Understanding Your Menstrual Cycle

Periods can often be inconvenient, uncomfortable and at times downright annoying! But did you know that they are a great way to check on a woman's health? What’s so good about a menstrual cycle I hear you ask? Regular ovulation is an indicator that all is well within the body - not only in terms of making babies, but also for general health. So, if you’re not thinking about ovulation, you’re not thinking about health. Periods can tell you what is going on with your body - does your period come every month, is late or early, or does it not come at all? Are your bleeds heavy and painful, or light and breezy? Do you know when you ovulate? Are you oestrogen dominant and progesterone deficient? Whether you are trying to get pregnant or not, there has never been a better time to get to know your menstrual cycle.

Stages of the Menstrual Cycle

The menstrual cycle has four stages: the follicular stage, ovulation stage, luteal stage and menstruation stage. A cycle normally lasts between 26-32 days, however, this can vary between women with some having longer or shorter cycles - anywhere around this is fine, if it is regular and consistent for you.

1. Follicular Stage During the follicular phase, follicle-stimulating hormones (FSH) are released from the pituitary gland, causing follicles to begin developing in the ovary. They produce oestrogen, which causes the lining of the uterus to thicken, ready for a possible implantation of a fertilised egg. The follicular stage normally starts on the first day of menstruation, ending with ovulation.

2. Ovulation Stage Ovulation occurs when a mature egg is released from the ovary ready for fertilisation. During the follicular stage, there is a domino effect on various hormones, starting with a rise in oestrogen levels which causes gonadotropin-releasing hormones (GnRH) to be released, which then causes the pituitary gland to produce increased levels of luteinising hormone (LH). The sudden rise in LH, then triggers ovulation. The egg is then moved into the fallopian tube towards the uterus. If fertilisation doesn’t occur, the egg disintegrates within 24 hours.

• Cervical mucus – what does it mean? Both before and during ovulation the cervix produces mucus. Before ovulation the cervical mucus is clear, slippery and elastic (like a raw egg white). This is when a woman is considered fertile, as this type of mucus assists sperm during conception. Once the fertile stage of the cycle has passed, the cervical mucus changes colour and texture, resembling a sticky, gummy or creamy texture, and being white, milky or yellow in colour.

• When do you ovulate? When you ovulate depends on how long your cycle is. Normally ovulation occurs 12-16 days before the start of the next period. If your cycle is regular, an easy way to calculate this is to minus 16 from the length of your cycle and then add 4. This will give you an idea of the days in which ovulation is most likely to occur. E.g. a 26-day cycle is most likely to ovulate between days 10 and 14 of a cycle (26-16 = 10+4 =14).

• When can I get pregnant? Once ovulation has occurred, an egg can live up to 24 hours. Sperm generally survive for three days but can live inside the vagina for up to five days if optimal fertile cervical mucus is present. Pregnancy may then result from intercourse that occurs from as early as five days before ovulation, until up to 24 hours following ovulation

3. The Luteal Stage During the luteal stage, large amounts of progesterone as well as some oestrogen are released. These hormones help to maintain and thicken the uterine lining. If fertilisation has not occurred, the corpus luteum breaks down and progesterone levels decline, leading to the disintegration of the uterine lining. During this stage, women may experience physical and emotional changes, including tender breasts, mood swings, anxiety, food cravings, fluid retention, bloating, and tiredness.

4. Menstruation Stage During the menstruation stage, the broken-down uterine lining moves out through the vagina (as menstrual fluid), with approximately 50-100ml of fluid lost per each period. Generally, menstruation lasts from three to seven days, however this can vary between women with some having longer or shorter periods. The length of a cycle can also differ from one month to the next. The ideal cycle would last between 5-7 days, starting and ending with a bright cranberry colour bleed, however this may be different for each woman. The colour of a bleed for most women can range between black, brown, dark red, bright red and pink.

Commonly experienced menstrual problems

1. Premenstrual Syndrome (PMS) Premenstrual syndrome (PMS) refers to several physical and psychological symptoms that may be experienced before each period. Physical symptoms include tender breasts, fluid retention, bloating, food cravings and headaches. Psychological symptoms include mood swings, anxiety, tiredness, and feelings of overwhelm. Research shows that for mild premenstrual symptoms making dietary and lifestyle changes i.e. eating a healthy diet, practicing yoga, relaxation techniques, and using herbal remedies may help.

2. Heavy bleeding during period (Menorrhagia) It can be hard to define what constitutes a heavy bleed, but changing a pad or tampon every hour, can indicate that bleeding may be excessive. This can be caused by several factors including: endometriosis, fibroids, polyps etc. Excessive blood loss can be a real concern, as it can lead to iron deficiency and anaemia in women. If you feel you suffer from heavy bleeds you should consult with a trusted healthcare professional to discuss further.

3. Bleeding/Spotting between periods Bleeding or spotting between periods can be a caused by several factors, including: endometriosis, a thyroid disorder, fibroids, STI’s, or may also be a side effect of some contraceptives or medications. If you are experiencing bleeding/spotting between periods you should consult with a trusted healthcare professional to discuss further.

4. Absence of a period (Amenorrhoea) Absence of a period is usually the result of hormonal imbalances, which can be caused by various factors including: polycystic ovarian syndrome, being chronically overweight or underweight, high intensity over-exercising, anxiety & stress, or dietary changes. Often, this can be temporary, but if it occurs, or lasts for more than six months, you should consult a trusted healthcare professional to discuss further.

After reading this, we encourage you to observe your cycle every month to check what your body is trying to tell you. Are your hormones in balance? Are any lifestyle factors impacting on you? Is your diet not great? Is there too much stress in your life? We want to ensure that all women understand their cycle, to not only support fertility, but also general health and wellbeing. If you are experiencing issues, or wanting preconception advice, we can help support you to make changes that will get your cycle back on track and prepare you for optimal health and fertility!