Fertility & Basal Body Temperature: Does Your Temperature not Drop when your Period Comes?

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Fertility & Basal Body Temperature: Does Your Temperature not Drop when your Period Comes?

In my acupuncture practice, I use Basal Body Temperature (BBT) extensively. All of my fertility patients track their BBTs, and many of my patients coming for menstrual or hormonal issues will as well.

While BBTs don’t tell us the diagnosis, they can definitely help us identify problems we’d have no other way of seeing, as well as target treatment schedules around when you’ll get the most bang for your buck.

Soon I’ll be writing a general post about BBTs, explaining what an ideal one looks like. For now though if you’re just getting started with BBTs, read my blog linked above.

Today’s blog is discussing a particular BBT chart quality that is a unique diagnostic indicator to Chinese medicine: temperature not dropping right when the period comes.

Why your temperature should drop with your period

In an ideal situation, right when your period comes, your temperature should show a dramatic fall back to baseline levels. Not a day later, or 2 or 3, but immediately.

If it doesn’t drop, it could potentially mean that you’re having issues with “blood stagnation”.

When blood leaves with the onset of menstruation, heat is discharged with it, and your temperature therefore drops.  (Western physiology has a different explanation, involving dropping progesterone levels. This is also true, but not clinically relevant to resolving the problem discussed in this post)

Cases where the temperature stays up almost always have a problem with the blood not being released well. This results in symptoms, signs, or problems such as:

  • Menstrual cramps
  • Clotty or chunky blood of usually a darker color
  • Repeated miscarriage
  • Inability to get pregnant


I’ll use a recent patient as an example, since she’s so typical for Blood Stagnation and had all of the above problems.

This patient had tried getting pregnant for 2 years. She had regular periods and her OPKs showed ovulation at the correct time. She was in good health and had barely any symptoms except crampy periods and some headaches around her period time. 

She finally got pregnant, only to lose the pregnancy at week 5. Six months later she got pregnant again, but had a subchorionic hematoma and lost this pregnancy as well at week 8.

That’s when she came to me.

Consultation revealed that she’d always had big dark clots in her blood that were dark purple to black in color. I advised her to start taking her BBTs, and sure enough, when her period came just a few days later, she didn’t have a temperature drop until day 3, the day when her blood would start flowing more clear red and liquidy and the clots and cramps were mostly gone.

Blood Stagnation and why it creates fertility problems 

Her blood wasn’t flowing well, so would form into big clots, that wouldn’t leave her uterus easily. In an attempt to get the stuck blood out her uterus had to tighten up/spasm, which brought on the cramps.

It is also believed that when we have blood stagnation, all the old blood in our uterus forms layers that block the formation of a good, fresh endometrial lining each month. A properly formed, fresh endometrial lining creates good implantation sites for the embryo.

Blood stagnation is also the root cause behind the many immune factors that contribute to repeated miscarriage, as well as the tendency to form subchorionic hematomas as she did. Discussing either of these problems is beyond the scope of this blog, but soon I’ll be blogging about each of these issues individually.

Her successful acupuncture treatment

Because this patient didn’t really have problems anywhere else in her cycle, we focused the majority of her treatment around her period time. I’d see her 3 times in the week leading up to her period until day 3 of her cycle. In those acupuncture visits I’d use electrical stimulation attached to needles in her abdomen, to help improve blood circulation in her womb.

I also started her on herbs immediately.

The first full cycle after starting treatment, her cramps dramatically improved, but  her temperature stayed high, and her blood quality was the same.

The next period came with the typical increase in dark chunky clots being released, along with increased cramping. I warn almost all my patients that it’s typically inevitable that they’ll have one horrible cycle, with ugly big chunks being released from the uterus and worse cramps as the uterus struggled to dislodge all that accumulated old blood. Her temperature still didn’t fall with the onset of her cramping again this month.

Month 3 came with almost no cramps at all, and much smaller clots that were all mostly the same color red as the rest of her blood. Her temperature dropped on day 2 of her period.

Issue resolved by Month 4

Month 4 was the same except that this time her temperature dropped as it should day one.

It took two more cycles for her to conceive after this, during which time her only treatment was herbs.

Treatment during first trimester of pregnancy

Once she conceived I saw her weekly throughout the first trimester. Since her body tended towards Blood Stagnation and with this being a leading cause of miscarriage and with her history, I wanted to make sure we were doing everything we could to maintain the pregnancy. She also took herbs for the first 3 months of pregnancy.

She went on to have a healthy baby girl.

How were her charts helpful for treatment?

With this patient, the fact that she had cramps but no problems at other other times of her cycle, would have led me to focus treatment around her period anyway.

But without the aid of her charts, I would have assumed that like most patients with blood stagnation, that there may be issues around ovulation as well.

Her charts however showed me that the only time we really needed to focus treatment, to get the most out of her time and money, was around her period time.

Her chart didn’t CHANGE her diagnosis, but it definitely helped us target treatment where it would be most effective.

What does YOUR BBT look like?

If you’ve been trying to start a family unsuccessfuly, I strongly encourage you to get started now taking your BBTs. The more months we have of temperature data as early on in the treatment process as possible, the faster we can hit the ground running. It’s OK to start taking BBTs when we start treatment, but the more data we have, the fast we can get info from it.

If you’d like to get started working on fertility for yourself, you can schedule an appointment now using the button below.

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