This week we talked to Stefanie Miska, founder of the Focus Health Clinic, and master of all things natural medicine! We discussed menstrual health and natural remedies for them – including an interesting use for castor oil!

Stefanie is incredibly well versed in traditional Chinese medicine and acupuncture, and she had some interesting things to say about how our menstrual cycles are connected to the different nerve endings in our bodies – even our hands! With her expertise, we also talk about how to combine traditional doctoral practice with natural healing remedies, Chinese medicine, and acupuncture. As people with periods, it’s great to learn how our menstrual cycles work, how we can tune into them, and how they affect us, and Stefanie is an expert in that. If you think that sounds interesting, make sure to keep reading!

In This Episode We Talk About

0:35 – How Stefanie Got Started in Traditional Chinese Medicine and Acupuncture
2:36 – What Makes Natural Medicine Different?
4:27 – The Optimal Menstrual Cycle
8:49 – What Does the Average Menstrual Cycle Look Like?
14:21 – What is the Process to Get a Diagnoses?
23:02 – How Does Acupuncture Work to Treat Hormonal Issues?
29:40 – How Do You Know When Your Menstrual Cycle is Working Right?
37:03 – The Ideal Get Rid of PMS Workout
39:09 – Castor Oil Packs and How to Make Them

Stefanie’s Instagram

Focus Health Clinic Instagram

Focus Health Clinic Website

Do Less by Kate Northrup

In The Flo by Alisa Vitti

WomanCode by Alisa Vitti

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Listen to the Audio

Read the Full Conversation


Hi, so today I am talking with Stefanie, all about menstrual health and her reproductive system. Stefanie Miska is a doctor of traditional Chinese medicine and a registered acupuncturist and herbalist practicing in Victoria, BC. She runs Focus Health Clinic and her practice is focused on reproductive health and perinatal support. So welcome, Stefanie. 

I figured we can hop right in – I would love to hear a little bit about your journey and how you got started with this particular kind of work? 

I received acupuncture as a young adult – I think the first time I was like 18, or 19. And it was obviously the basis for the work I do now, and was very influential and beneficial for my own healing journey, which has sparked some interest. I was really fortunate to have a practitioner who was really engaging, and tell me what was happening and what we were doing and why. So I really got to start understanding a little bit more about what we were working on. And that just, you know, sort of fueled the fire of interest for me. 

I enrolled in school a few years later, went to school in Victoria and in Nelson in the Kootenays, and did five years. That’s the training I have as a doctor of Chinese medicine and a registered acupuncturist and herbalist. I originally was receiving acupuncture for digestive health, and then just through practice, and of course a little bit also of my own personal experience, I became interested in other things. Going through the conventional medical system, through reproductive health things, sparked my interest in a different way, to really start learning a bit more about the reproductive system, about fertility and perinatal support. And then it kind of just snowballed from there. You start to have that interest, the patients start to come in, you start to see how needed this type of support and treatment is, and how beneficial they are and how successful they are. And then here we are now, a few years later!

Running your own practice, that’s pretty brutal. And did you open up doors last year? 

I know, there’s sort of like, there’s like a big blink of COVID. So it’s actually been two years! 

Covid kind of distorts time! 

Totally. I’ve been in practice since 2014; I had my own smaller clinic for a little while, then we opened Focus Health Clinic in August of 2019.

Very cool. And so what would you say is so different, and helps close those gaps of more traditional medical treatment? What’s different about what you do?

Yeah! So we’re not trying to replace or, you know, be opposing conventional treatment. There are just sometimes some limitations in the treatment options provided for people coming in with certain conditions. And so, oftentimes people have been presented with one or two options that don’t feel like maybe the route they want to take, and that’s when they come and check in with us, and start using acupuncture and herbal medicine. Then, my colleagues and my clinic, who are naturopathic doctors, massage therapists, and herbalists, are able to present some different treatment options and some different outcome options as well. I think the biggest thing to all of this is just giving people some choice, because sometimes it feels like there is no choice when you’re presented with a diagnosis, and then, you know, a single treatment plan that maybe doesn’t feel in alignment for what your goals are. So we’re able to offer that to them, and most people are pretty, pretty stoked, and pretty appreciative also.

It’s nice to have options and feel heard and understood, which can be a struggle otherwise, sometimes. 

Totally. And I know that, unfortunately, time is often the biggest factor with our conventional medical system. So people might get this diagnosis, they might get this treatment plan, but they don’t really understand why, or what’s going on in their body. And so we spend a lot of time talking about the ins-and-outs of what their condition is, and then just giving them some more time to explain things. I think that’s often where a lot of people are left a little bit in the dark, maybe feeling a bit confused, and don’t really understand exactly what’s going on.

So let’s bring it back to basics. What would you say is the optimal way a woman’s body goes through – I’m not sure if I’m even using the right words – but the menstrual cycle. 

It’s interesting because when you’re working in the menstrual cycle and the fertility world, you might hear words like “optimize fertility” and “optimize your health.” It’s a challenging framework to feel like you have to be at your utmost best self all the time, and that your cycle has to be perfect, in tip top shape, and everything has to be in total synchronicity and alignment. As a cyclical human with a menstrual cycle, that innately and technically is impossible – things are fluctuating and changing all the time, and are so influenced by so many different things. So like stress, diet, disease, illness, you know, quite a few different things. So I think more of optimizing your menstrual cycle is just understanding the ins and outs, the ebb and flow, of your menstrual cycle – what is going to potentially change it out of its norm, how to get it back to the normal. 

It’s more about understanding your body and living in tune with your internal environment – so your body, and then also your external environment. So that means like, the weather, the temperature, your colleagues, your job, stress – there’s so much more than just things working super well all the time. That’s one of the things we see most often when we’re talking about this type of thing; most menstruating people seem to have this sort of sigh of relief or a weight off their shoulders, when they know it’s okay to feel more tired, or more irritable, or more something, and they don’t have to be like functioning at their best self and high energy all the time. There’s just a bit of softening and a better compassion, I guess. And oftentimes, women will go back home to their husbands and say “I’m supposed to be tired when I’m bleeding” or, you know, “it’s okay, that I’m tired.” And that gives them a break from expectations of family dynamics as well, sometimes, which for some is really helpful. 

Yeah, and I’ve been learning more and more; I’ve noticed I am such a go go go kind of person, I like working and doing lots of things. And sometimes I’ll be hard on myself, if I’m not feeling in that state to do all those things. I’ve started noticing more so in the last few months, but it seems to actually be paired within my periods coming up, or it is my period week. And it definitely affects so much.

There’s tons of great resources – one of the books that talks a little bit about this, Do Less by Kate Northrup, and she talks about running a business and being a productive menstruating person. And how to wait and optimize your cycles, or like when to push more went to plan more when to like, be more contemplated. And there’s ways of still being conventionally busy, but also honoring the internal rhythms of your body, too. So scheduling launches, and more external networking things, in certain times of your cycle, and then scheduling more the contemplative rest in different times. You can do that based on your menstrual cycle, and you can also do it based on the cycles of the moon, because there’s often a comparison there as well. So when it’s the full moon, when it’s really bright, that would be your most energetic and outward facing self, and then the new new moon that’s a bit darker, and the sky is darker at night, it’s the more contemplative and restful, and you can – if we have the luxury of planning these things! 

Yeah, that’s a whole other level of planning! 

Yeah, it’s funny because it can seem like a lot of work. And for those who follow this or have put some prioritization in doing that second thing, seem to find, overall, it is actually a little bit more useful in the long run

I guess it’s cyclical. So you get into that pattern, and it just might seem like a lot to get into.

Yeah, definitely.

So what would you say are kind of the average things your body goes through for each week of your cycle?

Yeah, so it’s gonna be dependent; in the average “textbook cycle,” which I say is roughly 28 days, (it’s not) but if we’re saying that it’s roughly a month, which is four weeks, the more restful, quiet time would be when you’re bleeding – so when you’re menstruating, when you have your period. And that’s for a lot of different reasons; the hormones drop before your period, of course, you’re bleeding. So you might just feel a bit more tired. 

