THE MENSTRUAL CYCLE EXPLAINED

Jun 23

Your period is a vital sign. You can consider it your monthly health “report card”. Just like we can gain a lot of information about your gut health (and more) by your daily bowel movements, we can also gain a lot of understanding about our internal health for the past 30-90 days through our menstrual cycle (if you are not on hormonal birth control).

There is an entire symphony of hormones that are perfectly timed throughout our menstrual cycle so females can ovulate and go on to get pregnant or have a period. Our lifestyle choices, diet, how much we eat, stress, and our environment can all affect this hormonal harmony which can lead to symptoms that many of us experience.

Many women experience common, yet not normal period symptoms every single month. They are often told that hormonal birth control (HBC) is the answer to their problems and to visit their practitioner again when they are ready to get pregnant. We also see many practitioners advise patients to go on HBC for their missing or irregular periods. While this email is not at all to demonize anyones choices around hormonal birth control usage, we do want to explain the role that HBC plays in menstrual cycle health and regularity. Truth is, HBC does not actually regulateyour hormones; it simply shuts down your own endogenous hormone production and replaces those hormones with synthetic exogenous hormones. So, while HBC may reduce your hormone related period symptoms, this is only because you're halting the natural production of your own hormones. And unfortunately oftentimes, those same period problems will be back in full force when you do decide to come off of HBC.

All of that said, let’s take a quick crash course in what goes on during a typical / normal / non-HBC menstrual cycle as many of us have not been made aware of this process previously!

THE PHASES

PHASE 1: THE FOLLICULAR AND OVULATORY PHASE

The Follicular Phase lasts from day 1 of your cycle, until ovulation. This can be anywhere from day 14-18 in a healthy, regular cycle. Day one is the first day of bleeding or day one of your period.

During the follicular phase, the body is working its hormonal symphony to get an egg ready for ovulation. Your pituitary gland in the brain secretes a hormone called FSH (follicle stimulating hormone). This tells your ovaries to get a follicle ready. Estrogen also begins to increase during the follicular phase. Most women have better energy and mood during this phase of their cycle. As estrogen levels increase, your uterine lining is stimulated to grow and prepare for possible egg implantation.

When your estrogen levels spike, this triggers the pituitary gland to release luteinizing hormone (LH). The surge in LH triggers the release of the dominant follicle or mature egg from your ovaries. This is the ovulatory phase of your cycle.

Ovulation is the main event of your menstrual cycle. Whether you want a baby or not, ovulation is important for proper hormone production and will precede your period.

During ovulation some women may feel cramping (this is called mittelschmerz), bloating, some digestive discomfort, and/or a change in mood or energy. Or, some women may not notice anything at all.

After ovulation, the mature egg that was released is fertile for roughly 24 hours. If it is not fertilized, it disintegrates.

*FUN FACT: Did you know it takes 90-100 days for a follicle to mature? This means that your stress, diet and lifestyle choices from up to 3 months prior can affect your cycle, ovulation, and the health of your egg.

PHASE 2: LUTEAL PHASE

After ovulation, the luteal phase begins. Once you ovulate, the release of the egg turns into a temporary endocrine gland producing progesterone. You will not produce much progesterone if you do not ovulate. This is one of the reasons why ovulation is so important. Progesterone production peaks around days 5-7 after ovulation. If you are testing hormones, specifically progesterone, we always want to test 5-7 days after ovulation. When we have optimal levels of progesterone we should feel calm, have quality sleep, and experience minimal PMS symptoms.

During the luteal phase, we have rising progesterone to thank for the increase in our body temperature and our increased appetite. You may notice you have a bit less energy as well. Increasing your calories a bit during your luteal phase can be supportive, however aiming to maintain balanced meals with protein, healthy fats and plenty of colors and fiber is still a good goal to support blood sugar levels. Doing so will help with energy and cravings as well.

The luteal phase typically lasts anywhere from 12-14 days. Towards the end of those two weeks post ovulation, hormone levels typically begin declining. This drop in hormones is what starts the process of shedding the uterine lining- which is your period. You may notice a change in energy (up or down) or mood during these few days leading up to your period and even a few days into your period.

HOW DO I KNOW IF MY PERIOD IS NORMAL?

A healthy period should be pretty uneventful. Experiencing a bit of bloating, some slight changes in mood, appetite, energy and minor cramping can be normal. However, when we start experiencing missing or irregular periods, big mood swings, anxiety, insomnia, painful, heavy periods and large disruptions in digestion, those are all indicators we might need to support hormone health a bit further.

If you think something is off, testing can play a helpful role in figuring out what's going on and how to address it. We love the DUTCH test at Level TEN (though it's not exactly inexpensive). Not only does it show you your hormone levels and progesterone in comparison to estrogen, but we can also see how your body is metabolizing your hormones - which is a huge component to period symptoms and addressing WHY you may have hormonal symptoms in the first place.

Want to learn more? Some great reads on this topic are: