Currently more than half of the U.S. population is female, with many of them experiencing a monthly menses. Add in today’s access to information and you would think menstrual issues would be widely understood and efficiently handled, though sadly that is not so. Although each generation of women has a better idea of what is going on inside their bodies than the generation before, we still have many women who think that monthly irritability, cramps, or heavy bleeding is something they were born with or have to live with. I’m happy to say that is not the case!
How Do Hormones Affect your Menses?
In Western medicine, menstrual issues occur due to the rise and fall of estrogen, progesterone, and testosterone levels – three powerful sex hormones that control ovulation and the menstrual cycle. This monthly cycle has two phases: The Follicular Phase and the Luteal Phase, with Ovulation being the dividing line between the two.
Let’s take a closer look…
The Phases of the Menstrual Cycle
The Follicular Phase starts the menstrual party. It is the point where these sex hormones are at their lowest levels. When this happens, many women feel sad and irritable and develop PMS right before their periods begin. Why? It is thought that these low levels negatively affect serotonin, dopamine, and norepinephrine – the “feel good” chemicals in the brain.
Estrogen and testosterone levels start to climb, signaling the uterus to start releasing blood and tissue. For some women, this explains the cramps and clots they get as their periods begin. Menstruation can vary between 3 and 7 days on average and FSH, or Follicular Stimulating Hormone, is activated to start maturing a follicle, or egg sac.
Around days 12 to 14 women enter into the Ovulation Phase of the cycle. This is the point where the uterine wall starts to thicken in preparation for the possible implantation of a fertilized egg. High estrogen spikes can cause headaches or anxiety in some women during this time. Luteinizing hormone (LH) also spikes, triggering release of an egg from the follicle, thus starting ovulation. During this time progesterone continues to rise while estrogen and testosterone dip for a few days, causing some women to feel sluggish.
From there a women enters the Luteal Phase, where estrogen, testosterone, and progesterone all rise together. Progesterone is at its highest level at the start of this phase, and may cause a decrease in libido for some women. If a fertilized egg does not implant itself following ovulation then all these hormones will begin to decrease, the endometrial lining will loosen, and the body will prepare itself for the menses.
Special Menstrual Issues and Concerns
Menstrual cramps, or Dysmenorrhea, are mainly caused by strong uterine contractions and natural chemicals called prostaglandins found in the lining of the uterus. These painful cramps can also be caused by endometriosis, uterine fibroids, or pelvic inflammatory disease (PID).
Amenorrhea is the complete absence of menses for one or more menstrual periods. The most common cause of amenorrhea is pregnancy. Breastfeeding and menopause are normal reasons why monthly periods will cease. Amenorrhea can also develop with stress, excessive exercise, abnormally low body fat, eating disorders, and some medicines and contraceptives. Hormonal imbalances such as thyroid malfunction, polycystic ovarian syndrome (PCOS) and pituitary tumors can interrupt menses, as well as uterine scarring, vaginal abnormalities, and a developmental lack of reproductive organs.
Irregular periods, or Oligomenorrhea, occur when there are at least 35 days between periods (as opposed to the usual 28-30 days) or; alternatively, the periods can come and go at various times, and be accompanied by large clots. Hormonal imbalances are the usual cause here, though stress, contraceptives, eating disorders, extreme exercise, and marked weight loss or weight can also play a role. PCOS, endometriosis, PID, thyroid disorders, and cervical or uterine cancer can also cause irregular bleeding. It is normal to experience irregular periods when during the first year of menstruation and again once you hit perimenopause.
Heavy menstrual bleeding or bleeding that last more than 7 days is called Menorrhagia. In younger women this often happens due to a hormonal imbalance where estrogen prompts the uterus to make too thick of a lining; this imbalance can also cause the lining to be shed between your periods, otherwise known as spotting. Intrauterine devices (IUDs), uterine fibroids, polyps, and even early pregnancy can create heavy flows. Women in their 40s and 50s can develop a thick uterine lining which can cause heavy bleeding and be a sign of uterine cancer. Menopausal women who undergo hormone replacement therapy (HRT) can experience heavy bleeding, and can also be a sign of endometrial and uterine cancer.
Painful periods, heavy menses, and spotting can also be symptoms of Endometriosis. This condition occurs when the endometrial lining grows outside of the uterus. Other symptoms include pain one to two weeks around menstruation, uncomfortable bowel movements, pain during intercourse, and infertility. It is also possible to have endometriosis without any symptoms.
Can Acupuncture and Chinese Medicine Help With Menstrual Issues?
Yes! Acupuncture and herbal medicine are safe and effective ways to help regulate your menses. Traditional Chinese medicine regards a woman’s menstruation as a very important indicator of overall health. The body continually strives to be in a state of balance (homeostasis), but certain conditions can adversely affect the body over time; in women, one of the first signs of this imbalance can be seen through the menses.
There are many diagnostic patterns that can explain the symptoms a woman is experiencing – and it is possible for her to have more than one pattern presenting at a time. Here are four of the most common diagnostic patterns we see with menstrual issues:
Qi Deficiency – women with this pattern will experience early, short, or heavy periods as well as mid-cycle bleeding.
Qi Stagnation – this popular pattern is the culprit behind the moodiness and irritability associated with PMS. It is also responsible for that dull, achy pain, breast tenderness, and irregular periods.
Blood Deficiency – women with blood deficiency tend towards scanty or more watery, pale periods. Delay of menses is common, as is pain after the period. Blood deficiency can also play a role in post-menses headaches and infertility.
Blood Stagnation – sharp, stabbing pain is a hallmark of this pattern, along with a heavy and very dark red or blackish flow with large clots. It is common for women to feel fatigued and have pallor. Blood stagnation can also result in spotting, late periods, amenorrhea, and infertility. It is commonly a “root” pattern for endometriosis as well.
By identifying and addressing diagnostic patterns, Traditional Chinese medicine can help relieve the pain, cramps, heavy periods and so much more that many women contend with each month. If you suffer with any of these symptoms or conditions, please reach out to us. I can give you a thorough evaluation and come up with the proper acupuncture and herbal treatments to help regulate your period and have you feeling better every week of the year!