Patient: 26 yrs old female, married and has one 2 yr old son.

Main Complaints: Menstruation disorders with lower back pain and lower abdomen pain for about five years. Since 3 months ago, her menstruation had been irregular, lasting around 21 days, with each phase 5-10 days. These months, her bilateral calf and sole pain was worse, it had been worse in winter. These two days, this patient experience lower back pain, lower abdominal pain, tinnitus, dizziness, headache, irritability, palpitation, constipation and yellowish, short-stream urine, though her appetite and sleep were ok. Her tongue examination: red tongue with white to yellowish furs; pulse show wiry, slow and strong.

Traditional Chinese medicine diagnosis: Flaring of fire in the Liver and Gallbladder.

Prescription: Acupuncture, Chinese herbal medicine and food therapy (Jia Wei Xiao Yao Shan)

After three months treatment plan, the patient recovered completely from the condition and the symptoms did not recur during the next three years of follow-up.

Discussion: This patient was suffering from Blood Stasis in the menstruation cycle, irritability, distending sensation over the hypochondrium, lower back, sensation of heat on the centers of the soles of the feet and calf, flushed face, lips and tongue, tinnitus, palpitation, wiry and strong pulse and vicarious nose bleeding. These signs and symptoms indicated presence of pathogens in the Liver and Gallbladder classified as fire syndrome. Painful irregular menstruation can be managed satisfactorily with appropriate therapeutic principles once the symptom-complex differentiation is correctly established.