Know Your Flow: Blood Color, Consistency, and Clots

Essential Takeaways 
  • The color, consistency, and clotting of menstrual blood can tell us a lot about the underlying imbalances in our body that lead to menstrual symptoms. 
     
  • Ideally, menstrual blood is ruby red, somewhere between a thin and thick consistency, with minimal clotting.
     
  • Elix’s online health assessment will determine your unique root patterns of imbalance so that your personalized Cycle Balance tincture will improve your flow by supporting your body at the foundation.

Aunty Flow just came to town in all her full glory… yay. No really, yay! 

Our periods can serve as a fifth vital sign, acting as a monthly report card, shining a light on the underlying imbalances that contribute to both our menstrual and overall symptoms. We can learn so much about our body just by looking at the color, consistency, and clotting of our period blood. 

What is menstrual blood? 

Each month our uterine lining thickens to prepare for the potential implantation of an egg and subsequent pregnancy. If implantation does not occur then this thickened lining will dissolve and be released via our menstrual blood. Essentially our period is our body’s way of shedding our uterine lining; our menstrual blood is a combination of blood and uterine tissue. The average amount one bleeds during a cycle is about 2-3 tablespoons over 3-7 days (1). 

What does healthy menstrual blood look like? 

From a Traditional Chinese Medicine (TCM) point of view healthy menstrual blood is ruby red, somewhere between a thin and thick consistency, with minimal clotting. This means that there is ample Qi (our vital energetic life force) to produce and keep our Blood moving smoothly. When it deviates from this it just means there are imbalances in our body that are affecting its proper functioning, leading to differing color, consistency, and clotting. Menstrual blood can be another signal that something needs attention in the body, it's another clue about the root cause of our symptoms. 

Why is my period blood brown? 

One of the unique traits of TCM is pattern diagnosis, the why behind your symptoms. These are the patterns of imbalance that affect the fundamental functioning of your body, the root causes behind your symptoms. Each sign and symptom is a signal pointing to different patterns of imbalance. Elix’s online health assessment works to determine your dominant patterns of imbalance that are leading to your symptoms. Based on your pattern diagnosis herbs are chosen for your personalized Cycle Balance tincture to synergistically support these imbalances, so your body functions better foundationally so symptoms don’t appear. 

Next we’ll explore how to spot common patterns of imbalance affecting our menstrual cycle by looking at the color, consistency, and clotting of our period blood. 

Color

Pale (think watermelon pink): This indicates Qi and/or Blood deficiency. Qi is considered our invisible vital energetic life force, it’s the energy that keeps us alive and moving. TCM sees Blood as nourishing, moistening, and cooling, and it also houses our shen (the mental-emotional-spiritual aspect of ourselves).  Qi is not only a building block of Blood, but it keeps our Blood flowing freely, which we need for a symptom free cycle. So adequate Qi and Blood is needed for a healthy menstrual cycle. Deficient Qi or Blood can lead to symptoms like pale blood, heavy bleeding, fatigue, dizziness, shortness of breath, and dull achy cramps. 

Deficient Qi or Blood indicates a weakness in the Spleen organ system, which correlates to the western idea of our digestion. Our Spleen organ system is integral in the production of Qi and Blood. We need strong digestion, Spleen Qi, to produce quality Qi and Blood. Concentrating on strengthening the Spleen organ system is imperative when menstrual blood is pale. 

If you suffer from Qi or Blood deficiency your personalized Cycle Balance formulation may include:

  • Bai Zu (Atractylodes): This is a widely used Qi building herb, it strengthens the function of the Spleen organ system. From a western point of view it has been proven to boost immune function, relieve stress, and regulate blood sugar (2).    
  • Fu Ling (Poria): Fu Ling is often paired with Bai Zhu, as these two herbs reinforce the Spleen strengthening, Qi building qualities of each herb. Research has shown it has anti-diabetic, ant-aging, and anti-inflammatory properties (3). 
  • Dang Gui (Angelica): Dang Gui is one of the most widely used Blood tonifying herbs in TCM. It has been shown to have anti-inflammatory, antioxidant, heart protective, neuroprotective, and antispasmodic properties (4). 
  • Bai Shao (White Peony): Bai Shao is often paired with Dan Gui to promote the Blood tonifying qualities of each. Research shows it reduces pain, stimulates the immune system, and prevents damage to the liver. Its anti-inflammatory and antibacterial properties also aid in blood flow (5). 


