The Period Puzzle: Demystifying Your Monthly Cycle

A Deep Dive into the Menstrual Cycle

We often hear phrases along the lines of “You know your body best,” but how can we be more in-tune with our bodies, if we were not given the tools and knowledge to do so? In my interactions with patients and friends with female reproductive systems, it has come to my attention that how our bodies change during our menstrual cycle is not something that is commonly talked about. This creates opportunities for misinformation, dismissiveness, and even shame. It is my goal for my menstruating patients to work with their menses in congruency by understanding the changes their bodies go through, instead of vilifying and fighting it. This is a 3-part blog series. My previous blog discussed period basics & FAQs. This blog is a little more scientific in its explanation of the physiological processes occurring during your menstrual cycle, but it is my aim to provide a concise explanation for you all. So let’s dive right in!

Understanding the Menstrual Cycle

Day 1 is the start of menstruation. Your menstrual cycle goes from the start of menses to the start of your next menses, averaging roughly 28 days. For the purposes of this explanation, we will be following the 28-day cycle, but note, that everyone’s cycle length varies (as 21-35 days is still considered normal). We also discussed that ovulation occurs about 14 days before the start of your next period. To talk about the events that take place during the menstrual cycle, we can break the cycle down into 2 phases:

1.     The pre-ovulatory or follicular phase (~days 1-14)

2.     The post-ovulatory or luteal phase (~ days 14-28)

Pre-Ovulatory/ Follicular Phase

It is important to note that your reproductive system is controlled by your brain. Your brain releases two hormones called follicle stimulating hormone (FSH) and luteinizing hormone (LH). These hormones control the growth of the follicles contained in the ovaries. These follicles contain immature eggs. Over the follicular phase, the follicles containing immature eggs will grow and the hormones FSH and LH will signal estrogen release from the ovaries. Estrogen rises gradually from days 1-10, and increase more rapidly on days 10-14. Ovulation is when the follicle grows and eventually ruptures, thus releasing a mature egg.

Let’s now discuss what is happening in the uterus. The uterus or endometrium is working to create a nutrient-rich environment for the egg to implant and maintain pregnancy. This starts at day 1 of your menses when the old uterine lining is released from the vagina, lasting about 5 days (if you guessed that this is your period, that is correct J ). This is then followed by the proliferative phase which stimulates thickening of the uterine lining/endometrium from elevated estrogen levels. This thickening contains blood vessels for the transport of nutrients to support pregnancy. Additionally, changes in cervical mucus occurs in order to be more compatible for sperm. This is also referred to as discharge. If you are looking to conceive, the optimal fertility window is around days 11-15, when following a 28-day cycle.

Post-Ovulatory/ Luteal Phase

Following ovulation, we enter the post-ovulatory phase. The remains of the ruptured ovarian follicle become known as the corpus luteum, since the cells in the follicle have been exposed to LH. These cells continue to produce some estrogen and convert cholesterol to progesterone. This half of the cycle is thus dominated by increased progesterone levels produced by the corpus luteum. In a feedback system, progesterone signals to the brain to decrease FSH and LH production, thus reducing estrogen levels. This indicates that ovulation has occurred and the endometrium becomes receptive for implantation of a fertilized egg (sperm successfully meets the mature egg). High progesterone levels cause the uterus to go into a secretory phase where blood vessels increase rapidly and uterine glands begin to secrete more mucus. If fertilization does not occur during the fertile window, the cervical mucus begins to thicken becoming less hospitable for sperm. The corpus luteum degenerates, becoming non-functional. Meaning, no hormones are produced and Estrogen and Progesterone levels decrease. When progesterone levels decrease significantly, the blood vessels in the uterine lining collapse, which leads to the shedding of this layer through menstruation.

Please see the diagram provided below:

Img reference: https://cdn.britannica.com/07/55707-050-5927EDFB/changes-woman-cycle.jpg

You made it to the end! Thanks for reading and sticking around. If you found this information helpful and are interested in naturopathic tele-health care, book your Complimentary Introductory call today!

As always, Take good care.

Love,

Dr. Janki Dalal

Disclaimer: The information contained in this blog is NOT personal medical advice. This material is purely for educational purposes and is not a substitution for a proper medical diagnosis and treatment. Please consult with your doctor before implementing any new treatments.