What Are the Four Phases of the Menstrual Cycle in Chinese Medicine?

By Hannah Fries /

What Are the Four Phases of the Menstrual Cycle in Chinese Medicine?

In the quest to optimize wellbeing, we learn to live in sync with our physiological cycles, in the same way we modify our lives in accordance to the seasons of the Earth. You wouldn’t sunbathe in a bikini in the depths of winter, right? Okay, Wim Hof, we see you. The rest of us, however, are likely cozied up by the fire. Making lifestyle choices aligned with our inner seasons is equally as, if not more essential as honoring external seasonal shifts.

Inner seasons, huh?!? Take, for instance, the circadian rhythm. All bodies have this daily (24 hour) rhythm, during which we cycle through an ebb and flow of energy patterns. If we choose not to follow this innate pattern, by, for example, staying up all night, it won’t be long before we suffer the consequences. Planning our lives in accordance with the variations of our inner tempo keeps us feeling balanced and healthy.

Cycle Syncing with the Infradian Rhythm

Menstruating bodies operate according to something called an infradian rhythm - an internal clock that regulates our 28(ish) day menstrual cycle, and has a profound impact on our neurology, metabolism, immune system, gut and reproductive health/fertility. If we go about our days without an awareness of the perpetual shifts occurring throughout this cycle, we can easily fall out of sync with the deeper needs of our being. Recognizing that our needs, desires, and capabilities will be different at any given time of month, and adapting our behavior to these fluctuations, helps us to thrive. The concept of “cycle syncing,” coined by the wondrous Alisa Vitti, is used to describe this process of adaptation based on self-awareness and rooted in self-love. This terminology may be new, but the notion is actually quite ancient.

Inner Cycles through the lens of Chinese Medicine

In Chinese Medicine all beings are considered microcosmic embodiments of the greater web of life. As such, the elements and phases of the Universe form and transform us from within, operating by the same principles of nature seen all around us. The internal mingle and flow of elements creates our Inner Seasons. 

The energetic pattern of those with female physiology creates a unique seasonal flow each month. We can view the menstrual rhythm as a cyclical interplay of four main phases. Like the seasons of the year, the four phases are the four seasons of the menstrual cycle. Both the Chinese and Western medicine frameworks split the menstrual cycle into four phases, but the particulars of each phase differ slightly from one system to the next.

What are the four phases of the menstrual cycle in Chinese and Western medicine?

From the Western point of view, the infradian rhythm is a sequence of the following four distinct phases:

  • Phase 1: Follicular (the 7 to 10 days after your period)
  • Phase 2: Ovulatory (the 3 to 5 days in the middle of your cycle)
  • Phase 3: Luteal (the 10 to 14 days between ovulation and your period)
  • Phase 4: Menstrual (the 3 to 7 days of your period)

Chinese medicine recognizes 4 interrelated phases of the menstrual cycle that represent the elemental revolution spurred by the ebb and flow in the tide of Kidney Yin and Yang. The first half of the cycle (Blood + Yin) is considered Yin in nature, while the second half (Yang + Qi) is considered Yang:

4 phases of the menstural cycle

  • Blood Phase = menstruation (days 1-7 in a 28 day cycle), Inner Winter (Water Element)
    • During this phase the focus is on free flow of Qi and Blood. Blood’s abundant and easy flow is imperative to our vibrant and abiding wellbeing. 
  • Yin Phase = Follicular/postmenstrual (days 7-14 in a 28 day cycle), Inner Spring (Wood Element)
    •  Here we want to replenish and nourish Blood and Yin and tonify the Kidneys in order to rebuild the uterine lining and develop the follicles
  • Yang phase = Ovulatory + 1st half of Luteal (days 14-21 in a 28 day cycle), Inner Summer (Fire Element)
    • The fullness of Yin turns into Yang (Estrogen → Progesterone). Warm and tonify the Kidneys, while also strengthening the Spleen and resolving Dampness
  • Qi Phase = 2nd half of Luteal/premenstrual (days 21-28 in a 28 day cycle), Inner Autumn (Metal Element)
    • Stimulate free flow of Qi, invigorate Blood, and warm the Uterus to ensure a PMS-free week and a pain-free Blood Phase ahead.

Akin to our own inner seasons, we move from Inner Winter in the Blood Phase through to Inner Autumn in the Qi Phase. Each phase also corresponds with an Element (as noted above), with the Earth Element fostering the transitional pivot between phases, most notably between the Yang and Qi Phase. 

During each phase, we are energetically and hormonally primed for certain physical activities, mental-emotional states, consumption patterns, and a variety of other lifestyle factors. We can choose particular foods, exercises, projects, and communication styles that best match our internal rhythm, augment our health, and cultivate harmony and ease. You can read more about the best practices for nutrition, exercise & mindset, acupressure, and herbal medicine for each phase, or you can check out our course where we cover all of this information in depth!

Hannah Fries is a California-based licensed acupuncturist and herbalist (L.Ac.), writer, and Integrative Body Psychotherapy allied professional. She seeks to discover & alchemize the psycho-emotional and spiritual roots of disharmony in the physical body to help her clients transform the obstacles that interfere with their innate healing capacity. Find out more about Hannah and her work on her website at https://www.friespirit.com or on Instagram @friespirit.

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