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Understanding Your Menstrual Cycle

Understanding your menstrual cycle is an important tool in being proactive about your own health and fertility. Many women view their cycle as something to be endured, rather than an important part of the natural ebb and flow of their hormones. Reproductive problems in both men and women are rising at an alarming rate. For this reason, I will be focusing on the topic of fertility for the next couple of months. This article takes a closer look at the role hormones play in the menstrual cycle and the importance of recognising hormonal imbalances which could be impacting one's ability of falling pregnant.

A regular, well balanced cycle is often an indicator of general good health. Likewise, a disrupted or irregular cycle can be a sign of wider health issues, therefore learning about the mechanics of your own menstrual process can be a useful tool for understanding and monitoring your own health. It is important to be aware that every woman is slightly different, so please use this guide as a starting point, but let your body be your main source of information on whether your hormones are working in harmony.

On average, a cycle takes between 24 and 38 days. People often talk about a cycle being 28 days, however it is actually quite rare for a woman to fit this timeframe exactly and you shouldn't be concerned that your pattern is longer or shorter. Ideally, your cycle will be about the same length each time, but it is quite natural for patterns to evolve as we get older.

Monitoring your cycle

It is normal to time your cycle from the first day of your period. If you are currently in the middle of a cycle, you can count back to the first day of your last period to find where you currently are. In the event that you aren't currently having periods, you could try using the first day of the moon cycle as a kind of surrogate. Some people believe that menstrual cycles follow the orbits of the moon around the earth, although the evidence supporting this is disputed. While the words ‘menstruation’ and ‘menses’ come from Latin and Greek words meaning month (mensis) and moon (mene), and the average menstrual cycle is 28 days, it is not clear that there is any real link.

That said, if you’re not currently cycling, you have to start somewhere, and it may as well be with the phases of the moon. Use this resource to track the moon cycles, so you know where to count from.

Decoding your cycle

Although we use the term ‘cycle’ there are actually two overlapping and interacting cycles that govern menstruation. One takes place in your ovaries, while the other happens in your uterus. The delicate balance of these hormones, combined with the brain's pituitary gland form an intricate network that can be viewed as three phases: follicular (pre-ovulation), ovulation and luteal (post-ovulation).

Let's look at each of these three phases and what is going on in your body at each point in its cycle.

The follicular phase begins on the first day of menstruation, or bleeding, and lasts for 10 - 14 days. ‘Follicular’ refers to the follicles that begin to develop in the ovaries from day 1. Assuming that there is no pregnancy present, the top layer of the endometrium (the uterine lining) sheds and is passed out of the body through the vagina, while the remaining lining fills up with nutrients and fluids in preparation for nourishing a newly developed embryo. You can see from the diagram that all the hormones are low during the first half of this process.

At around days 10 - 14, oestrogen rises while luteinizing hormone and follicle stimulating hormone spike, triggering the ovulation phase. This hormone surge causes a mature follicle in one of the ovaries to swell and rupture, releasing an egg into the fallopian tube. This process can last around 16 - 32 hours and ends when the egg is released. The newly released egg can survive for around a day during which it must be fertilised if a pregnancy is to occur, otherwise it will be re-absorbed by the body. Because of the variability of each woman's cycle this small window may actually occur anywhere between days 10 and 16.

The luteal phase (post-ovulation) runs for the last 14 days of the cycle. Hormone production initially drops off, then oestrogen and progesterone rise to help prepare the endometrial lining to sustain a new pregnancy. If a pregnancy does not occur, hormone production drops off again, signalling the end of the cycle and triggering the breakdown of the endomitrial lining and the beginning of a fresh cycle. It is during the later part of the luteal phase that you may experience pre-menstrual tension (PMS). This can be characterised by irritability, agitation or low mood, and is caused by the drop off in progesterone, which helps you to feel calm when at high levels.

Hormonal imbalance and infertility

There is a lot that can be done to support your fertility prior to opting for IVF. Although this may ultimately be the route you choose to follow, making nutritional and lifestyle changes (which increase your chances of falling pregnant naturally or, failing that, ensure optimal health to deal with IVF and a subsequent pregnancy) becomes crucial for anyone wanting to have a baby. Low oestrogen levels, for example, can result in infertility but so can oestrogen dominance. Look out for my articles in July/August which will discuss many possible reasons you are struggling to fall pregnant. Look out as well for my programme which will begin early September, helping you get your health and body ready for pregnancy.

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