"Is TCM gynaecology only about periods?" A question that comes up often. The answer: the menstrual picture is certainly a focus, but it is far from all of it.

This article does not give a list of conditions TCM gynaecology can handle — under Malaysian regulations that list cannot be written, and should not be. It is about what a consultation actually covers, set out as 5 areas.

I. First: "gynaecology" describes the focus of the consultation, not a list of diseases

In TCM, gynaecology broadly means consultations that consider the menstrual picture, reproductive life stages and the overall state together.

It is a classification about focus, not about disease. That distinction matters:

• It does not mean a given condition can be treated. For anything already diagnosed by a doctor, follow your doctor's diagnosis and treatment. A gynaecology consultation does not diagnose or address conditions of fertility — those belong to obstetrics, gynaecology and reproductive medicine.
• It describes a way of understanding the body — treating changes in the cycle as part of the overall picture rather than as a thing on its own.

How TCM classifies any of this belongs to the theoretical framework of the organ systems and qi. That is a different kind of explanation from modern obstetrics and gynaecology, and the two should not be conflated.

II. The 5 areas a consultation covers

• The menstrual picture — cycle length, days of bleeding, how heavy, colour and texture, any clots.
• Changes around the period — mood, distension or pain, headache, digestion, sleep.
• Overall state — appetite, digestion, bowel habit, energy, whether you run cold or hot.
• Life stage — which stage you are at, and whether you are breastfeeding or post-menopausal.
• Existing diagnoses and medication — your doctor's diagnosis, what you take (including contraceptives and hormone medication), tests you have had.

That last one gets skipped, and it bears on both safety and what a practitioner can suggest. Contraceptives, hormone medication and anything prescribed as part of reproductive medicine should all be mentioned.

III. What to bring here, and what to take to a doctor first

This table deliberately does not match situations to remedies. TCM is not a self-assessment quiz — that judgement is the practitioner's work, after a consultation.

IV. See a gynaecologist first in these situations

• Bleeding between periods, or after intercourse
• Any bleeding after menopause — always get this checked
• A sudden marked increase in menstrual bleeding, or needing frequent changes of protection
• Severe abdominal pain that stops you functioning
• A lump you can feel in the abdomen or breast
• Fever with lower abdominal pain, or unusual discharge
• No cervical smear or routine gynaecological check for a long time

These need gynaecological investigation — including ultrasound or a smear where indicated — and a TCM consultation does not substitute for them.

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

V. Fitting it into life in Malaysia

• Track three months of cycles first. Start date, days, how heavy. Those few lines beat recall, and are among the most useful things you can bring.
• Keep your routine test reports. Ultrasound, smear, blood results — mention them at the consultation.
• Contraceptives or hormone medication you take. A photo of the packet is enough; no need to memorise names.
• Herbs and tonics from family. Red date tea, si wu, a tonic packet your mother-in-law bought — mention those too. The practitioner needs to know what you are actually taking.
• Ramadan, festive periods and travel. Cycles often shift when routine and eating change substantially — worth a sentence.

On preparing for the consultation: what to prepare before an online consultation. On each topic in turn: period discomfort, menopause, discharge and intimate discomfort, preparing for pregnancy, confinement.

In closing

✅ Worth remembering:

1. TCM gynaecology is a classification of focus, not a list of diseases.
2. A consultation covers the menstrual picture, changes around the period, overall state, life stage, and existing diagnoses and medication.
3. Contraceptives, hormone medication and anything from reproductive medicine must be mentioned.
4. Bleeding between periods, bleeding after menopause, severe pain, a palpable lump — see a gynaecologist first.
5. Routine smears and gynaecological checks are not something a TCM consultation replaces.

❌ Better not to:

1. Expect a list of "what TCM gynaecology can handle" — that is not how it works.
2. Stop prescribed medication on your own because you have started TCM care.
3. Treat new bleeding or severe pain as the same because "it's always been like this".

👉 If you are not sure "whether what I'm describing should go to a gynaecologist first, or can start with a TCM consultation", you are welcome to book an online consultation with HansMed, where a practitioner registered under the T&CM Act 2016 can assess it with you. For anything in section IV, see a gynaecologist first.

Reviewed by Mr. Siew Kuen Xian, a TCM practitioner registered with Malaysia's Traditional and Complementary Medicine Council under the T&CM Act 2016, practising in general TCM, internal medicine, pain management and TCM gynaecology.

Sit with a licensed TCM practitioner from wherever you are.

