A few years ago I was invited to the end of the week performance at the Rock ’n’ Roll Camp for Girls in Portland. The last band was a group of roughly 13-year-olds who had written their own song and were bringing a pretty punk vibe to the Alberta Rose Theater. At the end of the song the girls struck their fists into the air as the singer shouted with an air of resistant conviction “and…periods!” I was blown away. I would have been embarrassed beyond belief talking about periods with my family at 13 let alone yelling about them in front of a crowd of hundreds. Maybe these young women were the exception but they gave me hope that a generation of young women is embracing and talking about this aspect of our bodies!
As an acupuncturist at a women’s health-focused clinic, I am reminded daily that most of us don’t know what a normal period or menstrual cycle, let alone an ideal one, looks like. We may have grown up hearing our mom or sisters talk about their PMS symptoms or painful periods and think that is normal to spend a day in bed with a hot pack. We may have gone on birth control as young teenagers and not really known what our own normal would look like. We may find ourselves ready to try to start a family and not know when the best time of the month to try to conceive is.
If you have ever seen an acupuncturist you probably were asked about a dozen questions about your menstrual cycle – flow, color, consistency, PMS, vaginal discharge, breast tenderness and more. You may have never considered some these aspects but they help us guide our understanding of your body and how to best help it find balance. Our patients often follow up their answers with, “is that normal?” Let’s start with the basics and then explore what is normal and what is ideal when dealing with the menstrual cycle.
Your menstrual cycle starts on the first day of your period and continues until the day before you start your next period – roughly 28 days.
The period itself usually lasts around four days as your uterus sheds its lining to optimize conditions for a possible pregnancy this cycle.
From the start of the period to mid-cycle (when ovulation occurs) is called the follicular phase. During this time you are developing the follicles that will lead to your body releasing an egg at ovulation. Your uterus also begins to regenerate the endometrium (uterine lining) during this phase.
At ovulation your body releases an egg that is swept into the fallopian tubes and will spend the next few days making its way to your uterus. If a sperm meets the egg in route fertilization can occur and the newly formed embryo can implant in your uterus resulting in pregnancy. If not, the egg continues on its journey down and out and you can expect to continue cycling.
The second phase of the cycle is called the luteal phase and lasts from ovulation until the next period begins. During this phase, your body is continuing to grow uterine lining. The lining will reach its peak and hormones will trigger bleeding to begin starting your cycle over again.
Normal vs Ideal
In terms of your cycle, there can be a big difference between what is normal and what is ideal. For example, the ideal menstrual cycle is 28 days though only 15% of us have such cycles. 90% of people have cycles between 24 and 35 days.
The average period lasts four days plus or minus two days. Ideally, your period starts without spotting though many folks will notice spotting before their flow fully arrives. Usually, the majority of bleeding will occur on day 1 and 2. Ideally, your period is not accompanied by pain or discomfort though roughly 80% of women have some type of menstrual pain in their life. The amount of blood may vary and can commonly include some clotting though that is not ideal.
In a 28-day cycle ovulation will occur around cycle day 14. If your cycle is longer or shorter you can expect ovulation roughly 14 days before you expect your next period. If you pay attention to your vaginal discharge – also known as cervical mucus – throughout your cycle, you may notice slippery egg white discharge around ovulation. This discharge helps the sperm make their way to the egg and is an indicator of fertility. After ovulation, this discharge will dry up. At ovulation, some people will experience “mittelschmerz”, a dull pain that can last for minutes to hours. Breast tenderness around ovulation is also common.
The week following ovulation should be relatively uneventful. Breast tenderness should have died down and you should feel pretty good. In the week prior to your period people commonly experience various forms of PMS. These symptoms can last a full week or just a few days and are generally relieved once your period has begun. Ideally, symptoms are non-existent or minimal.
Common menstrual issues improve significantly with the use of East Asian medicine
Menstrual issues respond very well to acupuncture and herbal medicine. Typically, the most improvement is seen over a course of three months of treatment with each cycle showing significant progress to see changes in the cycle. If you are dealing with pain, PMS, irregularity or generally feeling off with your cycle then it may be the right time to give East Asian medicine a try. If you are coming off of birth control or thinking about starting a family, regular treatments can help regulate your cycle and enhance fertility. Here are some common issues that can be improved and/or resolved with regular treatment:
Many women experience low back pain or lower abdominal cramping before their period and/or during the first few days of their flow. Acupuncture, a heat therapy called moxibustion and customized herbal formulas can all help.
Clotting and flow
Do you experience clots in your menstrual flow? Many folks experience clots that range in size from an eraser head to a quarter. Blood clots passing through the cervix can increase pain and from an East Asian medicine perspective, they indicate that something is off balance.
Are you concerned your periods are too light or too heavy? Acupuncture and herbs can help with that too!
Symptoms of PMS can range from bloating and breast tenderness to irritability and sadness and can last days to more than a week before your period begins. From an acupuncturist’s point of view the qi, or energy of the body, is not flowing well and can be greatly improved by acupuncture and herbal medicine.
Are you unsure when to expect your period and ovulation? Many folks experience menstrual irregularity, especially when under great stress when coming off of birth control or with conditions like Polycystic Ovarian Syndrome (PCOS). Acupuncture and herbs can help regulate your cycle and get you closer to a 28-day cycle so you know when to expect your menses and when you are fertile.
At Willow Tree Wellness we are passionate about menstrual health and helping our patients find balance while empowering them with knowledge of their bodies and cycles. Book a complimentary phone consult or come visit us to experience the benefits of acupuncture and herbal medicine!