Tao Hong Si Wu Tang (桃红四物汤) — Four Substances with Safflower & Peach Pit

Tao Hong Si Wu Tang is a classical Chinese herbal formula used primarily for dysmenorrhoea with dark, clotted menstrual blood from blood stasis with blood deficiency. It is prescribed for Blood deficiency with Blood stasis, characterised by: irregular menstrual cycle with dark, clotted blood, painful periods (dysmenorrhoea), a dull or sharp pain in the lower abdomen that is relieved by the passage of clots, a pale or purple-tinged tongue, and a thin, choppy (Se) pulse. This pattern is extremely common in women of reproductive age and underlies many gynaecological conditions.

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Cautions
7. Frequently asked questions

Overview

Tao Hong Si Wu Tang — Four Substance Decoction with Safflower and Peach Pit — is the classical Chinese herbal formula that combines the foundational Blood-nourishing formula Si Wu Tang (Four Substance Decoction) with two powerful Blood-invigorating herbs — Tao Ren (peach seed) and Hong Hua (safflower) — to simultaneously nourish Blood and resolve Blood stasis. This dual action makes it uniquely suited to gynaecological conditions where Blood deficiency and Blood stasis coexist — an extremely common clinical scenario in women with painful or irregular periods, endometriosis and fertility^[21] difficulties. It is one of the most fundamental formulas in TCM gynaecology.

TCM pattern

Prescribed for Blood deficiency with Blood stasis, characterised by: irregular menstrual cycle with dark, clotted blood, painful periods (dysmenorrhoea), a dull or sharp pain in the lower abdomen that is relieved by the passage of clots, a pale or purple-tinged tongue, and a thin, choppy (Se) pulse. This pattern is extremely common in women of reproductive age and underlies many gynaecological conditions.

Key herbs

1. Shu Di Huang (prepared Rehmannia root, 6-30g) — nourishes Kidney Yin and Blood; the primary Blood-tonifying herb
2. Bai Shao (Paeonia lactiflora root, 6-12g) — nourishes Blood, softens the Liver and alleviates pain
3. Dang Gui (Angelica sinensis root, 6-15g) — nourishes and invigorates Blood; the most important single herb in TCM gynaecology
4. Chuan Xiong (Ligusticum chuanxiong rhizome, 3-12g) — invigorates Blood and moves Qi; prevents Blood stagnation
5. Tao Ren (Prunus persica seed, 3-9g) — powerfully breaks up Blood stasis and softens hardness; added to address the stasis component
6. Hong Hua (Carthamus tinctorius flower, 3-9g) — invigorates Blood, disperses stasis and alleviates pain; added alongside Tao Ren

Formula actions

1. Nourishes and invigorates Blood
2. Breaks up Blood stasis
3. Regulates menstruation
4. Alleviates pain

Conditions treated

1. Dysmenorrhoea (painful periods) with dark, clotted menstrual blood from Blood stasis with Blood deficiency
2. Endometriosis — one of the core formulas for the Blood stasis pattern of endometriosis; often combined with Gui Zhi Fu Ling Wan
3. Irregular menstrual cycle with both scanty flow (Blood deficiency) and clotting (Blood stasis)
4. Infertility where Blood stasis and Blood deficiency obstruct implantation and normal menstrual function
5. Post-partum Blood stasis with Blood deficiency — retained lochia and post-partum pain
6. Anaemia with concurrent Blood stasis in the pelvic region

Contraindicated in pregnancy. Use with caution in patients with significant Qi deficiency.

Cautions

Always consult a qualified Chinese herbalist registered with the Register of Chinese Herbal Medicine (RCHM). Online herbal consultations are available. See the prices page for costs.

Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide. After a full video consultation, Dr (TCM) Attilio D'Alberto formulates a bespoke herbal prescription and posts your Chinese herbs directly to your door.

Frequently asked questions about Tao Hong Si Wu Tang

What is Tao Hong Si Wu Tang used for?

Tao Hong Si Wu Tang is used for dysmenorrhoea (painful periods) with dark, clotted menstrual blood from blood stasis with blood deficiency, endometriosis — one of the core formulas for the blood stasis pattern of endometriosis; often combined with gui zhi fu ling wan, irregular menstrual cycle with both scanty flow (blood deficiency) and clotting (blood stasis), infertility where blood stasis and blood deficiency obstruct implantation and normal menstrual function, post-partum blood stasis with blood deficiency — retained lochia and post-partum pain. The formula targets the underlying TCM pattern producing these symptoms rather than the symptom in isolation, which is why pattern diagnosis by a qualified herbalist is essential.

How does Tao Hong Si Wu Tang work?

The herbs in Tao Hong Si Wu Tang work together: Shu Di Huang (prepared Rehmannia root, 6 30g) — nourishes kidney yin and blood; the primary blood-tonifying herb; Bai Shao (Paeonia lactiflora root, 6 12g) — nourishes blood, softens the liver and alleviates pain; Dang Gui (Angelica sinensis root, 6 15g) — nourishes and invigorates blood; the most important single herb in tcm gynaecology; Chuan Xiong (Ligusticum chuanxiong rhizome, 3 12g) — invigorates blood and moves qi; prevents blood stagnation. The synergy of these actions addresses the underlying TCM pattern.

How long does Tao Hong Si Wu Tang take to work?

For most patients, an improvement is typically noticed within 2–4 weeks of daily granule treatment. Full benefit usually requires 6–12 weeks, depending on how long-standing the underlying pattern is. Tao Hong Si Wu Tang is typically prescribed as part of an individualised treatment plan that may include other herbs or adjustments over time.

Is Tao Hong Si Wu Tang safe in pregnancy?

Use of Tao Hong Si Wu Tang in pregnancy should only be considered under the supervision of a qualified RCHM herbalist with pregnancy training, and only when the TCM pattern specifically calls for it.

Who should not take Tao Hong Si Wu Tang?

Always consult a qualified Chinese herbalist registered with the Register of Chinese Herbal Medicine (RCHM). Online herbal consultations are available. See the prices page for costs. Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide. After a full video consultation, Dr (TCM) Attilio D'Alberto formulates a bespoke herbal prescription and posts your Chinese herbs directly to your door. Tao Hong Si Wu Tang must be prescribed only after full pattern diagnosis by a qualified RCHM herbalist; self-prescription is not appropriate.

References

[21] Ried K. Chinese herbal medicine for female infertility: an updated meta-analysis. Complement Ther Med. 2015 Feb;23(1):116-28. https://doi.org/10.1016/j.ctim.2014.12.004. PMID: 25637159.