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Did you know that in 2015, the American College of Obstetricians and Gynecologists suggested that the menstrual cycle should be viewed as a vital sign?
This makes sense, as menstrual health is directly related to systemic health & function.
In fact, if paid close attention to, dare I say the menstrual cycle could even be used as a diagnostic tool. (Please see disclaimer above)
Whether you are a practitioner looking to support your female clients in their hormone-balancing & cycle-healing journeys…
Or if you’re a womxn who’s looking to understand your body on a deeper level so you can decode what your menstrual cycle could be telling you…
This article will teach you the basics of how to achieve an inside look on a womxn’s health through using the menstrual cycle as a vital sign & diagnostic tool.
The Menstrual Cycle as a Whole
Before we dig into how to use the menstrual cycle as a tool, you must first understand that the menstrual cycle & menstruation are two entirely separate things.
The menstrual cycle consists of a month-long process beginning with the first day of the period, to the day before the next period. It can be broken up into 4 distinct phases, each consisting of different metabolic processes such as specific hormonal fluctuations, the buildup of the nutrient-rich endometrial (uterine) lining & of course, the most important event of them all, ovulation. Read more about the menstrual cycle phases & accompanying hormones.
At the end of the month, hormones drop to their lowest points triggering the uterus to contract and shed the blood & nutrient-rich endometrial lining, resulting in menstruation.
As you can now see, the menstrual cycle is way more complex than simply getting a period once every 28-or-so days.
Contrary to popular belief, periods are not meant to be painful or symptomatic. The level of pain & symptoms a womxn experiences with her period is highly associated with her systemic health, inflammation levels, hormone balance, nutrient status and more.
Understanding how the menstrual cycle is translating systemic dysfunction in this way, is key to utilizing the menstrual cycle as a vital sign & diagnostic tool.
Interpreting The 5th Vital Sign
To use the menstrual cycle as a vital sign & diagnostic tool, you must first be able to identify the difference between a normal, healthy menstrual cycle & a dysfunctional, symptomatic cycle.
A healthy period should ideally:
Dysfunctions in menstrual health may appear as:
Although cycle symptoms may be statically “normal” or common amongst menstruators, they are definitely not biologically normal, and are typically a sign of systemic dysfunctions like elevated inflammation, hormone imbalances, nutrient deficiencies, chronic stress & more.
It can be helpful to keep track of symptoms throughout the menstrual cycle to get a big-picture look at what can be considered normal or what may be a sign of dysfunction.
Charting the Menstrual Cycle
By observing cyclical patterns within the menstrual cycle, you can clearly see what the underlying issues and/or dysfunctions may be triggering a womxn’s symptoms.
Utilizing information in this way allows womxn to get an inside look on their health so that they can seek the support they need to balance their hormones & optimize their reproductive health.
I recommend suggesting to your clients that they keep detailed track of their symptoms throughout their entire cycle and during their period.
For an advanced level look into the menstrual cycle, you could also suggest they keep track of their basal body temperatures and cervical mucus patterns throughout their cycle.
They can do this by charting their observations on paper, or through using a detailed charting app like Kindara or Read Your Body.
Observing Cervical Mucus Patterns
It is normal to experience fluctuations in vaginal secretions throughout the menstrual cycle, specifically within the fertile window, which occurs roughly 5-6 days before ovulation.
In response to rising estrogen levels in the follicular phase, the cervix produces fertile-quality cervical mucus. The mucus may appear sticky, or tacky at first and should evolve to become creamier, with more water concentration the closer to ovulation you get, eventually turning into a very slippery, egg-white quality of cervical mucus.
The presence of fertile-quality cervical mucus is a sign of optimal fertility and is very different than vaginal discharge. Occasionally womxn may observe fluid secretion outside of their fertile window, but in this case, it would be considered vaginal discharge and not cervical mucus. This may be an indicator of hormone imbalances and/or infection and should be examined by a qualified medical professional.
Abnormal vaginal discharge that appears grey or greenish in color, has a foul odor, or is accompanied by itching or irritation is a sign of imbalance or infection and should also be examined by a qualified medical professional.
Observing Basal Body Temperatures
Keeping track of basal body temperatures can be an easy way for womxn to observe their menstrual cycle from a birds-eye view.
To track basal body temperatures, you would need a basal thermometer, or a thermometer that records temperatures to at least 1/100th of a degree.
Instruct your clients to take their temperature first thing, at the same time every morning upon rising. They will want to ensure that they take their temperature before moving or getting out of bed, before taking a sip of water and before looking at their phone or engaging in conversation or sexual activity.
Temperatures in the follicular phase should ideally rest somewhere between 97.0 to 97.7 degrees Fahrenheit or 36.11 to 36.5 degrees Celsius.
After ovulation occurs, they should see a sustained rise in temperature at least 2/10s of a degree above the average follicular temps. Postovulatory temperatures may rise to 97.8 degrees Fahrenheit or 56.55 degrees Celsius and stay elevated until the next period arrives.
The thermal shift is a result of progesterone production after ovulation, which has a thermogenic effect, stimulating thyroid hormone, thus, increasing basal body temperatures. A sustained temperature rise is one way to confirm an ovulatory cycle.
If your client cannot determine if they experience a sustained temp rise, they may not be ovulating consistently, which could be an influencing factor in their cycle symptoms. Or, they could be taking their temperatures inaccurately. If you suspect the latter, recommend they visit a certified Fertility Awareness Educator to have their charts thoroughly inspected and to learn more about how to chart their cycles accurately.
Keeping track of basal body temperatures can give you insight on not only if your client is ovulating or not, but also the status of their thyroid health & function, adrenal health & hormonal status.
Interpreting & Monitoring Progress
Through keeping track of menstrual cycle symptoms, cervical mucus patterns & basal body temperature, one can use the menstrual cycle as not only a vital sign measurement, but also (dare I say), a diagnostic tool.
This is because when observed strategically, the menstrual cycle can provide great insight into a womxn’s health on multiple levels.
Not only can her period symptoms provide insight on her hormonal status and levels of inflammation, her menstrual cycle charts can help to confirm whether or not she’s experiencing hormone imbalances, adrenal dysfunction, thyroid dysfunction, and more.
The tangible data that comes from cycle charting is absolutely invaluable information for a womxn to have, as it is a completely free way that she can monitor her own health status & progress.
The good news is that the menstrual cycle is malleable. It can be heavily influenced by the quality of a womxn’s nutrition, environment, sleep patterns, stress levels, & exercise routine. This means that through making simple, strategic nutrition & lifestyle adjustments, the menstrual cycle can change & improve over time.
A womxn’s period gives her the opportunity once per month to pause, check in with herself & reflect on her progress. It is her internal report card, a vital sign, showing her precisely where she needs to make adjustments in order to experience a healthier, symptom-free cycle.
Embracing The 5th Vital Sign
I firmly believe that now, more than ever, womxn need access to quality information about their reproductive health & how they can use their menstrual cycle to their advantage in these ways.
The more practitioners are familiar with this vital information, the more accessibility there is for womxn of this world. Through teaching them how to utilize their menstrual cycle as a vital sign & diagnostic tool, we have the power to take back control of our bodies & reclaim our reproductive health once and for all.
Resources available upon request
Ashe Milkovic, NTP is a Nutritional Therapy Practitioner, Womxn's Health Specialist & Hormone Expert focusing in the field of womxn's reproductive health.