An Overview of Menstrual Cycles

The female reproductive cycle follows the rhythm of the moon. An average of 28 days in length, a normal cycle is heralded by ovulation mid-cycle and a period at the end, but this delicate balance is easily disrupted.

What Causes Menstrual Imbalance?

Sometimes pinpointing the causes of menstrual imbalance is challenging. What is considered a normal menstrual cycle is highly variable. One thing is for certain, however, poor health habits are often associated with menstrual imbalance and uncomfortable periods.

  • A high carbohydrate, processed foods diet
  • Chronic emotional stress with elevated cortisol levels
  • Lack of sleep and poor sleep habits
  • Hormonally active toxins from food and other sources
  • Rapid weight loss or weight gain
  • Change in contraception method
  • Hormonal fluctuations associated with perimenopause/menopause

Common Symptoms of Menstrual Imbalance

  • Irritability and mood swings
  • Uncomfortable periods
  • Cramping with periods
  • Headaches
  • Breast tenderness
  • Weight gain
  • Nausea

Healthy Tips from Dr. Rawls

  • Restore normal balance with good health practices
  • Avoiding any processed or fast foods
  • Regular exercise increases endorphins and reduces symptoms
  • Yoga is calming and increases natural endorphins
  • Swap soft drinks and other heavily caffeinated beverages for green tea or herbal teas instead
  • Allow plenty of time for sleep

Natural Options for Supporting Menstrual Balance

Vitex agnus castus (chaste tree berry) – Vitex is one of the most reliable natural therapies for balancing the menstrual cycle. Through feedback mechanisms to the hypothalamus, it increases natural progesterone secretion and balances ovarian function. Vitex has been used for this purpose for thousands of years and has an excellent safety profile.

It should be noted that Vitex is not a contraceptive; in fact, it is known to improve fertility. Be patient, it sometimes takes several cycles before Vitex provides full benefit.

Vitamin B6 – Vitamin B6 helps provide calm during a disrupted menstrual cycle. It is felt to increase synthesis of key neurotransmitters in the brain including serotonin and dopamine, both of which are typically depressed with menstrual imbalance.

Ashwagandha – If chronic stress is an issue complicating menstrual imbalance, ashwagandha is herb that can be taken with Vitex to gain additional benefit. Ashwagandha normalizes “stress hormones” and improves stress tolerance. It also promotes normal sleep at night without sedation during the day. Ashwagandha has also been shown to improve cognitive function and mental focus.

Ashwagandha has been the subject of numerous scientific studies and has a well-defined safety record. There are no known adverse consequences with using ashwagandha long-term.

L-theanine – L-theanine is a natural amino acid found in small amounts in green tea and certain mushrooms. As a supplement, it crosses into the brain and competes with exciting neurotransmitters. This has the effect of promoting calm and improving mental focus. Because l-theanine is metabolized by the same pathways as other amino acids in the body, it has no drug-like effects. .

Relora Chinese Tree Bark – Proprietary combination of two herbs clinically proven to normalize levels of cortisol and DHEA, two hormones that help handle the symptoms our bodies experience due to excessive stress, and to quiet the HPA axis without causing drowsiness.

When to See a Doctor

Most every woman experiences menstrual dysfunction at some point during life, but sometimes things can get out of hand. Heavy or prolonged bleeding, severe cramping, severe mood changes, anxiety, depression, or any other severe symptoms should be reported to a qualified healthcare provider.

If the need for contraception is an issue, low dose oral contraceptives are a safe option for both managing hormonal fluctuations and reducing symptoms associated with extreme menstrual dysfunction. Oral contraceptives are generally very well tolerated by most individuals and have a favorable safety profile. Talk to your healthcare provider if you are interested in this option.

*Statements on this page have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease. For medical concerns, please consult a qualified healthcare provider.

