THE EASE OF TRACKING A WOMAN’S MENSTRUAL CYCLE has come a long way. Now-a-days there are apps and programs that let you integrate your body temperature, diet, sleep patterns, etc.
If you are a bit old school (like me), you may still prefer to use pen and paper to track your cycles to help regulate your flow or to find out when you are ovulating to either prevent getting pregnant or to try and get pregnant.
What’s a Normal Flow
The chart above may look confusing, but it’s quite simple.
- Along the vertical (Y) axis – your body temperature taken first thing each morning
- Along the horizontal (X) axis – the days of your cycle
- Below the dates along the horizontal axis are other symptoms to track
Day 1 is always the first day of your menstrual flow, while day 14 is around the time when ovulation occurs (it will span 3-4 days on either side because of the life-cycle of the egg and sperm). Ovulation means that the woman’s eggs are fertile and ready to accept a sperm and procreate.
It’s clear from the graph above that there is a major dip in temperature during the follicular phase, just prior to ovulation, at which point the body temperature shoots up to start the luteal phase. The body temperature does this because of changes in hormone from the ovaries and other glandular tissue.
By charting your own menstrual cycle (see handout below) you can see if your body temperatures match that of a typical cycle and where there may be imbalances. The spike of your body temperature along with changes to your vaginal discharge (ie. egg white stickiness) is a hallmark signal for ovulation.
PMS stands for “Premenstrual Symptoms” and occurs a few days before Day 1 of the start of your cycle. Many women experience symptoms such as:
- bloating and increased bowel movements
- breast enlarging and tenderness
- mood changes
- food cravings (ie. sweets and chocolate)
- fatigue and lethargy
- lower abdominal cramping
- acne breakout along the T-zone of the face, jaw line and back
When PMS symptoms are experienced, there is often more uterine cramping and a heavier flow with larger blood clots. These symptoms are a classic representation of hormonal imbalances and can be managed with a healthy approach to diet, lifestyle, and stress for the average woman.
How to Track Your Menstrual Cycle
As I mentions earlier, there are many different apps and programs to track you cycle:
- Period Tracker
- Clue – Period Tracker
- Pink Pad Period & Fertility Tracker
- Monthly Cycles
- iPeriod Period Tracker
- Period Tracker Lite
- Fertility Friend Mobile
- My Calendar
All you need is a thermometer and your cell phone and away you go.
I recommend taking your temperature first thing in the morning before you get out of bed. Always use the same method to take your temperature (ie. under the tongue with a closed mouth) for accuracy.
If you prefer, print off the following handout to physically track your cycles and coordinating symptoms.
Download here –> Your Menstrual Cycle Tracker
Treatments for Irregular Menses
There are many natural supports that will help balance your mood, cramping, PMS, acne and hormonal fluctuation. It’s important to maintain a protocol for at least 3 cycles before deciding whether it is helpful or not. Talk to your Naturopathic Doctor about the following possible treatments:
Diet and Food Sensitivities
Diet and nutrition are the #1 place to start when your menses are irregular or you experience PMS. Maintaining a healthier diet will offer the best long-term result for your overall health and well-being. However, modifying your diet isn’t always easy. Take on
- Limit refined sugars and simple carbohydrates (especially 1 week surrounding Day 1 of your menstrual cycle)
- Eat more lean proteins (ie. chicken, turkey, lentils, beans, nuts, soy)
- Eat more fiber (ie. psyllium, flax, hemp, raw vegetables)
- Eat lots of fresh veggies for their high nutrient content
- Eat a low fat diet, especially for endometriosis but maintain some healthy fats (ie. avocados, nuts, seeds, lentils, fish)
- Don’t keep junk in the house (ie. deep fried fatty foods, ice cream, cookies, chips, pop, juice, alcohol)
- Eat in moderation– I don’t follow any 1 diet. I don’t limit my food intake but I do eat in moderation. Eating more “good stuff” (80%) will help to eat less “bad stuff” (20%)
- Stick to natural sugars, complex carbs, fruits and veg for any sugar cravings
- Eat dark chocolate at >70% cocao
- Avoid Dioxins (Food – beef, dairy, milk), polychlorinated biphenyls (PCB’s), and bisphenols (pesticides, petrochemicals and plastics) – These ingredients bind to estrogen receptors exert effects more potent than endogenous estrogens.
- Try an oligoantigenic or hypo-allergenic diet – To get your free comprehensive Hypo-Allergenic eManual including dietary guidelines, recipes for a 7-day meal plan, shopping lists, and food re-introduction schedule, sign-up HERE.
- Eat your way to fat loss… and craving control with my free “Seven Days to Sexy” e-course.
