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This is part one of a four-part blog series all about the female cycle! We will be looking at what impacts our sex hormones, how food can support and realign our system and what environmental factors need to be addressed to live our best lives.
In this post we will be covering myths about our cycle, some vocabulary every women should know and be comfortable using and what a "typical" cycle looks like.
The female cycle has unfortunately been a taboo topic touted with embarrassment and shame. I want to attempt to remove some of the outdated stigma and start a conversation to help empower women to take control of their hormonal health and thrive!
Let's start by looking at some of the myths around the menstrual cycle and see what you might already know.
Period Myths: bloating, mood swings and acne OH MY!
While these symptoms may be common, they are by no means normal or healthy. Let’s take a closer look.
PMS “premenstrual syndrome” – Many women have some form of PMS which includes but is not limited to bloating, mood swings, acne, sugar cravings and weight gain. These are simply a sign of imbalances of estrogen and progesterone during the luteal phase and can be rebalanced through targeted support.
Cramps just come with the territory – While there is some amount of contracting that takes place when the uterus is shedding its lining, an over production of a specific prostaglandin (PgE2) can cause painful menstrual cramps. On the other hand, PgE1 and PgE3 are considered antispasmodic and help to reduce excessive menstrual cramping. Our diet can drastically affect the intensity of these cramps. Read more here
It’s OK not to have a period – the lack of a period is a biological symptom of imbalance or distress in the body. Healthy levels of estrogen and progesterone are appreciated far beyond our reproductive system and provide lifelong benefits to the brain, cardiovascular system, bone health and much more. Read more here.
Heavy bleeding or spotting are normal – nope, these are not “normal” and again, are a sign of hormonal imbalance, specifically too much or too little estrogen respectively. We need to be listening to how the body is communicating its needs and this one is loud and clear. Using a therapeutic diet, exercise and targeted supplements, we can support our hormones and influence the quality of your cycle in as little as one cycle.
The Pill regulates your cycle – You may have been told that the pill helps regulate your cycle. This has been a common practice among many practitioners for decades. Unfortunately, the pill overrides the “brain-ovarian” line of communication and actually stops your body from making its own estrogen and progesterone. Read more here.
Vocab Lesson!
Ladies, I find very few women know the details of their cycle and even fewer know the accurate vocabulary to communicate their needs especially during dysfunction. Lets look at a few of the most important aspects to know.
Ovaries – paired organs that produce secondary oocytes (eggs to be released for fertilization)
Follicle – located in the ovaries - capsules that each contain one oocyte – Each month one follicle matures and generates a secondary oocyte to be ovulated (released)
The following 5 hormones work together to support and regulate 3 phases of a woman’s menstrual cycle. (Follicular phase, ovulation and the luteal phase)
Corpus luteum – is the casing of the follicle after the egg is released during ovulation
Estrogen – is produced in the ovaries during reproductive years (adrenal glands after) and promotes the development of the uterine lining
Follicle stimulating hormone (FSH) – is produced by the anterior pituitary gland and promotes follicular growth in the ovaries
Gonadotropin-releasing hormone (GnRH) - is secreted from the hypothalamus and initiates the monthly cycle. In the reproductive years, GnRH is released in response to estrogen and progesterone in the blood.
Luteinizing hormone (LH) – is produced by the anterior pituitary and stimulates ovulation
Progesterone – is produced by the corpus luteum and prepares and hold the endometrial lining in place
Hormone balance means having the appropriate levels of hormones at the appropriate times.
Getting to Know your Cycle
If you really want to evaluate your health, take a look at your cycle. There are many pieces to this puzzle that speak to the underlying health of our hormones such as cycle length, color, PMS symptoms and more. Along with heart rate, respiration, blood pressure and temperature, our cycle is considered the 5th vital sign for women once they have reached their reproductive years. Food and lifestyle play a major role in our hormonal symphony and in this blog series we will be looking at how we can Live in Harmony with our Hormones!
Intro to ovarian hormones: Let’s look at the main female sex hormones that influence our cycle.
