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Dr. Maryam Mahanian, DTCM, RAc
Irregular Menstrual Periods
It’s not unusual to have irregular periods. About 30% of women have them. Irregular periods are sometimes early and sometimes late. The thing is that they are unpredictable.
What's a Regular Period Anyway?
Before we can talk about irregular periods, we should define exactly what a regular period is.
It usually occurs every 28 or 30 days and lasts anywhere from 3 to 7 days. Every woman’s cycle is a bit different. You may get your period every 21 days or every 35 days, but as long as they occur with roughly the same number of days between each cycle, they are regular.
Other indications of a good healthy period is for it to be not too heavy and not too light, a bright red color, no big clots and no pain/cramping. The consistency of the menstrual blood shouldn’t be too thick and also not too watery. It’s also ideal to not have PMS (moodiness, breast tenderness, fatigue and bloating before the menstrual period).
How Do Irregular Periods Happen?
Irregular Periods occur when hormone levels are thrown out of sync.
The glands affected with the process of menstruation include the hypothalamus, pituitary gland, and the ovaries. This is often referred to as the HPO Axis.
Irregular menstruation is generally related to disruptions in the balance of hormones.
Some Causes Of Irregular Periods
Stress: Stress can alter and suppress the functioning of your hypothalamus – the area of your brain that controls the hormones that regulate your menstrual cycle. This will affect ovulation and your menstrual period may stop or become irregular. Usually, after your stress goes away, your menstrual cycles will become regular again.
Low Body Weight: Low body weight can interrupt hormonal functions and stop ovulation because it can suppress the hypothalamus. Women with low body weight can have very low estrogen.
Hormonal Imbalance: PCOS is a common cause of irregular periods because it causes hormonal imbalance. In PCOS, women have high levels of estrogen and male hormones which stay high. What this can result in is decreased levels of pituitary hormones which are in charge of menstruation and ovulation and your period becomes irregular.
Premature Menopause, Perimenopause or Menopause: In menopause, the ovaries don’t function as well and this causes low estrogen in the body. Low estrogen causes irregular or no periods.
Pregnancy and Breastfeeding
Intense or Excessive Exercise: Excessive exercise can cause hormonal imbalance.
Weight gain: Overweight women tend to have too much estrogen which causes hormonal imbalance.
Uterine Scarring: This is called Asherman’s syndrome. Scar tissue in the uterus prevents the normal buildup and shedding of the lining of the uterus causing very light periods or missed periods.
Pituitary Tumor: This is a benign (non-cancerous) tumor in your pituitary gland. The result of this tumor is elevated prolactin which then interferes with your menstrual cycle.
Uterine polyps and Fibroids
Medication: Certain medications may cause your period to stop or become irregular.
Chronic illness: Chronic illness can cause your period to be late by delaying ovulation. Your period will normalize once you recover from your illness.
Oral Contraceptive Pills
Most doctors will put a woman with irregular periods on the contraceptive pill (birth control pill). This will regulate menstrual cycles but unfortunately doesn’t treat the root cause of the irregularity. Consequently, when a woman discontinues the pill, the irregularity will most likely return.
The oral contraceptive pill works by tricking the body into thinking that it’s pregnant and suppresses ovulation. No egg is released from the ovary and pregnancy can’t occur. Essentially, the hormones override the body’s natural hormone balance.
Chinese Medicine Perspective Of Irregular Periods
According to Chinese medicine, there are three organ systems involved in irregular periods. These are the liver, spleen and kidney organ systems.
Liver: The liver controls the smooth flow of Qi (energy) in the body. Qi moves the blood so Qi and blood are interconnected. The liver also stores the blood so it’s referred to as the “woman’s organ” in Chinese medicine.
Spleen: The spleen has the function of making Qi and blood. It also keeps the blood within the vessels.
Kidneys: The kidneys are in charge of making the reproductive essence which is a vital substance closely involved in the menstrual cycle. The kidneys have a direct connection to the uterus.
“It is the rhythmic ebb and flow of blood and essence that give rise to periods”.
When these three organ systems are balanced, the cycle will be regular.
Let’s now talk about what causes the liver, spleen and kidneys to become imbalanced.
The liver can become congested (stagnant) when you experience frustration, emotional stress, unfulfilled desires and anger over time.
The spleen becomes weak if you worry, think too much, study too much or have a faulty diet.
The kidneys become deficient or weak due to genetics, age, overwork, too much sex, drug use, chronic disease and persistent lack of sleep.
