The Dao Does Journal Understanding your menstrual bleed

What am I looking for? Understanding your menstrual bleed ~

9 May, 2024

Molly Burton TCM Practitioner






Have you ever wondered what your period can tell you about your health? More than just a biological function, your menstrual bleed offers a powerful window into your overall health. In Traditional Chinese Medicine, it’s called ‘Tian Gui’, meaning ‘heavenly water’, it is rooted in the pre-Heaven Qi of the Kidneys and nourished by the post-Heaven Qi of the Spleen and Stomach, reflecting its profound connection to your health.

Understanding your menstrual flow, with its unique characteristics like colour, consistency, and volume and identifying accompanying symptoms, empowers you to take charge of your health and gain valuable insights into your internal state. Throughout your lifetime, you’ll experience approximately 450 menstrual cycles, each one potentially offering clues to your internal health at that time of your life. This knowledge can lead to specific actions for better health, such as dietary adjustments, lifestyle changes, or seeking professional guidance. With an average cycle lasting 28-35 days and a typical blood loss of around 30-80 ml, understanding your individual flow can become a powerful tool for self-awareness and proactive health management.

In the clinic, we spend a lot of time unpacking our patient’s menstrual bleeds and cycles, here are a few things to consider: colour, consistency, volume, pain, and clots. An ideal bleed is smooth, cherry red, with little to no pain, no clots, and a controlled flow across the 3-7 days. Let’s start by understanding your menstrual blood. It’s not just blood – it’s a complex mixture of:

Endometrial lining: this is the tissue that lines the inside of your uterus. Every month, your body prepares for a potential pregnancy by thickening this lining. If pregnancy doesn’t occur, the linings shed, and that’s what makes its way out as a period.

Blood: the shedding process involves the breakdown of blood vessels within the lining, which contributes to the red blood you see.

Mucus: this helps keep everything moving smoothly.

Colour and Consistency

The colour and consistency of your menstrual blood can tell a story about your health. It can range from pale pink to dark red, and be watery or contain clots. Traditional Chinese Medicine (TCM) interprets these variations as clues to your internal balance.

Pale, watery blood: This might indicate Spleen Qi deficiency. In TCM, the Spleen is responsible for transforming food into energy (Qi) and blood. Symptoms can include fatigue, bloating, heaviness in the body and a light, drawn-out period.

Bright red blood: This could be a sign of Yin deficiency with Heat. Yin represents cooling and nourishment, while Heat signifies excess internal fire. Symptoms might include hot flushes, night sweats, and thirst. Yin nourishes the Follicular Phase which can impact the growth of the follicles and thus ovulation (early, or delayed). To maintain balance, consider reducing activities that generate heat, like saunas or intense exercise and hot yoga.

Deep red or brown blood: This could indicate Liver Qi stagnation, a very common presentation in the clinic. Menstrual blood flow itself might be darker than usual and stop and start, reflecting the disrupted Qi flow. Here, sluggish blood flow, linked to Qi stagnation in the Liver, can lead to premenstrual symptoms like irritability, headaches, breast tenderness, and cramps. Ovulatory issues and irregular cycles are also common. Pain (worse just before and during menstruation) that worsens with pressure can be another sign. Stress is a common trigger, disrupting the smooth flow of Qi in the Liver, which plays a vital role in blood movement.

Purple blood: This could be indicative of Blood Stasis when blood flow becomes sluggish and stagnant, often leading to more severe symptoms. Pain becomes more significant, with a fixed, stabbing character that eases with the passage of clots (a telltale sign of Blood Stasis). Similar to Qi stagnation, pain worsens with pressure, and menstrual blood appears very dark, often containing clots. Periods can be both light (due to impeded blood flow) or heavy and prolonged as the body tries to expel stagnant blood. Cycles become irregular or absent, with possible spotting between periods.

NB: if you are experiencing painful periods that disrupt your daily activities or lead you to take pain medications, please consult your GP to rule out any underlying health conditions.

Please head over to Elizabeth’s latest entry on The Three Treasures to read about how to support your body whilst bleeding

Menstrual Flow and Duration

Now that we’ve examined the contents of your menstrual bleed, let’s talk about the flow and duration. A typical period lasts anywhere from 3 to 7 days, but some women may experience shorter or longer cycles. The flow will also vary throughout the period. But what is considered ‘normal’ in terms of flow:

Light: you can comfortably wear a liner or light tampon for several hours without needing to change it

Moderate: you need to change pads or tampons every few hours, but not every hour

Heavy: you soak through pads or tampons frequently (every hour or two) and may even pass clots larger than a 50c coin.

NB: if you are experiencing extremely heavy bleeding that disrupts your daily activities or if you constantly soak through pads or tampons, it’s best to consult your GP to rule out any underlying health conditions.

Factors Affecting Your Period

Several factors can influence your menstrual bleed including:

Age: periods tend to be lighter when you start menstruating as a young woman as the hormones regulate, and also at the end when you enter perimenopause the bleeding can change again. To understand more of the hormonal shift across the menstrual cycle you can read my previous entry here – What happens in the Menstrual Cycle? 

Hormonal Contraceptives: oral contraceptive pills, IUDs, and other hormonal medications can affect your period. Any bleeding whilst using contraceptives is considered a ‘withdrawal bleed’, whilst some women do not bleed at all.

Underlying health conditions: stress, thyroid issues and sudden weight changes can also disrupt hormonal balance and impact your cycle. Endometriosis, Fibroids and Iron deficiency can also cause irregular or heavy periods.

These presentations are general TCM presentations, please consult your Traditional Chinese Medicine Practitioner for an individualised diagnosis and treatment plan. Please consult your GP or Gynaecologist if menstrual symptoms are impacting your daily life.