HansMed Modern TCM

「医师，中医妇科是不是只看月经？」这也是不少读者常问的一句。答案是：月经确实是问诊的重点之一，但远不只如此。

这篇不列一张「中医妇科能处理的疾病清单」——那样的清单在马来西亚的法规下不能写，也不该写。这篇讲的是问诊实际会涵盖哪些方面，整理成 5 个方面。

一、先分清楚：妇科指的是问诊的重点，不是一张疾病清单

在中医里，「妇科」大致指的是问诊时会把月经、生育相关的生理阶段与整体状态放在一起看的一类问诊。

这是一个关于问诊重点的分类，不是一个关于疾病的分类。这个差别很重要：

• 它不代表能处理某某疾病。已经由医生诊断的疾病，请以西医的诊断与治疗为主。妇科问诊不诊断、也不处理生育方面的疾病——那属于妇产科与生殖医学的范畴。
• 它代表的是一种了解身体的方式——把月经的变化当作整体状态的一部分来看，而不是单独一件事。

至于中医怎么归类这些，属于脏腑与气血的理论框架，与现代妇产科的解释不是同一回事，两者不应混为一谈。

二、问诊会涵盖的 5 个方面

• 月经的情况：周期长短、经期天数、量的多寡、颜色与质地、有没有血块。
• 经期前后的身体变化：情绪、胀痛、头痛、消化、睡眠。
• 整体状态：食欲、消化、大便、精神体力、怕冷或怕热。
• 生理阶段：目前处于哪一个阶段，以及是否在哺乳、是否已停经。
• 已有的诊断与用药：医生的诊断、正在服用的药物（包括避孕药与荷尔蒙药）、做过的检查。

最后一项常被略过，但它同时关系到安全与医师能给什么建议。避孕药、荷尔蒙药与生殖医学相关的治疗用药，都请如实说明。

三、一张表看懂：什么适合先谈、什么需要先看西医

这张表刻意不写「哪一种情况对应什么调理」。中医不做自我对号入座——判断是医师问诊后的工作。

四、这些情况请先看妇产科

• 非经期出血，或性行为后出血
• 停经之后出现任何出血——请务必就医
• 经血量突然明显增加，或需要频繁更换卫生用品
• 剧烈腹痛到无法正常活动
• 摸到腹部或乳房的肿块
• 发烧伴随下腹痛，或异常的分泌物
• 长期未做过子宫颈抹片或例行妇科检查

以上情况需要妇产科的检查（包括必要时的超音波与抹片），中医问诊不能取代这些检查。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

五、大马生活里怎么安排

• 先记录三个月的周期：开始日、天数、量的变化。这几行字比回忆准确得多，也是问诊里最有用的资料之一。
• 例行检查的报告别丢：超音波、抹片、血液报告，问诊时一并说明。
• 正在吃的避孕药或荷尔蒙药：包装拍一张照片就好，不必背药名。
• 家里长辈给的药材与补品：红枣茶、四物、婆婆买的补包——请一并说明。医师需要知道您实际吃进去的是什么。
• 斋戒月、年节与旅行：作息与饮食大幅改变的时期，周期常会跟着变，值得提一句。

问诊前的准备方式，可参考：线上问诊前该准备什么。各个主题的细节，可参考：经期不适、更年期、白带与私密处不适、备孕期间可以看中医吗、坐月子。

结语

✅ 记住这几点：

1. 中医妇科是关于问诊重点的分类，不是一张疾病清单。
2. 问诊会涵盖月经情况、经期前后变化、整体状态、生理阶段、已有诊断与用药。
3. 避孕药、荷尔蒙药与生殖医学用药，请务必如实说明。
4. 非经期出血、停经后出血、剧烈腹痛、摸到肿块——先看妇产科。
5. 例行的抹片与妇科检查，中医问诊不能取代。

❌ 不要这样做：

1. 不要期待一张「中医妇科能治什么」的清单——那不是它的运作方式。
2. 不要因为开始中医调理就自行停掉医生开的药。
3. 不要因为「每次都这样」就把新出现的出血或剧痛也当成一样。

👉 如果您不确定「我这些情况，到底该先看妇产科，还是可以先从中医问诊谈起」，欢迎透过汉方中医的线上问诊，由依 2016 年 T&CM 法令注册的医师为您评估。第四节列出的情况，请先看妇产科。

本文由 萧焜贤 医师 撰稿审阅。萧焜贤 医师依 2016 年 T&CM 法令于马来西亚传统与辅助医药理事会注册执业，专长为中医全科、内科、疼痛管理与妇科。

无论身在何处，与持证中医师对坐。

汉方现代中医