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Treatment According to the Four Phases of the Menstrual Cycle in Chinese Medicine

Updated: Dec 21, 2023

In Chinese medicine, we tend to divide the menstrual cycle into four different phases - the period, the follicular phase, the mid-cycle/ovulation phase and the luteal phase. Each phase of the cycle is important in its own right `and, as practitioners of Chinese medicine, we tailor our treatment according to the phase of the cycle.

The onset of the period is the time of maximum Yang, after which it declines rapidly and Yin begins to rise. The treatment principle during this phase is to invigorate the Blood, alleviate pain and stop bleeding in the case of heavy periods.

If you are trying to conceive, our principle aim is to encourage the complete discharge of menstrual blood, so that a new endometrium can grow evenly on smooth base. This will help the implantation of an embryo later in the cycle.

During the follicular phase, the Yin rises and oestrogen increases. It is an important phase to establish a regular menstrual cycle and it is a crucial time for boosting fertility. Not only is this the time that the egg matures to its fullest potential for fertilisation, but it is also the time during which the lining of the uterus prepares and thickens to enable implantation to occur. During the follicular phase, our aim is to nourish Yin and Blood with acupuncture, herbs and blood-nourishing foods to support follicular growth and promote the thickening of the endometrium.

The next phase of the cycle is the mid-cycle or the ovulation phase. At this time, oestrogen peaks and Yin energy reaches its max, cervical mucus should be stretchy and abundant and the ovary is ready to release a mature egg, when prompted by hormonal messages from the pituitary gland. This is a crucial moment, which requires the free flow of Qi and Blood to enable the with from Yin to Yang to occur and trigger ovulation. So the focus of your practitioner will be to move Qi and Blood and encourage the growth of Yang, whilst tonifying the Kidney energy.

The final phase of ovulation is the post-ovulation phase or luteal phase. Treatment during this phase may vary according to whether the patient is wanting to conceive or not.

If you suffer from PMS or painful periods, but you are not wanting to conceive, the focus of our treatment will be on moving the Qi to alleviate pre-menstrual symptoms, or invigorating blood to alleviate pain. However, if you are wanting to conceive the post-ovulation phase in your cycle is an important time to tonify the Kidney Yang and Spleen Qi in order to promote progesterone.

For implantation to occur, the uterus has to provide a warm and receptive environment, with a thick, secretory endometrium and high progesterone levels. Not only does Kidney Yang support progesterone (which enables the BBT to remain high in the luteal phase of the cycle), but it also enables the uterine walls to draw inwards, holding the embryo firmly as it burrows into the secretory endometrium.

The strength of the Kidney Yang is dependant on the strong foundation of Yin that we built in the follicular phase of the cycle as Yin and Yang interdependent. It is also dependant on Spleen Qi which supports Kidney Yang.

So you can see that each and every phase of the menstrual cycle plays and important role in conception, and each phase is dependant on all the other phases.`The proper shedding of the endometrium during the period is vital for implantation to occur mid-cycle. The abundance of Yin and Blood in the follicular phase is vital, not just for promoting the quality of the eggs and the thickening of the endometrium in the follicular phase, but it is also essential for the switch from Yin to Yang mid-cycle, which triggers ovulation, and it is essential for a healthy corpus luteum, which secretes the progesterone so vital for implantation in the luteal phase.

When treating female infertility, we always adjust our treatment according to the stage of the cycle and the patient’s individual pattern. Herein lies our success!

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Menstrual Cycle

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