, coughing, phlegm. But then he pressed one extra question: “Did your period change at all?” — and “boom,” hundreds of replies came flooding in.
💬 Note from Doctor Luo: People do not pay much attention to this; they seem more focused on fatigue, coughs and phlegm. But a very large number of women experience menstrual changes, right? Many women report that after testing positive, their period suddenly stopped coming.
Why did the period go wrong? Three causes piling up together
The period suddenly stops, suddenly goes irregular — what exactly “knocks it off course”? Doctor Luo analyzes three main causes.
Cause number one: the battle with the external pathogen depletes qi, blood and body fluids. How do ordinary people put it? “It’s a fever — the heat dried it out.” That image is vivid, and it also makes sense. Doctor Luo explains: the external pathogen enters the body and “fights” the upright qi (zheng qi) inside; this battle depletes the qi, the blood and the righteous qi. The heat pathogen also scorches the channels and collaterals inside the body, burning up the body fluids (jin ye) and the yin blood.
💬 Note from Doctor Luo: We call it depletion of body fluids (jin ye) — the “jin” of Tianjin, the “ye” of liquid. The heat pathogen scorches the channels and collaterals like this. So the menstrual changes come in all shapes and forms: for some women the period vanishes all at once; for some it becomes very short, coming every ten or twenty days; for some the volume becomes very small, just a drop at a time, extremely scanty; and there are also the exact opposite cases, where it gets delayed; and then there is the endless dribbling kind, where the flow is gushing and simply cannot be controlled. Every kind of situation exists.
Cause number two: cold-natured medicine — cold piled on cold. After infection you are bound to take medicine, and some of those medicines are cold-natured (han liang). Cold-natured medicine cools the qi and blood — for women who were already yang deficient, already had a cold womb (gong han), taking this makes it colder still, cold piled on cold.
Cause number three: fear and panic, liver qi constrained (gan qi bu shu). During the pandemic everyone was frightened and tense the whole way through, and this mental factor has an enormous effect on the menstrual cycle. Doctor Luo points out the mechanism specifically: a woman’s uterus (zi gong) is heavily influenced by the movement of qi and blood in the liver channel — and the liver channel just happens to run right through the region of the uterus.
💬 Note from Doctor Luo: How does Western medicine put it? Western medicine says the infection disturbed the secretion of your hormones, and the change in hormone levels caused the irregularity. All these causes add up, and women’s periods really are affected.
“Better to treat ten men than one woman”: regulating the period is especially complex
So now that it is irregular, how do you regulate it? Doctor Luo puts the difficult truth up front: regulating a woman’s menstrual cycle is extremely complex.
💬 Note from Doctor Luo: In the old days they said, “Rather treat ten men than one woman” (ning zhi shi nan zi, bu zhi yi fu ren) — in the past, doctors sometimes could not cure women; sometimes the prescription was just slightly off, and her period would change along with it. So this really is quite complex. But let us roughly lay out the principles.
Regulating principle number one: you must rest properly (the most important of all)
You have already turned negative after the infection, but your period has changed. What is the very first thing to pay attention to? Doctor Luo’s answer is categorical: rest properly.
💬 Note from Doctor Luo: You absolutely must rest well and give your body’s qi and blood a chance to recover. It was already overdrawn after a big battle, and now you are still overdrafting — your account is about to run dry, right? Keep a regular sleep schedule and regular meals — this is the most important thing of all. If you are still busy all day taking care of the kids, bathing them, sending them to school before dawn, then cooking — I know this is extremely hard, so let your husband share the load, rest when you should, and do not push yourself too hard.
Regulating principle number two: pay attention to your emotions
Many women’s irregular periods are caused purely by emotions. Doctor Luo says this is the time to deliberately adjust your mood and pull yourself out of that panicky COVID mindset.
💬 Note from Doctor Luo: Stay optimistic — watch some comedies, relax more, sing a little, and so on. Adjust your emotions and pull yourself out of that COVID state of mind.
Regulating principle number three: tell apart qi, blood, yin and yang — replenish whichever side is deficient
When regulating the body, the most important thing is to figure out clearly which side is deficient — qi, blood, yin or yang — analyze it first.
For qi deficiency: tonify qi. If you are usually weary and lacking in spirit, have a swollen tongue with teeth marks on the edges, and sometimes have heavy periods that are hard to control, then after a big battle you are even more depleted.
💬 Note from Doctor Luo: At this point you need to supplement — lightly tonify the qi. Make soups with dang shen (codonopsis) and bai zhu (atractylodes); or take some Wu Ji Bai Feng Wan (Black-Boned Chicken and White Phoenix Pill) — that formula tonifies qi and nourishes blood, with qi-tonifying as the main job. Slowly build the qi back up.
For blood deficiency: nourishing the blood is the top priority. A very large proportion of women are sustained by blood — blood-deficient women are extremely common; and after a big battle the blood deficiency may well be more severe. Scanty periods, just a tiny bit, delayed periods — these are often cases where blood deficiency is especially obvious.
💬 Note from Doctor Luo: Nourishing blood has to be done slowly. I recommend Yu Ling Gao (Jade Spirit Paste); treat it like a drink and take it slowly — as long as you nourish, it will certainly help; slowly build the blood up. Dang gui (angelica) also works — take six or ten grams of angelica, boil it in water, drink it for two or three days, or three to five days; you can also put a little angelica in your soups, or boil angelica water for foot soaks. If your blood is deficient, you cannot remove stasis — the more you try to break up stasis, the more you injure the upright qi; if your blood is deficient, you cannot drive out the external pathogen either — it cannot be driven out, because your channels are empty inside. Nourishing blood is a slow process.
