Day one of your menstrual cycle begins on the first day of menstruation, the first day you bleed.
In a healthy, regular Menstrual cycle, there are four main phases, which should fall on these days:
1) Menstrual phase (From day 1 to 5)
2) Follicular phase (From day 1 to 13)
3) Ovulation phase (Day 14)
4) Luteal phase (From day 15 to 28)
In TCM terms, the cycle can be generally divided into yin phase ( menstrual and follicular) or yang phase (ovulation and luteal).
great link/reference: https://menstrupedia.com/articles/physiology/cycle-phases
Not many women these days have a regular cycle or a regular flow. This can be for many reasons and the treatment principle, (or approach) for the practitioner, depends on the individual diagnosis for each patient.
Some women may present with the primary issue of pain through the menstrual phase. This could be from cold in the uterus, liver qi stagnation, blood deficiency, kidney deficiency, or a combination of all of these.
For others, they may have a 'short cycle', get moody around day 21, and bleed day 24. This is usually due to kidney yang deficiency, often bought on by stress, overwork, improper diet or lifestyle. These women may also notice more weight-gain around the middle and their belly and buttocks are cold to the touch, compared to the upper body, (cold below, heat above).
Or you may get moody around ovulation, because the yang energy is too weak to rise and initiate the release of the egg. Everyone's cycle is different, with different issues.
TCM practitioners 'treat what they see', so treatment principles for each patient are slightly different when it comes to regulating the cycle. If you are trying to conceive (TTC), we start with regulating the timing and flow of the cycle, removing stagnation and strengthening where there is deficiency.
We usually allow 3 months of acupuncture and herbs to regulate the cycle. We tend to see women mostly in the first part of the cycle, during the menstrual and follicular phase, then once again at ovulation (day 11-13) and at day 21.
This is the same for those TTC with natural conception or prior to an IVF stim cycle or frozen transfer.
We do not herbs during an IVF stim cycle because of possible interactions. We tend to stick to acupuncture and dietary therapy during IVF stim cyles.
Treatment Principles during phases:
1) menstual phase: Nourish and move blood, clear heat
2) Follicular phase: Nourish kidney yin, blood (and yang)
3) Ovulation phase: Move qi and blood, warm and strengthen yang
4) Luteal phase: Strengthen yang
The dietary therapy focus changes throughout the cycle, as do your herbal formulas. e.g. More nourishing foods when you are loosing blood and more warming spices in the yang phase. This can further be broken down into time of the day... more warming pungent foods for breakfast when yang energy is rising, moving outward and cooler foods at night when the energy is descending and moving inward.
Your herbs at the follicular phase are quite different to those in the luteal phase because the Treatment Principle is different.
Lifestyle advice is generally around circadian rhythm and living more in balance... early to bed, no social media after 7pm, go to bed with the sun, get up with the sun.
Dr Jacqui Stocks