A nutritional and holistic guide to menstrual health

The menstrual cycle is now established by many as the body’s sixth vital sign alongside temperature, blood pressure, pulse, respiratory rate, and pain.

Period blood itself is also being studied for its potential to detect conditions including endometriosis, fibroids, toxin exposure, and even certain cancers.

When your period is irregular, painful, or absent, it is a signal from the body that deserves attention.

This guide will help you begin to interpret what your period may be telling you.

What is a healthy period?

A healthy period is:

• regular (every 26–32 days)
• relatively symptom-free
• without large clots
• not significantly painful
• manageable in flow

What your period blood can tell you

Period blood itself contains valuable information about what is happening hormonally.

If you see clots

Small clots during menstruation are common and usually nothing to worry about. However, if you regularly see clots larger than a 10-pence coin, this can suggest that the uterine lining has built up more than usual during the cycle.

Oestrogen is the hormone responsible for thickening the uterine lining in the first half of the cycle. When oestrogen is relatively high compared with progesterone – which is often referred to as oestrogen dominance – the lining can become thicker than normal. When the period begins, the body must shed this excess tissue, and this can appear as larger clots in the menstrual blood.

Menstruation is also a way for the body to release and renew, both physically and emotionally. Some women report one or two larger clots following an intense detox or deep emotional reset. When this happens, it is usually a one-off event and does not repeat in subsequent cycles.

Colour

Healthy menstrual blood usually ranges from bright red to dark red, reflecting strong circulation, vitality, and a well-nourished uterine lining.

Blood naturally turns darker when exposed to air, so colour can vary depending on whether you use a menstrual cup or sanitary products.

Darker or brown blood usually appears at the beginning or end of a period, when flow is slower.

In ancient medical traditions, including TCM, darker blood at the start of the period may be explained as a sign of reduced warmth or circulation to the uterus. Part of the treatment would be keeping the abdomen warm (this in modern life translates as avoiding crop tops and ice baths), eating hot foods with warming spices, and maintaining regular movement to improve circulation.

Persistent colour changes alongside other symptoms may indicate a hormone imbalance or altered uterine lining turnover.

Period pain

While mild cramping on the first day is normal, pain that leaves you curled up with a hot water bottle, doubling up on pain relief, or feeling unable to function is just too extreme and not something you have to live with.

The starting point is almost always magnesium.

Magnesium acts as a muscle relaxant, reducing uterine cramping; it lowers prostaglandins, inflammatory compounds that drive the contractions responsible for period pain; and it also has broader anti-inflammatory properties that ease the overall severity of pain. Magnesium is also depleted by stress, which is why many women are running on chronically low reserves.

It will come as no surprise that magnesium is one of the supplements I prescribe most often in my practice. If I were ever stranded on a desert island with a single supplement, this would be the one I would choose.

A simple clue that magnesium may be low is craving chocolate before your period, as dark chocolate is one of the richest sources.

I always recommend a food-first approach for optimal nutrient levels.

Magnesium-rich foods

• Dark chocolate (or pure cacao)
• Pumpkin seeds
• Salmon and other oily fish
• Chicken and beef
• Leafy greens, particularly spinach and Swiss chard

If pain persists despite dietary changes, functional testing can identify precisely what is depleted and what else may be contributing. In practice, I often prescribe 300–500 mg magnesium daily to clients with significant cramping, and clients usually observe significant pain reduction within two to three cycles.

When pain needs investigating

Pain that is severe, persists beyond the first day or two, or appears at other points in your cycle should always be investigated. It may indicate endometriosis – where tissue similar to the uterine lining grows outside the uterus – or adenomyosis, where it grows into the uterine wall. Both are frequently underdiagnosed. Both respond well to nutritional and lifestyle support alongside medical treatment.

My favourite way to reduce inflammation and pain during period is to make a ginger and turmeric smoothie. To make, add a thumb-length piece of ginger and turmeric root to a blender with ½ glass of water, blend on high speed for a minute, and drink. You can also add lemon or orange juice to enhance flavour.

Heavy periods

This affects more than 50% of women and can significantly impact the quality of their lives. If your periods are heavy, you know it can be traumatic. I’ve worked with women who were doubling up on sanitary products and, even then, their periods were flooding, with embarrassing incidents in work meetings and interrupted sleep with frequent trips to the bathroom.

I don’t need to explain in measurements what it means to have heavy periods. Women know they are going through too many sanitary products during the day and that they worry about leakage when out and about.  

Heavy bleeding also leads to subsequent iron depletion and fatigue, so it should be investigated and supported with nutrition and supplementation to re-nourish the body.

If you are in your teens, your period may be heavier as your body is adjusting to menstrual cycle, and also because your need for nutrients is high while you are still growing.

There are many causes of heavy periods, including high unopposed oestrogen, thyroid dysfunction, fibroids, and nutrient deficiencies.

Heavy bleeding often develops when the uterine lining becomes thicker during the cycle and the body then has to shed a larger volume of tissue.

Unfortunately, we are surrounded by environmental oestrogens – endocrine-disrupting chemicals – which are present everywhere – in our food, water supplies, cleaning products, and even other women’s HRT and birth control pills.

A disrupted gut microbiome and overburdened liver mean that the body cannot remove these chemicals efficiently.

I explore nutrition and holistic approaches in greater detail here.

Irregular cycles

Irregular cycles affect at least one in five women. The causes vary considerably, and identifying the right one is essential.

PCOS – Polycystic Ovary Syndrome

PCOS is one of the most common causes of irregular periods and disrupted ovulation.

Nutritionally, one of the most important foundations is blood sugar regulation, particularly removing highly insulinogenic foods – not just refined carbohydrates like bread and pasta, but also whey protein and oats, which spike insulin and drive androgen production.