For yang deficiency with cold: warm the yang. Women with a cold constitution — especially afraid of cold, cold hands and feet, a cold belly, wearing extra clothes all day, a pale face, diarrhea at the slightest chill, stomach pain when cold.
💬 Note from Doctor Luo: At this point you need to warm the yang — take Ai Fu Nuan Gong Wan (Mugwort and Cyperus Uterus-Warming Pill), soak your feet, and warm the body up. Drink some lamb soup with ginger and angelica in it — this is about getting warm.
For yin deficiency with heat: nourish the yin. When the external pathogen enters the body and turns into heat pathogen, it dries up the body fluids of the channels, so the period becomes extremely scanty, and it comes early — it arrives quickly.
💬 Note from Doctor Luo: At this point use some yin-nourishing medicine — take Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) and slowly improve the yin-deficiency condition. This will be especially good for you.
Beyond nourishing: clear stasis at the same time
Adjusting qi, blood, yin and yang is the foundation, but Doctor Luo stresses over and over: COVID produces blood stasis (yu xue) — it affects the heart and the cerebral blood vessels so heavily, and of course it affects the uterus too; it is stasis in there as well.
💬 Note from Doctor Luo: So on top of nourishing qi and blood and regulating yin and yang, you must clear stasis. If the period simply will not come, or comes as only a tiny bit, take some Yi Mu Cao Gao (Motherwort Extract Paste); the most precise choice would be Xue Fu Zhu Yu (House of Blood Stasis Decoction) — we use Xue Fu Zhu Yu for regulation these days, and the results are quite good. Or soak your feet with tao ren (peach kernel) and hong hua (safflower); for a more complete approach use Tao Hong Si Wu Tang (Peach Kernel and Safflower Four Agents Decoction) — peach kernel and safflower plus the Four Agents formula (prepared rehmannia, angelica, ligusticum, white peony), six or nine grams each, boiled in water, foot soak every evening — nourishing blood and clearing stasis, with excellent results.
Special alert: heavy unstoppable bleeding after COVID — Zhang Xichun’s Gu Chong Tang
There is one situation that deserves special vigilance: after COVID, the period suddenly will not stop and the volume is very large. What to do? Doctor Luo introduces the formula Zhang Xichun wrote about in his book, which he has discussed before — Gu Chong Tang (Reinforce the Thoroughfare Decoction).
💬 Note from Doctor Luo: Zhang Xichun described this formula in his book, and he said it is exceptionally effective, exceptionally good. The formula is raw astragalus and angelica, plus mulberry leaf and san qi powder — very classic. I often combine it with Gu Chong Tang, and I have written articles on it specifically.
What does this formula do? Doctor Luo breaks down its logic:
- Pathomechanism: insufficient upright qi, great loss of qi and blood, with a little deficient heat;
- Tonify upright qi: bai zhu (atractylodes) and huang qi (astragalus) — both tonify the upright qi;
- Restrain: long gu (dragon bone) and mu li (oyster shell) — hold back the blood that is rushing outward;
- Clear heat: sang ye (mulberry leaf) clears deficient heat;
- Activate and stop bleeding: san qi powder — activates blood circulation and stops bleeding at the same time.
💬 Note from Doctor Luo: Zhang Xichun used nine grams of san qi powder — that is three qian in the old system; I generally use about five grams, not that much, because his cases were more severe. If any friend finds that after COVID her period is extraordinarily heavy and the bleeding will not stop, you can try this formula — the results are quite good. This is a formula I use year-round; for women with this kind of beng or lou it works very well — beng is sudden gushing flooding; lou is continuous light loss, not much, but leaking on and on like a dripping tap. Together they describe the situation where the period cannot be controlled and drips endlessly.
Summary: first support the upright, then clear stasis, and let the blood return to its proper course
Finally, Doctor Luo gathers the whole approach to post-COVID women’s care into one sentence: this is caused by the body being depleted, with an external pathogen disturbing things on top.
💬 Note from Doctor Luo: First, rest; second, adjust your mindset; third, based on the state of your qi, blood, yin and yang, know which side is deficient and replenish that side; and at the same time clear stasis as you nourish — there is definitely blood stasis, basically everyone has blood stasis this time, so clear it bit by bit. And for that final kind of unstoppable bleeding, we also supplement and support the upright, then clear stasis — dissolve the stasis and let the blood return to its proper course; only then will the bleeding stop.
After COVID, women’s health issues are very special, and everyone should pay extra attention to adjusting and protecting themselves. Treating according to the pattern is the most important thing — if there is a Chinese medicine practitioner nearby, you can also ask them to diagnose and adjust for you; this is exactly what Chinese medicine is good at.
💬 Note from Doctor Luo: After this pandemic, this is where Chinese medicine excels — foreigners do not have it, but we do — we have Chinese medicine. So protect the health of women; I hope everyone is fine and returns to normal. This series on the lingering effects of COVID ends here. Next we will go back to the medical cases of the great classical physicians and take them slowly, one by one. I hope what I have said is useful to you, and I hope everyone has already passed safely through this COVID ordeal. See you in the next series.
Adapted from Doctor Luo Dalun’s health lecture (COVID recovery series: women’s menstrual health).