Try a simple dietary trick to help regulate your cycle: “The seed protocol”
Day 1-14: 1 Tbsp freshly ground flax seeds + 1 Tbsp pumpkin seeds daily Day 15-menses: 1 Tbsp freshly ground sunflower + 1 Tbsp sesame seeds daily
- Flax and sesame seeds are full of lignans, which block excess estrogens
- Sunflower seeds are high in selenium, a trace mineral that is essential for the liver detoxification
- Pumpkin seeds high in zinc, which supports progesterone release
Exercise and being active is key to improving circulation of blood, lymph, nutrients and hormones. Not only does it help to improve your physical health, but it can decrease stress (ie. cortisol), which can have many negative relationships on the body such as diabetes, thyroid condition, cardiovascular disease, increased pain perception, infertility and sex hormone irregularity, poor bone health, poor immune function, negative thoughts and so much more.
Exercise doesn’t have to be going to the gym to pump weights. It doesn’t have to be running a marathon. Exercise can mean different things to different people.
As long as you are moving everyday, able to complete any activity that you’d like, have a healthy BMI range and you feel good, that’s what matters most. However, if you have a specific goal (ie. to lose 10 lb, fit into your size 6 dress again, lower your risk of heart disease) then a specific workout will give you optimal results. Learn the best and worst workouts for you and how resistance training changed my life.
Fitness should be a priority in every person’s life. It’s as important as eating healthy foods, drinking water and sleep. But many people are “too busy” to exercise. This is mainly because they haven’t made exercise a priority, but also, it takes an effort and isn’t always convenient. It’s really easy to find excuses not to train.
I am no exception. When I’m feeling off, low in energy, or experiencing PMS symptoms I don’t have much enthusiasm to workout. When this happens, I do 4 things:
- Manage your stress with one of these 8 strategies to manage stress in a healthy way.
- Start with something easy that’s already part of your day. If you can fit in exercise and healthy living your daily life you will have much more consistency.
- Get rid of your excuses and do something. If you know that no excuse (aside from emergencies) will stop you from getting just 10 minutes of activity into your day, then the stress of feeling guilty will be a major stress relief. You can workout anywhere. There is no space where you can’t do some squats, lunges, or wall push-ups. Add in some bands and you are rocking and rolling. Getting started is the hardest part – if you can get started and begin to create endorphins you will not only feel better, but also most likely get more energy to workout harder. Print off my 5 favorite exercises to do in awkward spaces for some body weight and band workouts.
- Be kind to yourself. You don’t have to complete an Ironman everyday. Do what you can and then rest. If you are feeling especially low one day, try getting a friend to go with you for a walk, or try a drop-in dance or aerobics class. Do something fun that nourishes your body.
- Ginger, peppermint, chamomile, lavender tea– to calm the stomach and nervous system down.
- Vitex agnus-castus– to help with symptoms from PMS, fibroids, menorrhea (extended bleeding during the menses), androgen acne. Vitex tinctures work as prolactin inhibitor and dopamine agonist to regulate menstrual flow (Meczekalski et al, 2015).
- Dioscorea villosa– an antispasmodic and anti-inflammatory with potential progesterone-like activities. Tinctures of wild yam root help with dysmenorrhea, endometriosis, PMS, threatened miscarriages, premature labor and uterine spasms (Lima et al, 2013).
- Contraindicated in bile duct pathologies, obstruction, inflammation, cancer, intestinal spasm, pancreatic cancer
- Calendula– Calendula tincture or tea can be very effective in reducing menstrual cramping as soon as they begin. It is a warming herb that promotes lymphatic drainage and movement (Preethi et al, 2009).
- Medicago sativa– aka Alfalfa leaf tinctures contains phytoestrogens, which means these are weaker estrogens than ones made by the body and much weaker than xenoestrogens (synthetic). Studies are recognizing phytoestrogens to have protective effects on hormone-related conditions (Hwang et al, 2015).
- Angelica sinensis– aka Dong quai root. This herb is a uterine tonic, which means it helps support and strengthen the uterine with conditions such as amenorrhea, dysmenorrhea, PMS, endometriosis, fibroids, dysregulated estrogen levels, menopausal symptoms, threathened miscarriage, premature labor and infertility (Ahmed et al, 2014).
- Chamaelirium luteum– This herb is also a uterine tonic and has similar mechanisms of action as Angelica sinensis. This tincture helps with amenorrhea, dysmenorrhea, PMS, endometriosis, fibroids, dysregulated estrogen levels, menopausal symptoms, threathened miscarriage, premature labor and infertility (Challinor et al, 2012)
- Viburnum opulus– aka campbark helps with spasms in conditions such as dysmenorrhea, endometriosis, PMS, threatened miscarriage, and premature labor (Nicholson et al, 1972).
