An Acupuncturists Guide to the Menstrual Cycle

The longer I work in the health industry, the more I realize how few of us truly understand what is occurring in our bodies during our menstrual cycle. To make matters worse, the amount of misinformation out there on how to manage our health may be ruining our hormone health even further. The period is now considered the 5th vital sign in healthcare. That is, one of the 5 key indicators of your overall health!

Personally, I never received much explanation on what it meant to have a period or how to manage it. I was just given my first pad at 14 and sent on my way. Much of what we consider to be ‘normal’ symptoms associated with menstruation are not normal at all. Remember, just because something is common, it doesn’t make it ‘normal’. If I had a dollar for every time I’ve asked my patients whether they experience pain during their period and they said ‘just the normal amount,’ let me tell you… I would have a lot of dollars. Sure, you should feel a change in your body, because your body is changing, but it should not be an event that leaves you crippled with pain, tears or frustration.

In order to support the natural ebb and flow of our hormones throughout the month, we need to adjust our lifestyle and diet between each phase. Keep in mind these are simplified explanations and generalized tips. If you are experiencing difficulties with your menstruation cycle, it is best to seek advice or treatment from a healthcare practitioner.

Phase I – Menstruation

The uterine lining is shed from the body, and the pituitary begins making FSH (follicular stimulating hormone) and LH (luteinizing hormone) to stimulate the growth of new follicles.

The body is discharging old, accumulated blood to make way for the formation of new blood. In Traditional Chinese Medicine (TCM), the focus is on invigorating Qi and Blood flow to ensure this process occurs smoothly and unimpededly. Qi and Blood stagnation can often cause cramping and pain during this phase.

Lifestyle: keep your body warm, increase rest, and avoid strenuous activities - gentle exercise only. Your energy is focused inward, so spend some time alone or with the people you love.

Diet: focus on soups, stews, whole grains, root vegetables and dark leafy greens. Avoid cold foods/drinks and sour foods.

Phase II - Follicular Phase

One of the follicles becomes dominant and begins to produce increasing levels of estrogen. This causes the uterine lining to thicken and the cervical fluid to increase.

In TCM, the main principle is to nourish the Blood and Yin, as these become depleted during menstruation. However, there is also a Yang aspect in the growth of the dominant follicle.

Lifestyle: ideal time for socialising, more vigorous exercise, new projects, creative activities, and sex.

Diet: protein rich foods are crucial in rebuilding Blood and Yin. Meat, eggs, beans, cooked leafy greens, seeds, fish/shellfish, bone marrow and broths. Drink plenty of water.

Phase III - Ovulation

LH surges, triggering the release of the egg from the dominant follicle. Fertile cervical mucus increases (sometimes with an ‘egg white’ consistency) and the cervix is now open.

In TCM, this is when Yin is at its peak. Yang will also begin to rise. Your body transforms from Yin dominance (just before ovulation) to Yang dominance (just after ovulation) in this phase.

Lifestyle: time to de-stress, increase relaxation and creative activities. Exercises that stretch and move the pelvic region will help the body prepare for menstruation. Verbalizing your thoughts and feelings in this phase will help offset potential moodiness or internalized frustration in your luteal phase.

Diet: focus on lighter foods like fish, chicken, quinoa, rice and cooked vegetables. Herbs and spices such as ginger, garlic, leeks, onions, cardamom, cinnamon, cumin, basil, etc, will help move the Qi/fluids and warm the body.

Phase IV - Luteal Phase

The corpus luteum (the casing of the dominant follicle from which the egg is released) begins to secrete progesterone, further changing the uterine lining and consistently increasing the body’s temperature. The egg travels down the fallopian tube and into the uterus. If the egg is fertilised, implantation occurs.

In TCM, this is where Yang is at its peak. The major indication of Yang in this phase is warmth (which causes increased basal body temperature). However, there is also the beginning of Yin, which may trigger withdrawal and moodiness.

Lifestyle: PMS may occur, which indicates that you need to slow down. You may begin to feel introverted, so take some time to yourself or to journal your thoughts. Continue exercising, however, to a lesser intensity. For those prone to stagnation, gentle exercise in this phase will help smooth the flow of Qi.

Diet: Increased protein intake and warming / cooked foods to help support the Yang. E.g., slow cooked stews, soups and broths with vegetables, root vegetables and gentle grains. Include warming spices like ginger, cinnamon, nutmeg, cloves, rosemary, etc.