REFERENCES
1. Mirghafourvand M, Mohammad-Alizadeh-Charandabi S, Ahmadpour P, Javadzadeh Y., Effects of Vitex agnus and Flaxseed on cyclic mastalgia: A randomized controlled trial, Complement Ther Med. 2016 Feb;24:90-5. doi: 10.1016/j.ctim.2015.12.009. Epub 2015 Dec 29.
2. Khalilzadeh E, Vafaei Saiah G, Hasannejad H, Ghaderi A, Ghaderi S, Hamidian G, Mahmoudi R, Eshgi D, Zangisheh M., Antinociceptive effects, acute toxicity and chemical composition of Vitex agnus-castus essential oil, Avicenna J Phytomed. 2015 May-Jun;5(3):218-30.
3. Arentz S, Abbott JA, Smith CA, Bensoussan A., Herbal medicine for the management of polycystic ovary syndrome (PCOS) and associated oligo/amenorrhoea and hyperandrogenism; a review of the laboratory evidence for effects with corroborative clinical findings, BMC Complement Altern Med. 2014 Dec 18;14:511.
4. Jang SH, Kim D, Choi MS., Effects and treatment methods of acupuncture and herbal medicine for premenstrual syndrome/premenstrual dysphoric disorder: systematic review, BMC Complement Altern Med. 2014 Jan 10;14:11.
5. Depypere HT, Comhaire FH., Herbal preparations for the menopause: beyond isoflavones and black cohosh, Maturitas. 2014 Feb;77(2):191-4.
6. van Die MD, Burger HG, Teede HJ, Bone KM., Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials, Planta Med. 2013 May;79(7):562-75.
7. Schellenberg R, Zimmermann C, Drewe J, Hoexter G, Zahner C., Dose-dependent efficacy of the Vitex agnus castus extract Ze 440 in patients suffering from premenstrual syndrome, Phytomedicine. 2012 Nov 15;19(14):1325-31.
8. Ambrosini A, Di Lorenzo C, Coppola G, Pierelli F., Use of Vitex agnus-castus in migrainous women with premenstrual syndrome: an open-label clinical observation, Acta Neurol Belg. 2013 Mar;113(1):25-9.
9. Zamani M, Neghab N, Torabian S., Therapeutic effect of Vitex agnus castus in patients with premenstrual syndrome, Acta Med Iran. 2012;50(2):101-6.
10. Sampalis F, Bunea R, Pelland MF, Kowalski O, Duguet N, Dupuis S, Evaluation of the effects of Neptune Krill Oil on the management of premenstrual syndrome and dysmenorrhea, Altern Med Rev. 2003 May;8(2):171-9.
11. Garrison R, Chambliss WG, Effect of a proprietary Magnolia and Phellodendron extract on weight management: a pilot, double-blind, placebo-controlled clinical trial, PubMed. Altern Ther Health Med. 2006 Jan-Feb;12(1):50-4
12. Kalman DS, Feldman S, Feldman R, Schwartz HI, Krieger DR, Garrison R., Effect of a proprietary Magnolia and Phellodendron extract on stress levels in healthy women: a pilot, double-blind, placebo-controlled clinical trial, PubMed. Nutr J. 2008 Apr 21;7:11
13. Talbott SM1, Talbott JA, Pugh M., Effect of Magnolia officinalis and Phellodendron amurense (Relora®) on cortisol and psychological mood state in moderately stressed subjects, PubMed. J Int Soc Sports Nutr. 2013 Aug 7;10(1):37
14. Biswajit Auddy, Jayaram Hazara, Achintya Mitra, Bruce Abedon, Shibnath Ghosal, A Standardized Withania Somnifera Extract Significantly Reduces Stress-Related Parameters in Chronically Stressed Humans, JANA, Vol. II, No. I, 2008, pp. 50‐56.
15. Usharani Pingali, Raveendranath Pilli, Nishat Fatima, Effect of standardized aqueous extract of Withania somnifera on tests of cognitive and psychomotor performance in healthy human participants, Phamacognosy Research, January‐March 2014, Vol. 6, Issue 1, pp. 12‐18.
16. K.N.Roy Chengappa, Christopher Bowie, Patricia Schlicht, David Fleet, Jaspreet Brar, Ripu Jindal, Randomized Placebo-Controlled Adjunctive Study of an Extract of Withania somnifera for Cognitive Dysfunction in Bipolar Disorder, J Clin Psychiatry, 74:11, November 2013, pp.1076‐1083.
