Nearly every woman has had a time in her life where she’s been waiting on the edge of her seat for her period to show up. Occasionally this delay causes a gal to pee on a few sticks, while she wonders if her life is about to change forever, only to very anti-climactically get her period a few days later.
Late periods or more accurately termed, long cycles happen for a variety of reasons and don’t all lead to pregnancy. This is often a perplexing situation for many women, and after a resounding “this is me” from countless women after my Instagram post last week, I see this issue is something many women resonate with. I hear you, so this post is all about what defines a long cycle, what is happening in your body from a Chinese medicine and conventional medicine perspective, and when you should seek advice from your primary healthcare provider.
What is the difference between a Long Cycle and a Late period?
Technically nothing, but “long cycle” more accurately describes what is happening hormonally, whereas “late period” only points to your period as opposed to the entire menstrual cycle. It’s common for women and even some doctors to only consider the time in which women bleed. The entire menstrual cycle, including ovulation will play a part in the period timeline. In this blog I will refer to long cycle and late period as one in the same.
What constitutes a long cycle?
A period should come every 35 days and if it’s later than that it’s considered a long cycle. This may be a one-off occurrence, in which case there’s not much cause for concern. If a long cycle occurs consecutively for 3 months, then I highly recommend seeking advice from your doctor and having your hormones tested. Long cycles are a type of irregular period, and if they are consistent then this could indicate an anovulatory cycle or a long follicular phase. Both of which may indicate hormonal imbalance.
Why could a long cycle occur?
- Emotional stress: This is usually a one-off situation where during a particularly stressful month, a woman’s period may be a bit later than usual. This is the result of a complex interplay of hormones and cortisol.
- Travel: Another one-off unless you travel to different time zones frequently. Jetlag is essentially disordered sleep and will affect your circadian rhythm, which play an important role in hormone regulation.
- Long-term breast feeding: Prolactin, the hormone responsible for lactation stops ovulation and thus a period. This is completely normal, and some women’s period returns while breastfeeding, but due to prolactin being typically high they may not ovulate regularly resulting in a long cycle.
- Polycystic ovaries + syndrome (PCOS): A metabolic and inflammatory condition that often results in anovulatory cycles, or long follicular phase. Tempe Simmons wrote an entire blog on PCOS. You can find it here .
- Long-term use of the birth control pill: This varies for each woman, but the gist of it is, after a while of being on hormonal birth control your own hormones go on vacation and when you finally wake them up again two, three… ten years later, it takes them a while to find their groove again. Many women end up with long cycles or find their cycles don’t return at all for months. Dr. Jolene Brighten wrote a book all about this called, Beyond the Pill and we’ve written countless posts and blogs on the topic as well.
- Under Eating: Eventually leads to hypothalamic amenorrhea, or no period due to malnourishment. Until it stops altogether the hypothalamus will slow or stop the release of gonadotropin-releasing hormone (the hormone that starts the menstrual cycle) as a way of self-preservation.
- Over-exercising: Like undereating, over-exercising along with calorie restriction can lead to hypothalamic amenorrhea. Increasing calorie intake and decreasing intense exercise will help to restore your menstrual cycle.
- Thyroid disease: The thyroid is key in regulating menstruation. Too much or too little thyroid hormone (TSH), which actually comes from the pituitary gland and is like your thyroid’s assistant, can contribute to long cycles. It’s highly advisable to ask you doctor for a full thyroid panel to rule-out thyroid involvement when exploring the reasons for long cycles.
As you can see there are a range of reasons why long-cycles could be occurring. Therefore, it’s important to check with your doctor if you notice a change in your cycle.
The Chinese medicine perspective
Chinese medicine always has a truly poetic way of describing the functions of the human body. Some of these concepts overlap nicely with Western medicine, and some are all their own. My favourite are those that involve nature. There’s a strong emphasis on a nourishing diet and adequate rest when it comes to women’s health. Pretty much any TCM gynecology book you pick up will always recommend women stay warm, eat nourishing foods, and avoid strenuous exercise and strong emotions during menstruation. This concept is nearly lost in our modern world, but it’s never too late to start some of these traditional practices. As you read through TCM’s causes of long cycles you’ll notice a big emphasis on blood.
- Chronic illness, excessive work, chronic bleeding, under eating, breastfeeding for too long (more than 2 years): These factors weaken the spleen, the organ responsible for transforming nutrients from food into energy and blood the body needs to carry out many functions. Interestingly in TCM breast milk and blood come from the same source.
- Blood deficiency: If blood is deficient then the meridians responsible for menstruation are unable to bring on a period at the proper time. Blood deficiency can be associated with low ferritin and iron from a conventional medicine perspective. This could occur through a lack of iron rich nutrition, and/or for many of the reasons listed above.
- Exposure to cold and damp, invasion of cold: Exposure to external cold and damp conditions cause blood to congeal. When this happens, new blood isn’t collected for menstruation and eventually a period is delayed. This is known as “cold invading the uterus”. When the period does come, it’s common for the bleed to start with dark purple blood and be quite painful. Some examples of circumstances where cold might invade the uterus would be, wearing clothing that bears the stomach or back in damp and cold conditions. It’s especially important young girls stay warm and dry just before and during menstruation, and coincidentally it’s the time of life where young women want to wear as little clothes as possible regardless of the weather. This can lead to problems later in life.
- Hereditary kidney weakness, overwork, too many children close together: The kidneys are the first organ said to form as a baby and contain our original essence. This essence can only be spent not gained, so much of Chinese medicine revolves around how to maintain our essence, or good health into old age. Sometimes people are born with inherently weak kidney essence due to poor health of the parents or genetic conditions that affect an infant from birth. If the kidneys become weak, they fail to nourish the meridians responsible for bringing on menstruation, so a period may come late. An example of this is when a girl gets her first period later than 16 years of age.
- Emotional stress: Long standing emotional distress may lead to liver qi stagnation (the organ responsible for the smooth flow of qi), over-time this leads to blood stasis, or blood that is stuck and unable to move easily. This obstructs the meridians responsible for bringing on menstruation, delaying the period. When a period does come on it may be full of clots and painful. There may be irritability and general PMS symptoms preceding the period.
It may not seem like Western medicine and Chinese medicine speak the same language, but they work incredibly well together! I tend to use an integrative approach, combining TCM with Western medicine by working with doctors and gynecologists. This approach ensures a thorough investigation is done in order to find the best result. The most important thing is to pay attention to your cycle, it’s a vital sign just like your heart rate and blood pressure.
Have another read through the list and see if you resonate with any of roots causes from either a Chinese medicine or conventional medicine perspective. Many of us could work on managing our stress and workload. Foundational lifestyle modifications are at the core of all changes to our heath and should be addressed as part of your overall care. Getting your cycle on track could simply mean seeking guidance from your doctor, acupuncturist, naturopath etc. There’s so much to be gained by being aware of your hormonal ebbs and flows.
As always, we want to hear from you. If there’s something that you want me to elaborate on, shoot us and email, DM us on Facebook or Instagram. We’re all here for you at MCM!
Andrea works Tuesay/Wednesday 9am-2pm and Thursday/Friday 2pm-8pm
138 Tanti Avenue, Mornington
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