As mentioned in the Exercise modality above, stress is a major contributor to many illnesses, physical imbalances and mental instability. Try taking on one of the following healthy stress management techniques to support a healthy state of mind.
- Creativity and hobbies
- Meditation and breathing
- Gratitude and Mindfulness
- Human touch, smiling and laughter
- Perception and empathy
- Positive self talk, while avoiding gossip and comparisons
- Limiting electronic impact
- Physical activity
- Intention and optimism
- Wholesome entertainment – Music, books, movies, cognitive games
- Community and social support
- Completing tasks
- Creating healthy boundaries
- Food for mood– fish oil, coconut oil, soy, nuts (ie. almonds, walnuts), foods with L-tyrosine
- Supplements: Phosphatidylcholine (PC), Phosphatidylserine (PS), Glycine, Branched chain amino acids (BCAA- valine, leucine, isoleucine), Magnesium
- Herbs: Gotu kola, Ginkgo, Rosemary leaf, Bacopa, Withania, Rhodiola, Glycyrrhiza, Astragalus
- Drink lots of water and relaxing herbal teas
- Iron: Blackstrap molasses, animal meat, whole grains, dried fruit, egg yolk, chickpeas, green leafy veggies.
- Iron deficient anemia
- B12 and folate: Eggs, crab, salmon, sardines, meat, seafood, yeast, fermented cheese
- Pernicious anemia (B12 and folate deficiency), pain, GI disturbances, fatigue, depression, neurological dysfunction
- Vitamin C: Citrus fruits, Tomato, Dark green leafy veggies, Potato, peas, peppers, broccoli, spinach
- Helps absorb iron, immune deficiency
- Vitamin B6: Egg yolk, soy beans, dried beans, peanuts, walnuts, banana, avocado, cabbage, cauliflower, potato, prunes
- Cofactor for GABA and Serotonin, anxiety, depression, pain perception
- Magnesium: Hard water, wheat, millet, rye, rice, nuts & seeds, green veggies, soy
- Muscle cramps, insomnia, constipation, vomiting, panic attacks, weakness, lethargy
- Calcium: Dairy, green leafy veggies, corn, sesame, almonds, tofu
- Luteal sx of fatigue, anxiety, depression, personality disturbances, mm cramps
- Fish oil (EPA, DHA): Fish, algae
- Inflammation, depression, cognitive decline
- Probiotic: Supplements, yogurt, kefir, kimchee, sauerkraut, kombucha
- GI disturbances, dysbiosis, yeast overgrowth
- Chromium: Whole grains, yeast, cheese, beef, organ meat, molasses
- Blood sugar irregularities, high cholesterol, peripheral nerve pain or discomfort
- Cinnamon: Supplement, spice
- Regulate blood sugar, high cholesterol, craving control
Acupressure and Acupuncture
Irregular menstrual cycles will benefit from regular acupuncture sessions focusing on the Kidney or Liver meridians depending on the source of the dysmenorrhea. A classic diagnosis of “Liver Qi Stagnation” is common. Some of the treatment points include the following, however each individual will be unique and their picture may present differently, having them require alternate points.
- CV 3 to regulate menses and benefit the uterus
- CV 4 to nourish blood and yin, regulate menses, calm the mind
- CV 6 to tonify Qi and yang, regulate Qi in the lower burner
- LV 3 to promote smooth flow of LV Qi, resolve dampness, regulate menses and blood, calm the mind
- LV 14 to promote smooth flow of LV Qi, harmonize LV and ST, move and expel blood clots
- SP 6 to promote function and smooth flow of LV Qi, nourish blood and yin, regulate menses and uterus, eliminate stasis, stop pain
- ST 29 to move Qi in pelvis, relieves stagnation of blood
- ST 36 major point for release of stress, promotes movement in abdominal distention, indigestion, and edema
- LI 4 to tonify Qi, stop pain, release exterior
- TW 5 to subdue LV yang, release the exterior
- GB 34 to promote smooth flow of LV Qi, resolve damp heal, relax soft tissue
- Pulsatilla (200C) – These people are weepy, emotional, empathetic, easily discouraged and constantly needing change. Pulsatilla remedies have an aversion to fatty foods, are thirstless and prefer open air.
- Sepia (200C) – You will find a Sepia in a state of indifference or apathy. They are introverted and irritable from stress, PMS, or childbirth due to a hormonal stasis and being burned out.
- Ferrum phos tissue salts (6X) – Ferrum Phos aids the oxygenation of the blood and helps prevent the need for extra iron especially towards the end of a pregnancy when many women become anaemic. Prescription iron tablets commonly lead to uncomfortable constipation, so if you can keep your iron levels up naturally, you can hopefully avoid the need for them.