But as your bleeding stops, and your hormones start to pick back up again, leading towards ovulation, you might notice your energy levels getting a bit greater and higher. And then, technically, it’s said that at ovulation (so roughly like mid cycles – if you have a 28 day cycle, it’d be at day 14, though not many people follow that schedule) you would be your most energetic outward facing person, and personable self. There’s studies that show the scent you emit changes to attract mates. There are studies that show that the symmetry of your face actually becomes more in alignment – everything outward facing becomes more appealing to procreate. And so yes, that’s maybe important for family planning. But also you can think about how that might be better for business, if you’re trying to connect with people. It might be better for networking, socializing with friends-  you’re gonna feel more outward facing. And then as ovulation finishes, that’s when we start to tuck back in again. And so you might start to feel your energy and vibrancy waning a little bit, and we start to kind of get into that fall, kind of like getting ready for hibernation, which would be like coming back down to menstruation again. So it roughly follows this ebb and flow of the menstruation, up to the ovulation, and back down to menstruation. So we kind of see that ebb and flow over and over again, for all of our menstruating years.

Yes. So many years. And it’s crazy that it’s not as talked about openly, that we’re not educated about our menstrual cycles when it’s something we deal with as women and menstruating people for decades and decades.

Yeah, it is unfortunate that we have not included a bit more in education in school. And you know, we’re seeing a bit of a change in this, though not a ton. I’m not sure what your childhood was like, but what your parents talked about in terms of your period; was it hush, hush, did you hide your tampons? Like, you aren’t supposed to tell anyone when you have your period, you are supposed to do everything as you normally would, even if you were bleeding and feeling tired, or have cramps or pain. So there’s just sort of this innate messaging that we should hide our menstruation and not let it guide our life when, really, menstruation may be seen as the giver of life and the start of life; we should be honoring that more.

So that’s kind of the basics for the cycle. But a lot of women feel somewhat off from that, whether it’s irregular periods or pain. I say it’s different for each kind of thing – I was going to ask how can you know if something’s off? But I guess it really tends to come down to how you’re feeling? Do you have anything to touch on regarding that? 

I mean, I would mostly just trust your body and what you feel, and hopefully then what you know to be true. If something feels off, look into it; if you can, ask your doctor again. If they’re not as receptive as you as you want them to be, there’s other avenues you can look into, like naturopathic medicine, or other allied health people who specialize in reproductive care. So whether that’s an acupuncturist, maybe there’s a massage therapist – again, it’s going to be out of their scope, to diagnose or treat or anything – but they might just have some more insight for you if they have experience in that. For example, many of my patients have come in with like a list of complaints. And then based on those complaints, I’m like, “well, that looks like X syndrome or X  pattern,” whether it’s PCOS or endometriosis or PMDD, please go write all that stuff down and follow up with your doctor. So like, we can help them get their thoughts together to take to their care provider, which is sometimes helpful as well.

So you work really hand in hand with a care provider? 

Yeah. And, you know, I think the main thing is that we’re just really taught that, however shitty we feel around our menstrual cycle, that that’s normal, and it’s common, and we’re supposed to feel that way and suck it up. So really, if there’s extreme pain, extreme mood fluctuations, excessive bleeding, any of those things, they are cause for concern and should be checked out. A little bit of like, feeling a bit more fatigued, a little bit of irritability, some mild mental cramping, that maybe doesn’t get in the way of your day. And ideally, you don’t need to take any pain medication. And if they’re becoming more challenging, or debilitating or getting in the way of day to day life, then it’s time to check in with somebody.

Yeah, the big thing is if it’s really starting to affect your day-to-day life. So how do you go about actually diagnosing people; you’d mentioned like they give a list and it gives you an idea, and then it’s kind of hand in hand with a doctor? What kind of tests or diagnosis is there? Is it mainly like a hormone level track? Or is it more than that?

It really depends on what that complaint is. So again, as an acupuncturist and doctor of Chinese medicine, it is not within our scope to diagnose anything from a Western perspective. So PCOS or endometriosis, we as Chinese medicine practitioners have our own terminology of words and language and diagnosis we would use based on that lens specifically. 

