Living in an assigned-female-at-birth (AFAB) body can be challenging. Already the world around us is changing so rapidly, and as if that weren’t already enough, then internally, our hormones are also always in flux. Understanding our cycles can help us to feel empowered in our bodies and find that what we thought was a weakness, is really a strength. This article will explore a new lens through which you can view your menstrual cycle: one that comes from ancient Chinese medicine and has been developed and refined thousands of years more than the conventional medical system and is still practice widely today.
If You’re Queer, This is For You Too
Even if you are a queer-identifying individual in an AFAB body, this article can help you deepen your relationship with yourself. Maybe your female anatomy will change in your upcoming medical transition, maybe you plan for it to stay the same, or maybe you’ve already gone through medical transition and find yourself navigating new territory in your new AFAB body. No matter your current state, the information below can guide you.
Being Both
If we take a look at fetal development, we all start out as both sexes before hormonal influences trigger a shift. When we are conceived, we are both, and some people remain both for their whole lives. Not as rare as we once thought, the Hudson Institute of Medical Research tells us that, “an estimated 1.7 per cent of babies are born with intersex conditions, although many variations are not apparent at birth.” Gender and sexuality exist on a spectrum, alongside masculinity and femininity.
All beings, no matter your genitalia or sexual orientation, cycle. For example, our primary stress hormone cortisol has a diurnal rhythm, higher in the morning and lower in the evening. Even those who find themselves in assigned-male-at-birth bodies experience hormonal fluctuations throughout the day, seasonally, and a certain subset of men experience a more stark decline in hormone levels, andropause, similar to menopause.
Giving Your Cycle the Attention it Deserves
In China, as in America, gynecology and the treatment of AFAB bodies was not always given the attention it deserved. A 7th century Chinese medicine scholar and physician, Sun Simiao, published a comprehensive encyclopedia called The Essential Prescriptions 備急千金要方. Sun Simiao was the first physician to increase attention around the treatment of women and children. He placed gynecology at the beginning of his writings, devoted three whole scrolls to the topic, and emphasized, “the need for ‘gentleman engaged in the art of nurturing life’ to devote particular attention to this topic because ‘women are ten times more difficult to treat than men’.”
He was the first to argue for ‘separate prescriptions and special care for women’s bodies and minds’; and, according to Sabine Wilms, distinctive scholar and translator of ancient Chinese literature, “he thereby set the stage for the fully- fledged emergence of gynecology as a respected medical specialty in the official, government-sponsored system of medical training [in China].”
Your Body’s Menstrual Anatomy
The menstrual cycle in Chinese medicine is a complex set of interactions involving Yin, Yang, Qi and Blood throughout six different phases. Without going into the intricacies, here are some fundamental components to help you understand what is needed for this particular cycle to function smoothly.
The Uterus is its Own Ecosystem
The uterus is a physical organ, just like the others in many ways, made up of epithelial tissue, muscle, tissue, and surrounded in a fascial web that suspends the fallopian tubes and ovaries. The first Chinese physician to study and write about female-bodied anatomy was Fu Qing-Zhu. He called the uterus’ ecosystem, which includes the uterus, kidneys, heart and associated vessels of the Bao Luo and Bao Mai, the “Bai Tai.”
All About Communication
The uterus facilitates communication between the kidneys and the heart. The Bao Mai connects uterus to heart and the Bao Luo links uterus to kidneys. The heart is the “emperor” of the body. It holds the highest place in the chest cavity and governs the blood. It has many functions, but among them it helps to regulate the nervous system, calm the spirit and stabilize emotions. The kidneys are central in their ability to support growth, development, reproduction, and sexuality. They also house the Zhi Spirits which connect us to our will power and control the mingmen, which is our fundamental energy stores, similar to adrenal function.
Working Together
There are many “sub-components” to each of the organs. For example, kidney jing and heart blood are responsible for normal menstruation, and if either are deficient, blood will not be available to the uterus for menstruation to occur; kidney water and heart fire work together to provide material substance for Chong and Ren, also allowing the menses, and reproduction, to occur. Many other organs are connected to and through the uterus, since in Chinese medicine, everything exists in relationship to each other, instead of in isolation. These notes are only the tip of the iceberg. Together these organs, channels, and systems work with other qi moving and blood producing organs to help the menstrual cycle to flow smoothly.
The Extraordinary Vessels
From a Chinese medical perspective, the uterus, Bao Gong, is one of 8 extraordinary organs. That means this organ has special functions that set it apart from many others. We all know that the Uterus holds the potential to house a fetus & grow a placenta, but is also the starting place for 3 extraordinary vessels: the Ren Mai (Conception Vessel), the Du Mai (The Governing Vessel), and the Chong Mai (The Sea of Blood).
The uterus is the central bridge between these 3 channels that connect us to our deepest source energies. They run up and down the front, back, and middle of the spine, creating an interconnected web of strength along our body’s central channel. These channels offer many nuanced layers of meaning, but all together, they help us to maintain connection to both the ephemeral, subtle realms and the physicality of the earth. When these channels are flowing smoothly through the uterus, they allow us to stand straight up, with alignment of the spine, comes also alignment to our higher purpose.
The Pelvic Floor
These channels all connect in to the uterus and descend to the perineum, the bottom most point of the pelvic floor. The pelvic floor is the basket of the bottom. It cradles all of our vital organs, sustaining life for us by upholding the weight of all that our body takes in, transforms, and puts out. In many Chinese cultivation practices, such as qigong and taiji, there is a light seal placed over this area to promote strength and prevent prolapse.
