Your Monthly Report Card: A TCM Guide to Building Blood 🩸

"At two times seven, the Tian Gui arrives... and the menses come on time."
Huang Di Nei Jing, Su Wen Chapter 1

Your period is your monthly report card. Every cycle, your body tells you how well it is making, storing and moving Blood.

The ancient Chinese doctors understood this thousands of years ago. They saw a regular, comfortable cycle as a sign that a woman was well nourished and in balance. Painful, scanty, late or exhausting periods were not something to just live with. They were messages.

In modern America, most girls and women were taught the opposite. Ignore it, numb it, push through it. So let's slow down together and learn how to read the report card, and build Blood in a way that fits real life.

What is Blood in TCM?

In Chinese medicine, Blood (Xue) is more than the red stuff in your veins. It nourishes your skin, hair, eyes, muscles and tendons. It also anchors the mind, helping you feel calm, settled and able to sleep.

Three organs work as a team:

• The Spleen makes Blood. It turns the food you eat into Qi and Blood. No healthy Spleen, no healthy Blood.
• The Liver stores Blood. It controls the smooth process of building the uterine lining each month.
• The Heart governs Blood. It moves Blood through the body and houses the Shen, our spirit.

For women, Blood is especially precious. We lose it every month, we grow babies with it, and we make breast milk from it. That is why women's health in TCM so often comes back to one question: is there enough Blood, and is it flowing smoothly?

Why so many women today are running low

I see Blood deficiency all around me, every day. It's not because women are doing something wrong. It is because modern life is set up in a way that drains Blood faster than we can make it.

• Skipped and rushed meals. Coffee for breakfast, lunch at the desk, dinner at 9 pm. The Spleen can't make Blood from food it never receives.
• Cold, raw and processed food. Iced drinks, smoothies, salads, processed and fast foods weaken the Spleen's "digestive fire."
• Chronic stress. Worry and overthinking injure the Spleen. Frustration and repressed anger congest the Liver.
• Not enough sleep. The Nei Jing teaches that when we lie down, Blood returns to the Liver. Late nights and screens cut that time short. (Bedtime needs to be at 9 or 10 pm for optimal rest, a later night with a longer morning sleep in does not work as well.)
• Pregnancy, birth and breastfeeding. Each one asks for a lot of Blood, and many mothers never fully rebuild. The optimal child spacing in TCM is 3.5-4 years, and fully weaning the first child before becoming pregnant.
• No village. In many cultures, women are fed and cared for during their period and after birth. Here, most of us go right back to paid labor, parenting, car pool and driving, and endless housework. 6 weeks to 4 months is not enough. Two years per child would be ideal.

Signs your Blood may be low

You don't need all of these. Even three or four can point you in the right direction.

On your report card (your period):

• Light, short or pale flow. Spotting at ovulation or flow that is slow to start with spotting for a day (or more) before flowing
• Cycles that run longer than 28-30 days
• Painful or dull cramps toward the end of your period
• Feeling wiped out, weepy or dizzy after your period

In daily life:

• Pale face, lips or nail beds
• Dry skin, dry eyes, brittle nails or thinning hair. Hair that won't grow past your shoulders.
• Feeling dizzy when you stand up quickly
• Trouble falling asleep, or light sleep
• Anxiety, feeling easily startled, or a racing heart
• Numbness or tingling in your hands and feet
• Muscle cramps or twitches, especially at night

Step one: take care of your Spleen

Here is the foundational piece of Blood-building that is often missed. You can eat all the iron-rich food in the world, but if your Spleen is weak, you won't turn it into Blood. So we always start with digestion.

Remember the basic rules of the Spleen Healing diet:

1. Warm and cooked. Soups, stews, congee, roasted vegetables and warm drinks are easy for the Spleen to transform.
2. Eat enough, but not too much, at regular times. The Spleen loves rhythm. Small, steady meals beat one giant dinner. Breakfast, second breakfast, lunch, afternoon snack, dinner.
3. Avoid dampness-forming and "toxic" foods. Go easy on sugar, dairy, fried food, alcohol and ultra-processed snacks.
4. Eat in peace. Sit down. Put the phone or book away. Chew. Even five calm minutes makes a difference.