Short cycles

Cycles shorter than 25 days may indicate infrequent ovulation and elevated unopposed oestrogen. This is worth investigating via testing and symptom analysis.

Skipped periods

Amenorrhoea – the absence of periods – has several potential causes including stress, thyroid dysfunction, exhausting international travel, and most commonly, undereating.

Undereating is far more common than acknowledged, particularly in younger women. When caloric intake drops too low, the body shuts down reproductive function as a protective response to prevent further depletion and pregnancy.

Ovulation can usually be restored by eating consistently enough, and for many women a minimum of 2,000 calories per day is a realistic starting point.

Strict ketogenic diets can also suppress ovulation and cause periods to disappear entirely, even in women eating enough calories overall.

Research and clinical experience suggest a minimum of 90 to 200 grams of whole food carbohydrates daily – foods like sweet potato, apple, squash, blueberries rather than pastries and pasta – is needed to support regular ovulation.

I would also add, that beyond having calories and carbohydrates, it is also about anything that your may perceive as a threat, and this may include lifestyle stress. Healthy periods can happen when you feel safe – nutritionally and emotionally. 

Ovulating and having real periods matters beyond fertility. The broader consequences of chronic anovulation include significant bone loss during the years when peak bone mass should be accumulating, impaired cardiovascular health as the protective effects of oestrogen and progesterone are lost, mood and cognitive effects as progesterone’s neurosteroid activity disappears, and disrupted metabolic function affecting insulin sensitivity, body composition and thyroid health.

If you have never had a period, all of the above should be investigated, including genetic causes such as Turner syndrome.

Tracking and testing

Tracking the cycle daily over at least three months is one of the most useful ways to understand your hormonal health.

In my practice, I often use the DUTCH Cycle Mapping test, which measures hormones across the full month to confirm ovulation and identify imbalances in hormones, including cortisol, their metabolism, and genetics that standard blood tests miss entirely.

Early periods and external oestrogen exposure

A first period at eleven or younger may indicate elevated oestrogen. This is increasingly common as girls are exposed to environmental xenoestrogens, which mimic their natural hormones. These are found in plastics, food packaging, and even cosmetics.

Even if this occurred decades ago, identifying and limiting exposure to endocrine-disrupting chemicals, while helping the body remove their build-up, is essential and can make a significant difference to your long-term hormonal and systemic health.

I also have concerns about transdermal HRT gels transferring to others, particularly to young girls. It is well documented that hormone contamination through skin contact within 60 minutes of application can occur. This may add to the overall burden of hormone-like substances already present in our environment.

Nutrition and gut health for healthy periods

What you eat is foundational, but digestion matters as much as diet. Without sufficient stomach acid and digestive enzymes, even a good diet may not be delivering what the body needs.

If you have digestive symptoms, or if food sits in your stomach for hours after meals, nutrient absorption may be compromised.

The gut-hormone connection is closer than most women realise. Up to 40% of women with IBS report worsening symptoms during their period – bloating, cramping, and bowel changes that track hormonal fluctuations. Oestrogen and progesterone both affect gut motility and sensitivity. If your gut is already compromised, your period will show it.

Strict plant-based vegan diets are an area of concern

Over the years in my practice, I have seen significant deficiencies in women eating no animal products – not only vitamin B12, but also carnosine, taurine, haem iron, and multiple key minerals. These deficiencies show up directly in hormonal and menstrual health, often leading to period problems and sometimes to an early loss of periods and earlier onset of menopause.

A diet that supports healthy periods includes:

• quality animal protein
• anti-inflammatory fats from olive oil and oily fish such as salmon, mackerel, and sardines
• fibre and phytoestrogens from cruciferous vegetables, sprouts, and berries

Working with your cycle

Women have different nutritional and emotional needs at different points in the cycle.

The first one to two days of your period are a time when the body genuinely benefits from rest and nourishment. If that is not fully possible, avoid overscheduling and create some recovery time during your period.

In many traditional cultures, menstruation was a time of heightened intuition and reflection. Women were often consulted on important decisions during or after their period, when clarity and intuition were considered strongest.

This traditional wisdom is worth recovering: the body has its own rhythms and wisdom, and working with them supports both menstrual and overall health.

Can the pill help regulate periods?

What the pill produces is a withdrawal bleed, not a period. A real period requires ovulation, which requires the body to make its own hormones. The pill suppresses this whole process.

The appeal is understandable if your periods are painful or irregular. But whatever is driving those symptoms – nutrient deficiencies, hormonal imbalance, toxin exposure, gut dysfunction, or conditions such as PCOS or endometriosis – is getting masked instead of  being addressed. 

All of the underlying causes continue simmering quietly in the background and often resurface, sometimes more pronounced, when the pill is eventually stopped.

True cycle regulation comes from understanding why the cycle is disrupted and addressing the root causes holistically.

References

De Léséleuc, L. et al. (2025) ‘Avoiding touching until 60 min – contamination of transdermal estradiol gel after physical contact’, Menopause, [online]. Available at: https://pubmed.ncbi.nlm.nih.gov/40556830/ (Accessed: 12 March 2026).

Dehnavi, Z.M., Jafarnejad, F. and Kamali, Z. (2018) ‘The effectiveness of magnesium on menstrual symptoms among dysmenorrheal college students: a randomised controlled trial’, International Journal of Women’s Health and Reproduction Sciences, 6(4), pp. 428–433. Available at: https://www.ijwhr.net/pdf/pdf_IJWHR_624.pdf (Accessed: 12 March 2026).

Zaheer, A. et al. (2024) ‘Potential for and challenges of menstrual blood as a non-invasive diagnostic specimen: current status and future directions’, Annals of Medicine and Surgery, 86, pp. 4591–4600. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11305704/ (Accessed: 12 March 2026)