But as an acupuncturist that focuses so much on reproductive health, it’s important that I understand the languaging, understand the ins and outs of what’s happening in the body when there is a diagnosis like that. So, you know, it really depends on what they’re coming in for, if they’re having really extremely painful periods, you know, we want to rule out things like cysts, or fibroids, or endometriosis, or PCOS, which is polycystic ovary syndrome, which just means cysts on your ovaries. You know, if there’s really heavy bleeding, we want to rule out fibroids, but again, not within my scope. 

So when I hear these things, if there’s a red flag that comes up, then I mention that they should go follow up with this specific thing they’ve mentioned with their doctor. So they can get lab work done, they test hormones and different things through the blood. So you’ve gone into a lifelabs and they draw blood and they can check your labs, they can do ultrasounds, they can do abdominal, so like over your belly, and vaginal, which means they stick the wand into the vagina and look around there. Sometimes there’s like laparoscopic surgery, so that means they go in a bit more and look around. And there’s also dried urine testing, which is considered a Dutch test or called a Dutch test, which you may have heard about, which is just another angle of looking at hormones, potentially some people say in a more in depth way as well. So typically, it does involve working with the medical doctor, or the specialist. Naturopathic doctors can order all these labs and all these tests as well, but it will be out of pocket based on where we live. 

And then if anyone is in the States, there’s functional medicine doctors, and sometimes acupuncturists are considered primary care. In some states they can order some of these tests as well.

So it really does come down to where you live, but hopefully you’re able to kind of find a way to access tests. 

I’m in this world every single day. So for me, I see this stuff often, where if someone has never experienced any of this or doesn’t know, or is experiencing this in their body for the first time, it can seem a little daunting and overwhelming. So that’s why talking to someone who at least has some focus or specialty in this can just help guide you if you’re feeling really lost about what to look for or ask for. We do have to advocate for ourselves, even if we don’t necessarily know or understand our bodies super well. It is hard to advocate for ourselves if we don’t even know how.

And say, a family practitioner, nothing against them, but it can be very general. So when you’re coming with a very specific plan, it’s nice to have someone that specializes in that, and has even more of a knowledge base to help.

Everyone has their toolkit – in Chinese medicine, we have our toolkit of acupuncture, herbs, cupping, you know, a few different modalities we use. When you go to the doctor typically, the main tool in their toolkit, based on my experience and in my practice with my patients, has been that they offer birth control pills or some form of birth control.

That was actually a question that came up, that using birth control is such a highly recommended thing for regulating your hormones. Would you say it’s very effective? Or what are some other ways of doing that?

Yeah, and so just to finish off my thought before was that I’ve had people who are diagnosed with something, and then the doctor recommends birth control. And then they give us a call saying “these are my symptoms, this is my recommendation, do you think you can help me not follow this course of treatment because that’s what feels better for me.” And so we are able, after we assess their case, to say “yes, I think that we can help you” and make sure we have a plan in place. So we’ll say let’s try this for the next six months; if there’s an improvement, then you know, maybe birth control is not the best option for you. And we are quite successful actually, with being able to support people with some of these things, with acupuncture and herbs. 

But there’s so many different types of birth control. So it’s hard to say like this generic blanket statement, but there’s not necessarily a way that birth control can regulate or optimize your cycle. There’s many reasons or times when birth control is the best option for people – like for example, someone’s in extreme pain, or is having some extreme symptoms. Sometimes going on birth control for a certain amount of time to just give the body a break while you do some of these more like potentially natural options, is great and really necessary. 

If someone is potentially not menstruating or has PCOS, and they give you the menstrual pill to help regulate your menstrual cycles, it’s not necessarily going to do that. There’s reasons why going on the pill while you have PCOS could potentially be beneficial – like some people will say that when you’re on the pill, and you have that sort of breakthrough bleed, or you have your period, when you stop taking the pill for that week it just allows the lining of your uterus to shed and have a bleed. It’s important to let that tissue move and not just sit there for many months if you’re not bleeding, so there’s some benefit there. 

