Understanding the Holistic Menstrual Cycle

The menstrual cycle as described in Traditional Asian Medicines is an example of the complexity and beauty of the female body.  When laid out clearly it provides workable and comprehensible language to diagnose imbalance in the hormonal cycle.  Traditional Asian medicine is always most concerned with understanding the root cause of the symptom.  It is by understanding and identifying the underlying cause that symptoms can be brought back into balance and the system can be healed.  

When human beings first began to experience the world, their perceptions were influenced by their relationship to nature.  With time and with deep contemplation, patterns in nature were discovered. Principles based on celestial and earthly influences describe the connection between a human being’s bodily processes and a greater universal process by which all energetic movements are governed.  For instance, the relationship between the way qi (energy) and blood circulate in a female’s body and the way qi and blood circulate in the lunar cycle can influence the menstrual cycle.  The ideal menstrual cycle would follow the lunar cycle very closely.  However, this rarely happens in the modern world.  In eastern medicine, there is a relationship between the influence of the moon and the menstrual cycle.  The moon influences the way energy flows throughout our bodies.  It controls patterns of fertility and affects the psychological and emotional body.  The correlation to the moon as the yin or feminine body means that the moon has more effect on the female of the species, who is yin predominant, than on the male.  While it takes years to study and understand acupuncture and herbal medicine, these are essential, accessible concepts.

Traditional Asian medicine draws from ancient concepts of the elements of nature, thermal aspects of the earth and cyclical timing in a person’s life.  In modernity, humans are out of touch and out of balance with a life grounded in the elements and nature.  Returning to a medicine that has its roots within these foundations can improve individual vitality and fertility. It is truly ancient medicine for the modern world.

Most eastern traditions of medicine begin by understanding the core topics of yin and yang energies.  Yin and Yang are important fundamental topics in understanding the eastern menstrual cycle because they clearly divide the follicular phase of the cycle and luteal phase of the cycle into clear sections.  The genesis of yin and yang dates back to 3322 BC when the Chinese folk hero, Fu Xi believed he found the “8 essential hexagrams depicting yin and yang on the back of a turtle.” (Shima, 2009)  His discovery lead to the creation of the I Ching and ancient Taoist philosophical principles that became foundational tools in the entire progression of eastern philosophical and medical theory.  The I Ching established original yin and yang theory.  This theory became the foundation for analyzing the menstrual cycle and its fluctuations throughout the month.

Yin dominates the follicular phase of the cycle.  It is represented by the energy of the moon.  Yin is dense, nutritive, heavy, precious, wet and cooling.  Yin dominates nighttime and it is passive, slower, inactive but without yin there can be no action.  Yin correlates to the western hormone estrogen.  Like estrogen, yin increases at puberty and continues to heighten in the reproductive years of the female body before it starts its decline in perimenopause.  For every individual the quantity and quality of yin varies depending on constitution, illness, psychology and lifestyle.  This is how eastern medicine explains why there is no one particular guide as to how old a person can be to become pregnant.  Much of this age determination is dependent on many other factors of that person’s health.

Yang energy dominates the luteal phase of the cycle.  It is represented by the energy of the sun.  Yang energy dominates daytime. It is bright, active, dynamic, dry, organizing and hot.  Yang energy corresponds with the hormone progesterone.  Without yang, nothing grows and nothing comes to fruition.  It is the fire underneath the pot that cooks the energy to feed us.  

Qi and blood play an enormous role in the menstrual cycle.  Like yin, blood is a dense and nutritive substance and as females we use and require tons of the stuff.  When blood is strong the menses flow is healthy, not clotted, and lasts anywhere from 4-7 days.  Blood plays a major role in the folic cycle representing Day1- Day 7 or almost half of the follicular phase.  Blood creates the stage for the entire menstrual cycle that will follow and much of a person’s constitution can be determined by examining the quality, quantity and timing of blood.  

Qi is slightly elusive in its understanding as it is very functional and unseen; yet qi is a part of all things in our bodies.  Qi, like yang, is dynamic and vast.  It moves, delivers and creates.  And while it plays a part in all aspects of the menstrual cycle, it dominates in the days before ovulation, the luteal surge and the premenstrual phase.  When qi is weak it becomes less forceful, leading to stagnation and unclear increases and interaction within the menstrual cycle.  Stress hormones and overwork decrease and stagnate qi.  

Cold and hot are thermal qualities that play a role within the eastern menstrual cycle.  Yin and blood are both cooling and dominate the follicular phase.  This cooling aspect is ideal to grow and develop follicles within the rich soil of the ovaries.  Coolness should be substantial and consistent, providing dark, moist, calm conditions.  Inconsistency within this coolness allows too much warmth to break through and can delay or confuse the development of the follicles.  Yang and qi both warm and circulate and dominate the luteal phase of the cycle and all of gestation.  The presence of yang or progesterone increases the body temperature to create the ideal warmth and consistent environment for growth.  If yang is weak, temperatures do not grow or become erratic in the follicular phase leading to a relative cold breakthrough.  

The interplays of yin and yang, qi and blood and hot and cold are dynamic and the length of the menstrual cycle is nonstatic.  Menstrual cycles are commonly averaged as a way to standardize care.  Normally menstruation occurs once a month, but sometimes it can vary at other intervals which are considered non-pathological.  The cycle of waxing and waning of hormonal levels happens every month from menarche to menopause with the exception of during pregnancy.  Variation in the hormonal pattern varies only according to the patient’s health and constitution.  It reflects the available energy for each woman and, likewise, reflects deeper systemic problems in the presence of imbalance.

Each new menstrual cycle begins with a clean slate.  The first phase of the eastern menstrual cycle is comprised of Day 1-14, relatively, depending on the cycle length.  It starts with menses. It is the time of the cycle when the uterus sheds its lining and in the process loses blood.  This menses phase typically last from 1-5 days but can extend to 7 days.  If it exceeds 7 days eastern medicine may consider it imbalanced.  In the first phase blood is moving and it relies on the healthy flow of qi and blood to be complete and balanced. Day 6-14 is known as the postmenstrual period.  Due to the loss of qi, blood and substance, the body is often weak during this phase and care must be given to those with a deficient constitution so that secondary syndromes do not manifest, especially if pregnancy is being attempted at ovulation.  

The second phase of the cycle is represented by day 15- 28, again relatively based on the cycle length.   Day 15-19 is known as the ovulatory period or mid-cycle.  Ovulation is dependent on the supply of qi and the movement of blood. If there is a deficiency in either blood or qi, yin or yang, at any other point in the cycle, it can show up at this stage of the cycle as a disorder of ovulation.   Day 20-28 is known as the premenstrual phase.  As qi and blood in the body reaches their heights, if pregnancy has not taken place, the uterus prepares for menstruation.