Liver Qi Stagnation: If irregular periods are due to liver Qi stagnation, the periods will usually come late and your cycle will be longer than 35 days.
Liver Qi stagnation over time creates an accumulation of heat. This heat can cause the periods to come early – your cycle will be shorter than 22 days perhaps.
Spleen Deficiency (Weakness): If irregular periods are due to the spleen not being able to hold or contain the blood in the vessels, then the periods will come early.
If the period is delayed, this may be due to the spleen not being able to produce enough Qi and blood.
If the kidneys being weak are the reason why one experiences irregular periods,
If there is insufficiency of the kidney essence (or yin – cooling energy), then the periods may be delayed. But if there is heat that is coming from the kidney-yin being deficiency, then the periods will come too early.
On the other hand, if there is a weakness or deficiency of the kidney yang (warming energy), there will be too much cold in the body leading to delayed periods.
In my clinical practice, the I often see an element of Liver Qi stagnation in my patients who experience irregular periods.
Liver Qi stagnation is very easily treated with acupuncture. Acupuncture works by moving and regulating the Qi and the blood by stimulating particular acupuncture points.
Chinese Herbal medicine is another modality used in my clinical practice and is extremely successful when treating hormonal imbalance and irregular cycles.
A Few Common Chinese Medicine Patterns
Kidney Deficiency
Causes: Constitutional kidney Qi deficiency (genetic deficiency), prolonged illness, too many deliveries (childbirth), sexual overstrain, decline of kidney Qi with old age
Symptoms: irregular periods with small amount of menstrual blood, light color, profuse white thin vaginal discharge
Other symptoms may include restlessness, tinnitus, soreness and weakness in lower back and knee’s, frequent clear long stream urination especially at night, pale tongue with white coating, thready weak pulse
Liver Qi Stagnation
Causes: stress, anxiety, anger, frustration
Symptoms: include irregular cycle with heavy or scanty menstrual blood, normal or purplish color, menstrual flow comes and stops, clots appear in blood, distension and soreness in breasts and lower abdomen which is relieved when menstrual flow comes
Other symptoms include depression, irritability, frequent sighing, fullness in the chest, distension in the ribs area.
Spleen Qi Deficiency
Causes: over worrying, improper diet, over physical work
Symptoms: include irregular cycle with heavy or scanty menstrual flow, light color of menstrual blood, thin quality
Other symptoms include dull complexion, poor appetite, bloating after meals, bloating in abdomen
Age & Irregular Periods
If you’re a younger woman (in your 20’s) with irregular periods, mostly likely it’s due to a liver & spleen disharmony.
If you’re in your mid 30’s, irregular periods continues to be due to liver Qi stagnation at the root but also coupled with some kidney weakness as the kidneys become weaker as we age.
If you’re in your late 30’s and 40’s, then kidney deficiency will definitely be addressed with Chinese herbal medicine.
Nutritional Advice
I give detailed nutritional advice depending on your Chinese medical pattern.
Women with irregular periods won’t necessarily have identical patterns according to Chinese medicine. That’s why it’s important to treat the individual and not the disease.Doing this also makes the results of the treatments extremely effective because the protocol is customized.
Regarding some general health recommendations, I tell my patients that a well-balanced diet is so important to regulate periods. If you miss meals, eat very little or eat a lot of fast foods and deprive your body of proper nourishment, the body goes into starvation mode causing irregular periods or no periods.
Here are a few dietary tips:
Eat a diet based on natural, whole foods
Eat plenty of fresh fruits & vegetables, legumes, nuts, seeds and whole grains
Eat plenty of healthy fats like coconut oil, avocados, eggs, grassfed butter and fish
Avoid refined carbohydrates like white bread & pasta. Instead try to have beans, peas, lentils which are slow carbohydrates. Slow carbohydrates are slowly digested causing a slower and lower rise in blood sugar after being eaten. Eating slow carbohydrates regulate blood sugar and minimize insulin resistance and balance hormones.
Lifestyle & Self-Care
Take time for yourself. A tired and stressed out body will definitely have an effect on the menstrual cycle. Try meditation, journalling, hobbies, gardening and anything else that brings you joy.
Also, try to moderately exercise daily. Anything that gets your heart rate up. Good ways to move your body is walking for at least 30 minutes every day, hiking, swimming, yoga, biking and dancing.
Avoid excessive exercise as this can cause a disruption in your hormonal balance.
Herbal Medicine & Acupuncture