But long term, it’s maybe not going to get you where you want to go. So someone is coming in who wants to get pregnant at some point, they have PCOS, or they have some menstrual cycle challenge and they know they want to get pregnant in a few years, and they put them on birth control, well, we’re just going to stop whenever they decide to come off their birth control and maybe want to get pregnant. Then we have to start then, which might push back that journey, quite a bit longer. So just having the conversation like, What are the goals? What’s the timeline? And should we try and figure out what’s going on with your cycle now, so that when you want to get pregnant in three years, like you actually have a menstrual cycle? Or you’re actually ovulating? Or, you know, whatever the goal is. 

So, yes, and no, I think it’s a little bit over-prescribed, but again, not my scope to comment on anyone’s prescription. We just look at what their goals are, and then they talk about their prescription with their doctor. And then we talk about what we can do on our end as well.

Yeah, so it is a tool, and sometimes it’s very helpful. And other times there’s other tools that might work better for them.

Yeah, and there’s a lot of folks that are wanting to use birth control to not get pregnant. You know, there are a couple options that work really, really well that are not the birth control pill, but it does require more time and effort, and a bit more understanding of our bodies, which unfortunately, I think a lot of people and care providers can be quick to dismiss as too much work. Which I think is really just saying that we don’t understand our bodies well enough to figure this out without a pill.

Yeah, but there are actually other ways, and it’d be great to learn more and kind of continue developing that so it can be more accessible for some people. I know, that was my case – I had been on the pill for probably 10 years, didn’t want to take hormones anymore, and stopped and tried to like, look at my ovulation thing, and it wasn’t accurate for my cycle. I got pregnant, thankfully, in my situation quite quickly. But every person is so different, how it’s going to affect you. 

So what are some treatments you do? I know, it’s obviously going to be very different depending on the person’s situation, but from someone that doesn’t know about these different treatment options, thinking acupuncture, how does sticking something in actually work to relate to your hormones and help with all of that?

I know, it’s a little confusing, right? Yeah, I mean, I don’t want to get too-too much into it. But we use acupuncture points on certain parts of the body to encourage a certain outcome, I guess. So that might look like increasing blood flow, increasing circulation, lessening pain. And so there are studies that show how it changes the messaging system in your body with your hormones and with their pain receptors. 

And then I also use Chinese herbs as well. So if someone’s coming in with any reproductive challenges or complaints from me, a big part of my practice is using the herbal products as well. Oftentimes, for again, increasing circulation, breaking up sort of – we use the word stagnation –  but anytime that there’s like pain in the body, from a Chinese medicine lens it’s often there’s some lack of movement or lack of circulation; imagine like a cyst or a fibroid, that’s like an accumulation of something. And it’s something that’s so, so stuck and sitting there, so you want to encourage more circulation of blood flow to those areas that might lessen the pain, or potentially, reduce the size of the cysts and fibroids, or adhesions from endometriosis or things like that. 

So in my practice, we’re using the acupuncture and the herbs to address the complaint. So it really depends what the plaintiff’s complaint is, but we have acupuncture points, and we have Chinese medicinal herbs that are helpful for mood regulation. So like PMS, PMDD, depression, anxiety, insomnia, PMS symptoms, like headaches and breast tenderness, cramps. There’s some that work really quickly; that means if you’re feeling cramps, you take some and you feel better pretty quickly. And there’s more along the lines of what I use is you’re taking herbs for a couple cycles to really help sort of rewrite that what’s been happening in your body for however long you’ve been experiencing these symptoms, and trying to encourage the shift in either moving pain or like encouraging more blood flow to address the main complaint that they come in for. So it’s kind of like a tandem.

So it seems kind of like the acupuncture is working within the body to kind of do what it needs to do and herbs and all that is kind of introducing something into the body to help that. 

Yeah, that’s a good way of putting it. So sometimes we, of course, do acupuncture points, like over the low abdomen, or low back. But there’s also a lot of points that connect with the pelvic area, connect with the uterus and the ovaries that are on our feet, and our hands. So those, you know, you might come in saying, “I get menstrual cramps,” and then I stick some acupuncture points in your hands. And then you’re like, “why does it work!?” But that would just involve talking about the system and the meridians and circulation and whatnot, which is probably a little bit more in depth than most people want to listen to right now. 

