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 Nicola Endicott MRRS (T) and Wellmother teacher wrote this for the Shiatsu Society Journal 

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Over the years of being a Shiatsu practitioner, I have been asked to help women with their monthly cycles for different reasons. Some examples are: they were experiencing pre-menstrual tension, heavy or painful periods, their period stops and starts, they want to conceive, they need help with endometriosis, fibroids, polycystic ovaries, IVF treatment, incomplete miscarriage…. On the whole, I found Shiatsu made a difference and was a good framework to support women to understand more about their bodies and what was happening.

In my experience, a woman’s monthly cycle can often be a good mirror of her general health. Before a Shiatsu session, I ask women about their periods and where they are at in the cycle. For me, this informs the focus of a Shiatsu session, whether a woman experiences any ‘problems’ or not, simply because a woman energetic needs are different depending on where she is in her cycle.

I am writing this article for many reasons, the obvious one being that it is such a taboo subject and so I want to make it a more accessible subject for men and women. I also want to discuss how our views of the monthly cycles shape our experience of them and how some Eastern and Western approaches to a healthy monthly cycle differ or complement each other.

My Story

I worked out that I have been having monthly cycles for around 40 years now! Apart from a break during my pregnancy and breast feeding, that is still a lot of cycles!

I do remember how un-prepared and uninformed I was when it all started. I knew absolutely nothing about why I was bleeding or what it was all about, all I knew was it was happening to other girls in my school class. When I was thirteen, the doctor prescribed strong pain killers, that was the limit of the help available then for cramping pain, diarrhoea, feeling faint and lack of energy during periods, amongst other symptoms.

When I first started studying Shiatsu in my early 20’s, I stopped taking pain killers, I became more skilled at ‘being with the pain’ and I realised the pain was an opportunity to feel myself more fully. I was interested to find out what Shiatsu could do for my monthly symptoms. I learnt about the role of the Spleen, Heart and Liver in the making, circulating and enabling of a smooth flow of the Blood. I also learnt how some points could address some of the common difficulties in the menstrual process. I found that working on the meridians with stretches really helped move my energy and emotionally gather my energy. Working on the points never seemed to shift much for me, but practising Aikido, which really moved my energy really did help, changing my mental state with it. I also received Shiatsu once a month, which undoubtedly helped; I often timed my Shiatsu to be during or just after my period, since I found it helped build up my energy levels and helped me be with what I was going through. I also learnt much about bringing attention to the hara, moving from the hara and I benefited from the use of a hara belt, which I found literally held my pelvis together and made me feel more cohesive.

I bought Maciocia’s  Gynecology book and felt heartened to see the long list of menstrual irregularities described. I had no idea there were so many aspects of what I experienced that where classified under different patterns of deficiency or excess in Chinese medicine. It was heartening to see the list, because I had no concept of what was ‘normal’ or ‘healthy’. It made me reflect on the differences in Western and Eastern views on what is healthy? For example, in Western medicine short scanty periods are not considered a problem. However in Chinese Medicine they would be concerned that less menstrual blood indicated either Blood stagnation, since perhaps the lining of the uterus was not sufficiently shed or Spleen deficiency if the lining on the uterus was too thin.

In my 30’s, I learned about the Extraordinary Vessels as well as the Heart-Uterus and Kidney-Uterus Vessels with Suzanne Yates. These, I would say, made the most impact energetically and physically on my menstrual cycle. It also helped me understand the process more deeply. It made sense that deeper meridians in the body and the direct connections to the Uterus,(Heart and Kidney) affected what is a deeply transformational process. I based my project for the Wellmother diploma on the menstrual cycle.

There weren’t many books on menstruation that I felt inspired by, but one I did was: ’The Wild Genie’ by Alexandra Pope. I attended a weekend workshop with her in London. I really enjoyed the way she facilitated women to share their experiences of their monthly cycles and noticed how empowering this was. After Alexandra’s workshop, I decided to set up a workshop myself for Shiatsu practitioners to explore their understanding of monthly cycling and its energetic meaning. Each time I have run the workshop, I have been struck by how powerful it is simply for women to share their stories and how much experiential Shiatsu knowledge can be gained in this way.

