The Menstrual Cycle Explained
As women, we learn to accept that every month our body goes through changes which, put simply, are down to whether or not we get pregnant. From menarche (first time of menstruation) all the way through to menopause (no longer menstruating), our bodies prepare themselves for pregnancy each month by allowing the lining of the uterus to thicken. This is to assist a fertilized egg to implant – leading to pregnancy.
If we do not get pregnant, aka no egg is implanted, then that thickened uterus lining breaks down because it’s no longer needed. The lining tissue along with blood and mucus leaves the body as what we know as our period; sometimes known as TOM (time of month), aunt Flo, mother nature and plenty of other terms I’m sure you have heard from women. I think the first step to normalising periods is by calling them periods, full stop. They are not something we have to hide or be embarrassed about.
Just think that if it were men who had a monthly cycle which meant they bled for days, do you think they would be hiding it? Probably not. They would probably be competing with each other to boast about who bleeds the most.
And here lies one of our issues as women – playing ourselves down. Anyway, I digress. I’ll leave the women empowerment talk for another day.
Our periods are a reflection of our overall health. However, far too many women I know as well as clients I work with, either don’t know enough or don’t pay enough attention to their cycle.
Women often don’t realise that our cycle can be affected by small and big events in our lives; from quitting a job you hate, or getting a job you love, leaving an abusive relationship or finding yourself head over heels in love, going through a traumatic event, dealing with work stress, having an unhealthy relationship with food, gaining or losing weight etc. – they all have an effect on our menstrual cycle whether we realise it at the time or not.
Before we get into it, let’s brush up on a few terms related to the menstrual cycle:
Menarche (pronounced Men-ar-kee)
The first period/menstrual cycle in females, signalling the possibility of pregnancy.
The discharge of blood, mucus and tissue aka your period. It is considered day 1 of your menstrual cycle and usually lasts between 3-7 days.
FSH (Follicle Stimulating Hormone)
Causes an egg to mature in an ovary. Stimulates the ovaries to release oestrogen.
LH (Luteinising Hormone)
Triggers the release of a mature egg (ovulation).
The release and movement of an egg. Usually around day 14 of a 28-day cycle. Lasts 1-2 days.
One of the main sex hormones that are related to our cycle. Oestrogen is the dominant hormone in the first half of the cycle and is involved in repairing, thickening and maintaining the uterus lining.
It also stops FSH from being produced (so that only one egg matures in a cycle) as well as stimulating the pituitary gland to release LH. Oestrogen peaks around the 12th day of our cycle. It drops during days 13 and 14 before rising slightly again and then has a second lower peak at about day 21.
The other main sex hormone that’s related to our cycle and is the dominant hormone in the second half of the cycle. Progesterone is usually the culprit for anxiety, mood swings, tears etc. We know it well!
However, it also helps reduce inflammation, helps calm the central nervous system, improves sleep and helps stimulate the building of bone tissue, and keeps oestrogen levels in check whether they are too high or too low.
Progesterone is involved in maintaining the lining of the uterus hence its importance in pregnancy. It stays approximately at the same level and then begins to increase slightly from around day 12 all the way through to around day 21 when it slowly begins to decrease again.
Our cycle explained in 2 halves:
Put simply, this is the first half of your menstrual cycle. It starts on day 1 of your period. This half is said to last ~14 days in what is usually referred to as a ‘normal cycle’ of 28 days, however, cycles can range from 21-35 days. Oestrogen is the dominant hormone in this half of your cycle.
You should generally feel great in this phase of your cycle as it is when your skin tends to clear up, your confidence increases, you can learn new skills easier, you have more energy and overall you tend to just feel good in yourself.
This is the second half of your cycle and begins after ovulation and generally lasts around 14 days, but again this can vary, stopping when your next period starts. Progesterone is the dominant hormone in this half of your cycle.
This phase of your cycle is when you tend to retreat inwards, feel anxious, teary and may have mood swings as your serotonin levels drop. Having foods that are high in tryptophan (such as turkey and seeds) can help to spike serotonin production in the body.
You may also feel bloated and have water retention in the lead up to your period. This is completely normal so don’t panic if the scales jump up in the week prior to menstruation. It is normal – so when you track your cycle you know when to expect these fluctuations from month to month.
As little as 12.4% of us have what is considered a ‘normal’ 28-day cycle.
How do I know what day to count as day 1 of my cycle if I want to start tracking?
Day 1 of your menstrual cycle isn’t when you get ‘spotting’ of blood. This is probably the end of a previous cycle and can happen at any stage when progesterone drops. Day 1 is classed as the first day you have a proper flow of blood. You can track your period manually, counting this as Day 1, or you can use an app such as ‘My Calendar’, ‘Clue’, ‘FitrWoman’ and multiple others!
The important thing is that you start tracking and becoming more aware of the stage of the cycle you are in at any given time as it can tell us a lot about how we are feeling and how we react in certain situations.
Did you know?
- The average woman will have 400-450 menstrual cycles in her lifetime.
