For Menstrual Headache and Rhinitis, Try Xiongzhi Shigao Tang

Some women develop headache and rhinitis symptoms before their periods—a phenomenon whose cause is hard to explain clearly. But TCM classics contain a formula for symptomatic treatment, and that formula is Xiongzhi Shigao Tang.

Xiongzhi Shigao Tang comes from the Yizong Jinjian. It is composed of Chuanxiong (Ligusticum), Gaoben (Ligusticum sinense), Baizhi (Angelica dahurica), Shigao (Gypsum), Qianghuo (Notopterygium) and Juhua (Chrysanthemum). Modern usual doses: Chuanxiong 10 g, Gaoben 10 g, Baizhi 12 g, Sheng Shigao (Raw Gypsum) 30 g, Qianghuo 15 g, Juhua 10 g.

In the Yizong Jinjian, Xiongzhi Shigao Tang is mainly used for “headache with distension, severe headache as if splitting, fever and aversion to wind, red face and eyes, thirst with desire to drink, difficult or constipated stool, yellow urine; red tongue with yellow coat, floating rapid pulse.” The original formula also has modifications: “For severe pain, add xixin (Asarum); for wind exuberance with dim vision, add fangfeng (Saposhnikovia) and jingjiesui (Schizonepeta spike); for heat exuberance, add zhizi (Gardenia), lianqiao (Forsythia), huangqin (Scutellaria), bohe (Mentha) and gancao (Licorice); for constipated stool and red urine, add xiao (mirabilite) and dahuang (rhubarb) to attack, and it will self-resolve.” Today this formula is mostly used for premenstrual syndrome, relieving rhinitis, gum swelling and pain, and menstrual headache that appear before a woman’s period. For severe menstrual headache, one may further add on the basis of this formula danggui (Angelica), chishao (Red peony) and mudanpi (Moutan) to clear heat, cool blood, regulate menstruation and stop pain.

Chuanxiong, Gaoben, Baizhi and Qianghuo in this formula are all acrid-warm and all treat headache; Baizhi is also a common TCM herb for biyuan (chronic rhinitis, sinusitis, etc.). Raw gypsum and chrysanthemum are cooling: raw gypsum clears heat and drains fire, chrysanthemum pacifies the liver and brightens the eyes. These herbs effectively relieve the relevant symptoms of premenstrual syndrome. Moreover, this formula combines warm and cool in a balanced, moderate composition, without the fault of being too warming or too cooling, so it causes few side effects.

Some women, during their periods, not only have headache but also swollen, painful gums, requiring long-term painkillers (ibuprofen) and anti-inflammatories (metronidazole); such patients may choose this formula to replace Western medicine. Other patients also have constipation; when using this formula they may add, as appropriate, laxatives such as huomaren (Cannabis seed), yuliren (Prunus seed), mangxiao (Mirabilite) and dahuang (Rhubarb).