Phases of the menstrual cycle and the focus of TCM treatments through these phases by Holly Wignall

The menstrual cycle is categorized into four distinct phases, in traditional Chinese medicine (TCM), we see each phase characterized by specific energetic and physiological changes related to the dynamic interplay of yin and yang energies and the concept of Qi (vital energy) and Blood.

The 4 phases are as follows:

  1. Day 1-4 – Menstruation/period – move blood and qi yin
  2. Day 4-12- Follicular phase – nourish blood and yin
  3. Day 12- 16- Ovulation phase – move qi and blood and strengthen yang yang
  4. Day 16- 28 – Luteal phase – boost yang and qi

The exact timing of these phases varies between every woman and can change over time or due to external factors.

In a “general” cycle of 28 days with ovulation occurring on Day 14, the first 14 days is the Yin phase and the next 14 days is the Yang phase.

The Yin phase is the nourishing part of the cycle where the focus is on building blood, strengthening follicles (small sacs containing immature eggs), creating a healthy endometrium (uterine lining) and increasing cervical mucous, all with the aim to prepare for pregnancy.

After ovulation, the Yang phase is about movement and Qi (energy), where the focus is on moving the egg through the fallopian tubes unobstructed, increasing necessary Qi for foetus growth, or ensuring the endometrium gets shed properly during menstruation.

Maintaining a good and balanced energy flow is essential to a healthy menstrual cycle, as well as a healthy overall well-being.

Phase 1: Blood Phase ~ Menstruation 1-4

The first phase of your cycle is menstruation when your uterus sheds its uterine lining. This phase is dominated by descending movement of blood and qi.

The focus is on invigorating the flow of Qi and blood to ensure the lining can shed off fully. This also alleviates menstrual cramps caused by Qi stagnation or blood stasis.

Energy + Lifestyle: The first few days of your cycle will bring down your energy. This is a time to turn inward and focus on rest and self-care practices such as taking a bath and napping. After a few days, your estrogen levels will begin to rise along with your energy levels.

Phase 2: Yin Phase ~ Follicular/Postmenstrual Phase – 4-12

In the follicular phase, oestrogen rises to support the thickening of the uterine lining and a new follicle in the ovaries. The endometrium needs to be re-nourished by fresh blood and essence.

The focus is on building Yin, which corresponds to the blood and tissues in the endometrium. However, sufficient Yang is also required to spur the growth and maturation of the dominant follicle.

Energy + Lifestyle: As oestrogen peaks, so does your mental and physical energy levels. Lean into expansion, creativity, and productivity. Here you can ramp up your exercise routine with high-intensity and endurance workouts.

Phase 3 – Ovulation – 12-16

Rising oestrogen triggers a surge of hormones (LH & FSH) which causes the release of an egg from the follicle. There is a switch of dominance from Yin to Yang energy, where Yin energy is at its peak and Yang energy is beginning to rise.

The fallopian tubes must be clear of Qi stagnation, blood stasis or phlegm obstruction for a smooth pathway for the egg to travel down. This can be achieved by boosting Yang energy.

The fertilized egg will continue travelling to the uterus and attempt to implant in the endometrium.

This phase is the only time during your cycle when you can get pregnant (Fertile window: on ovulation day and approximately 5 days before and 1 day after that day).

Energy + Lifestyle: Ovulation lasts just 12 to 24 hours, but with a continuation of the follicular phase’s high energy and pop of testosterone, you’ll be feeling more energetic and potentially in the mood. Listen to your body.

Phase 4: Luteal Phase – 16-28

Progesterone rises and becomes the dominant hormone, which proliferates the uterine lining to support potential pregnancy if the egg were to be fertilized. The Yang energy is at its peak, which is reflected in the higher BBT.

All resources (qi, yin, yang, and blood) are utilized to prepare the body for potential pregnancy. With pregnancy, the Yang energy, especially that of the Kidney, is vital for rapid cell division, the implantation of the fertilized egg, as well as the development of the embryo. There is an abundance of movements, which is an expression of Yang energy.

If pregnancy does not occur, progesterone fades, and triggers the menstrual phase into beginning a new cycle. Qi is the conductor of this cycle and needs to be plentiful and flowing for the cycle to run smoothly. Dysregulation of Qi can result in PMS and painful periods.

Energy + Lifestyle: A dip in oestrogen and rise of progesterone, which is more of a sedating hormone, will cause energy levels to slump. The upside is progesterone’s happy, calming effect. This is a time to preserve energy and practice breathwork, yoga, or journal.


Holly is available at Mornington Chinese Medicine from 2pm-8pm Thursday and  9-2pm Friday and Saturday.

138 Tanti Avenue, Mornington, VIC

03 5973 6886

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