Menstrual disorders/Dysfunction – Also known as Period disorders
Many women have never experienced a normal symptom free regular period. Right from the very beginning of their fertile phase of life they have been plague with unpleasant and at times painful symptoms. A woman’s menstrual cycle should flow without unpleasant symptoms of pain, heavy bleeding, clots, sore breast, headaches, spotting, premenstrual syndrome, irregular periods, or no periods. She should experience a sense of where she is at throughout her cycle with a growing awareness of the impending period. In Chinese medicine period dysfunction is a sign of when there is an imbalance in the flow of qi causing depletion of qi which leads onto stagnation of qi and blood.
What happens when there is dysfunction resulting in the following symptoms?
- No periods or irregular periods
- Early or late periods
- Heavy periods with or without clots
- Light periods
- The absence of fertile mucus
- Yeast or bacterial infections
- Bleeding between periods
- Period pain or pain mid cycle
- Premenstrual Symptoms of irritability, mood swings, headaches, breast tenderness, acne, fluid retention, food cravings.
There are many things that can have an effect a woman’s menstrual cycle. These include physical, emotional and mental stress, overwork, insufficient sleep, nutritional deficiency such as zinc, selenium, vitamin D and B’s and magnesium, medication, obesity and inflammation, consuming a diet that consist of a lot of cold foods/beverages that creates internal cold in the reproductive organs. Qi deficiency and blood stagnation.
If you are particularly stressed your follicular phase may be drawn out causing Estradiol to rise and fall giving false fertile mucus. Experiencing fertile mucus is not a sure sign of ovulation.
Now is a good time to recap on what is a normal period cycle. What is happening to a woman’s body as she experiences the flow of her menstrual cycle?
What is a normal menstrual cycle?
Day one of a woman’s cycle begins with a bleed when the uterine lining is shedding itself. This should be a bright red bleed and have an even ebb and flow to it which will last approximately for the first 2-4 days. It then should ease off and change to a dark red/brownish colour for another day or 2. It should cease by day 7. Any bright red bleeding beyond 7 days is considered abnormal. Any spotting prior to your period beginning are related to the final days of the previous cycle.
The first phase of the cycle is referred to as the follicular phase. This starts the moment the uterus has shed its lining. It usually begins at around 7 days to 21 days. This is the phase where a few follicles (6-8) begin to ripen. Our follicles which contain 1 egg each, have been under development for months (100 days) prior to this. Hence, a menstrual problem could be a result of follicles becoming unhealthy during their maturation phase over the months prior to their release. Over the follicular phase it is the job of each follicle to produce oestrogen (Estradiol -specific to the folliciles), testosterone and progesterone. This type of oestrogen is one of your happy hormones and yang in nature. It is what stimulates a good mood and libido via the neurotransmitter serotonin (promotes feeling of wellbeing and happiness) and dopamine (associated with motivation and pleasure). As your follicles are reaching their matured state their release is triggered by the luteinising hormone which breaks open the ripest of follicles and an egg is released. That is ovulation. Not all follicles make it to the end, only 1 or 2 do. The eggs that do not mature are reabsorbed by the ovary. The final stages can take a few hours, but the moment of ovulation only takes a few minutes whereby a woman may notice a slight twinge or mild pain on either side of the pelvis or both. If you are a young woman and have lower levels of Follicular Stimulating Hormone (FSH) then your follicular phase could be longer. When you are older, such as in your forties with higher levels of FSH your follicular phase will tend to be shorter.
Estradiols main job is to prepare the lining of the uterus by thickening it ready for the fertilised embryo to embed. The thicker the lining the heavier the period. Estradiol’s also stimulates the formation of fertile mucous. It is normal for all woman to produce vaginal mucus. This is made up of cells from the vaginal wall, healthy bacteria and fluid made from the cervix to keep the area moist and healthy. It should be white, clear, or pale yellow and have a mild salty odour. If it is heavy, moderately yellow/greenish in colour and causes discomfort such as itching then this may indicate you have an infection. Leading up to the time of ovulation the vaginal discharge will increase and should have a slippery egg white consistency to it. This is known as fertile mucus and is a healthy sign that the follicles have produce good amounts of Estradiol. Its main purpose is to help sperm as quickly as possible, to find its way up through the cervix, through the uterus and into the fallopian tubes where it is intending to meet up with the newly release egg in order to do its job of fertilization.
