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Understanding Your Menstrual Cycle - With A TCM Perspective

Traditional Chinese Medicine (TCM) perceive the fluctuating hormones in our cycles as the flow of Yin and Yang energies in our body throughout the month.

Where a general cycle is 28 days and ovulation occurs on Day 14, the first 14 days is the Yin phase and the next 14 days is the Yang phase.

The Yin phase is the nourishing part of the cycle where the focus is on building blood, strengthening follicles (small sacs containing immature eggs), creating a healthy endometrium (uterine lining) and increasing cervical mucous, all with the aim to prepare for pregnancy.

After ovulation, the Yang phase is about movement and Qi (energy), where the focus is on moving the egg through the fallopian tubes unobstructed, increasing necessary Qi for fetus growth, or ensuring the endometrium gets shed properly during menstruation.

Maintaining a good and balanced energy flow is essential to a healthy menstrual cycle, as well as a healthy overall well-being.

General overview of the menstrual cycle:

The menstrual cycle can be broken down into four main phases.

The exact timing of these phases varies between every woman, and can change over time or due to external factors such as stress.

For instance, a cycle that came late can be a sign of blood deficiency, blood stasis, excessive cold, liver stagnation, or kidney deficiency from a TCM diagnosis.


Days 1-5 (Menstrual Phase)


  • The thickened endometrium which is meant to support a pregnancy is no longer required, so it breaks down and sheds as menstrual blood.

  • The first day of menstrual bleeding is considered Day 1 of the cycle.

  • Your period can last anywhere from 3 to 8 days.

  • Bleeding is usually heaviest on the first 2 days.

TCM’s Perspective

  • There is a descending flow of Qi and blood, old blood is expelled for the regeneration of fresh blood and tissues.

  • The focus is on invigorating the flow of Qi and blood to ensure the lining can shed off fully. This also alleviates menstrual cramps caused by Qi stagnation or blood stasis.


Days 1-13 (Follicular Phase)


  • The follicular phase starts on Day 1 of your cycle and ends when you ovulate (overlaps menstrual phase).

  • The follicle-stimulating hormone (FSH) stimulates your ovaries to produce follicles, each containing an immature egg.

  • By the time menstrual phase ends, one healthy egg will mature and become dominant (rarely, two or more eggs mature). The rest of the follicles will be reabsorbed.

  • The maturing follicle sets off a surge in estrogen, which thickens the endometrium to prepare for a possible pregnancy. This allows the embryo to grow in a nutrient-rich environment.

TCM’s Perspective

  • The endometrium needs to be re-nourished by fresh blood and essence.

  • The focus is on building Yin, which corresponds to the blood and tissues in the endometrium. However, sufficient Yang is also required to spur the growth and maturation of the dominant follicle.


Day 14 (Ovulation Phase)


  • A rising estrogen level will induce the release of the luteinizing hormone (LH), which triggers ovulation.

  • Around day 14 (anywhere between day 11-16), an egg is released from one of the ovaries and moves down the fallopian tube towards the uterus to be fertilized by a sperm (if present).

TCM’s Perspective

  • There is a switch of dominance from Yin to Yang energy, where Yin energy is at its peak and Yang energy is beginning to rise.

  • The fallopian tubes must be clear of Qi stagnation, blood stasis or phlegm obstruction for a smooth pathway for the egg to travel down. This can be achieved by boosting Yang energy.

  • The fertilized egg will continue travelling to the uterus and attempt to implant in the endometrium.

  • This phase is the only time during your cycle when you can get pregnant (Fertile window: on ovulation day and approximately 5 days before and 1 day after that day).


Days 15-28 (Luteal Phase)


  • After the follicle releases the egg, it changes into corpus luteum. This structure releases mainly progesterone and some estrogen, which maintains the thickness of the endometrium for a possible implantation.

  • In the case of pregnancy, your body will produce human chorionic gonadotropin (hCG). which maintains the corpus luteum and hence the endometrium.

  • If conception does not happen, the corpus luteum disintegrates. This leads to decreased levels of hormones, signaling the unfertilized egg to break down and the uterus to shed its lining.

  • The cycle begins again on the onset of your period (Day 1).

TCM’s Perspective

  • The Yang energy is at its peak, which is reflected in the higher BBT.

  • With pregnancy, the Yang energy, especially that of the Kidney, is vital for rapid cell division, the implantation of the fertilized egg, as well as the development of the embryo. There is an abundance of movements, which is an expression of Yang energy.

  • Without conception, the endometrium is in a state of stillness, which is an indication of Yin energy. This is also reflective in pre-menstrual syndrome (PMS), where your mood might be more withdrawn. As Yang energy declines, your BBT drops.

Note: Information provided is not a substitute for a physician or any form of medical care. Individual symptoms differ due to different body constitutions. One should consult a licensed TCM practitioner for an accurate diagnosis and treatment.

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