General characteristics

Menstruation is the stage of a females monthly menstrual cycle when the lining of the uterus is shed due to the absence of pregnancy and leaves the body, via the vagina, as blood.

The menstrual cycle is around 28 days long and is seen as beginning on day 1 with the start of the menstrual bleeding. The bleeding usually lasts around 4-6 days. Once the lining of the uterus is properly shed, hormonal influences cause the lining to regrow and an egg is released from the ovary (ovulation) on around day 14 of the cycle. The egg will begin to travel down the fallopian tubes and into the uterus ready for possible fertilisation and implantation into the now thick and blood filled uterine walls. The egg stays alive for around 24 hours and this is when a woman is most fertile and most likely to become pregnant. If the egg is not fertilised it breaks apart and is absorbed into the uterus walls and, as certain hormone levels drop, the uterine walls begin to prepare for shedding with the next menstrual bleed, usually 14 or so days after ovulation occurs.

Many changes in hormone levels occur throughout the menstrual cycle. Oestrogen levels are low during menstrual bleeding whilst follicle stimulating hormone (FSH) is released to ripen and prepare an egg for release. As the follicle containing a ripening egg matures, it begins to signal for the release of luteinizing hormone (LH) which causes the follicle to rupture and for the egg to be released. LH continues to be produced by the corpus luteum (the structure containing the egg) which in turn leads to a rise in progesterone levels. Progesterone stimulates the growth and thickening of the lining of the womb, in readiness for its acceptance of a fertilised egg. If the egg is fertilised and implantation occurs, the corpus luteum will continue to secrete progesterone throughout the pregnancy. If the egg is not fertilised, it will rupture and initiate a drop in both oestrogen and progesterone which will eventually initiate menstruation.

Knowing when you ovulate can be useful for several reasons, it can indicate your period of fertility which is helpful when trying to conceive or for contraceptive purposes and can also give an indicator for the timing of your next menstrual period.

Irregularities within the cycle are relatively common and can be related to many health conditions such as polycystic ovaries, fibroids, excessive weight gain or weight loss, strenuous exercise, poor diet, breast feeding, some medical treatments (chemotherapy and blood thinners for example), contraceptive medicines and inter-uterine devices, pelvic inflammatory disease, menopause, puberty, prolonged or severe stress, diabetes, hormonal imbalances (often due to thyroid or pituitary gland irregularities) and pregnancy. Problems with the menstrual cycle include irregular bleeding or bleeding between periods, irregular cycles, severe blood loss with menstruation, excessive pain with menstruation and pre-menstrual syndrome/tension.

Healing objectives are to maintain proper nutrition throughout the cycle (to maintain iron levels or to prevent excessive cramping with sufficient calcium for example), to gently nudge hormones into a correct balance and to ease any symptoms such as emotional distress, painful breasts etc. with herbs and natural healing.

Useful herbs

Agnus castus (or chasteberry) is perhaps the most well known of the herbs that help to regulate and 'normalise' the menstrual cycle, tackling many symptoms such as water retention, heavy bleeding, irregular periods, PMT, pain etc. It can be fairly slow to take effect (a few months) but may be used safely for long periods of up to a year at a time, perhaps much longer, without any ill effects. The effective dosage varies for each individual so begin with 1 ml of tincture once daily and increase gradually over several months to a maximum of 1-2 ml 4 times daily.

St Johns wort, motherwort, vervain and skullcap are useful in alleviating many of the symptoms of PMS such as food cravings, anxiety, anger and general emotional distress. Use equal parts of the tinctures and take a teaspoon of the mix 3 times daily a few days before your period is due and for the first day or so to help stabilise the emotions.

Nettle, oatstraw, and raspberry leaf tea can taken daily throughout the month to keep iron levels high and provide calcium and magnesium to help alleviate pains from cramping during menstruation.

Heavy blood flow can be a sign of endometriosis so get yourself checked. Heavy blood flow can be stemmed or slowed by drinking a mix of equal parts of lady's mantle, nettle (to boost iron levels), yarrow, raspberry leaf and american cransebill. Drink 2 -3 cups daily during menstruation.

Pain can be averted by drinking raspberry leaf tea throughout the month and with the use of crampbark tincture. Take half a teaspoon of crampbark tincture every 3-4 hours during your period to help with pain. Also consider longer term use of a more wide acting formula such as agnus castus, black cohosh, wild yam root and motherwort tinctures in equal parts, 1 teaspoon 3 times daily for a few months, to correct any hormonal imbalances.

Irregular cycles can indicate hormonal imbalance so try taking a formula containing agnus castus, black cohosh, squaw vine, holy/blessed thistle, dandelion root and ginger. Use equal parts of the tinctures and take a teaspoon in water 3 times daily for a few months.

Bleeding between periods can be a sign of fibroids so check that this is not the case.

A lack of periods (presuming you are not pregnant or breastfeeding) can occur as a result of anaemia (nettle and yellow dock root tea), thyroid imbalance (kelp tablets), and hormonal imbalance (agnus castus). Absent periods can also be encouraged with the use of 'emmenagogue' herbs such as parsley, pennyroyal, angelica root, fennel seeds, shatavari root, black cohosh, centaury, rosemary, sage, damiana, juniper berries and vervain. Use equal parts in a tea and drink a cup daily for several days, or in tincture form. 1 teaspoon in water daily. If your period does not come, try taking the tea for a few days before the next period is due. Ginger root (add a pinch to the tea or a few drops of tincture) can be used to improve blood flow to the uterus and increase the likelihood of menstruating and the health of the reproductive area.

Fenugreek seeds can help to bring on absent menses and also help regulate an erratic cycle.

For water retention, take a teaspoon of dandelion root tincture in the mornings or drink a couple of cups of nettle tea daily.

Dark coloured, thick or clotted blood indicates stagnation and congestion in the uterus and can result from infections or inadequate blood supply to the uterus.