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Chinese medicine readily appreciates how emotional strain can be a direct cause of menstrual dysfunction.

Menstrual health: A traditional Chinese Medicine perspective

Understanding menstrual disorders

In the west, we are accustomed to thinking that maladies surrounding menstruation –  pain, heavy bleeding, premenstrual tension (PMT) and headaches, to name but a few – are part and parcel of the female experience. Symptoms can range from the mildly annoying to utterly debilitating, impacting all areas of one’s life. Thankfully, TCM takes a different view and teaches us that, while incredibly common, these conditions are not found in a harmonious bodily landscape and need not be silently endured.

How is menstruation understood in TCM?

In TCM, the nature of a woman’s menstrual flow and cycle is a window in to the state of her physical and emotional being. A menstrual complaint, therefore, gives us valuable insight in to where balance has been lost and how best to bring it back. 

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TCM holds that menstruation – tian gui or ‘heavenly water’ – is present when the ren (Conception) and chong (Penetrating) channels fill with qi and blood, respectively, and derives from jing – our core, inherited essencethat governs reproduction and growth. Jing forms the substance of a woman’s eggs and is involved, with the heart, in ovarian function.

The mind-body connection inherent to TCM philosophy is clearly illustrated in menstrual physiology, where the heart houses the shen (spirit/ mind, including the hypothalamus and pituitary glands), governs the blood and is connected to the uterus/ ovaries via a channel called the bao mai (Uterus vessel). There is, therefore, a direct correlation between TCM heart function in ovulation and the hypothalamic-pituitary-ovarian axis. As such, Chinese medicine readily appreciates how emotional strain can be a direct cause of menstrual dysfunction (1).

The cycle

Menstrual cycles are governed by an intricate dance and interplay of hormones. In TCM, like the waxing and waning of the moon,  a woman’s cycle follows the ebb and flow of yin and yang energy throughout her cycle where the follicular phase (day 1-14) pertains to yin and luteal phase (day 14-28) to yang.

The follicular phase is marked by the onset of menstruation as a result of a sharp drop in oestrogen and progesterone. In TCM, menstruation occurs when yang (reflected in progesterone levels) has reached its maximum and switches to yin. We then see follicular development as the pituitary gland stimulates follicle stimulating hormone (FSH) and leutinising hormone (LH). In TCM, this process relies and draws on our jing. The growing follicles, nourished by yin and blood, then secrete oestrogen. Increasing oestrogen levels reflect the growth of yin and blood and can be observed, to a degree, in the presence, quantity and quality of cervical mucus leading up to ovulation. If yin rises sufficiently, it will trigger the transformation to yang. This transition is reflected in rising progesterone (and, therefore, yang) levels and an LH surge. Under the influence of LH, the empty follicle – having released its egg – secretes progesterone and this maintains the uterine lining (endometrium) until menstruation or conception (1,2).

Many herbs are suitable for self-care. However if a health condition does not resolve with home remedies we recommend using the information in Herbal Reality along with your health advisors, especially herbal practitioners from the professional associations listed in our Resources page (‘If you want to find a herbalist”). When buying any herbal products, you should choose responsible manufacturers with independently assured quality standards and sustainability practices. Check the label carefully for the appropriate safety and sustainability information.

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