Yeah, but I think a lot of us have at one point seen the diagram of the foot or the hand, and how it relates to your spleen and different things. You touched on kind of the herbs and that sort of thing, and that can be for a few months. So that sounds like it’s kind of to help your body get to where your body can do things on its own.

Of course, that’s always the ultimate goal. You know, we’re always changing, and there’s always gonna be things that come up, and I don’t think that health is a place we get to and stay. There’s this quote, this Homer quote that I have, in my house, “the journey is the thing.” So yeah. You set yourself up the best you can to have these to be the long term benefit. Health and healing is always a work in progress, and is always going to take some attention, you know, and sometimes we have more time and attention that we can offer. And sometimes we don’t. 

But if anyone comes in with almost any menstrual cycle complaint, I usually say “let’s work together for three cycles. If your cycles are roughly a month, it’s going to be three months, and then let’s reassess at that point.” I kind of also say that the menstrual cycle is sort of like the report card after, and checks if we’ve done our homework. So if we don’t do any work leading up to our cycle, any work being taking your herbs, or whatever the homework is, we’re not going to notice any change, right? Cuz we haven’t done our homework and our report card is going to reflect that. It’s kind of a silly analogy. 

Yeah, that makes sense. 

If we do our homework for 1, 2, 3, 4 months, typically, then our report cards or periods are going to reflect that, because we’ve maybe taken our herbs, we’ve looked at what we’re ingesting in terms of food and drink, maybe address stress a little bit, maybe done some things like castor oil packs, and like other things for pain or inflammation, like looking at inflammatory foods and things like that as well. And then typically within a few cycles is where people start to really notice a bit more of a change. And it does take commitment, because especially when it’s your reproductive health, you can’t necessarily see the benefit as it’s happening. So you might do one or two or three months, where you might start to notice a little change. So it can be challenging to stay motivated. So it’s just trying to find the commitment of doing these things over time where you really start to see the benefits. 

Yeah, it’s really the long-term game. 

Yeah, I know. We love our quick fixes. I mean, me too, but it’s hard with reproduction. I rarely see any quick fixes for menstrual health.

Yeah, well, that makes sense. Just like you explained it, it’s gonna take three or four weeks before you will have any indicator of if something’s possibly working or not, and then it starts to compound over the next few months. 

Yeah, yeah, totally. 

Okay. I’m just checking on our questions here. One person said, “how do you know if things aren’t working,” – but I think it’s really like staying in tune with your body, kind of taking notes.

Most people will say, if your cycle is between 21 and 35 days, you’re in the normal bracket, so if your cycle, that means you have a bleed, is more frequently than every three weeks, every 21 days, or it’s longer than 35 days, so it’s longer than like, you know, five weeks or six weeks, that’s potentially a red flag. If you have a ton of pain, that’s a red flag. If you’re really heavily bleeding, potentially a red flag. If you have really light bleeding, so you’re only using a panty liner, and like not really having much flow, potentially something to look into. And if you have a ton of spotting before, also something to look into. Again, not all these things are like major red flags, but we can see the impact of dysregulated hormones in so many other facets of life. So if you have many days of spotting before your menstrual cycle, you might also have really bad headaches before your cycle. So then by addressing those hormonal things, like the spotting, and then maybe taking another look at that, then maybe your headaches will go away, too. So maybe they’re not a huge cause for concern. But we don’t have to suffer; even if it’s a little bit there’s ways of addressing anything. So essentially, if you have any complaint about your menstrual cycle, I would ask somebody about it.

Yeah, it’s always worth asking. And just because something’s common doesn’t mean it needs to be your normal. You can be more comfortable throughout it all. I found that very interesting. And it’ll probably be reassuring for people that cycles can be 21 to 35 days. 

Yeah, you’ll hear different numbers, you’ll hear a lot of different stats with this type of thing. And 21 is definitely on the shorter side, for sure. But you would want to just look at that with somebody. And if you’re tracking your cycles, and knowing when you ovulate, and knowing how long the different phases of your cycle are, then for some people a shorter cycle is just the way their body is.

