The 4 phases of the menstrual cycle in TCM

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In previous posts we saw that the TCM definition of Blood is different from

the Western definition of blood; that the main functions of Blood are to

nourish and moisten the entire body and provide an anchor for Shen (Spirit/

Mind), the Ethereal Soul, and Qi; that the Spleen, the Kidneys, and the

Heart play major roles in producing Blood; and that the Spleen, Heart, and

Liver. There are different TCM syndromes which can underlie menstrual

problems. Liver Qi Stagnation almost always will underlie cases of PMS.

Blood Deficiency can play a role in menstrual problems.

 

When Blood is made, first it goes to nourish and moisten the Organs (viscera

and bowels). It next moistens the channels and vessels. After this, it

moistens the rest of the tissues like the muscles and skin. What is left

over after nourishing and moistening these tissues collects in the uterus.

When enough Blood collects in the uterus, it " overflows as the menses. " In

healthy women this typically happens every 28 to 30 days. (Bob Flaws, Curing

PMS Naturally with , p. 34.)

 

If not enough Blood collects, no menses takes place. If the Blood is not

controlled properly, menstruation will occur too early or too late.

(Automatically suspect Heart, Spleen, and/or Liver imbalance and rule in or

out in cases where menstruation comes too frequently or too late. These 3

Organ systems control Blood. Automatically suspect Blood Deficiency and

Heart, Spleen, and/or Kidney imbalance and rule in or out in cases where a

young woman quits menstruating. These 3 Organ systems have the most to do

with making Blood, and if there is extreme Blood Deficiency, the woman will

not menstruate.)

 

TCM views the menstrual cycle as being made up of 4 roughly equal phases.

These are Blood, Yin, Yang, and Qi. These 4 phases also can be thought of

as the menses (Blood), pre-ovulation (Yin), post-ovulation (Yang), and

premenstrual (Qi).

 

The diagram in the Flaws book and the text are somewhat confusing in places,

so I'm going to paraphase and simplify heavily here. Think of

the Blood phase as phase 4. The day the period starts is day 1 of phase 4,

the Blood phase. It can last from anywhere from 1 to 7 days depending on

the age of the woman and her health. During this phase, the uterus empties

itself of Blood. This leaves the body relatively Deficient of Blood. If

the woman has tendencies to Blood Deficiency, the time during the menses can

be particularly rough on her. In cases where a woman has problems during

the menses, suspect and rule in or rule out underlying Blood Deficiency or

tendency to Blood Deficiency.

 

Phase 1 starts the day the period ends. This is the Yin phase. Because the

body has been left relatively or very Blood Deficient by the menses, this is

a period which is characterized by the body making a lot of Yin and Blood to

make up for what was lost during the period. Suspect Yin Deficiency or a

tendency to Yin Deficiency when a woman has problems after her period ends

for the month.

 

Phase 1, the Yin phase, leads up to ovulation. In order for ovulation to

occur, Yin has to transform into Yang. (It's a common idea in TCM that Yin

can transform into Yang, and Yang into Yin.) Ovulation and the

transformation of Yin into Yang corresponds to a rise in the basal body

temperature. (Yang warms and activates; Yin cools and calms.) The Yang

phase is the post-ovulation or second phase. If the woman has not made

enough Yin during phase 1 or if she is Yang Deficient, Yin will not

transform into Yang, and ovulation will not occur. Suspect Yang Deficiency

problems if the basal body temperature fails to rise. Also consider the

possibility of Yin Deficiency. Suspect Yang Deficiency if a woman has

problems around the time that ovulation should have occured. Also, Qi

Stagnation and/or Blood Stasis can interfere with ovulation.

 

Phase 3 is the Qi phase. This is the premenstrual phase. In order for

things to go smoothly during this phase, the Yang has to stay strong and the

Qi has to move. If Qi doesn't move (Stagnates), we're talking PMS -

Premenstrual Syndrome. Water retention, sore and tender breasts, cramps,

emotional roller coaster, irritability, anger, all the charm of a rabid

porcupine, etc.

 

Phase 4, the Blood phase, starts the day the menses starts.

 

PMS isn't always due to Qi Stagnation problems, but most of the time, it

will be due to Qi Stagnation problems. " Problems may occur in any of these

four phases and may occur for reasons other than the dominant correspondence

in that phase. Hosever, when a problem occurs in any of these four phases,

the Chinese doctor will first investigate to see if the dominant

correspondence, whether yin, yang, qi, or blood, is behaving as it should at

that time. " (Flaws, PMS, p. 37) In other words, PMS could be due to

problems with Blood, Yin, or Yang, but the most probable Root will be Qi

Stagnation problems. Likewise, problems during the menses could be due to

Yin, Yang, or Qi problems, but the most probable is Blood imbalance. And so

on.

 

Some women have various problems throughout the menstrual cycle. It is

possible for an individual to have Blood, Yin, Yang, and Qi problems.

 

In addition, TCM gynecology also considers the age of the woman in relation

to menstrual problems. In girls, the number one cause of menstrual problems

is the Kidneys. The production of Blood is dependent on the Kidneys. The

Kidneys supply Essence (Jing) in the production of Blood. Adolescent girls

have immature Kidneys. For this reason, the production of Blood may be

irregular, and this in turn causes the menses to be irregular.

 

In women, the most probable cause of menstrual problems is Liver imbalance.

In older women, a weakened Spleen is the most probable Root of menstrual

problems. Because the Spleen plays a major role in the production of both

Qi and Blood,, it is common to see problems during both the Qi and the Blood

phase in older women.

 

Victoria

 

 

 

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