Understanding your cycle

What is a “normal” cycle?

Many women have a preconceived notion of what their cycle “should” look like. Keep in mind that a certain amount of variation is considered “normal”. Cycle day 1 is the first full day of menstrual flow.

Cycle Length: 24-36 days

Menstrual flow: 2-7 days with lots of variation in the flow

Ovulation: Anywhere from day 6 to 21. **This is why it can be helpful to follow your body’s natural signs of ovulation (increase in cervical mucus, increase in sex drive) rather than go off of a calendar.

Should I use BBT charts, OPK tests, etc.?

If you have a fairly regular cycle, using one of these methods to gather some information on when you ovulate is a good idea. Once you are pretty sure of the timing of your cycle (how long is your flow, how many days from the first day of flow to ovulation, how many days from ovulation to the first day of your period) most women should stop tracking. I say this for two reasons. 

First, over time charting and OPK tests tend to make most women feel crazy and/or be a depressing reminder of their fertility struggles. Second, it might make you ignore other signs and symptoms that can actually be more helpful for getting pregnant —increases in cervical mucus and increase in sex drive. These can sometimes occur at the “wrong” time of your cycle because ovulation can vary from month to month in all women.

There is some other useful information that comes from tracking your cycle that might help you troubleshoot your fertility issues if this is early in your journey. If the first half of your cycle is consistently short, that might be a sign of declining ovarian function. If the first half of your cycle is consistently long, that might be a sign of polycystic ovarian syndrome. If the second half of your cycle is consistently short, that might be normal or it could indicate problems with your progesterone levels. If you’ve done some charting and you have questions, feel free to ask me, or talk to your provider. 

Is my flow “normal”?

Ideally, women should experience no pain, or a very minimal amount of pain leading up to and during menstruation. If the pain you experience is dull, achy pain that varies from month to month, a combination of acupuncture and Chinese herbal medicine can often give significant relief. If your menstrual pain is sharp, stabbing and fixed, and//or you have very significant clotting, it indicates the possibility of anatomical issues such as fibroids, polyps, or endometriosis. Acupuncture and Chinese herbal medicine can still be helpful, but it’s also a good idea to talk to your provider about your options. Please see my additional handout on endometriosis.

What if I don’t have a regular cycle?

If you don’t have a regular cycle, this is the time to call your provider and ask for an exam and testing. The exceptions are if you have recently given birth, are nursing, or have recently stopped birth control. In all of those cases, it is perfectly normal to have an interrupted cycle for a certain length of time. Depending on how comfortable you are waiting, three to six months is reasonable.

There are all sorts of reasons you may not have a regular menstrual cycle, many of which can be addressed through lifestyle changes or medications. Here are the most common reasons women aren’t cycling regularly, all of which I’ve seen in my practice:

  • Typical or atypical PCOS
  • Hypothalamic amenorrhea
  • Thyroid issues
  • Premature ovarian failure
  • Recently stopped birth control, gave birth or are nursing
  • Elevated prolactin levels from a benign tumor in the pituitary gland


I’m here to help. Feel free to give me a call at 920.574.0447 or send me an email at leah@wholefamilyacupuncture.com