I think I have a dysfunctional menstrual cycle. What are the symptoms of a cycle which is not optimal? 

Symptoms of a menstrual cycle which needs support are:

• Heavy bleeding- you should not need to change protection more that 3-4 times a day

• Losing clots which are bigger than a 5 pence piece size.

• Pain- you should only experience minimal cramping on day 1 of your period which does not interfere with your day.

• A cycle less that 24 days in length- this means that your follicles may not be ripe enough when you ovulate

• A cycle that is more than 32 days long- follicles are taking too long to ripen, which pushes back the ovulation window. This may be due to an energy production issue, suboptimal follicular fluid health, hormones being out of balance or a condition such as PCOS

• A complete absence of periods- this is classed as being without a period for 3 months or longer. -A short Luteal phase- once you ovulate, an ideal window of time before you get your period is 12-14 days. This gives enough time for your lining to build.

• PMS- if you are feeling irritable, have really low mood, tender breasts, and fatigue in the 1-2 weeks approaching your period, this is a sign of a dysfunctional cycle and hormone balance needs addressing.

• Brown discharge as your period starts. This is a hormone imbalance as the flow should start with a red appearance. 

• No stretchy cervical mucous noted throughout the cycle. This may indicate that ovulation is not
  occurring. 

• No rise in temperature around ovulation, or no sustained temperature throughout the follicular
  phase. We may need to investigate Progesterone levels.

• Mid cycle pain. This can be a sign of Ovarian cysts, Endometriosis or PCOS. 

• A cycle where you bleed for less than 3 days. This may indicate a thin lining. 

  Cycles that have a bleed where colour is brown, very dark red, purple or a lighter pink.

Do you support women who have Endometriosis? 

Yes I have supported many women with Endometriosis where their symptoms were debilitating and affecting their ability to function. The acupuncture treatment aims to lessen inflammation and pain and address blood stasis. In some instances I can eradicate pain, and in some I can dial down the intensity to allow the woman to manage until she can access Gynaecology services for an ablation. I have worked with women who had been advised of their infertility being attributed to Endometriosis who were then able to conceive with acupuncture alone, or acupuncture and ablation. Once an ablation has taken place, Acupuncture may prevent the lesions from reoccurring.

How can acupuncture help with Endometriosis?

The evidence has been weighed up by the British Acupuncture Council for the role of acupuncture in the treatment of endometriosis, and has been compiled in this document:
https://acupuncture.org.uk/fact-sheets/endometriosis/

How can acupuncture help with painful periods?

It is thought that the mechanisms in treating any pain condition with acupuncture, works on reducing inflammation. In addition there is a belief in Chinese medicine that all pain is caused by stagnation. 

Treatments aim to improve blood flow which brings fresh nutrients, oxygen and anti- inflammatory processes to the area. There is also a treatment approach which considers cold in the Uterus having an impact on pain in the menstrual cycle, which we address with warmth. The evidence has been weighed up by the British Acupuncture Council for the role of acupuncture in the treatment of painful periods, and has been compiled in this document.

https://acupuncture.org.uk/fact-sheets/dysmenorrhoea/ 

Do you support women who have a PCOS diagnosis? 

Yes, I have helped many women to regulate their cycles with PCOS which improved their ovulation frequency and subsequently their fertility. I have observed a cycle move from a 62 day cycle on average to a 28 day cycle within 11 weeks of treatment. This was in conjunction with some supplements which were signposted by me. 

How can acupuncture help PCOS?

A course of 12 acupuncture treatments have been shown in studies to: 

• Affect b-endorphin secretion, which increases GNRH
• This release in turn has a positive effect on follicular growth and promotes ovulation.
• Improve blood flow to the ovaries
• Controls hyperglycaemia by increasing insulin sensitivity.
• Reduce inflammation.
• Lower the body’s stress response by modulating the sympathetic nervous system
• Recover a dysfunctional menstrual cycle
• Down regulate androgens 

https://pmc.ncbi.nlm.nih.gov/articles/PMC9637827/ 

What are the mechanisms that can help an irregular cycle from a Chinese medicine point of view?

In Chinese medicine, there are many factors which contribute to a healthy menstrual cycle. Blood is made by the Kidney, Spleen and Heart, and treatments aim to tonify these organs. We also look at addressing stagnation, and warming and tonifying the Uterus where there are signs of cold. We look to address hormone balance, by addressing yin and yang imbalance, and to build energy to help the ovulation process. Treatments aim to move the blood in the pelvic cavity, which brings fresh oxygen into the uterus, follicular fluid and ovaries. This aids from egg recruitment all the way through to ripening, and builds the uterine lining to aid implantation. Your treatment will be based around your individual diagnosis which is based on your signs and symptoms.

Treatments aim to improve blood flow which brings fresh nutrients, oxygen and anti-inflammatory processes to the area. There is also a treatment approach which considers cold in the Uterus having an impact on dysfunction in the menstrual cycle, which we address with warmth. We also consider diagnosis of Kidney yin, Spleen Qi, and Liver Qi deficiencies having an impact on building enough blood for the period, as well as Qi deficiency to allow the energy for the demanding processes of ovulation. 

Does everyone ovulate on day 14? 

No, many women have irregular cycles and may not ovulate on day 14. It is a good idea to record your daily temperatures and record cervical mucas to pinpoint exactly when ovulation is taking place in your cycle. This allows us to check whether your follicular phase is long enough or too long, or if you have a Luteal phase dysfunction, all of which impact on your fertility. 

I am tracking my cycle through an app. Can I rely on this information?

If the data is collected based on daily accurate temperature tracking, ovulation confirmation, and a place to input cervical mucus tracking, and/or daily urine testing then yes! If the data collected is based on when you have had a previous period, or previous ovulation, it is using an algorithm which is an estimate. It can take a few months for the algorithm to learn how your body works. If you have irregular cycles, this can mean a few months of being in the dark. 

I am tracking my cycle through my smartwatch/ a tracking ring. Is this information reliable?

There are many tracking devices available on the market. For pinpoint accuracy, a smartwatch app or a tracking ring are a little unreliable unfortunately. There are more sensitive devices such as an internal thermometer, or wearable armband. There are also daily urine device tests. When you have a consultation with me, I will pass on the information about each device, and you can then decide which is best to fit into your budget and lifestyle. 

I am testing my ovulation using test strips. Are these reliable?

If your baseline LH level is optimal, and you have a normal LH surge a test strip can predict ovulation, as it measures the differences between baseline and the release of LH which indicates ovulation is about to happen. This can be really helpful in timing sex for conception. However it cannot confirm ovulation has taken place.

Some women have several LH rises throughout a cycle with no ovulation, so this would trigger a positive on the strips, so can be confusing. If your LH rise is suboptimal, or baseline level is too high due to PCOS, the difference may not be enough to be detected by an ovulation strip.

You may need to switch to a Quantitative strip, rather than a Qualitative strip as these measure the levels and a positive tests indicates a threshold has been reached. For some women the LH rise is very quick and short (called rapid onset peaks) and may not be detected unless testing twice a day.

To throw even more confusion into the mix, some tests have a higher threshold to indicate a positive test. You can switch your testing schedule or test types if any of the above apply to you. However, the most reliable way to indicate ovulation has taken place if you have any of these issues, is to record temperatures, chart cervical mucous, or do Progesterone testing which occurs through the cycle such as Dutch testing, or using daily PDG test strips. 

An interesting paper on the different methods of predicting ovulation can be found here: https://pmc.ncbi.nlm.nih.gov/articles/PMC5689497/ 

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