After I gave birth to my son in 2010, I realised how much birthing had parallels with menstruation. My uterus had practised those contractions I had experienced in the birth for many years during each period, though obviously less intense and less powerful. I also realised that my pelvis had practised loosening up in the sacrum for many years (that’s why wearing a hara belt had helped me during my periods), I had also developed  stamina for accepting and being with pain and most importantly I had developed a trust in my body.

Every monthly cycle is different, for me the challenge each month is: how can I honour this process, which takes me to a deep and vulnerable place in myself and still connect to and function in this world?

Small ways in which I manage to do this are: If I am working during my period, I acknowledge that I have less energy and simply do less. If I have a gap of time anytime in the day, I lie down or stretch. I notice that I am slower, I notice I have overrun, but I don’t expect or want to be any different, it is simply how things are at this time the month. When I give Shiatsu during my period I value my ability to be more intuitive in this time, I know my body is physically more open and I am emotionally more sensitive to the world around me.

Penetrating Vessel

Penetrating Vessel

Menstruation and the Chong Mai

From my perspective, Chinese medicine can add a substantial amount of understanding and helpful concepts in taking care of a woman’s monthly cycles.

During menstruation the lining of the womb is shed and post-menstruation the lining of the uterus grows back. How well these two processes take place, will determine how ready a woman’s womb is for implantation. Whether a woman wants to get pregnant or not, the Eastern view still looks at whether these processes are happening since they are an indication of a woman’s overall health. Interestingly, observations are made about the colour of the menstrual blood, if it is dark brown this would indicate Blood stagnation, pale pink would indicate Spleen kyo, bright red blood with few clots is considered healthy. The length of bleeding that is considered normal is 4-6 days.

The concept of the Chong Mai, the ‘Sea of Blood’ in Chinese Medicine, being important to a woman’s health, seems to make a lot of sense, in terms of the fact that girls/women menstruate monthly for many years  and then go through a process to of cessation of menses.  It is well known in Western medicine that there is a bigger volume of blood circulation during pregnancy and that supply of blood to a woman’s placenta is important at that time.

In Chinese Medicine they consider the Chong Mai, (as well as other Extraordinary Vessels) to circulate ‘Essence’, which is more akin to our genetic/inherited constitutional energy. So working on the Chong Mai during pregnancy makes a lot of sense from this point of view. It also makes sense to work on the Chong-Mai pre-pregnancy to create the best conditions for conception.

It took me some years of working with the Chong Mai with clients and on myself before I could really experience it as an energy and see the effects of working with it. I gave Shiatsu once to a woman who had recently haemorrhaged profusely and nearly died giving birth. I worked on the Chong Mai and she immediately felt the effects, she knew that what I was doing was what her body needed and asked for more.

The whole concept of prevention seems to be given much more weight in Eastern approaches. Preventing stagnation of Blood, by supporting a healthy monthly cycle, could be helpful for preventing fibroids, cysts on the ovaries and endometriosis.

Hormonal contraception

Many women use hormonal contraception now days, whether “The Pill”, hormonal Intrauterine System (IUS), patches or injections. “The Pill” works by suppressing ovulation and making the lining of the uterus thin and cervical mucous impenetrable. In the Western approach “The Pill” is also offered as a solution to severe teenage acne, painful, heavy or irregular periods, for PMS and endometriosis.

The conveniently short and light bleed women on “The Pill” experience for the seven days when they stop taking it, may itself cause what is considered Blood stagnation in Chinese Medicine. It’s interesting that the combined pilled (containing oestrogen and progesterone) is not recommended for women with a history of high blood pressure , heart disease, blood clots, diabetes, or liver or gall bladder .

Hormones don’t just orchestrate reproduction, they also help to regulate many of our body’s processes, like digestion, growth, temperature, blood composition; they can also alter our emotional state. So if a woman is on “The Pill” they may experience some changes to other bodily or emotional processes too, not just their fertility.

Jane Lyttleton in her book ‘Treatment of Infertility’ says that most teenagers with severe acne have in fact Polycystic Ovarian Syndrome and that taking the ‘Pill’ to treat this, simply masks this problem, which then only gets diagnosed much later in their lives when they have problems conceiving.

