A process that evolved over time for one purpose: reproduction.
Build up the endometrial lining in preparation for a potential pregnancy.
The eggs develop and are released. The corpus luteum develops after the egg release.
Estrogen, FSH and LH increase to support this process.
If there’s a pregnancy, the egg is fertilized. And the corpus luteum continues to secrete progesterone.
And the lining is kept for egg implantation and for nourishing the embryo/fetus.
And if there isn’t a pregnancy, then that lining sheds. The corpus luteum dies.
Our bodies know what to do. They’ve been programmed to do this for centuries.
It should be straightforward and simple, right?
So why are there so many period irregularities and complications then?
And why is it so hard to tell what a healthy and regular period is supposed to be like?
Or maybe you read the intro and didn’t recognise any of the words and are wondering: how does the menstrual cycle even work?
Well, in this article we’ll cover:
- An overview of the menstrual cycle and how it works
- What a healthy period looks like
- Common menstrual cycle irregularities
Menstrual cycle overview
So if you were feeling lost reading the intro we’re going to dig a little deeper into what happens during your menstrual cycles.
First of all, your menstrual cycle can be explained by both the ovarian and the uterine cycles.
These cycles are essentially the same process but differ based on what changes they’re describing. The ovarian cycle describes the follicle and egg development in the ovaries during this ~4 week process.
And the uterine cycle describes changes in the uterine lining (also called endometrium lining).
The first 2 weeks of the ovarian cycle are called the follicular phase.
During the follicular phase, the follicle develops from a primary follicle to the secondary follicle.
Follicular stimulating hormone, FSH, stimulates the development of this process (hence the name). Luteinizing hormone, LH, also supports this process.
Estrogen continues to rise leading to a spike in LH and FSH right before ovulation. In response to the spike in LH, the follicle ruptures and the egg is released.
Congrats, you’ve just ovulated!
Alongside this process, in the uterine cycle, the endometrial lining is shed while the primary follicle is developing. And then, as the follicle continues to mature, the uterus enters the proliferative phase. This is where the endometrial lining grows in preparation for a possible pregnancy.
Once the egg is released, FSH and LH levels dip completely because their job, to stimulate and release the egg, is done for now. The follicle turns into a structure called the corpus luteum (yellow body).
The corpus luteum starts to secrete progesterone. The secretion and increasing levels of progesterone cause the uterine lining to thicken even further and enter the secretory phase.
If there’s no pregnancy, the egg doesn’t get fertilised and disintegrates. The corpus luteum “shrivels up” into a corpus albicans (white body). And the uterine or endometrial lining gets the green light to start shedding. And the shedding starts this cycle all over again.
What a healthy menstrual cycle looks like/What it means to have a healthy period
Alright, so now you know what the heck is happening inside your body when you are menstruating and even when you’re not.
But without being able to see what’s happening inside, how do you know if your menstrual cycle is healthy?
And what are signs and symptoms that suggest estrogen, progesterone or other hormonal imbalances?
Let’s first start with what a healthy menstrual cycle looks like.
Now, there will be variations. Everyone is different!
For example, maybe you’ve been told that a healthy menstrual cycle is supposed to be 28 days.
But that’s not always the case. Healthy menstrual cycles can differ and be anywhere from 26-38 days.
Ideally, you’d want your cycle to be the same number of days consistently. But it is normal to have fluctuations here and there especially if you’re under stress.
It’s also normal to experience some low mood or irritability, and some physical symptoms such as back pain or breast tenderness.
Our periods ebb and flow and manifest what we went through the past month or so. So if last month was more stressful than usual, you may experience more symptoms than usual. And that is totally fine.
During menstruation, a bright red cranberry color is an indicator of a healthy cycle and balanced estrogen and progesterone levels.
Another really important indicator of a healthy menstrual cycle is ovulation!
How do you tell you’re ovulating? One accurate way to do so is by measuring your basal body temperature (BBT). This is done using a special thermometer that has 2 decimal places. Your BBT dips right before ovulation (or release of the egg). And rises after you’ve ovulated.
Another way is to check for discharge called cervical mucus. This is a whitish sticky or tacky discharge secreted around ovulation. Its purpose is to help the sperm reach the egg and to protect the uterus from infection and pathogens.
Ovulation happens around the middle of your cycle. Some women will ovulate around 14 days, some a little before or after.
Remember to check with your healthcare professional if you want to know more about your own periods specifically.
Menstrual cycle irregularities you should pay attention to
Ok, so we said the consistency of your cycle is important. Longer cycles (more than 40 days or more than 6 weeks for example) can indicate a problem.
If your cycle is longer than 6 weeks, make sure to check in with your healthcare professional.
A common reason for long cycles is the absence of ovulation (anovulatory cycle). The absence of ovulation can indicate issues such as hormonal imbalances.
Anovulatory cycles are seen in conditions such as PCOS.
Additionally, if you’re experience severe PMS symptoms such as:
- Mood swings in to things you can usually handle
- Severe breast tenderness or back pain
These PMS symptoms can suggest excess estrogen (commonly seen in PCOS). Severe pain (back, pelvic, etc.) can also suggest endometriosis.
Period blood can also suggest hormonal imbalances:
- Dark red: excess estrogen
- Light pink: low estrogen
- Brown: too little progesterone
Make sure to check in with your healthcare provider if you’re worried about any of these symptoms.