An irregular menstrual cycle indicates that something is amiss. Whether the cycle is too short, too long, very heavy, very light, absent, with spotting mid-cycle, painful, or any other deviation from a “normal” menstrual cycle, there is a dysfunction of the channels that control the menstrual cycle. When there are problems with the menstrual cycle, fertility may also be compromised, as the channels that control menstruation also play important roles in conception and pregnancy.

What is a “normal” menstrual cycle? A normal menstrual cycle is 26 to 30 days, with 3-7 days of bleeding, without PMS, with little to no pain, with total blood loss of between 30 and 90 mL of fresh, red, unclotted blood.

Chinese medicine understands the core of reproductive activity as being controlled by the uterus (which includes all the reproductive organs, including the uterus, ovaries, fallopian tubes and cervix), the heart function and kidney function. The kidneys store jing. Kidney jing, or kidney essence is a crucial aspect of reproduction, and is comprised of prenatal jing and postnatal jing. Prenatal jing is what you get from your parents, and postnatal jing is that which is formed from lifestyle and diet. In ancient China when doctors referred to kidney jing, they were describing what modern medical science refers to as the gametes (sperm and eggs). Kidney yin and kidney yang regulate different parts of the cycle, influencing different hormones. The heart controls blood and is the “Emperor” of the other organs. The heart controls the activity of the pituitary and hypothalamus, which controls the entire menstrual cycle. The uterus pathways, or Bao Mai (uterus vessel) and Bao Luo (uterus channel), is the connection between the heart, the uterus and the kidneys. The Bao Mai is a channel that runs from the heart to the uterus. The Bao Luo runs from the uterus to the kidneys. Heart and kidney qi exert their influence on the uterus and menstruation through these channels. While these organs and pathways control reproductive activity, hormones and fertility, there are other important organs and pathways that are necessary for the menstrual cycle to function effectively. The liver, spleen and lungs are other organs that are important for proper function. The liver moves and stores blood and qi, a very crucial part of menstruation. The spleen makes qi and blood. The lungs govern qi. These five yin organs: kidneys, heart, liver, spleen and the lungs, are all necessary to ensuring that vital substances (jing, blood and qi) are abundant and moving properly. Important pathways for menstruation, other than the Bao Mai and Bao Luo, include: the Ren, Chong, Dai and Du channels. The Ren channel is known as the “sea of all yin.” The Chong channel is known as the “sea of blood.” The Ren and the Chong both start in the area between the kidneys and pass through the uterus. They strongly influence the abdomen and the organs within the abdomen. The Dai and Du channels are channels that can aid in gynecology practice, but they are not as important as those previously mentioned in treating fertility and menstrual disorders.

Chinese medicine takes a different approach to menstruation and fertility than allopathic medicine. Chinese medicine takes a holistic approach to correcting patterns of disease without invasive procedures. Using herbal medicine, acupuncture, moxabustion, and diet therapy, Chinese medicine is very adept at treating less serious conditions that are causing fertility issues. Often allopathic physicians treat imbalance and disease processes by stopping the normal processes with drugs and surgeries for a quick fix. A quick fix can be convenient, but often will come with side effects, some more serious than others, that can result in unfavorable, sometimes long term, negative effects. When there are severe causes for infertility, the allopathic approach can offer a more reasonable expectation of good results than Chinese medicine (such as blockage of the fallopian tubes, or severely inadequate sperm). For most menstruation issues, which of course, can cause fertility issues, Chinese medicine can offer quite good results if one is patient with regular treatment for several months to a year.

Amenorrhea, dysmenorrhea, oligomenorrhea, fibroids, cysts, menorrhagia, polymenorrhea, premenstrual syndrome are some menstrual disorders which are typically very successfully treated with Chinese medicine by correcting imbalances (blood, qi, yin, yang, damp, heat or cold) in the organs and channels of the body.

Endometriosis and polycystic ovarian syndrome (PCOS) are two of the more serious, but also quite common, menstrual disorders that cause irregular menstruation and can be a cause of fertility issues. Many women with these conditions receive great benefit from acupuncture and Chinese medicine.

Endometriosis causes infertility rates at roughly three times that of the rate of the general population. Endometriosis is defined by the presence of endometrial tissue in the pelvic cavity, but outside of the uterus. Women with endometriosis seem to have impaired immune surveillance, which allows for the endometrial fragments that pass through the fallopian tubes during menstruation, to attach to structures in the pelvis and grow, causing pain (due to inflammation and internal bleeding) and blockage of structures (from inflammation and scar tissue) over time. In Chinese medicine, impaired immune surveillance is typically a pattern of kidney yang deficiency, therefore treating endometriosis with Chinese medicine typically has a primary focus on tonifying kidney yang. Another emphasis of treating endometriosis with Chinese medicine is breaking down endometriosis tissue, by clearing blood stagnation, and by clearing dampness. Chinese medicine is very successful at regulating cycles and greatly reducing menstrual pain due to endometriosis.

Polycystic ovarian syndrome (PCOS) is a common disorder of ovulation, affecting the endocrine, nervous and cardiovascular systems, with resulting metabolic disorders. PCOS is a syndrome in which the ovaries are covered in cysts, with menstrual cycles typically very long and irregular, with many anovulatory cycles, and excess androgens (resulting in acne, body hair, weight gain). PCOS sufferers have higher incidences of diabetes, hypertension and pregnancy complications. The expression of polycystic ovarian syndrome can vary greatly depending on the severity of hormonal disturbance. For women with a more severe case, with no or very infrequent ovulation, fertility may be seriously compromised. Treatment of PCOS with Chinese medicine aims to increase ovulation frequency (to aid fertility) as well as treating other patterns associated with the syndrome, such as supporting kidney jing (especially in cases where amenorrhea began at puberty), clearing phlegm-damp accumulation, regulating liver qi, and regulating the Ren, Chong and Dai channels. As with endometriosis, Chinese medicine has great success regulating the cycles of women with PCOS. Acupuncture and Chinese medicine also help to increase ovulation frequency and reduce the number of anovulatory cycles.

While many patients seeking the help of acupuncture and Chinese medicine with menstrual disorders are hoping to reduce pain and support fertility, they will find that their overall health will improve. Problems with menstruation are indicative of imbalance and blockage in the body, and when menstruation is harmonized, the entire system will improve. Reduced pain, clearer skin, balanced mood, and increased energy are just a few of the pleasant side effects of regulating cycles and improving fertility with acupuncture and Chinese herbal medicine.