How Traditional Chinese Medicine Explains Your Menstrual Cycle Phases
In Traditional Chinese Medicine (TCM), the complexity of the menstrual cycle is understood in such a beautiful way. It is seen as a reflection of a woman's internal landscape as a whole, revealing the state of the internal organs, the quality of Qi and Blood, the harmony between Yin and Yang, and the emotional environment of your being that cycle.
Each phase of the menstrual cycle corresponds to specific energetic shifts as yin transforms into yang and then repeats all over again. Clinically, women’s health is the main thing Acupuncture and TCM is helpful for. Whether it is just to have less pain, or to improve their fertility, Acupuncture hones in on each phase of your cycle to assess and treat the imbalances underlying the root cause of your conditions. Scroll to the end to see a quick overview.
The Menstrual Phase (Days 1-5): Purge & Reset
The menstrual phase marks the beginning of the cycle, Day 1 being the day that you begin your bleed. The body releases Blood (the uterine lining) and clears what is no longer needed from that cycle since there wasn’t a pregnancy. In TCM, this is considered a delicate time due to the loss of Blood, which temporarily reduces the body’s Yin, making rest and warmth extremely crucial during this time. Kidney Yin, which nourishes the reproductive system, plays a central role. When one’s Kidney Yin or Blood is deficient/low, a person might experience light bleeding, fatigue, dizziness, or a sense of feeling “drained” during this time. However, when Blood is stagnant, often due to emotional stress, cold, or chronic tension, the menstrual flow might be full of sharp cramps, clots, darker bleed, and heavy flow.
During this phase, TCM emphasizes taking things slowly. Warmth is important: consuming warm foods, warm compresses, and avoiding exposure to cold help support proper movement of Blood. Light movement, such as walking or stretching, can increase circulation while preventing strain on the body. Since Blood relates to the Shen (Spirit), emotional gentleness is important. Emotional strain during your menstrual cycle can worsen cramps or fatigue. Creating a quiet, calm environment helps the body reset and prepares the foundation for the remainder of the cycle. An ideal period typically consists of 2-3 moderate flow days of deep red color with minimal to no clots or cramps. Anything outside of this is something that Acupuncture and TCM can help regulate and restore balance to.
The Follicular/Pre-Ovulatory Phase (Days 6-14): Building Yin
Once the menstrual cycle ends, the body transitions into a rebuilding phase. Yang energy begins to rise, along with your energy level; however, Yin must also be replenished after menstruation. This is often described as a time when the body “fills the well” and creates the uterine lining for a potential pregnancy. This lining, and estrogen itself, relates to Blood and Yin in TCM. The Liver becomes especially important here, since it’s responsibility in TCM is that it stores Blood in the uterus and ensures the smooth flow of Qi throughout the cycle. When the Liver Qi flows harmoniously, emotions are stable, digestion is smooth, and the reproductive system receives the nourishment needed to prepare the body for ovulation and potential pregnancy.
For those looking to get pregnant, the Kidneys also play a major role in the success of ovulation and implantation. Kidney yin and yang provide the source energy for proper building of Blood and Yin for the uterine lining, as well as maintaining the proper environment and nourishment post ovulation. If your periods are light, your cycles are short, or you have sadness/grief throughout your cycle, this typically means your Kidney Yin needs extra nourishment. This is often a focus for fertility focused patients in the clinic.
The follicular phase is for increasing and building vitality. People often notice having more energy, clearer thinking, and more optimism. Yet this increase can easily be disrupted if Liver Qi becomes stagnant, something that occurs with stress, irregular routines, or emotional suppression. When Qi doesn’t move well, symptoms such as tension headaches, irritability, digestive sensitivity, or breast tenderness may appear during this phase. Supporting the Liver with nutrient-rich foods, gentle movement, and emotional expression helps ensure that Qi and Blood nourish the ovaries as the follicles develop. Nourishing your Spleen Qi and Kidney Yin during this time with warm foods, broths, slow movement, relaxation, and avoiding overworking help with creating a lovely uterine lining for pregnancy.
The Ovulatory Phase (Around Day 14): The Peak of Yang and Qi
Ovulation marks the high point of Yang energy in the cycle. Everything that has been building (the Yin phase) now reaches its peak as it all transforms into Yang energy. Qi is strong, Blood is abundant, and the body feels a sense of openness and is more expressive. This is a phase where many people feel more social, confident, and emotionally steady. In TCM, this reflects the harmony between the Liver, which ensures smooth release of the egg, and the Spleen, which supports the body’s overall vitality and transformation of nutrients.