- Hot pack over the lower abdomen to help with cramping.
- Massage over the uterus or lower back with any abdomen discomfort
- Castor oil packs over the lower abdomen away from the days of your menstrual flow. Learn more here.
- Alternating hot and cold showers consist of 3 minutes as hot you can manage while staying relaxed (be sure not to burn yourself), followed by 1 minute of the coldest water you can handle. Repeat this contrast in temperature 2-3 times per shower, always ending on cold.
- Sleep at least 7 hours per night to help regulate your hormones, immune system and nervous system.
What to Use for Your Flow
- Menstrual Cup– this re-usable silicone cup avoids the worry about TSS (toxic shock syndrome) or other vaginal irritations from normal tampons. Companies such as Diva Cup, make high quality and safe products.
- Sea sponge– natural sea sponges absorb the menstrual flow and can be reused for up to 6 months with proper cleaning care.
- Pads– there are so many variations of pads: overnight, wings, liners, thong, cotton, hemp, bamboo, organic. Make sure you are changing them at saturation or at least every 12 hours. Even though you aren’t inserting the pads into your vagina, they are in direct contact with the mucosal membrane, which makes for quick uptake into the blood stream. Make sure to choose products that are free of chemicals and harmful toxins.
- Tampons– tampons are my least favorite method for controlling menstrual flow, however they are convenient. If you do choose to use tampons, pick ones that are dioxin-free (pesticides often sprayed on cotton and bleaching agents) and replace within 6 hours of insertion to avoid TSS and immediately after swimming.
Causes for Abnormal Menstrual Cycles and Vaginal Discharge
- Amenorrhea: primary (never having a period) and secondary (losing your period)
- low body weight/ fat mass
- hormonal imbalance
- excessive exposure to xenoestrogens
- anemia (iron or B12/folate)
- Imperforated hymen
- cervical obstructions
- Sheehan’s syndrome
- pituitary adenoma
- PCOS (Polycystic Ovarian Syndrome)- The underlying cause is unknown, however there is an increased risk for those with genetic pre-disposition. PCOS results in a hyper-secretion of androgens from the ovaries causing an arrest of follicular development and cyst formations in the ovaries. Read more here.
- Endometriosis or adenomyosis– When endometrial tissue grows outside of its normal inner lining of the uterus (ie. muscle layer of the uterus)
- Uterine fibroids (aka uterine leiomyoma, myoma, fibromyoma, fibroleiomyoma) – Fibroids are benign smooth muscle tumor, which when in the uterus can cause severe pain or heavy period.
- Cervical dysplasia (aka Cervical intraepithelial neoplasia)- Abnormal cell growth of the cervix doesn’t typically change the menstrual flow, but it can be painful or cause obstruction. Most common cause of cervical dysplasia is Human Papillomavirus 16 and 18. This can be a very serious condition of cervical cancer, which is why any abnormal Pap Smear should be followed up by taking a biopsy of the cells.
- Oral birth control, IUD, hormonal patches– Hormonal contraceptives are meant to alter your menstrual cycle and make it more predictable or in some cases absent. If your cycle is abnormal or you are experiencing concerning symptoms, you may need to change the strength of the birth control method.
- STI’s and PID– Sexually transmitted infections (STI) and pelvic inflammatory disease (PID) can interfere with normal menstrual flow but most likely cause abnormal vaginal discharge. If you notice yellow, green, grey or very odorous discharge, please visit your primary care physician.
- Ectopic pregnancies– when the pregnancy occurs outside of the uterus therefore disrupting the menses, increasing pain and without a viable fetus.
- Pregnancy– before you jump to conclusions about diseases or getting intricate lab testings, make sure you aren’t pregnant first. Use any basic test from your doctor’s office or drug store.
- Menopause– Menopause is the time when a woman stops ovulating and their menstrual cycles slow down. A small population of women can experience early pre-menopausal symptoms of hot flashes, drying of vaginal tissue, pain during sex and lack of menses.
Testings and Further Investigation
- Pregnancy test
- Papsmear and culture (including HPV screen)- followed by biopsy if cervical dysplasia
- CBC blood test to rule out anemia (iron, B12)
- Hormone blood panel (TSH, prolactin, FSH, LH)
- Pelvic ultrasound– transvaginal
- Fasting blood glucose
- Progesterone challenge (while off of hormone-based contraception)
- CNS imaging of the pituitary gland if all other tests are negative and other glandular tissue symptoms are present
Coming Off Your Oral Contraceptive Pills or IUD or Hormonal Patches
- Use extra protection during the transition (ie. condoms)
- Support your body’s detoxification first before coming off – liver, adrenals, kidneys, lymphatics. Read more here.
- Get help and speak to your local Naturopathic doctor