17. Usharani Pingali, Raveendranath Pilli, Nishat Fatima, Effect of Withania Somnifera Extract on Mental Stress Induced Changes in Hemodynamic Properties and Arterial Waveform Reflections in Healthy Subjects, Current Topics in Nutraceutical research, Vol. 11, No. 4, pp. 151‐158, 2013.
18. P.Nalini, K.Manjunath, N., K.Sunil Kumar Reddy, P.Usharani, Evaluation of the analgesic activity of standardized aqueous extract of Withania somnifera in healthy human volunteers using Hot Air Pain Model, Research Journal of Life Sciences (May 2013), Vol. 01, Issue 02, pp. 1‐6.
19. Pingali Usharani, Nishat Fatima, Chiranjeevi Uday Kumar, Evaluation of a highly standardized Withania somnifera extract on endothelial function and biomarkers of oxidative stress in patients with type 2 diabetes: A randomized, double‐blind, placebo‐controlled study, Int. J.Ayur. Pharma Research, 2014; 2(3): 22‐32.
20. P. Usharani, P.V. Kishan, Nishat Fatima and C. Uday Kumar, A comparative study to evaluate the effect of highly standardized extracts of Phyllanthus emblica, Withania somnifera and their combination on endothelial dysfunction and biomarkers in patients with type 2 diabetes mellitus, IJPSR, 2014; Vol. 5(7): 2687‐2697.
21. Garrison R, Chambliss WG, Effect of a proprietary Magnolia and Phellodendron extract on weight management: a pilot, double-blind, placebo-controlled clinical trial, PubMed. Altern Ther Health Med. 2006 Jan-Feb;12(1):50-4
22. Kalman DS, Feldman S, Feldman R, Schwartz HI, Krieger DR, Garrison R., Effect of a proprietary Magnolia and Phellodendron extract on stress levels in healthy women: a pilot, double-blind, placebo-controlled clinical trial, PubMed. Nutr J. 2008 Apr 21;7:11
23. Talbott SM1, Talbott JA, Pugh M., Effect of Magnolia officinalis and Phellodendron amurense (Relora®) on cortisol and psychological mood state in moderately stressed subjects, PubMed. J Int Soc Sports Nutr. 2013 Aug 7;10(1):37
24. Nobre AC1, Rao A, Owen GN, L-theanine, a natural constituent in tea, and its effect on mental state, Asia Pac J Clin Nutr. 2008;17 Suppl 1:167-8.
25. Simon P. Kelly, Manuel Gomez-Ramirez, Jennifer L. Montesi, and John J. Foxe, L-Theanine and Caffeine in Combination Affect Human Cognition as Evidenced by Oscillatory alpha-Band Activity and Attention Task Performance, J. Nutr. 138: 1572S–1577S, 2008.
26. Tori Hudson, ND, Women’s Encyclopedia of Natural Medicine, Keats Publishing, Copyright 1999.
27. David Winston and Steven Maimes, Adaptogens, Herbs for Strength, Stamina, and Stress Relief, Healing Arts Press, Copyright 2007
28. Donald Yance, Jr., CN, MH, RH(AHG), Adaptogens in Medical Herbalism, Healing Arts Press, Copyright 2013
29. Sebastian Pole, Ayurvedic Medicine, The Principles and Traditional Practice, Churchill Livingstone/Elsevier, Copyright 2006
30. Merrily A. Kuhn and David Winston, Herbal Therapy & Supplements, second edition, Wolters Kluwer Health / Lippincott Williams & Wilkins, Copyright 2008
31.David Hoffmann, FNIMH, AHG, Medical Herbalism, the Science and Practice of Herbal Medicine, Healing Arts Press, Rochester, Vermont, Copyright 2003
32. Medicines from the Earth, Lecture notes, Conference May 31-June 4, 2013Annual conference on herbal medicine, Black mountain, NC
33. Lisa Ganora, Herbal Constituants, Foundations of Phytochemistry, Herbalchem Press, Copyright 2009
34. Bone and Mills, Principles and Practice of Phytotherapy, 2nd ed., Churchill/Livingston, Copyright 2013
35. Sheldon Saul Hendler, Ph.D., M.D., FACP, FACN, FAIC, PDR for Nutritional Supplements, 2nd edition, Thomson Reuters, Copyright 2008
36. PDR for Herbal Medicines,4th edition, Medical Economics Company, Montvale, N.J., Copyright 2007
37. Mark Blumenthal, Editor, The ABC Clinical Guide to Herbs, American Botanical Council, Copyright 2003