Made from cholesterol, estrogen and progesterone are the main hormones produced in our ovaries. During childbearing years, the ovaries are the main location of estrogen and progesterone production. However, once menopause hits, the adrenal glands become the site of production. Imbalances of these two hormones can cause many menstrual and uterine dysfunctions. The timing and fluctuations of hormone levels as well as their relationship to one and other, all contribute to the health of our cycle and our entire system.
Along with heart rate, respiration, blood pressure and temperature, our cycle is considered the 5th vital sign for women once we are of reproductive age.
A “normal” cycle lasts somewhere between 21-35 days (28 being the average) and can be considered normal and healthy anywhere in that range. Outside of that window can indicate anovulation (lack of ovulation) even though you still might have a bleed phase. For the sake of this blog, I will be using a 28 day cycle and day one will be the first day of the bleed phase. The bleed phase or menstruation is the accumulation of effects from the previous hormone cycle and should be considered the last phase. In the teenage years, the follicular phase can be as long as 32 days, but the luteal phase is the same, between 10-16 days (Briden).
Phase 1
Follicular Phase: (first day of your period until ovulation)
Duration: 7-14 days (this can be shorter or considerably longer)
This phase lasts 1-3 weeks. The follicular phase is the final "race to the finish line" where approximately 6-8 follicles are maturing and getting closer to one follicle reaching ovulation.
At this point, the hypothalamus, in the brain, signals the pituitary to shuttle follicle stimulating hormone (FSH) to the ovaries to help the follicles make estrogen. As estrogen levels begin to rise, the uterine lining, or endometrium, begins to regenerate (you might have heard the this referred to as the proliferation phase) and thicken to provide the perfect environment for an egg to live if ovulation takes place.
FSH will be lower when we are young so the follicular phase will be longer. However, as we age, or say in our forties, we have more FSH so our follicular phase will be shorter.
Rising estrogen concentrations paired with minimal progesterone levels continues to stimulate the release of gonadotropin releasing hormones (GnRH), from the hypothalamus and FSH and luteinizing hormones (LH) from the pituitary gland. Rising LH stimulates the ovulation of an egg from the matured follicle. On to phase 2!
Phase 2
Ovulatory Phase: Days 14-17 generally
Duration: 3 - 4 day window but ovulation takes place in one day
A spik in LH and estrogen stimulates one follicle to mature completely and be released into the fallopian tube where it travels to the uterus. At this point, the uterine lining is fully formed. There is also a sharp rise then rapid fall in testosterone during this phase.
Phase 3
Luteal Phase: Days 14 - 28 generally
Duration: 10 - 14 days
Once the follicle releases the egg, the follicle is now called the corpus luteum. While in the ovaries, the corpus luteum is the main producer of progesterone and smaller amounts of estrogen.
Estrogen levels continue a smaller but significant rise to further boost the growth of the uterine lining. The rise in progesterone signals the body to keep the thickened lining in place in anticipation of a fertilized egg. The rise in progesterone also signals the pituitary gland to stop releasing FSH and LH.
If the egg has not been fertilized, the corpus luteum is reabsorbed into the body. Estrogen, progesterone, and testosterone will reach their peak concentration and begin to fall to their lowest levels right before menstruation begins.
If there are symptoms of PMS, it is due to relative estrogen dominance where estrogen levels are too high compared to progesterone levels.
Phase 4
Menstrual Phase: day 23 - 28 or so
Duration: 3 - 7 days The average blood loss is 35-150 ml or 2-10 tablespoons which translates to 8 or less soaked tampons/pads a day with no more than 2 heave days.
Progesterone production drops as the corpus luteum gets reabsorbed into the body. This drop in progesterone triggers uterus to shed the endometrial lining and the menstruation phase begins.
The consistency, color and duration of our menstrual period is a powerful sign of your hormonal health and provides a wealth of information. We will explore that information in an upcoming blog.
References:
Briden L. The Period Repair Manual 2nd ed revised. Greenpeak publishing; 2018
Photo reference:
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