Understanding your menstrual cycle
The chart below shows an optimum menstrual cycle of 28 days. A cycle length of 26-32 days, when regular, is perfectly normal. It is also normal for the occasional disruption to the cycle due to illness or stress. (i.e. the cycle may lengthen or shorten by a few days). A menstrual cycle that is always irregular suggests a problem. The presence of pain, emotional disturbances, or spotting also indicates issues. Anything other than a smooth fresh bleed suggests a problem.
The acupuncturist will provide treatment based on your TCM diagnosis. They will modify it depending on the cycle phase you are in. The ‘nutritive’ Yin phase or follicular phase is all about egg development and preparation of the womb lining. The ‘active’ Yang or luteal phase is about the egg release and maintaining progesterone levels.
Sometimes treatment will be carefully timed to coincide with the part of the menstrual cycle that needs attention.
Menstruation (Days 1-7)
This is the time of the cycle. The body sheds the old endometrium. This allows a new nutrient rich lining to form. The bleed should be fresh red in colour with a smooth flow, which lasts ideally between 3-5 days.
Common problems during this phase include: pain (before, during or after). Stop-start bleeding may start or finish with brown discharge. There may be small or large clots. A bleed can be watery or foul smelling. Bleeding can be very heavy or scanty and may be prolonged. Other issues include tiredness, low back ache, night sweating, and sweaty palms and feet.
Acupuncture treatment during this phase includes encouraging the smooth flow of blood, improving egg quality and encouraging the development of the new endometrium.
Post menstruation (Days 7-14)
As well as the new endometrium forming, competing follicles are developing. Towards mid-cycle, there is a spike of LH (Lutenising hormone), which facilitates the release of an egg from the dominant follicle. As ovulation approaches, women will notice an increase of cervical mucus, which thickens to an ‘egg white’ consistency at ovulation.
Problems during this phase include: pain during ovulation, lack of cervical mucus, delayed/early ovulation, mid-cycle spotting. Acupuncture treatment during this phase includes: improving egg quality and encouraging ovulation.
Post Ovulation (Days 14 – 21)
Once the egg has been released it lives for around 1-2 days only unless fertilised in the fallopian tube. Levels of progesterone are high during this phase, which prepares the endometrium for implantation.
Problems during this phase include: inability to maintain progesterone levels, which can prevent implantation and low mood. Acupuncture treatment during this phase is aimed at maintaining progesterone levels.
Pre-Menstrual (Days 21 – 28)
Progesterone levels are at their peak during this time. It should be a time of increased energy and creativity for a woman. However, as we all know, this isn’t always the case. Explaining this in western medicine terms is difficult. However, the TCM understanding is that a ‘stagnation’ of Qi affects a women’s mood. This is usually caused by stress, causing outbursts of anger or tearfulness. This, as most women known, can cause problems in life. Some women will also start to experience pain a number of days before the period begins.
Acupuncture treatment focuses on promoting ‘a smooth flow’ of both emotions and the bleed (ie a pain free period).