In this third article in our series on basal body temperature testing, we look at the luteal phase of the cycle that occurs after ovulation. The previous articles can be found here and here. In the luteal phase, the core temperature should rise by 3 to 5 tenths of a degree and stays at this level for 14 days. In a healthy cycle with no pregnancy, the temperature should drop once the period starts. If pregnancy occurs, the temperature will stay high. The change in temperature reflects the changing balance of hormones in the body, and in the luteal phase it is progesterone that dominates, produced by the corpus luteum that is left behind after the mature egg leaves the dominant follicle. As with the follicular phase, various internal imbalances can be observed in the BBT chart, and the particular nature of the imbalance is reflected in a different chart pattern.
Figure 1 gives an example of a cycle where the luteal phase is too short. Because the BBT generally rises in the luteal phase, it is considered the yang half of the cycle. If this phase is less than 12 days long, it indicates a deficiency in the body’s kidney yang energy. If the phase lasts less than 3 days, it may be that ovulation has not happened at all, so blood tests should be done to test for this. From a Western point of view, if the progesterone support is weak it is less likely that successful implantation of any fertilised egg will occur, so it is of vital importance to support the kidney yang. Warming herbs, acupuncture with moxa or the use of a heat lamp or even a hot water bottle can all be used to help build and support kidney yang.
In figure 2, the average level of the luteal phase is low. This again reflects a deficiency in the kidney yang. In figure 1 the kidney yang could at least warm sufficiently over a portion of the luteal phase, but in this case it is insufficient overall. In this case, it is necessary to build kidney yang as before in addition to supporting the yin. One can think of the yin as being like the fuel and the yang as being like the fire. To get a decent fire you need enough fuel, so in this case both need to be strengthened.
If the luteal phase is very variable like in figure 3, it indicates a condition of internal instability which could come from emotional issues. Alternatively if the temperatures are very high then it could also be due to liver fire, which could be confirmed by other signs such as red eyes or face, being quick to anger or excess sweating. If the cause is due to emotional anxiety, then relaxation techniques such as deep breathing, yoga or meditation can all supplement the acupuncture treatment quite nicely.
Figure 4 shows the temperature declining in the luteal phase and then staying low for extra days until the period (in contrast to figure 1 when the period comes when the temperature falls). Traditionally this is thought of as a combination of kidney yang deficiency and qi deficiency. This would be confirmed if there was any spotting in the few days before the period, as one of the functions of the spleen is to hold the blood in the blood vessels. From a Western point of view, early spotting is reflective of an early decline in progesterone levels.
Overall then, the BBT chart can be a very useful diagnostic tool, so we recommend tracking temperatures to all of our patients to enable a clearer diagnosis and more effective treatment with acupuncture and herbs.
Wednesday, April 9th, 2014
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