If you have no appetite in the morning, that is a classic sign of Spleen Qi deficiency. Eat a small, warm breakfast anyway. Within a few days, your morning hunger usually comes back.

Step two: Eat to build Blood

Once your Spleen is supported, these foods give it great material to work with.

A word on liver. In TCM, we say "like nourishes like." Liver is one of the most Blood-building foods there is, rich in iron, B12, folate and vitamin A. A little goes a long way. If you can't stand the taste (most of us can't!), dehydrated liver capsules like our Beef Liver Pills are an easy way to get it in.

If you are pregnant or trying to conceive, liver is very high in vitamin A, so keep amounts moderate (6 capsules daily, the equivalent to about 3.5 ounces per week) and check with your provider about how much is right for you. And please don't start high-dose iron pills on your own. Ask your doctor to check your iron levels first.

A Blood-building day

The rhythm of the Spleen is about five small meals a day. Here is one real-life example. There is lots of wiggle room, so tailor it to your schedule and your family.

Busy mama tip: Make one big pot of broth and one big pot of stew on Sunday. Freeze in jar-sized portions. Now half your week is already done. Meal prep is the way!

Step three: rest, move and reconnect

Food is only half the story. How you live matters just as much.

• Go to bed between 9 and 10 pm. Blood returns to the Liver when we rest. The hours before 11 pm are the most restorative.
• Rest on day one or two of your period. You don't have to cancel your life. Just do less. Skip the workout, order takeout, take a warm bath, put your feet up, watch your favorite show.
• Keep your belly and low back warm. Wear a layer over your midsection and use a hot water bottle for cramps.
• Move gently every day. A 20-minute walk keeps Liver Qi flowing so Blood can move where it needs to go. Intense exercise can wait until after your period.
• Find your people. Isolation is hard on the Heart and the Spleen. Call a friend, share a meal, swap freezer soups with another mom. Rebuilding the village is medicine too. Find ways to connect that are easy and fit into your daily life. Fellow school moms, church friends, neighbors. Exchange smiles and friendly greetings with the people at the store or on the street - those little sparkles light up our day and do a lot for our mental health.

For mothers and daughters

New mothers. Birth and breastfeeding use an enormous amount of Blood. Traditional Chinese culture honors this with "sitting the month," about 30 to 40 days of rest, warm soups and family support after birth. You may not get a full month, but you can borrow the spirit of it. Ask for help. Accept every meal that's offered. Keep broth and stew on hand, and rest whenever the baby rests. Have boundaries. Do not host people during this time. If people want to come meet the baby, they should also be bringing food and folding laundry or even mopping your floor. It's an honor to be invited into the tender space of postpartum.

Teen girls. The Nei Jing tells us a girl's cycle begins around age 14, when the Ren and Chong vessels open. Most girls these days start earlier, for reasons that I may explain in another piece. This is a beautiful time to teach our daughters to see their cycle as wisdom, not shame. Celebrate! Help them notice their energy, mood and flow. Make sure they eat a warm breakfast. Teach them that tiredness and big cramps are signals worth listening to.

When we care for our own Blood, we show our daughters how to care for theirs.

When to see your doctor

TCM and Western medicine work beautifully together. Please see your doctor if you have:

• Very heavy bleeding (soaking a pad or tampon every hour or two)
• Missed periods, or a period that suddenly changes a lot
• Severe pain that keeps you from daily life
• Fainting, shortness of breath or extreme fatigue

Ask for a blood test that checks your iron levels, including ferritin. It's a simple way to see how your Blood is doing on paper.

Be gentle with yourself

You don't have to do all of this at once. Pick one thing this week. Maybe it's a warm breakfast or going to bed 30 minutes earlier. Maybe it's liver pills on your bedside table. Maybe it's a pot of soup.

Even a little Blood care goes a long way. Watch your next few cycles. Your report card will start to show it.

With love,
Dr. Suuzi

This article is for educational purposes only and is not a substitute for medical care.

Featured image: Hilma af Klint, Group IX/UW No. 25, The Dove, No. 1 (1915). Photo by Rhododendrites via Wikimedia Commons.