Menstruation demystified

What is a menstrual cycle? A simplified explanation…

A menstrual cycle is an important rite of passage into womanhood. It can also serve as an important metric to measure a woman’s health, yet discussing a menstrual cycle is seen as faux pas, or even something dirty. But it is quite the opposite. The menstrual cycle is an integral part of women’s health. If I had understood my menstrual cycle as a young adolescent, I think I would have less shame and embarrassment about my period. It is also important to note that if you are taking hormonal birth control, you are not having a period. You are experiencing a “withdrawal bleed” so it is not possible to get a full picture of your health if you are taking hormonal birth control. 

Basic Physiology

 To understand how important a menstrual cycle is we must understand normal physiology of a menstrual cycle. A “normal” menstrual cycle is defined by most medical textbooks to last an average between 28-32 days but can vary between 26-34 days. The way we measure the length of a cycle is from the start of a period (or bleeding) to the start of the next, that is the total menstrual cycle. This can vary in length, but a healthy menstrual cycle should not vary greatly from the average length. If a menstrual cycle is drastically longer or shorter that is an indicator that something may be out of balance. People often refer to the time of the cycle when bleeding occurs as a period or the menstrual cycle, but the entire cycle is around 28-32 days. It is important to note that a cycle can vary from woman to woman and a woman should pay attention to what is normal for her cycle.

Hormones  

To understand a healthy cycle, we need to understand the hormones at play and their basic functions. I will discuss estrogen and progesterone in a simplified manner here but there are other hormones that are very important that I do not address here.  

Estrogen is responsible for breast growth, growth of pubic hair, lipid metabolism, skin health, brain health, has a role in our mood, bone health, and sexual health. If your estrogen is low, you may experience a light period or no period at all like what happens in menopause.  Missing periods can also be seen in women who are under a great deal of physical stress or emotional stress. If your estrogen is high, you may experience weight gain especially in the waist, hips, and breasts, fibrocystic changes in your breasts, fibroids, fatigue, feelings of depression or anxiety, symptoms of “pms”.

 Progesterone is responsible for preparing the uterus to accept a fertilized egg, it stabilizes the uterine endometrium, and keeps the uterus from contracting and rejecting an egg. If the egg is fertilized progesterone will maintain the “quietness” of the uterus and the pregnancy. If it is not fertilized the egg will degenerate lowering the progesterone and initiates menses or the “period”. If progesterone is too high at a certain point in the menstrual cycle a woman will not ovulate.

 The Cycle

A menstrual cycle starts with day one of a woman’s bleeding, we call that day one of the cycle. The bleeding is the shedding of the uterine lining. The bleeding can last on average anywhere between 4 days to eight days with varying levels of menstrual blood flow. On day one of the menstrual cycle the hormones estrogen, progesterone, luteinizing hormone, and follicle stimulating hormone are at their lowest point during the 28-day cycle.

From day one to around day 7 the estrogen slowly rises causing the uterine lining to thicken and become a good place for implantation of a fertilized egg. Estrogen reaches its peak at around day 14, the average time for ovulation to occur. Ovulation is when the ovary releases a follicle to be fertilized by a sperm or to degenerate if not fertilized by sperm. After ovulation, estrogen drops, which can be an explanation for some symptoms associated with low estrogen such as headache that women experience at the beginning of their period and other times during the month. If the egg is not fertilized the uterine lining will be shed. This is what we call the period. If the egg is fertilized, progesterone which is produced by the follicle will be responsible for keeping the uterus from contracting and helping to maintain a pregnancy.

 Understanding what your cycle is telling you…

The reason why I think it is so important that a woman has a normal period, not a withdrawal bleed, is because the timing, quality, quantity, duration, and symptoms tell us something about her overall health. If a woman has a cycle that is one day and very little blood, it is an indicator that there are some imbalances with her hormones. We cannot tell what is going on without further investigation. Our periods are a great measure of our overall health, and we need to embrace them and support them. If we can use the information, we learn from our period we can improve our overall health.

Here are a few things you should not be experiencing during your period: pain, excessive bleeding (soaking more than a pad an hour), severe headaches, severe mood swings, exhaustion, or excessively long bleeding. If you are experiencing these symptoms, you would benefit from further investigation with a trained provider.

There are ways in which you can naturally help support your cycle. Very simple and inexpensive ways include getting enough restful sleep, minimizing stress, eating healthy whole foods, drinking enough water, eliminating processed foods, exercising four to five times a week but not excessively, eating enough good fat in your diet, not restricting calories so much that your body is in a deficit for a long time… this is not an exhaustive list.

If you want to learn more about your menstrual cycle or any women’s health topic, send me a message here or an email. Click the link in my bio to access my website where you can send me an email. I do consultations and would be happy to talk to you to see if I can help! As always this is not medical advice.