Your Period: What’s Normal, What’s Not, and What to do about it.

Women are fortunate to have a natural monthly process that gives us information and clues about the inner state of our body, as well as remind us of our connection with the ebb and flow and creative force of nature. I like to think our periods are a message to us, and we can learn a lot from them if we know how to listen.

First let’s talk about what is “normal”. A period is considered regular if it has a consistent cyclical pattern. The average length between menses is 28 days, although variation of somewhere from 25 to 33 days is considered normal. Average length of bleeding is three to seven days, without clots or pain.

Heavy Flow
What’s up: If you have to change your pad or tampon more than five times a day, or bleeding lasts longer than 7 days, that would qualify as heavy. This could be caused by fibroids or endometriosis, although some women bleed heavily for no obvious reason. In Chinese medicine it could be due to heat (think inflammation) or emotional upset or stress.

What to do: Dietary change can be important if it is due to fibroids or endometriosis – eliminate dairy, sugar and processed foods, which all cause “damp accumulation” in the body. If it’s not one of those two things, then working on your stress levels, getting regular exercise, and Chinese herbs can help.

Light Flow or Late Menses
What’s up: Birth control pills and the Merena IUD can reduce your flow. If you’re not on hormonal birth control and you see nothing but a little bit of staining and only require a light panty liner or pad, it could be a thyroid problem. Otherwise, in Chinese medicine it could be due what we call a blood or yin deficiency.

What to do: If the Pill is reducing your flow and that bothers you (which isn’t likely), try a different birth control method. If it’s a thyroid problem, you may need meds. See your gyno, who can refer you to an endocrinologist. Otherwise, make sure you are getting at least 2-3 oz of meat or fish several times week. If your vegetarian and don’t want to add meat, bulk up on dark leafy greens.

Irregular Cylces
What’s up: Maybe yours used to come every 28 days but is now arriving on day 21, 35, 28, and back to 21 again. It could be stress, severe weight loss, extreme exercise, or extreme weight gain, all of which can knock your hormones out of whack. Medications that work on the central nervous system, like antidepressants, can also mess with your cycle. Endocrine disorders like thyroid disease can cause irregular periods, too, as can polycystic ovarian syndrome (PCOS). An ultrasound can show if you have ovarian cysts, as well as blood tests to show your levels of testosterone and lipids (which are usually raised with PCOS).

What to do: Acupuncture and herbs can help. There can be many reasons for irregular periods – deficient blood, deficient Qi, stagnant blood, and stagnant Qi. Most doctors will want to put you on birth control to regulate periods, which doesn’t necessarily fix the problem – just covers it up. If the period change is sudden, don’t wait longer than three months to see your gyno. If you do have PCOS, acupuncture and herbs can help.

What’s up:
 Usually the cause is prostaglandins, chemicals manufactured in the uterus that bring on contractions to expel the uterine lining during your period. But if you have incredibly disabling cramps, it could be endometriosis, which affects 7 to 10 percent of women. The disorder is marked by uterine tissue growing outside the uterus, typically in the pelvic area.

What to do: Eliminate dairy, reduce red meat and cheese (which promote the synthesis of prostaglandins), supplement with fish oil (which reduces prostaglandins), Vitamin C, E, B6, and magnesium. Reduce stress. Acupuncture and herbs can help.

What’s up: A wide variety of symptoms can be present with PMS – bloating, fatigue, weepiness, melancholy, irritability, breast tenderness, insomnia, headaches. PMS is related to to high levels of estrogen and relatively low levels of progesterone. Estrogen levels can be raised due to diet, body fat, or decreased breakdown of estrogen from the liver.

What to do: Eliminate dairy, refined sugar and processed foods, reduce caffeine.  supplement with fish oil, Vitamin C, E, B6, B12 and magnesium. Reduce stress, get more sunlight, exercise. Acupuncture and herbs can help a lot, and check out this article.

What’s up: Low-dose birth control pills can lead to breakthrough bleeding. If you’re not on the Pill and spotting lightly before your period comes, it can sometimes be a sign of low progesterone, but it’s nothing to be alarmed about. In chinese medicine it is usually due to a yin or spleen deficiency.

What to do: If you’re on the Pill and the spotting doesn’t resolve itself in a few months, ask about a higher-dose Pill. Acupuncture and herbs can help to boost yin and Qi.

In my practice I have become convinced of the profound effect that the psyche and our emotions can have on the menstrual cycle and our health in general. Please pay attention to and honor how you are feeling. Take time to turn inward and and slow down during your period.


Photo by Kristen-W

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  1. The Delicious Day on February 7, 2013 at 7:05 am

    This is fantastic. Seems we are always told that all of these things are “normal” or just part of “it” – glad to know the signs. Great post!

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