Phases Of The Menstrual Cycle
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Ever wondered how exactly the menstrual cycle works?
If we look at the cycle from a biological perspective we can divide it into to four phases, these phases are regulated by the hypothalamus and the anterior pituitary gland of the brain and the ovaries.
In Traditional Chinese Medicine (TCM) we look at the cycle through the theory of yin/yang, and Qi/Blood.
Yin and Yang Theory
Yin and Yang refers to two opposing energies that cannot exist without each other
For example, yin can be likened to night cool, darkness, and stillness, in contrast yang can be likened day warmth, brightness and activity.
Qi and Blood
Qi is the energy that flows through the meridians of the body, it can be explained as the driving force that provides life to the cells in the body.
In Chinese medicine blood is nourishing in nature and plays an important role within the female reproductive system, particularly when it comes to supporting growth of the endometrial lining.
THE MENSTRUAL CYCLE
Below is a breakdown of the menstrual phases firstly what is going on from a biological perspective followed by how this is can be in explained in TCM theory and what our focus may be when using TCM to regulate the menstrual cycle.
Menstrual Phase
The menstrual phase begins on the first day of full bleeding.
When embryo implantation fails to occur in the previous cycle, this causes oestrogen and progesterone levels to drop.
This prompts the lining of the uterus (the endometrium) to shed.
Bleeding can last anywhere from 3 – 5 days (sometimes longer)
TCM
During menstruation the yang energy descends transitioning into the yin phase.
On the days of bleeding the focus of treatment is the smooth flow of qi and blood, this will ensure the old lining is completely cleared out allowing for fresh new lining to grow.
As TCM practitioners we want to help you achieve a pain free period.
Follicular Phase
The follicular phase overlaps with the menstrual phase, also starting on day one of the cycle.
The hypothalamus sends signals to the pituitary gland to produce Follicular Stimulating Hormone (FSH), this hormone stimulates to growth of new follicles (fluid filled sacs that contain immature eggs).
One follicle will become dominant and continue to mature, while the rest of the follicles are reabsorbed back into the body. (occasionally more than one follicle can mature).
The Maturing Follicle releases oestrogen which causes the endometrial lining to thicken, in preparation for an embryo to implant.
TCM
Once bleeding has ceased the treatment focus shifts to building yin to stimulate the growth of new follicles.
It is also important to nourish and promote blood flow to the uterus, to support thickening off the endometrial lining.
Ovulation
The continual rise in oestrogen levels stimulates the pituitary gland to release luteinizing hormone (LH).
When LH levels surge this prompts the dominant follicle to release its matured egg, that will travel down the fallopian tube to be fertilised by the sperm.
If you are trying to conceive this is the phase of your cycle where you are most fertile.
TCM
When ovulation occurs, yin reaches its peak and the cycle begins to transition into yang.
Treatment is focused on supporting the transition of yin into yang to promote ovulation and encouraging implantation (if pregnancy is the goal).
Luteal Phase
After the dominate follicle has released its mature egg it begins to change into the corpus luteum, which is responsible for the secretion of several hormones including progesterone, oestrogen and inhibin.
Progesterone and oestrogen continue to stimulate the growth of the endometrium.
While inhibin suppresses FSH (to stop more follicles from maturing).
If implantation occurs the placenta will start to produce human chorionic gonadotropin (hCG) this hormone helps maintain the corpus luteum and keeps the endometrial lining thick.
If implantation doesn’t occur the corpus luteum begins to degenerate leading to the decrease in oestrogen, progesterone and inhibin, which will stimulate the endometrial lining to shed and prompt the beginning of a new menstrual cycle.
TCM
Yang is now dominate in the luteal phase causing a slight rise in your temperature
Treatment will be focused on warming the yang and encouraging flow of qi and blood to the uterus to support pregnancy.
