Understanding Menstrual Health Through Traditional Chinese Medicine
History
East Asian medicine has a long and rich history. The earliest records of gynecological medical writing date back to the Shang Dynasty (1500–1000 BC). The Yellow Emperor’s Classic of Internal Medicine (Huang Di Nei Jing Su Wen) contains many references to women’s physiology, anatomy, diagnosis, and the treatment of gynecological patterns. It describes the function of the Uterus and its connection to the Heart and Kidneys via the Bao Mai (Uterus Vessel).
In my clinic and training, I integrate both Traditional Chinese Medicine and Western medicine to best support women’s health and overall wellbeing. This approach allows me to combine acupuncture, herbal medicine, and lifestyle counseling to help each patient holistically.
The Uterus in Traditional Chinese Medicine
In TCM, the Uterus is one of the six extra Yang organs, though it also expresses Yin functions. It plays a central role in menstrual health and fertility, with menstruation and labor being natural expressions of its ability to store and discharge Blood. During pregnancy, the Uterus nourishes and protects the fetus, reflecting its Yin function of nourishing and supporting life. Because it embodies aspects of both Yin and Yang, it is uniquely important in maintaining reproductive and hormonal balance.
The Uterus is closely connected to the Kidneys via a channel called the Bao Luo. Normal menstruation and fertility depend on the state of Kidney-Essence, Heart-Qi, and Heart-Blood. The connection with the Heart explains why emotional stress can strongly influence menstrual health. Giovanni Maciocia recommends using the acupuncture point Heart 5 (Tongli) to support this connection.
The Menstrual Cycle in TCM
From a TCM perspective, menstruation, the bleeding phase, is under the control of Liver-Blood and the Penetrating Vessel (Chong Mai). In Western terms, the menstrual phase usually lasts 3 to 5 days, with menstrual fluid being a mixture of Blood and endometrial tissue. Average blood loss is about 35 mL.
The Follicular Phase, or Proliferative Phase, is influenced by Liver-Blood, the Kidneys, and the Directing Vessel (Ren Mai). Multiple ovarian follicles begin to mature under the influence of FSH and other hormones, but only one typically becomes the dominant Graafian Follicle, which continues to maturity.
Ovulation occurs when the egg is nearly mature. Rising Estradiol levels trigger a surge of LH from the anterior pituitary, usually around cycle day 12, lasting about 48 hours. This LH surge releases the secondary oocyte from the dominant follicle. From a TCM perspective, ovulation is governed by the Kidneys (Yin and Yang) and the Directing (Ren Mai) and Penetrating (Chong Mai) Vessels.
The Luteal Phase begins after ovulation and ends the day before the next period, usually lasting about 14 days. The Corpus Luteum produces Progesterone, preparing the body for pregnancy. This phase can be subdivided into two parts in TCM:
First half – Under the influence of Minister Fire and Kidney-Yang, reflected in the post-ovulation temperature rise.
Second half – Governed by Liver-Qi and Liver-Blood, essential for moving Blood in preparation for menstruation and in coordination with the Penetrating Vessel (Chong Mai).
TCM divides the cycle into practical phases for treatment:
Phase 1: Invigorate Blood – optimal when Kidney-Blood is descending; if bleeding is heavy, herbs that invigorate Blood while stopping bleeding may be used.
Phase 2: Nourish Blood and Kidney-Essence – best for replenishing Blood, as menstrual Blood is considered part of Tian Gui.
Phase 3: Strengthen the Kidneys, governing, directing, and penetrating vessels, and support the Spleen if necessary.
Phase 4: Move Qi, invigorate Blood, warm the Uterus, expel Cold, and resolve damp-phlegm if needed.
Diagnosing and Supporting Women’s Health in TCM
In TCM, diagnosing and treating women’s health involves examining the menstrual cycle, tongue, pulse, and a range of physical and emotional symptoms.
Tongue diagnosis: The tongue coating, also called tongue fur, reflects the state of the Yang organs, especially the Stomach. A thin white coating with root is normal and indicates healthy Stomach-Qi. A thin coating may indicate Stomach-Qi deficiency, while a thick coating could indicate excess conditions such as Cold, Heat, Dampness, Phlegm, or food retention. Tongue shape, movement, cracks, or swelling can also provide insights into deficiencies or excess patterns.
Menstrual blood analysis: Color, volume, and consistency provide additional information. For example, light pink blood may indicate Blood deficiency, potentially Liver-Blood deficiency, guiding treatment strategies to tonify Blood and support the Spleen.
It’s important to note that this information is educational. Accurate diagnosis works through a comprehensive new patient intake, discussion of all body systems, and individualized treatment planning.
Supporting Women’s Health Holistically
I am happy to treat women’s health concerns and hormonal imbalances, with a focus on menstruation. Good menstruation forms the foundation of fertility, and it involves both physical and emotional wellbeing. In my clinic, I combine acupuncture, herbal medicine, TCM dietary guidance, and lifestyle counseling to achieve the best outcomes.
If you’ve been thinking about seeking support for painful periods, menstrual irregularities, dysmenorrhea, or other women’s health concerns, I would love to treat you. You can schedule an appointment online through the patient portal link or call/text (831) 216-6539. I am committed to serving this community and helping women stay strong, healthy, and empowered.
References & Further Reading
This post draws on concepts from Obstetrics and Gynecology in Chinese Medicine (2nd Edition) by Giovanni Maciocia, a foundational text in the field of Traditional Chinese Medicine.