Ovulation and Conception

Some women are physically aware and can feel when they ovulate. Other women can monitor their ovulation through the vaginal mucus production, basal body temperature readings or urine tests.

Many women who wish to conceive, stop taking hormonal contraception for this purpose. At this point, the body has to re-adjust its hormonal balance and re-learn to ovulate, if it hasn’t been (with progesterone only pill, ovulation may still happen). The body also has to build up the lining of the uterus to be more receptive to implantation and develop a ‘normal’ menstruation and cycle again. This can take some time, since the right hormonal conditions need to be re-established.

Shiatsu can support a woman to find her natural monthly cycles again, by developing greater body awareness, helping her to connect more directly with her womb and its energetic connections. Working on a woman’s core energy with the extraordinary vessels can be very powerful to support the changes needed and to help her establish a deeper understanding of her body. Working with the Kidney energy can support hormonal balance, working with the Chong Mai can support correct movement of Blood.

It can be useful to work pre-menstruation to support a healthy shedding of the uterine lining and pre-ovulation to support the rebuilding of the uterine lining as well as the process of ovulation.

The Heart-Uterus Vessel

I often teach the Heart-Uterus connection to clients, and many women are amazed at how they can ‘feel’ their uterus and realise how calming the connection is to the heart.

In my experience, there are so many situations than can lead to a woman weakening or cutting off her Heart/Uterus connection, mainly out of a strategy for surviving the pain experienced after miscarriage, difficult birth, abortion or abuse. The great thing about the Heart-Uterus is that clients can learn to work on these connections with about 5 minutes of instruction at the end of a Shiatsu session. When a woman has experienced the Heart-Uterus connection in her body, she may also have insights into her past pain that help heal the connection further; this is so empowering and so effective.

Healing our monthly cycle

I have concluded that our relationship with a woman’s monthly cycle is something that is in great need of healing. It’s such a taboo and has so much negativity pilled on it, and yet without a healthy menstrual cycle women struggle with their health, their work, their relationships and with conception.

I find it amazing that girls are still ‘hiding’ and ‘ashamed’ of menstruating; that women in the work place who are menstruating are expected to take pain killers and keep working in the same way as usual, as if nothing was going on in their bodies, as if they had no discomfort or felt unwell in anyway. Advertising for tampons are still about how a woman could do rock climbing whilst having her period. If you think about it, this is just so inappropriate.

The general message to women is that periods should be ignored and hidden; there is no reason to rest or do anything differently. To my understanding, resting or slowing down during a period is no different to sleeping at night or slowing down activities during the winter season.

My question is: how can any process in the body be healthy if we do not acknowledge it in the first place??

I find it interesting that in 1947, Japan became the first country to introduce menstrual leave for women who “suffered heavily” with period pain or performed work deemed “injurious” to their health during menstruation. In Indonesia under the 1948 Labour act, women have a right to two days of menstrual leave a month.

I read recently, about a Bristol based company, Coexist, that primarily employs women; they decided to introduce menstrual flexibility policy for women; this may be a first in the UK!  Alexandra Pope, who is facilitating this initiative says “”It has nothing to do with women getting special concessions or working less,” Pope says: “It is about offering flexibility. So it might be that women can work from home, or come into work a little later. With more flexibility, we can deliver a lot better and be a whole lot healthier to boot”. “The benefits are that you are healthier, happier and in touch with your needs,” Pope adds. “Working with your natural rhythms means your creativity and intelligence is more fulfilled, which has to benefit your work and business.”


Obstetrics & Gynecology in Chinese Medicine by Giovanni Maciocia
Treatment of infertility with Chinese Mecedicine by Jane Lyttleton
The infertility cure by Randine Lewis
The Pill, are you sure it’s for you?  By  Jane Bennett & AlexandraPope
The Guardian, Saturday 5th March 2016 ‘Menstrual Leave’ Talk of the week


CPD Questions:

  1. What is your experience of monthly cycles? What is your understanding of what happens energetically?
  2. What meridians would you work on immediately after menstruation? What would be the quality of the session you would give?

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