A Dialogue Between Dr. D and The Beginner Mind:
S: Per my recent blog post, I was two weeks late on my period. As I mentioned in my article, I would have typically started taking blood-stagnation herbs after being 3-4 days late. This time I did not and it seemed to work to my benefit. In your practice, how do you determine if someone is late due to heat/cold/qi stagnation/blood deficiency, and whether or not to push their cycle with herbs or just wait it out?
D:A late period can be reduced down to two possible categories of causes. In modern body types, both may be at play. But first a little bit of background…
The Oriental medicine (OM) view describes human beings as organic transforming machines. Digestion is part of this transformation (transforming the energy of food to the energy/substances of life function), and internal blood transformation is a part of that process. We can describe the menstrual cycle in the same terms. Nutrition is taken in from the outside, it is combined with one’s own internal energies (digestive, enzymatic, body heat, etc.). New substances and functions are produced, and blood is the main product. The newly created blood is manufactured and delivered to the tissues that require them. At that time the blood is “used up” and eventually becomes ready for discharge. The key is this: only when the life-giving nutritional energies of the blood are spent will the blood be suitable for discharge. If the blood’s nutrient value is still high then the system continues to assimilate the nutrient while containing the blood during the process.
Basically what this is saying is that, in the case of delayed menstruation, the start time of menstrual flow is as related to the blood’s state internally as much as it is related to the day of the cycle. The two must be in harmony. The internal organ-level workings of a woman’s health is the key.
If a woman has a weakened physiology or metabolism, then it can easily happen that the blood’s nutrient is assimilated very slowly, and this slows down the cycle and delays the menstruation. This is one major cause of a late period. In that case, the best treatment is to improve the transformation by boosting the physiological functions. We usually use specific digestive tonics that are formulated for gynecological application. There is no need to “push” the flow to start or “break” the blood stagnation. Rather, we boost the assimilation.
The other situation may be pathogen-related. That picture is complicated to describe here. The treatments possibilities are many, and in that situation we may see the use of “pushing” to start a period a suitable treatment. In that situation the blood may be ready to move, but there are other forces holding it back.
S:This is a great perspective and creates a complete picture of why women experience menstrual delay. It is hard to completely transform nutrients in the blood when our minds and bodies are not integrated. I think this happens too much in today’s modern world. It is unnatural for women to have to bear responsibilities at their job, and also at home and with children. This really cuts down on our time to relax, which is crucial for processing. I also believe that this lack of down-time creates emotional stagnation patterns which can stagnate the qi and exacerbate blood deficient tendencies.
Do you often advise female patients to slow down and make more time for themselves to integrate?
D: Yes, absolutely. But not every woman needs that [slowing down], and some may actually need more activity and stimulation to balance things out. Typically women with these types of gynecological issues do need more quality time in repose, however.
S: Also, this idea of digestion raises a viewpoint that is fairly unique to OM. In Western med. we are taught from an early age that our menstruation is an excretory function. Since our bodies did not need the blood and nutrients in our uterus to nurture a fetus then they are expelled at the end of each month. A contraopposite viewpoint is the one presented by OM, which is that women do use this blood. We can in fact use the nutrients contained in our uterine lining for our own health if we can take ownership and accept this part of our body.
D: Western descriptions of physiology and menstruation are usually considered excretory. This is not inaccurate, but it is indeed an incomplete view. The actual discharging process is excretory, but the process as a whole is regarded as regenerative. The analogy often used is this: in order to grow a sprout from a seed (egg to fetus), the soil must be fresh, clean, nutrient-rich, and tilled (all the nutritive capacity of the uterus). The process of regeneration is offering the ideal environment for the fetus’s development. Cold, hard, dry, or nutrient-deficient soil will not be suitable earth for a seed to sprout.
S: That is a beautiful analogy. Thank you for sharing your view. May your elucidation benefit many!