Biphasic Tinctures and your Women’s Health Practice
Herbs have a deep tie to women and to women’s hormonal balance, and have been used as part of rituals around menstruation, pregnancy, childbirth, menopause, and more. Biphasic tinctures are an herbal tradition that also dates back to even the earliest roots of western herbalism.
A woman’s menstrual cycle is separated into 2 distinct phases, the follicular phase and the luteal phase. During the follicular phase, a woman’s pituitary gland secretes primarily the hormone FSH, or follicle-stimulating hormone. This hormone does exactly what it sounds like it would- it stimulates the ovary to produce follicles, which are the early version of the egg that will later be ovulated. This process is driven by estrogen, which is made by the cells of the ovary at the same time.
Ovulation marks the beginning of the luteal phase of the menstrual cycle. After ovulation, the primary hormone driving the luteal phase of the menstrual cycle is progesterone, made by the corpus luteum, the tissue which is left over after an egg is ovulated (I think of it like an active “egg shell”). Progesterone is required to help to keep the lining of the uterus from shedding off too early, to allow for implantation of a fertilized egg into the wall of the endometrium.
A biphasic tincture supports both phases of a women’s menstrual cycle, providing 2 different herbal formulas- one formula for use between the start of menstruation through ovulation, and the second from ovulation through menstruation. In my own clinic, I call these “Pre-Ov” and “Post-Ov” to make it easy for patients, meaning pre-ovulation and post-ovulation.
The Pre-Ov formulas, used during the follicular phase of the cycle, contain herbs that support the primary hormone during that time, estrogen. The Post-Ov formulas, used during the luteal phase of the cycle, contain herbs that support progesterone. Biphasic tinctures also often contain herbs used in both formulas that support the communication pathways between the hypothalamus, pituitary gland, and ovaries, referred to as the “HPO axis”.
There are a plethora of herbs that can be used in this way and included in biphasic formulas. Some of my favorite herbs for Pre-Ov/follicular formulas include black cohosh, alfalfa, dong quai, fennel, licorice, vitex, and motherwort. Black cohosh, alfalfa, fennel, and dong quai are believed to have some estrogen-like activity (although this is controversial in the case of black cohosh). Other herbs like vitex and motherwort are great for balancing hormonal systems and improving communication on the HPO axis. Licorice is one of my favorites to include due to it’s support of adrenal function.
For Post-Ov/luteal formulas, it is best to focus on herbs with a progesterone supporting action. The most information has been published on vitex, blue vervain, and wild yam for this action, along with partridge berry, fenugreek, and lady’s mantle. There are many other herbs which could be included.
Many manufacturers create standard formulas that can be purchased pre-mixed as a biphasic tincture, such as Wise Woman Herbals’ PhytoEst and PhytoProgest formulas. Additionally, many practitioners like myself like to mix the individual herbal tinctures into custom formulas for patients based upon their needs.
There are great resources available to learn more about these botanicals and others- check out Emerson’s Practitioner Resource Center to look through the monographs on these herbs and others to learn more!
By Jaclyn Chasse, ND
Dr. Jaclyn Chasse is a naturopathic physician and the VP of Scientific and Regulatory Affairs for Emerson Ecologics. She proudly serves as the President of the AANP and thinks everyone needs a good probiotic!