I


talk about menstrual cycles all the time—every day, multiple times a day. I talk about menstrual cycles so often and


in such detail that I forget it’s not “normal” to do so. When we do talk about menstrua- tion in our culture, it’s typically to lament the PMS, the pain, or the messy inconve- nience of it all. What we don’t talk about is what is actually happening in our body every month, or the way our cycles can provide a striking window into the status of our overall health.


As a practitioner of Chinese medicine, the details of a woman’s menstrual cycle will inform my treatment plan for any is- sue related to her cycle (of course), but it will also inform my approach in treating almost any other complaint. Every aspect of your menstrual cycle tells me something important about the state of your general health: the length of your cycle, the volume of blood, the color of blood, the timing of ovulation, your basal body temperature, any pre-menstrual symptoms, and the pres- ence or absence of cramping are all quite revealing. Positive changes in your cycle as we move through treatment also serve as a useful barometer to track your body’s jour- ney back toward balance; this is true even if your primary complaint had “nothing” to do with your menstruation.


This article is the first in a year-long series for ELMTM


Bottom line? Menstrual cycles matter. Maine chronicling different


aspects of women’s menstrual health. My hope is that by the end, you’re as comfort- able and curious as I am about the monthly event common to half of our population.


We’ll start here with PMS and the big- gest menstrual myth: that PMS is normal. PMS is not normal! It may be common—up to 80% of women report some constella- tion of PMS symptoms leading up to their menstrual cycle—but it’s not normal… which brings us to the second biggest myth: that if you have PMS you must simply suffer through. Wrong again! In the vast majority of cases, PMS is both prevent- able and treatable.


So, what are we talking about? What is


PMS exactly? PMS (pre-menstrual syn- drome) is a constellation of symptoms that occur anytime from ovulation—usually about two weeks after the start of your pe- riod—until your period starts again. Some women suffer for the full two (or more) weeks; others experience symptoms just


a day or two in advance of their period. Symptoms include breast tenderness, water weight gain, fatigue, irritability, depressed mood, night sweats, acne, bloating, constipation, diarrhea, migraine, cravings, anxiety, and insomnia. All of these are responses to the body’s post-ovulatory/pre- menstrual hormonal fluctuations.


As your body approaches your period, it has to break down hormones to shift you from “pre-menstrual” to “menstrual.” An optimally functioning body does this efficiently and you are gloriously oblivi- ous to the process and symptom-free. A body that’s functioning less optimally will have a harder time navigating this transi- tion and this is when symptoms show up. Think of PMS as a monthly stress test; like anything under stress, the weakest links are the likeliest to break down. Do you tend to have bowel changes, nausea or cravings? Your digestion needs attention. Does PMS show up as fatigue, anxiety or insomnia? You’re likely to be more generally run- down. Is it breast tenderness, irritability or headaches that show up for you? From a Chinese medicine perspective this points toward stagnation specifically in your Liver* system; Western translation? Your detox pathways need support so they can process hormones out of your system more efficiently.


The good news is that in supporting and strengthening the systems that are ex- hibiting symptoms, you can alleviate your PMS. In doing so, you also course-correct your body more generally. Why should you care? The more optimally your body is functioning in any given moment, the more likely it is that you’ve staved off larger health issues that might have otherwise ac- cumulated over time. The best part? You’ve freed up your energy so you can get out there and live your most extraordinary life!


So what to do? How to manage PMS symptoms on your own? For most women, getting back to the basics of sleep, nutri- tion, exercise, mindfulness, hydration and play goes a long way.


Be brazenly boundaried about your sleep. Sleep is when your body can finally take care of itself, unencumbered by the daily demands you place upon it during your waking hours. Honor your body by honoring that time. Treat your bedtime like an appointment you wouldn’t dare miss. Keep consistent sleep and wake times


whenever possible to support regulation of your hormones and all the other systems in your body.


Optimize your digestion. Your food can only nourish you if your body is properly absorbing it. If digestive distress is a chronic struggle, seek out professional help. Acupuncture and Chinese medi- cine can be enormously beneficial; other modalities have their own, sometimes more appropriate interventions. Interview providers and find a good fit.


Eat real food. Every day we’re bom- barded with some new health craze around food. Bottom line, in the words of the brilliant food journalist Michael Pollan: eat real food. Sounds simple, but it’s far less common than you think—and not always easy. Eat a wide range of seasonal and or- ganic foods. Limit processed foods, refined sugar, alcohol and coffee, and increase your fiber intake. We can all benefit from this advice, but it’s particularly important if you suffer from PMS; making these changes will help your body eliminate estrogen more efficiently and less uncomfortably. If you’d like to go deeper, a skilled practitio- ner of Chinese medicine will have dietary suggestions specific to you and the support your individual system needs.


More specifics of what to curb:


• Quit the caffeine: I know! I also love a good cup of coffee in the morning, but it’s true that caffeine can make PMS worse. It constricts blood ves- sels—including those supplying blood to the uterus—making it even more of a no-go if you tend to cramp. It can increase irritability—the opposite of what is most often required during a premenstrual time. And from a Chinese medicine perspective, caffeine (and especially coffee) stresses the Liver* energetic, leaving you more suscepti- ble to many common PMS symptoms.


• Avoid alcohol: Coffee AND alcohol?! I know!! But have you picked up on all this talk about PMS and your liver? A glass of wine may feel like welcome relief at the end of a long, irritable, pre-menstrual day, but it’s actually only adding insult to injury. We know alco- hol inhibits hormone regulation—the opposite of what you’re aiming for. Do your liver a favor and skip it, at least during the second half of your cycle.


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