If these organ systems are balanced, ovulation occurs smoothly and often without any symptoms. If there is underlying disharmony, like Liver stagnation, accumulation of Dampness, Kidney deficiency, or Spleen weakness, ovulation may come with discomfort such as bloating, sharp pain/cramps, or even spotting. Nutrient-based meals and moderate movement help maintain balance and ease during this time. This is a time when inspiration and creativity peak; therefore, leaning into expressive activities can be very supportive.
The Luteal/Pre-Menstrual Phase (Days 17-28): Return of Yin & Test of Balance
After ovulation, the body transitions back towards Yin if there is no pregnancy. The Yang heat that peaked during ovulation would continue to increase to nourish the pregnancy, but if there is no pregnancy, then it begins to recede inward, supporting the potential for preparing for menstruation when yin is lowest. This shift makes the luteal phase sensitive to stagnation or deficiency. It's during this phase that many women may experience PMS symptoms such as mood swings, bloating, tender breasts, digestive issues, fatigue, or cravings. In TCM, these symptoms are often linked to Liver Qi stagnation, Spleen Qi weakness, or Dampness obstructing the smooth flow of energy. If Yin is also deficient, then the Yang may not be anchored during this time, leading to other imbalances such as night sweats, restlessness, or insomnia.
Emotions are significant in this phase. Since Liver Qi is closely tied to emotional movement, unresolved frustration, anger, or stress can significantly worsen PMS symptoms. Digestive changes reflect the Spleen’s role in transforming food into Qi and Blood; when the Spleen is overworked from worry or overthinking, cravings, bloating, or loose stools may appear. Warming, soft foods, grounding routines, and gentle movement help shift the body towards balance. Supporting the spirit is just as crucial; meditation, journaling, or expressing your feelings towards others, can help ease the emotional fluctuations that arise during this shift.
Quick overview of cycle phases:
Menstruation (Day 1 to ~5): Blood & Yin are declining; Qi begins to move
Qi begins to rise, Yang is starting to stir
Yin and Blood are at their lowest.
Common symptoms:
Cramps = Qi stagnation
Clots/sharp cramps = blood stasis
Very light flow = Blood deficiency
Flooding/bright red = Heat pushing blood out
Restlessness/insomnia = Yin deficiency
Follicular Phase (Post-menses, Day ~5 to 12): Yin & Blood increases
Yin phase: the body rebuilds Blood and Yin to prepare for ovulation.
Fluids increase; estrogen corresponds to Yin.
This is the MOST YIN part of the cycle.
Common symptoms:
Dryness = Yin deficiency
Headache/irritability = Liver Qi stagnation preventing Yin from building
Insomnia/restlessness = Yin deficiency
Ovulation (Day ~12 to 16): Peak Yang Activation
Yang Qi surges to release the egg — a moment of strong movement and heat.
This is the MOST YANG point of the cycle.
Common symptoms:
Ovulation pain/cramp = constrained Liver Qi or Yang not moving smoothly
Anxiety/insomnia = Yin not anchoring the sudden rise of Yang
Migraines = Liver Yang rising or Qi stagnation
Luteal Phase (Post-ovulation, Day ~16–28): Yang warms and holds; Yin begins to decline
Yang warms and increases to support implantation and maintain the potential pregnancy.
This is a Yang-with-Yin support phase. Yang is dominant, especially if there is pregnancy.
Yang may start to decline if there is no pregnancy.
Common symptoms:
PMS & irritability = Liver Qi stagnation
Breast tenderness = Liver Qi + Damp
Heat, night sweats = Yin deficiency causing Yang to rise
At the end of this phase, if pregnancy does not occur:
Yang declines
Qi moves the Blood → menstruation begins again
This returns you to Yin → Yang transition.
Embracing Your Full Cycle
TCM views the menstrual cycle as a monthly dialogue between the body and its internal conditions. Each phase of the cycle provides insight into the functioning of the Liver, Spleen, and Kidneys, as well as the movement of Qi, Blood, Yin and Yang. When the menstrual cycle is relatively symptom-free and smooth, it suggests that Yin and Yang are in balance. When symptoms come up, they are treated not as individual problems, but as signs of deep imbalances that can be addressed through herbal support, changes in lifestyle, regulating emotions, and improved daily rhythms. Acupuncture treatments weekly or biweekly are often recommended for 1-6 cycles for best results depending on the case. Treatments for fertility challenges are recommended weekly and with specific timing around ovulation or transfers.
Understanding and comprehending the menstrual cycle through TCM turns it from something that “happens” into something that is deeply complex and empowering in women's bodies. By learning to transition and move with its phases, rather than against them, you can experience more ease, steady emotions, and a connection to natural rhythms that shape your health.
