The 4 Phases of Your Menstrual Cycle: A Clinical Herbalist's Guide to Supporting Each Stage

December 15, 2025

If you've read my previous post on what a healthy menstrual cycle looks like , you'll remember how I compared the four phases to the seasons - each with its own rhythm, energy, and needs. Today, I want to dive deeper into how we can support each phase with herbs.

But first, let me be clear about something important: herbalism is fundamentally holistic. When I mention specific herbs for certain symptoms below, I'm offering examples, not prescriptions. Your body is infinitely more complex than a simple problem-solution equation. You might need support across multiple phases, multiple systems, and multiple tissue states all at once. And here's the beautiful part, herbs are complex too. A single plant can address inflammation, support hormone metabolism, nourish your nervous system, and improve circulation simultaneously. This is why working with a herbalist who sees your whole picture matters so much.

With that foundation laid, let's explore each phase.

Phase 1: Menstruation (Winter)

This is your body's pause button: a time of shedding, rest, and turning inward. In a healthy cycle, menstruation should be relatively comfortable, with minimal cramping, moderate flow, and no severe mood disruptions.

Common challenges during menstruation:

Painful cramping (dysmenorrhea)
Heavy bleeding that soaks through protection quickly
Severe fatigue or brain fog
Mood changes including irritability or sadness

When cramps are present, we're often seeing inflammation, tissue tension, or poor circulation to the pelvic region. Research has shown that dysmenorrhea involves elevated prostaglandin levels and increased uterine contractility, which is exactly where herbs like cramp bark (Viburnum opulus) shine, as it's both an antispasmodic and helps modulate inflammatory pathways.

For heavy bleeding, yarrow (Achillea millefolium) has been used traditionally as a hemostatic, helping to moderate excessive flow while supporting tissue tone. Meanwhile, nettle leaf (Urtica dioica) provides rich mineral support, which is particularly important when you're losing blood monthly.

Phase 2: Follicular Phase (Spring)

After your period ends, oestrogen begins its climb. This is your growth phase: energy returns, creativity sparks, and you might feel more social and outgoing. Your body is literally preparing to ovulate.

Common challenges in the follicular phase:

Slow energy recovery post-bleed
Hormonal acne beginning to appear
Digestive sluggishness
Extended bleeding or spotting

This phase is all about building. If you're feeling depleted, nettle appears again here (see what I mean about herbs doing multiple things?), along with nutritive herbs like oats (Avena sativa), which support the nervous system while providing minerals for rebuilding.

For many people, supporting liver function during this phase helps with hormone metabolism. Dandelion root (Taraxacum officinale) gently supports liver and digestive function. This is important because your gut health directly impacts hormone clearance. Research indicates that dandelion has hepatoprotective properties and supports healthy bile flow.

If acne is creeping in, it's often a sign that hormone metabolism needs support, or that inflammation is present. This is where a combination of liver herbs, anti-inflammatory herbs like turmeric (Curcuma longa), and hormone-balancing plants might be considered, but remember, the specific combination depends entirely on your unique constitution, tissue and nervous system states, and overall presentation.

Phase 3: Ovulation (Summer)

This is your peak, the height of summer. Oestrogen reaches its apex, then testosterone surges. You might feel confident, energised, even magnetic. Ovulation itself should happen smoothly, though you might notice some mid-cycle spotting or a slight energy dip.

Common challenges around ovulation:

Ovarian pain or mittelschmerz (twinge in the lower abdomen attributed to egg release)
Breast tenderness
Bloating or water retention
Energy crash instead of peak

When ovulation is painful, we're often seeing inflammation or adhesions. Red raspberry leaf (Rubus idaeus) is beautifully suited here, it's a uterine tonic that supports healthy tissue tone throughout the reproductive system. It is traditionally used to help tone uterine muscles (particularly in the lead-up to childbirth) and for menstrual discomfort.

For bloating and water retention, dandelion leaf (not the root this time) acts as a gentle diuretic while providing potassium, unlike pharmaceutical diuretics that deplete it. This helps with fluid balance without throwing your electrolytes into chaos.

Phase 4: Luteal Phase (Autumn)

Progesterone takes centre stage now. This is when many people experience PMS: mood changes, breast tenderness, food cravings, and fatigue. In a healthy cycle, these symptoms should be minimal.

Common challenges in the luteal phase:

Significant mood swings, anxiety, or irritability
Breast pain and swelling
Intense sugar or salt cravings
Insomnia or disrupted sleep
Headaches or migraines

The luteal phase is where I see the most complex presentations in my practice. When progesterone is low or when oestrogen isn't being cleared efficiently, symptoms can be intense. Vitex (Vitex agnus-castus) is well-known for supporting healthy progesterone levels, and research has demonstrated its effectiveness for PMS symptoms, though it's not appropriate for everyone and works best with carefully-timed consistent use over several cycles.

For mood support, oats (Avena sativa) nourish a depleted nervous system, while passionflower (Passiflora incarnata) can help with anxiety and sleep disruption. For breast tenderness, red clover (Trifolium pratense) has been used traditionally.

The Bigger Picture

Supporting your menstrual cycle with herbs isn't about throwing individual plants at individual symptoms. It's about understanding your unique patterns, your tissue states, your nervous system patterns, your history and complete health picture and then crafting an approach that addresses the underlying systems creating your current presentation.

Maybe you need liver support across all phases because hormone clearance is your root issue. Maybe your nervous system is depleted and needs nourishment before we even think about hormone-specific herbs. Maybe inflammation is your primary pattern, showing up differently in each phase.

This is the art and science of clinical herbalism, seeing the forest and the trees, understanding both the individual herbs and the complex human being taking them.

If you're struggling with menstrual symptoms, consider working with a qualified herbalist who can see your whole picture and create a personalised protocol that actually addresses your needs.