- Period syncing with people you spend time with/live with is a myth. It’s actually more likely that your periods just crossover at some point.
- The bleed you have when taking oral contraceptives ISN’T a normal period. It’s a withdrawal bleed – referring to the withdrawal of hormones in your pill, and body. The pill does its job (of preventing pregnancy) by stopping your ovaries from preparing and releasing eggs. You won’t get the normal hormone fluctuations, ovulation or period whilst on the pill.
ANOTHER FUN FACT:
The gynecologist (Dr. John Rock) who was campaigning for the pill to be used back in the late ’50s/early ’60s by Catholics, added the 7-day break in the hope that the Pope would approve it. He sold it as more of a cycle regulator than a contraceptive, hoping that the Catholic Church might approve it in this way. They did not. Yet, here we are 60 odd years later and still taking the 7-day break from the pill each month.
This break in the pill is NOT necessary so you do not have to take it at all. If you want to bleed every month, reduce it to a 4-day break, but remember that the bleed you are having isn’t a period so it’s not something you have to have. It’s perfectly safe to take your pill right through.
Common menstrual issues:
- PMS or Premenstrual Syndrome = Combination of psychological and physical symptoms that happen in the luteal phase of the menstrual cycle (2nd half). Physical symptoms include bloating/water retention, cravings, breast tenderness, headaches, fatigue, oversleeping, low sex drive and trouble sleeping,
Other symptoms include mood swings, anxiety, anger, loss of interest in activities/socialising, tearfulness and struggling to concentrate. These are all brought about by the fluctuation in hormones during this phase.
If you suffer from these symptoms and it’s affecting your quality of life, you should seek advice from your GP as there are options available to you. Some women might need or want medication to treat their symptoms, some will use exercise to ease their symptoms, some will take the oral contraceptive pill, some will take supplements such as vitamin B6 alongside their diet and others will try methods such as acupuncture or CBT.
- Dysmenorrhea = Painful periods are common in women and are thought to be caused by the uterus having to squeeze harder than necessary to shed its lining.
- Heavy bleeding = Can sometimes lead to anaemia due to the loss of blood each month.
- Primary Amenorrhea = When a girl has reached age 15 and hasn’t had a period.
- Secondary Amenorrhea = absence of a period for 3 months or more after previously having a normal cycle.
- Oligomenorrhoea = Less than 9 cycles a year OR your cycles are greater than 35 days.
- Functional Hypothalamic Amenorrhoea = Loss of periods and can be caused by intense over-exercising, weight loss, psychological stress and illness.
- PCOS = Having 2 or more of the following features – irregular periods, excess androgen (high levels of male hormones – can mean excess facial or body hair), and polycystic ovaries (fluid-filled sacs surrounding the eggs).
If you suffer from any of the above and it’s affecting your quality of life, you should seek advice from your GP as there are options available to you. Some women might need or want medication to treat their symptoms, some will use exercise to ease their symptoms, some will take the oral contraceptive pill, some will take supplements such as vitamin B6 alongside their diet and others will try methods such as acupuncture or CBT depending on their situation. It’s not normal to have your cycle interefere with your life in a negative way so don’t think that you have to. Speak to your doctor and figure out the options available to you.
Period Product Options:
- Disposable sanitary pads
- Disposable tampons (with or without applicators)
- Reusable tampon applicator
- Organic tampons
- Reusable pads
- Eco-friendly tampons
- Period pants
- Menstrual cups
There are some great charities and organisations around the world improving education and access to menstrual supplies.
- Binti International works in the UK, the USA and Africa to help improve access to pads, as well as educating around menstruation to help break the stigma surrounding periods.
- Femme International distribute reusable menstrual products, as well as running an educational program in schools and communities in Kenya and Tanzania.
- The Red Box Project is a UK based community-based initiative that places red boxes of period products in schools for those who may not be able to afford them.
- The Cup Effect is a charitable NGO and social enterprise that helps to campaign for awareness around menstrual cups and make them more widely available. They have linked with countries including the UK, Kenya and Malawi to provide training sessions about menstrual cups and distribute them to people living on low incomes.
I hope this has given you a good overview of the menstrual cycle and what’s going on in each phase. I think it’s important that we are aware of the different stages we go through – from menstruation, the follicular phase, ovulation and the luteal phase.
Knowledge is power, particularly when our cycle dictates so much about ourselves and our mood, energy, concentration etc. If you are aware of the different phases, then you can plan around your cycle and make the most of it!
So, if you aren’t already tracking your cycle – start now by downloading an app at least. I use ‘My Calendar’ but you can use any. On your first full day bleeding, log it as ‘day 1’ of your cycle and off you go! Once you have a few months tracked you can see if your cycle is regular in length if you have symptoms around ovulation, do you suffer from PMS etc.
The more we open the conversation on this topic, the more we will all learn about it and the effects it has on our lives.
I will be going into the menstrual cycle and training in my next post so make sure to sign up for my newsletter to receive the updates!