Written by Michelle Oravitz L.Ac., FABORM. Michelle is an acupuncturist, ayurvedic practitioner, and certified hypnotherapist specializing in fertility health. Michelle was inspired to change her career from architecture to acupuncture after having her own reproductive imbalances resolved by her acupuncturist. Her method of treatment encompasses not only herbs and acupuncture, but also incorporates diet, supplements, essential oils, and most importantly the mind and how it influences conception. She helps women and couples both online and in person, and is the host of The Wholesome Fertility podcast.
Written on 10/22/20
Michelle Oravitz is an acupuncturist, ayurvedic practitioner, and certified hypnotherapist specializing in fertility health.
The menstrual cycle has been referred to as our fifth vital sign – and for good reason! For women in their reproductive years, the menstrual cycle is the epicenter of not only their reproductive health, but also their overall health.
What disrupts our cycles?
The menstrual cycle can be disrupted if a woman has thyroid conditions, hormonal imbalance, PCOS, hypothalamic amenorrhea, ovulatory conditions, or has been on birth control for a prolonged period, among other reasons.
In Traditional Chinese Medicine (TCM), menstruation and blood can tell us a lot about what your body is trying to tell you. For women, blood is very important for fertility health as well as the menstrual cycle. The period can show practitioners if their patients are blood deficient, have stagnation, too much blood heat, too much cold, dampness, or any other underlying patterns.
As TCM practitioners, we consider the internal environment to be very similar to how a woman’s environment affects a woman’s conditions. Our bodies have their own ecosystem and just as with nature, any disruptions can cause imbalance to the overall function and well-being.
When assessing patients, we ask lots of questions! We look at how they feel during their whole cycle, how long their cycles last, how many days they bleed, the color and consistency of the blood, if there is pain (cramps, headaches), how their emotions are, etc. All of these aspects can be signs of specific imbalances that are reflected.
What is the menstrual cycle?
The menstrual cycle refers to a woman’s full cycle, not just menstruation. The menstrual cycle can range anywhere from 24-38 days.
Most women have their own “normal” cycle which doesn’t necessarily last the textbook 28 days. This only applies if their “normal” is consistent cycle to cycle, meaning if your cycle lasts 30 days one month, it will continue to do so. We consider cycles to be abnormal when they suddenly change to longer or shorter, or switch between the two.
Your menstrual cycle is considered “normal” if the cycle length is consistent cycle to cycle.
What does it mean if my cycle length changes?
If your cycle length changes, there are a few questions you should ask yourself:
- Are you pregnant?
- Have you recently gotten off of the birth control pill?
- Have you checked to make sure you don’t have underlying hormonal imbalances?
- Have you gotten a full thyroid panel done?
- Did your doctor rule out PCOS?
- Have you noticed breast milk? If so it’s important to have your doctor check prolactin levels!
- Are you displaying signs of perimenopause?
There are many other factors, but those are some possible causes to rule out and address with your physician.
When does my cycle start?
The first day of a woman’s menstrual cycle is the first day of her bleed. This is the beginning of the follicular phase (first half of the cycle from period to ovulation). The basal body temperature should lower to around 97 degrees during this time with normal fluctuations of up and down within this range.
During this bleed time, it’s important to note how the woman feels and how the blood looks. Normal blood should look like a burgundy color and there should be no spotting before or after the period.
Normal period blood should look burgundy in color and there should be no spotting before or after the period.
There should be no pain or PMS — yes, that’s right! There is a difference between what is common and what is imbalanced. PMS is a sign of imbalance and isn’t normal. You should experience no cramps, headaches, and although there may be slight lethargy, it shouldn’t feel overwhelming.
What are some signs of imbalances in my cycle
- Cramps or headaches early on in the bleed show some type of stagnation (qi or blood stagnation).
- Cramps or headaches later in the bleed, or towards the end, show deficiency (mostly blood and can also include qi deficiency) because this happens after the loss of blood.
- Weakness or lethargy can also be due to stagnation or deficiency of qi or blood.
- Brown or dark spotting before or at the end of the period can signify stagnation of blood and possibly also qi.
- Dark blood or clots can be due to blood stagnation, blood heat causing stagnation, or blood deficiency causing stagnation.
- Bright red blood can be due to blood heat.
- Pale blood can be due to blood deficiency.
- Other things to notice are bowel movements – do they change during the period? Is there loose stool, diarrhea, or constipation before, during, or after?
- The bleeding time should last anywhere from 3-5 days. It is important to note if the bleeding is heavy or light? Some patients describe barely soaking a pad the whole time, this is way too little. Others have the total opposite problem of bleeding so much that they can’t leave the house!
What’s next in my cycle?
After the bleed, the body continues to prepare for ovulation as estrogen rises and a dominant follicle grows and prepares to release an egg. During this phase, cervical mucus gets produced. Cervical mucus is essential to create a sperm friendly environment in the vagina and allows for sperm to swim more freely to await the release of the egg.
It is important to note cervical mucus consistency. During the time leading up to ovulation (more or less 4 days) the cervical mucus should look like creamy, white lotion. This mucus allows the sperm to survive and advance so that they are ready and close to the egg during ovulation (sperm can survive for up to 5 days!).
Cervical mucus allows the sperm to survive and advance so that they are ready and close to the egg during ovulation.
The peak mucus on the day of ovulation is an egg white consistency. Many people may think something is wrong when they see mucus and they have never learned what it means! But this is a great sign of fertility health and is another clue that things are functioning correctly during the menstrual cycle. Keep in mind that mucus can be too scarce or excessive and just like everything, needs to be in balance.
After ovulation, the cycle enters the luteal phase which continues until the beginning of the next cycle or into pregnancy. The basal body temperature should rise to around 98 degrees with normal fluctuations that are not too erratic. If the temperature does not rise or if it doesn’t remain high, it may signify a possible ovulatory imbalance. If this is the case it is important to see a specialist such as a Gynecologist, OBGYN, or Reproductive Endocrinologist.