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Limited evidenceWomen's health

Si Wu Tang

The four-herb blood tonic that underlies most Chinese gynaecological formulas, used for irregular or painful periods. A meta-analysis of its Taohong variant in period pain is positive, but it pools small unblinded Chinese-language trials, so the result should be treated as a hypothesis.

Evidence last reviewed: August 2026

What the science says

  • Taohong Si Wu Tang for primary dysmenorrhoea Limited evidence

    A systematic review and meta-analysis in Explore pooled randomized trials of Taohong Siwu Tang for primary dysmenorrhoea and reported reduced pain compared with control. The primary studies were small, mostly unblinded, and used varying comparators, so the pooled effect is likely optimistic.

  • Base formula itself is barely studied clinically Limited evidence

    Almost all clinical work uses modified versions (Taohong, Xiangfu and others) rather than plain Si Wu Tang, and a Chinese-language research review of the Siwu series notes that mechanistic and animal work substantially outweighs clinical evidence.

  • Mechanistic research is preclinical Limited evidence

    Recent Si-Wu-Tang studies concern gut microbiota, liver steatosis and ovarian insufficiency in rodent models. None of these findings have been tested in people.

Dosage & safety

Studied doseTraditional decoction of dang gui, chuan xiong, bai shao and shu di huang, typically taken daily in the week before menstruation; granule forms usually state 6–9 g twice daily. Trial doses are not standardized.
SafetyCommonly causes digestive upset or loose stools. Dang gui and chuan xiong have antiplatelet activity and may interact with warfarin and other anticoagulants; stop before surgery. Not appropriate during heavy menstrual bleeding, and avoid self-prescribing in pregnancy. Heavy or persistent period pain deserves investigation for endometriosis or fibroids rather than long-term self-treatment.

Scientific references

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