What’s Going On With My Period?
A Holistic Lens on Irregular or Painful Cycles in Your 30s
By Candise Yang, L.Ac., NCCAOM | Serving Oakland, Berkeley, Rockridge, and the East Bay
Your cycle used to be like clockwork - now it’s unpredictable. Or maybe your cycles have always come with some challenges - but the symptoms have been harder to ignore lately.
You’re in your 30s. Menopause is still far off. You eat well, try to manage stress, and maybe you’ve even had labs done - only to be told everything looks fine.
From the perspective of optimal medicine, that response is incomplete.
As a practitioner trained in the diagnostic systems of both Chinese medicine and functional medicine, I see your menstrual cycle as both a barometer of how your body is doing and one of the clearest indicators of internal balance. When your cycle becomes irregular or painful, it's not just a nuisance - it’s your body signaling that something deeper may be shifting - hormonally, metabolically, emotionally, or even physically, such as with fibroids or inflammation in the pelvic tissues.
What Can Disrupt Your Cycle in Your 30s?
These are some of the most common patterns I see in clinic:
1. Stress, Overwhelm, and Dysregulated Cortisol
Chronic stress doesn’t just live in your mind - it reshapes your hormonal landscape. Cortisol, your primary stress hormone, directly impacts ovulation, estrogen/progesterone ratios, and inflammatory tone.
You may notice:
Irregular cycle lengths
Shortened luteal phases (less than 10 days)
Worsened PMS, anxiety, or insomnia
Spotting or skipped periods
From a traditional lens, this often presents as Liver qi stagnation with underlying yin depletion - a state where the body is both tense and undernourished. Functionally, I often see low progesterone, elevated cortisol, or early signs of HPA axis dysregulation.
2. Anovulation and Low Progesterone
Even if you're bleeding monthly, you may not be ovulating consistently. This is more common than many providers realize - and it has consequences.
Signs of low progesterone include:
Cycles under 26 days
Mid-cycle spotting
Poor sleep, especially around ovulation or premenstrually
Increased anxiety or mood instability
This often reflects a pattern of blood deficiency, spleen qi depletion, or a lack of sufficient luteal-phase hormone production. I frequently use cycle phase–specific custom herbal formulas to restore ovulation, nourish blood, and regulate progesterone naturally.
3. Pelvic Congestion - Endometriosis, Fibroids, or Inflammatory Patterns
Painful, heavy, or clotty periods may be written off as “normal,” but they often reflect deeper inflammatory or structural issues. In some cases, the root may be endometriosis, fibroids, or long-standing blood stagnation and poor circulation in the lower abdomen.
What I look for:
Severe cramping that worsens with stress or diet
Bleeding with clots or dark red tissue
Painful bowel movements or intercourse
Fatigue and digestive issues around the cycle
A combined strategy of acupuncture, custom herbal formulas, and anti-inflammatory nutrition can reduce pain, improve flow, and shift chronic patterns of pelvic tension.
4. Blood Sugar Imbalance and Subclinical PCOS
Some women in their 30s begin to experience insulin resistance even if they don’t fit a textbook PCOS diagnosis. Irregular cycles, cravings, and fatigue are often early signs.
Signs include:
Cycles longer than 35 days
Acne, especially on the jaw or chin
Weight gain or stubborn belly fat
Hair loss or facial hair growth
In TCM terms, this reflects phlegm-damp accumulation and sometimes kidney deficiency. Functionally, I may see elevated fasting insulin, low SHBG, or delayed ovulation on charting. Acupuncture/acupressure, dietary shifts, and cycle-specific custom herbal formulas can all help.
Labs to Consider
If your cycles are painful, irregular, or changing, I often recommend the following baseline tests:
Thyroid panel (TSH, Free T3, Free T4, TPO antibodies)
Sex hormones (Estradiol, Progesterone, LH, FSH - timed to your cycle)
Vitamin D and ferritin
Fasting insulin or glucose, Hemoglobin A1C
CRP or hs-CRP (inflammation)
DUTCH test (in select cases for hormone and cortisol mapping)
If you've already had lab work done, I’ll review it with you in detail. If not, I help my patients access the labs they need - most can be ordered through their insurance, and anything remaining I can requisition directly at a discounted out-of-pocket rate.
How We Treat - Naturally and Strategically
Every treatment plan is tailored based on your constitution, symptoms, and lab data - from traditional diagnostic readings to modern lab work findings.
We may incorporate:
Acupuncture/acupressure to regulate flow, support hormone balance, and calm the nervous system
Custom herbal formulas, often tailored to your specific phase of the cycle, to reduce pain, improve ovulation, and support overall reproductive health
Nutrient repletion and supplements targeted to hormonal metabolism, blood sugar control, or inflammation
Lifestyle and nutrition strategies that match your current cycle phase and health goals
You Deserve More Than "Just Take the Pill"
If you’ve been told your options are hormonal birth control, an IUD, or simply to wait it out - know that you have more tools available.
Custom, holistic care can restore balance at the root. And when we integrate data with lived experience - from traditional diagnostic readings to modern lab work findings - we begin to see the whole picture.
Next Steps
Your cycle is a vital sign.
If you're noticing changes in timing, flow, pain, or mood, don’t ignore them. There are safe, effective ways to support your body naturally. Let's work together to understand what it needs to return to balance.