Yeah. Well, thank you so much. We covered so much – it’s hard to kind of dig in without specifics, because it is such a broad topic. And there’s so many issues.

Before we started recording, you mentioned a bit more about PMS and PMDD. Were there any more specific questions about that? I do want to touch on that.

It was primarily about having really bad PMS – Is that normal? Or what are things you can do about that? And there’s been growing curiosity about PMDD and what exactly that is, and how you go about diagnosing and then treating those things.

Yeah – there’s PMS and there’s PMDD. PMDD is considered a version of PMS, but where there’s a lot more disruptive, like psycho-emotional, symptoms. So if someone is feeling super low mood, potentially like major depressive symptoms, or more manic or super high anxiety – essentially, a lot of people describe it like they’re Jekyll and Hyde, or the experience a personality change – if that feels like you, that’s more along the lines of PMDD. And that is something to talk to your doctor about. Again, the most common treatment is some sort of antidepressant, maybe an anti-anxiety medication. And again, I treat people in my office all the time, who maybe have decided they want to try a few months without and we can help regulate some of those symptoms with acupuncture and herbs. And then we also work alongside people who want to take the medication that doctors prescribed and they want to also have some support. Because again, it can take a few months and a few cycles to start seeing benefits from acupuncture or from your medication. So some people want to really tackle it from both sides. 

But PMS, besides from just feeling a little bit irritated, maybe towards your spouse or your friends, anything more than that is something to address. And that doesn’t mean you’ll have PMDD, but it does mean that maybe you should look at some things that might be causing more irritation. So that can of course be like stress in your day-to-day life. It can also be related to diet, or sleep. There’s so many reasons why we might be feeling more irritated. 

For most people, not everybody, but for most people, moving your body a little bit more is going to help immensely with that. From a Chinese medicine lens, we look at that emotional irritation as like a stagnation of emotions, and our physical body has stagnated. So if you’re someone who gets some cramps and headaches and maybe breast tenderness, and super irritated, we want to get that energy moving. So just a light sweat, it doesn’t have to be an intense exercise, but for most people, exercises and movement are pretty influential. We also give people herbs that help increase that movement as well. But that’s one thing people have a little bit of potential control over, moving their body a little bit more. 

But with PMDD, it’s definitely the more psycho-emotional component, so check in with your doctor. Unfortunately, not everyone’s doctor is really going to be super supportive or aware of PMDD. So if you know that this is not right, you turn into somebody else two weeks or a week before your period, talk to somebody. And if they don’t believe you, hopefully you have the resources to talk to somebody else, whether that’s a counselor or another doctor, or a walk-in clinic, or an acupuncturist or naturopathic doctor. Just because one person doesn’t believe you doesn’t mean that your story is untrue, or that your feelings are invalid, or that the next practitioner is not going to believe you. And I think that’s the thing I see a lot with menstruating people and their reproductive concerns and menstrual cycle concerns, that feeling of not being heard or believed, unfortunately.

Yeah, it’s so discouraging. And I think it’s really nice to hear from you, and that it’s not always going to be your experience. Keep trying, there are people out there that understand and want to help you.

Yeah, and just as hormones are fluctuating and changing, so are your symptoms. I have people who have PMDD, and then they don’t, or they get pregnant, and their symptoms change. Things fluctuate, and so your reality now doesn’t necessarily mean that’s your reality forever. 

That’s interesting, and again, very reassuring. In terms of movement for PMS, I just want to clarify – like, a walk and some stretching, or like really getting more of a sweat on?

I mean, if you’re angry, get that sweat on, go do something and channel that somewhere, because it’s not going anywhere. So it’s either going to stick in your body where you’re gonna snap at your kids or your spouse or your co-worker, or you can just sprint laps at your park. Or if you have a safe place, maybe go throw some rocks in the ocean, like big heavy rocks. Just doing something so you can really get that out, because we keep a lot in. There’s this little saying “we store our issues in our tissues.” So if we’re angry and we do nothing, it goes nowhere. So that might make our cramps worse, or headaches worse, the clots in our menstrual blood worse. There’s a lot of ways it’s going to show up otherwise. 