Pelvic floor physical therapy can be a potent medicine for bodies to heal from gastrointestinal, urinary, muscular, as well as reproductive challenges since all of these systems converge and have shared functions in this region. A healthy balance of ascending and descending qualities are necessary for healthy pelvic floor function.
The Arrival of The Heavenly Water: An Initiation & Rite of Passage
Our Bodies’ Cycles of 7 and 8
In Chinese thought, AMAB individuals grow and develop in cycles of 8 years; while AFAB individuals do the same in 7 year cycles. These cycles were thought to end after 8×8 years for AMAB folks and 7×7 for AFABs. This means that by traditional standards, men were thought to have 64-year lifespans and women 49 years.
Though the typical lifespan is much longer in today’s era and AFAB individuals have a longer life-expectancy than AMABs, the fundamental premise of these cycles can help us understand the body’s rhythms over a lifetime. They also help us to understand our body’s lifecycle as it relates to all other living things, reminding us that we are not so different from the world around us. Just as our cells grow, live, and die, so do the stars. The microcosm mirrors the macrocosm.
Between the ages of 14-16, in both male and female-bodied individuals, there is a developmental milestone called the arrival of the Tian Gui, heavenly water. Tian gui is a sticky, viscous substance, akin to cervical mucus at ovulation in AFAB individuals and to ejaculatory fluid in AMABs.
Menarche Like a Monarch
Today, however, the average age of menarche, the first menstruation, occurs at an average of 12 years old, instead of 14 or 16. This number is telling us that at the same time we are living longer lives, we are aging quicker. It’s no surprise that there are higher rates of chronic disease than there ever has been.
The arrival of this “heavenly water” marks a time of fire and fullness. There is a spicy and abundant energy available to explore the world, and it translates to the innate desire that teenagers have for excitement, adventure, and relationship. Libido is enlivened during this phase as well.
Taking Care During Shifts
In AFAB bodies, the arrival of the menses marks the beginning of an ongoing cycle for many years to come, one where the chong mai, an extraordinary vessel, fills up with blood and releases it again and again, from one moon cycle to the next. Bleeding happens when, and only when the “cup is overflowing.” the blood is able to fill the chong from one moon cycle to the next, creating a space where a baby could potentially be implanted.
Other shifts at this time include the opening of the Ren Mai, a central vessel along the front of the body that helps to descend menstrual blood, but is also part of the microcosmic orbit: a cycling of energy through the front and back of the spine. Ultimately, this period is a transformational time of becoming. As we age, the natural energy that we have begins to wane, and appropriate nourishment of the spleen can make a world of a difference. At age 7 x 7, or 35 years, the function of the kidneys and of the transportation and transformation of the middle jiao begin to decline. Eating well, moving often, and sleeping in a routine become supportive measures to maintaining longevity.
The Beauty of The Blood
Blood has both yin and yang qualities to it. It is inextricably intertwined with Qi, which moves it and is contained within it. It is said in the Huangdi Neijing 黃帝內經, the Yellow Emperor’s Inner Classic, that, “Blood is the mother of qi…qi is the commander of blood.” Qi is an energetic, predominantly yin force, that not only mobilizes the blood, but contains it; an energetic holding, similar to surface tension of a water molecule. This is the dichotomy of form and function through the lens of a single substance; but all organs, systems, and fluids in Chinese medicine hold both yin and yang qualities, just in different configurations and proportions.
Teamwork Involved
With this physiology in mind, we might say that blood is moisture, warmth, and nourishment, one that has a propulsion of its own. Menstrual blood is more viscous than normal blood, which sets it apart. For menses to occur, the blood must be abundant. Like a fountain, the menstrual cycle is essentially an outpouring of the overflow created over the cycle. Blood is comprised from the food and water we take in as well as the healthy function of the spleen, stomach, pancreas, lungs, and heart. After moving through these organs, the blood is ready, in all of its glorious form & function.
Another important organ system guiding a healthy menstrual cycle is the liver. The liver stores the blood and moves the qi, both essential functions for all gynecological complaints. The liver also does the work of the kidney, disseminating its vital substances throughout the body. Kidney yin and yang is involved in some way in every bodily function.
Stay tuned for part 2 in this blog series to learn about the menstrual cycle model from a Chinese medical perspective, hidden signs of an unhealthy menstrual flow, and how to create more ease around your menses.
References
- Wilms S. Nurturing Life in Classical Chinese Medicine: Sun Simiao on Healing without Drugs, Transforming Bodies and Cultivating Life. Journal of Chinese Medicine. 2010;93:5-13.
- Li Z. The Extraordinary Vessels and Gynecological Diseases. Journal of Chinese Medicine. 2022;70:14-17.
Meet the Author
Miquella Young is a naturopathic doctor and licensed acupuncturist whose main goals are to dive into the deeper messages that lie beyond her patients’ pain, trouble sleeping, anxiety, or depression. She understands that many people may have the same diagnosis as each other, but maintains that the way they express that diagnosis is unique to them. Dr. Young focuses more on her patients’ unique expressions, habit patterns, and cycles of illness and health than the disease labels they have been given.
To schedule an appointment with Dr. Young, call 503-956-9396 or contact us now to schedule an appointment today.