Dark red or brown
: This indicates Qi stagnation, our energy becomes stuck causing a physiological traffic jam in our body. Since we need the smooth flow of Qi to move our Blood, when our Qi becomes stuck our blood flow is impacted. Blood does not flow as freely and it sits in our body longer than it should, leading to a darker menstrual flow. 

In TCM the Liver organ system is the general in charge of movement, it keeps our Qi and Blood flowing smoothly in our body, which we need for healthy menstrual blood. Other symptoms of Liver Qi stagnation can include breast tenderness, irritability, painful periods, irregular periods, depression, bloating, headaches, fatigue, poor digestion, difficulty sleeping, cold hands and feet (poor circulation), and tense shoulders. If you deal with Qi stagnation your personalized Cycle Balance formulation might contain the following herbs, which help keep Liver Qi flowing. 

  • Xiang Fu (Cyperus): Known as the “holy medicine” for menstrual issues it is shown to have antidepressant, hypoglycemic, antioxidant, anti-inflammatory, antipyretic, and analgesic effects (6). From a TCM point of view it helps relieve Qi stagnation as well as alleviate pain. 
  • Chai Hu (Bupleurum): Chai Hu has antibacterial, anti-inflammatory, antioxidant properties and has been shown to reduce stress (7,8). From a TCM point of view it relieves Liver constraint (i.e. gets Qi flowing again). 


Purple
: If Qi stagnation is left to its own devices for long enough Blood stasis can develop. This is a progression of Qi stagnation, because if our Qi isn’t flowing neither will our Blood. If our Blood isn’t moving it can become stuck in our body, unable to flow out during our menstrual cycle leading to pain. The hallmark symptoms of Blood stasis are sharp stabbing cramps, clots, and purple blood. 

If you are experiencing Blood stasis then your formula may contain some of the following Blood moving herbs, many of which are known to help relieve pain. 

  • Yan Hu Suo (Corydalis) - From a western point of view, Yan Hu Suo has analgesic properties and improves blood flow by increasing the diameter of blood vessels (9). According to TCM, Corydalis invigorates blood, promotes the movement of Qi, and alleviates pain of all kinds. 
  • Yi Mu Cao (Motherwort)- In western medicine Motherwort is a uterine stimulant that reduces blood clotting and allows blood to move more freely throughout the body (10). In TCM it invigorates the blood and dispels stasis. It also promotes urination, reduces toxic swelling, and regulates heavy or irregular menstruation. 

    Consistency

    Thin: Think of this as very watery Blood. This can indicate a deficiency of the Spleen organ system, there isn’t enough Qi to produce quality Blood, resulting in thin watery Blood. This would be supported in the same way as someone with pale blood, with herbs that support the Spleen organ system and help tonify the blood, like Bai Zu (Atractylodes), Fu Ling (Poria), Dang Gui (Angelica), and Bai Shao (White Peony).     

    Thick: This can indicate excess heat in the body. Heat correlates to the western concept of inflammation. From a TCM perspective when we have excess heat in the body it can “cook” the Blood, making it congeal and thus thick. If you have thick menstrual blood your formula may contain herbs that clear heat, such as:

    • Bo He (Mint) - Mint is antibacterial and antiviral, reduces blood pressure, and induces healthy bile flow (11,12). In TCM Mint releases the exterior and disperses heat, thereby clearing the head, brightening the eyes, and benefiting the throat. It also vents rashes and disperses stagnant Qi.  
    • Zhi Zi (Gardenia Pod)- From a western point of view Gardenia Pod has strong antioxidant and anti-inflammatory properties (13). TCM uses this herb to balance heat and resolve dampness. 

