A guide to menstrual cycles
Your menstrual cycle is like your monthly report card and can actually tell you so much about your health. But often classic symptoms that something isn't quite right are dismissed.
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In this blog we'll go through what is 'normal', what is not, and how to troubleshoot if something doesn't seem quite right.
So let's give a bit of background into the menstrual cycle:
There are 4 stages to your cycle, and day one of your period is day one of your cycle, from here until ovulation this is known as the follicular phase, where under the influence of estrogen our endometrial lining grows and the egg is maturating in the ovary. During this phase estrogen builds and peaks just before ovulation, normally this is when we feel our most energetic, capable and efficient.
Just before ovulation, luteinizing hormone (LH) and Follicle stimulating hormone (FSH) are released from the pituitary gland, which signals the ovaries to release an egg.
After ovulation, we enter the luteal phase and as estrogen, LH and FSH drop, progesterone rises. Progesterone is a neuroendocrine hormone that acts on the GABA receptors in our brain and keeps us really calm and relaxed (which is why usually people feel good during their luteal phase). Progesterone supports the uterine lining and makes it nutrient-dense, if conception occurs it facilitates the embryo implanting into a thick endometrial lining.
As we come close to our period, progesterone will start to decrease and estrogen starts to build.
What's 'NORMAL'
A cycle between 25 days to 35 days is considered normal and a cycle between 28-30 would be ideal. Both the follicular phase and luteal should last around 11-14 days, with ovulation occurring in the middle (not always on day 14, but for many on day 14-18).
Regardless of if your cycle fits into the normal category or not, I highly recommend tracking your cycle using Basal Body Temperature (BBT). Mapping this out confirms if and when ovulation occurs, which can guide you in predicting future fertile windows, and gives you an indication of the length of the follicular and luteal phase.
Troubleshoot my period
Why is my cycle short?
A shorter than 25-day cycle could be a few things, using your BBT you can determine if one phase (follicular or luteal) is shorter than it ideally should be. A short follicular phase could impact the egg maturation phase, and a short luteal phase could indicate suboptimal progesterone levels.
Why is my cycle long?
A longer than 35-day cycle may impact your fertility in a couple of ways, firstly, the longer our cycles are, the less we have each year and therefore the less opportunity within the year to conceive. A long cycle may also indicate excess androgen, excess estrogen, or insulin resistance, and is common in those with PCOS or endometriosis.
What About my Bleed?
Should start with fresh red blood, be heavy for a few days and taper off to nothing and should last between
approximately 3-7 days. As the flow of blood changes, it's normal for the colour to turn darker red or even brown as it oxidises. Dark red, almost black or pink or light red may indicate there is something else going on.
The amount, quality and colour of the bleed can be difficult to determine depending on what type of protection is used, usually, a pad or moon cup will give you the best indication.
Menstrual blood is not just composed of blood and is rich in stem cells, endometrial lining and vaginal flood, the consistency may change during your cycle and from person to person. Small clots are quite normal, however anything larger than a medium grape is worth getting checked.
A shorter than 2-day cycle or very light bleeding could indicate ovulation has not occurred, a hormone imbalance, or low progesterone, or can occur if a woman is premenopausal. Whereas a very heavy bleed is common with fibroids, polyps and endometriosis
Please remember, every person is completely unique and 'normal' can look very different from person to person, and cycles can also change over time and during different life stages! There are also many things that can impact our cycle on a month-to-month basis, such as increased stress, exercise or poor sleep and diet which can delay ovulation and delay bleeding.
What if I don't have any period at all?
Amenorrhea occurs when a woman, who previously had regular menstrual cycles, stops having periods for at least three consecutive cycles or six months. It can be caused by various factors, and it's essential to determine the underlying cause to guide appropriate treatment, some reasons might include, pregnancy, hormonal imbalances (common in those with PCOS), stress, over-exercising, under-eating (hypothalamic amenorrhea), thyroid disorders, medications etc.
Is Pain Normal?
Some women may experience more pain than others, excessive pain, that is debilitating or needs heavy and ongoing pain relief is not normal and is more commonly associated with endometriosis (PCOS is not associated with pain!).
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Can I support my cycles?
Yes!! Despite what we're often told (that we just have to put up with it!) we can support our hormonal health and cycles. We can lengthen or reduce them if they sit outside the 'normal' window, we can investigate excessive blood loss or pain by understanding the why.
Our cycles are so important when it comes to our fertility, I really encourage you to take a special interest in getting to know your cycle, listening to what it is telling you about your body and connecting to it. Sadly our world has made them 'gross' and taboo, but there is empowerment in understanding this part of your body more!
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