I am just a big fan of any nonlinear movements. So we spend a lot of time walking, running, and doing things like this. So anything that’s just like doing something else. Because again, from a Chinese medicine and acupuncture point, a lot of these meridians – you can’t see what I’m doing but they’re on the side of your body – so like dancing, twisting, yoga, hula hooping, getting like a dance party in your kitchen, but it’s just whatever feels good. I can tell you a bunch of ideas, but if you would prefer to just jump on a trampoline or skip rope, it doesn’t matter what you do. You’re going to know what feels better so if you go and do this super intense hit workout and you feel utterly exhausted, maybe that was too much. For most people, a light sweat is ideal, so a brisk walk, maybe a little jog, but you don’t have to totally exert yourself, and you do not have to punish yourself for feeling a certain way by pushing yourself harder.

Yes, definitely. 

But for cramps, and depending where you do it in your body, for PMS, castor oil packs are one of the first things I recommend.

What is the castor oil pack; is it an insert?

No, it’s topical. So you can YouTube this, you can YouTube how to do a castor oil pack. They make it a little bit more complicated, I think, in some of those videos. Essentially you just need an old cloth that you never want to use for anything else, because castor oil is very thick and stains, and a bottle of castor oil, which you can get at any drugstore, and then some sort of heat source. I like my plug in heat pad, but you can also use a hot water bottle. You essentially put some castor oil on your cloth, and then put the oil side down on your belly, usually below your belly button, and then put the heat source on top, 10 to 15 minutes a couple of times a week. You can also do it over your liver – which you would have to look on Google where that is – it’s just under your right breast or chest. There’s a few different reasons why that works, but it just helps, with muscle contraction and softening at the same time, which can help with cramps. And if you do it over the liver, there’s a little bit of that sort of like detoxing, moving the hormones through your body, as well, from a Chinese medicine lens. The liver is a strong contender with PMS, so we want to like, adjust the liver as well.

But you can Youtube castor oil packs, or you guys can send me a note or find me on Instagram (@FocusHealthClinic), but it’s super straightforward. And if they tell you to make it more complicated, just simplify it to whatever works for you. You know, 10 to 15 minutes a couple times a week leading up to your period can be really helpful. I usually tell people from ovulation to when they’re expecting their period, try and do it, you know, two or three times a week.

Okay, and that’s more manageable. It’s not like every day. 

Yeah, no, no, no, most people aren’t gonna do that.

Yeah, exactly. But when it’s recurring two to three times a week, it’s easier to stick to it.


Yeah. You just don’t want to do it when you’re heavily bleeding, or if you’re trying to conceive.

Yeah. So do a little bit of research, if you’re looking into that.

Yeah, but pretty safe and gentle, especially because it’s topical. You probably heard, if you had a midwife, they would have told you about the castor oil drink, trying to induce labour. Don’t do that.

Yeah, they said don’t do that, there’s some bad stories of people doing that. I was told, in terms of drinking it, don’t drink too much.

Yeah, there’s gonna be varying opinions on that too. But we’re not ingesting it. So you don’t have to worry about it.

Yeah, so it’s more safe. Perfect. 

Great, so that was a lot of good information. I’ve got notes that I’ll include, and the book by Kate Northrup.

Yeah, and another – I can send you these as well – but WomanCode by Alisa Vitti, and also her other book called In The Flo. I recommend that to almost everybody. She is a person who has PCOS, but the woman code is just a super basic intro, really easy to read, on what your hormones are, how to balance them or regulate them, her top five ways of doing that. And I just think it’s a really great starting point for anyone who’s kind of just curious about their cycle and their hormones, because it’s really easy to digest – which, when you’re learning about all this stuff, can be really overwhelming and really dry sometimes. So it’s a really great book.


Thank you so much for your time.

 Yeah. Thanks so much.


And that was our Conversation with Stefanie! We had a great time talking to her and learning so much about menstrual cycles and how medicine affects them. As people with periods, we’re stuck with this for most of our lives, so becoming well-informed is a great way to set yourself up for success. If you want to learn more about Stefanie, make sure to check out the Focus Health Clinic and their Instagram (@FocusHealthClinic), and follow her @Ritual.Medicine!