    Clots 

    Clots are indicative of Blood stasis, the blood flow is impaired, leading to Blood pooling together in clumps leading to menstrual blood clots. Herbs that move the Blood like Yan Hu Suo (Corydalis) and Yi Mu Cao (Motherwort) could be used in your formulation to help break up the clots and keep the Blood flowing smoothly (just like with purple blood above). 

    Heavy Flow 

    Common patterns of imbalance that lead to a heavy flow include Qi deficiency or Heat. 

    Qi not only moves the Blood, but it contains the Blood within the vessels. When Qi is weak it doesn’t have enough strength to keep the Blood in the vessels, leading to heavy bleeding because the Qi cannot hold the Blood. Blood would most likely be lighter in color in this case. Herbs known to boost our Spleen Qi will be prioritized. 

    If the Blood is a bright red color the heavy bleeding could be the result of heat in the body. Heat is akin to inflammation from a TCM perspective. When there is heat in the body it can quicken the speed of blood flow causing a gushing heavy bright red menstrual flow. Herbs that clear heat will be prioritized. 

    Tracking Your Cycle

    Tune-in to your blood flow by tracking the color, consistency, quantity, and clots each month. This will give you valuable information about how your progress is trending and what might need more attention. Your blood flow is a great guide to what underlying imbalances are present and require more support. 

    What Else Can I Do?

    Our lifestyle plays a large role in not only our overall health but our menstrual health. Cycle Balance works more efficiently with a balanced lifestyle. Below are some general lifestyle tips, based on the patterns of imbalance discussed above, that you can incorporate into your daily routine that will help your body heal at the root. 

    Tips to boost our Spleen Qi (aka our digestion):

    • Focus on including more well cooked, easy to digest, warming foods 
    • Try to reduce the amount of added sugars and industrial seed oils in your diet  
    • Go for an easy after meal walk, which can help stimulate our Spleen organ system
    • Focus on chewing your food more, digestion starts in the mouth  
    • If your digestion needs a little more support, eat more well cooked simple meals with few ingredients
      • Example: Chicken, greens, and sweet potatoes with one or two spices 
    • Include more centering activities that help us digest our emotions, like meditation, Qi Gong, Tai Chi, or deep breathing (even 30 second breath breaks are helpful!) 
    • Try to reduce the consumption of cold foods and beverages, which take more effort to digest, diverting energy towards digestion instead of other activities 

    Tips to keep our Liver Qi (as well as our Blood) flowing smoothly:

    • Increase intake of fiber, dark leafy greens, and cruciferous vegetables 
    • Express your emotions as pent up emotions can further stagnate the Liver Qi
    • Get daily movement, exercise helps keeps our Liver Qi flowing 
    • Find ways to respond to stress like meditation, breathing, journaling, talking to loved ones, movement, whatever helps you metabolize stress productively as stress can make acne worse 
    • Start your morning with a glass of room temperature lemon water 
    • Wear loose clothing, tight clothes can restrict Qi flow 

    Tips to help balance heat:

    • If your digestion can handle it, increase the amount of cooling foods to help combat heat
      • Cucumber, celery, and watermelon are a few options 
    • Reduce the consumption of alcohol, caffeine, and fried and spicy foods as these can increase the amount of heat in our body
    • Stay well hydrated 
      • Coconut water (without any added sugar) is like nature’s Gatorade
      • Mint or green tea are also great cooling beverages  

    Regain that healthy flow 

    Cycle Balance is a great way to support your flow because it works at the root to help support the underlying patterns of imbalance that are contributing to your menstrual symptoms. It doesn’t simply mask symptoms, but gets to the why behind your symptoms. Take the online health assessment to start your journey to feeling your best all month long! 