Ovulation is a very significant event whether you are trying to conceive or not. Because after ovulation the follicle then restructures itself and becomes the Corpus Luteum. This is a temporary gland (growing to 4cm) that secretes progesterone throughout the now Luteal Phase of the cycle. This is the final phase (the last part of the 100-day journey for the follicle) that last about 10-16 days after ovulation if conception has not been achieved. If conception has taken place it will continue producing progesterone for the first 3 months of pregnancy whereby the placenta then takes over producing this hormone. Progesterones main job is to maintain a pregnancy but it does a lot more for a woman. It is Yin in nature as opposed to oestrogen which is yang. It is one of our calming hormones in this phase of the menstrual cycle. It calms the nervous system by converting to a Neurosteroid called allopregnanolone making it easier to cope with stress. This is one of the things that hormone-based contraceptives do is that they rob the body of this mood enhancing hormone as it contains progestins not progesterone and therefore does not convert to allopregnanolone. This could be why woman experience more anxiety while taking them. Progesterone also reduces inflammation, build muscles, promotes sleep, and protects against heart disease.
So, you can see that the developing follicle requires good health and nutrition for the entire 100 days so it has enough strength to develop a healthy corpus luteum that will produce enough progesterone to complete the cycle whether pregnant or not.
If you have developed a healthy corpus luteum then you should have developed a healthy uterine lining – not too thick and not too thin. There should be enough progesterone to avoid premenstrual spotting or pain. As you near the end of the luteal phase the luteum corpus shrinks away and the progesterone levels drop which stimulates the uterus to contract and shed its lining. Interestingly two thirds of the lining it reabsorbed with only the endometrial tissues being expelled. The average loss of blood is about 50mls. Less than 25mls is a scanty flow and more than 80mls is a heavy flow. You would only know this if you used a menstrual cup. The length of a normal cycle range is 26-35 days long for adults and for teenagers up to 45 days long.
How can this dysfunction be corrected?
Restore total health to restore reproductive health. That means consuming the healthiest diet you can that is filled with an abundance of vegetables especially green vegetables balanced with protein, healthy fats, and healthy carbohydrates. Avoid all processed carbs such as sugar, breads, cakes, and pastries. Instead include healthy carbs from vegetables, fruits, nuts, and seeds. Try to consume a diet that it as natural as possible. Undereating is another stress that can stop your periods by shutting down your ovaries. Nutrient dense nutrition is what is needed to convince your hypothalamus that you have enough nutrition to ovulate and have a healthy period.
Avoid endocrine disruptors such as all plastics. Not just the ones that contain BPA. All plastics are thought to be endocrine disruptors. It is recommended to avoid the following gas much as possible – pesticides/herbicides, bakery foods and flours (bromide), soft drinks, vegetable oils, processed meats, textiles, vinyl upholstery, fire retardant in furniture, carpet, scented candles, personal products other than natural ones, air deodoriser, dry cleaning. Where possible stick with natural products for the body and home. These endocrine disruptors/xenoestrogens are known to interfere/mimic with your hormones.
Address all stressful situations in your day to day life such as work stress, relationship stress, working too hard that leaves insufficient time in your day to nurture and nourish yourself well. When a woman is dealing with intense stress the hypothalamus puts a hold on reproduction until the danger has passed and it is safe. If chronic stress continues this menstrual suppression continues and is known as hypothalamic amenorrhea. You need time in your day to practice relaxation techniques such as yoga or tai qi and diaphragmatic breathing.
Getting enough sleep is vitally important for your reproductive hormones to flow as they should. It is also important to get enough sleep at the right time of the day to keep the circadian rhythm of the body in sync. This means that heading to bed at around 9pm is going to allow you to get good quality sleep while your melatonin hormone (sleep hormone) is being release and your sympathetic nervous system is at is quietest time for the day. The more sleep that you can get prior to 3am the more nourishing it will be for you. After this time, the sympathetic nervous starts to produce cortisol again preparing the body to awaken when the sun begins to rise. Good quality sleep is especially important the week before your period is due, so it has enough energy to undertake the job of menstruation.
Regular exercise is beneficial for period health as it helps to reduce stress, improves circulation to the pelvic organs and reduces inflammation. However excessive exercise can shut down the menstrual cycle as there is simply not enough fuel to go around. There needs to be a balance between dietary energy intake and energy expenditure.
Supplement yourself where appropriate under the guidance of a natural health practitioner.
Make time available to have acupuncture treatments and appropriate herbal supplementation to correct imbalances.
Take time to address chronic inflammation that is creating inflammatory cytokines which are chemical messengers that impede ovulation. Use your natural health practitioners to help you with this.
Use a period tracking app so you can keep track of your cycle.
Your period cycle is your body’s barometer of your underlying reproductive health.