    Sources 
    1. https://my.clevelandclinic.org/health/articles/10132-menstrual-cycle 
    2. Yang L, Yu H, Hou A, et al. A Review of the Ethnopharmacology, Phytochemistry, Pharmacology, Application, Quality Control, Processing, Toxicology, and Pharmacokinetics of the Dried Rhizome of Atractylodes macrocephala. Front Pharmacol. 2021;12:727154. Published 2021 Nov 3. doi:10.3389/fphar.2021.727154
    3. Li X, He Y, Zeng P, et al. Molecular basis for Poria cocos mushroom polysaccharide used as an antitumour drug in China. J Cell Mol Med. 2019;23(1):4-20. doi:10.1111/jcmm.13564
    4. Wei WL, Zeng R, Gu CM, Qu Y, Huang LF. Angelica sinensis in China-A review of botanical profile, ethnopharmacology, phytochemistry and chemical analysis. J Ethnopharmacol. 2016;190:116-141. doi:10.1016/j.jep.2016.05.023
    5. Jiang H, Li J, Wang L, et al. Total glucosides of paeony: A review of its phytochemistry, role in autoimmune diseases, and mechanisms of action. J Ethnopharmacol. 2020;258:112913. doi:10.1016/j.jep.2020.112913
    6. Wang F, Zhang S, Zhang J, Yuan F. Systematic review of ethnomedicine, phytochemistry, and pharmacology of Cyperi Rhizoma. Front Pharmacol. 2022;13:965902. Published 2022 Oct 7. doi:10.3389/fphar.2022.965902
    7. Yang F, Dong X, Yin X, Wang W, You L, Ni J. Radix Bupleuri: A Review of Traditional Uses, Botany, Phytochemistry, Pharmacology, and Toxicology. Biomed Res Int. 2017;2017:7597596. doi:10.1155/2017/7597596
    8. Li HY, Zhao YH, Zeng MJ, et al. Saikosaponin D relieves unpredictable chronic mild stress induced depressive-like behavior in rats: involvement of HPA axis and hippocampal neurogenesis. Psychopharmacology (Berl). 2017;234(22):3385-3394. doi:10.1007/s00213-017-4720-8
    9. Alhassen L, Dabbous T, Ha A, Dang LHL, Civelli O. The Analgesic Properties of Corydalis yanhusuo. Molecules. 2021;26(24):7498. Published 2021 Dec 10. doi:10.3390/molecules26247498
    10. Shang X, Pan H, Wang X, He H, Li M. Leonurus japonicus Houtt.: ethnopharmacology, phytochemistry and pharmacology of an important traditional Chinese medicine. J Ethnopharmacol. 2014;152(1):14-32. doi:10.1016/j.jep.2013.12.052
    11. Parham S, Kharazi AZ, Bakhsheshi-Rad HR, et al. Antioxidant, Antimicrobial and Antiviral Properties of Herbal Materials. Antioxidants (Basel). 2020;9(12):1309. Published 2020 Dec 21. doi:10.3390/antiox9121309
    12. Tafrihi M, Imran M, Tufail T, et al. The Wonderful Activities of the Genus Mentha: Not Only Antioxidant Properties. Molecules. 2021;26(4):1118. Published 2021 Feb 20. doi:10.3390/molecules26041118
    13.  Xiao W, Li S, Wang S, Ho CT. Chemistry and bioactivity of Gardenia jasminoides. J Food Drug Anal. 2017;25(1):43-61. doi:10.1016/j.jfda.2016.11.005
    This article was reviewed by Dr. Liem Le.
    Dr. Liem Le is a Doctor of Chinese Medicine, Functional Medicine Practitioner, and Nutritionist Integrative Medicine Department at H. Lee Moffitt Cancer Center. He is a part of the teaching staff for the Masters program for the Functional Medicine and Human Nutrition program at University of Western States. Dr. Le is currently working on his fellowship in Integrative Medicine with the Academy of Integrative Health and Medicine via a scholarship from the White House to complete the initiative.

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