The Menstrual Cycle: Your Fifth Vital Sign and Its Impact on Overall Health
Your menstrual cycle plays a key role in your overall health, not just your fertility.
Reproductive hormones including estrogen, progesterone, and testosterone, impact
many areas of health including: bone strength, metabolism, brain function, muscle
tone, mood, sleep and so much more. Just like heart rate, blood pressure,
temperature, or oxygen levels, your menstrual cycle can tell you a lot about your
overall health.
What does a healthy menstrual cycle look like?
There isn’t a “one size fits all” but rather a range of normal parameters to look out
for. In general, one women’s particular cycle should be fairly consistent from month
to month and fall within the following parameters:
Length from one period to the next: 26-34 days
Menstrual bleeding: 3-7 days in duration with a variety of bleeding patterns (light,
medium, and heavy) including at least one day of heavier flow. Heaviest flow should
be no more than 6 pads/tampons per day.
Associated menstrual cycle symptoms:
Pain and mood changes are common but not considered normal.
It is typical to experience occasional mild cramping or pelvic tension as well as some
breast fullness. However, there should not be a need for pain medications. Severe
cramping, painful/cystic breasts, and migraines or headaches suggest a hormonal
imbalance.
In the same line, mild shifts in mood and energy level are to be expected while
extreme or disruptive changes to your mood, energy, and sleep are signs of an
underlying problem.
Understanding the Four Phases of the Menstrual Cycle
The menstrual cycle can be broken down into 4 phases, each characterized by shifts
in our hormones. It is these hormonal changes throughout the month that cause
fluctuations in our moods, cravings, energy levels, and more. I like to think of these
shifts as four seasons we transition through each cycle. Each season brings unique
physical signs and inner guidance that can clue us in on our overall health and
wellbeing.
Phase 1 – Menstruation a.k.a. Your Period – Winter
From 1 st day to last day of bleeding (days 1-7). Estrogen, progesterone, and
serotonin are at their lower points during this phase while inflammatory chemicals
reach a peak. During this time, you shed the old uterine lining and prepare for a
fresh start. It is common for women to feel more introspective with a desire to stay
in and rest, eat comforting foods, and partake in gentler movement/exercise.
Phase 2 – Follicular phase – Spring
From day 1 until ovulation (variable but typically days 1-13). During this phase,
your body is preparing a follicle (egg) to be released for ovulation. Your uterine
lining is growing and becomes lush in preparation for a potential pregnancy. At
about day 3 your estrogen levels start to rise and subsequently your testosterone.
These rising hormones usually translate into a feeling of spring! You may have more
energy, confidence, motivation, positive moods, improved memory and focus and
higher sex drive.
Phase 3 – Ovulation – High summer
Generally this occurs mid-cycle, sometime between days 14-18, give or take.
Estrogen peaks at this time and triggers release of luteinizing hormone (LH) from
the brain, which causes the dominant follicle to rupture and release an egg. This
peak in estrogen creates an observable change in cervical mucus that is an accurate
indicator of ovulation. This cervical mucus is copious, clear, stretchy, often
described as like “egg-whites”. It functions as a lubricant and makes the vagina and
cervix more hospitable to sperm while weeding out abnormal sperm.
Your egg can only be fertilized for about 12-24 hours after release. However, sperm
are able to live inside the fallopian tubes for 3 to 5 days. Therefore, you are fertile
for about 5 or 6 days every month.
During this phase, most women feel at their best in regards to energy, desire, mood,
and optimism thanks to the elevated estrogen and testosterone levels. It is a time of
peak ripeness. We are more likely to problem-solve, socialize and have a higher sex-
drive.
Phase 4 – Luteal phase – Late Summer into Autumn
From ovulation to the day before your next period. Typically lasts 14 days but 9-14
days is considered normal (Days 14-28).
The luteal phase has two distinct hormonal landscapes and what happens depends
on whether or not fertilization occurs.
Shortly after ovulation estrogen levels decline a bit and progesterone takes over.
Progesterone is produced by the corpus luteum, the hollow or “shell” left on your
ovary after the egg is released. Higher progesterone levels usually translate into
calmer moods and better sleep. You will notice a change in cervical mucus to thicker
more pasty/dry.
If fertilization occurs, the egg will implant on the cushy uterine lining. Progesterone
will remain elevated and estrogen will continue to support the lining of your uterus
as it sustains the growing embryo until the placenta is formed.
If fertilization does not occur, progesterone and estrogen will drop, along with
serotonin. This represents the greatest fluctuation in hormone levels for most
women.
During this shift, you may experience lower moods and lower energy as that bright
and sunny ovulation energy changes into a desire to spend more time quietly.
This is when women experience PMS symptoms including irritability, weepiness,
cravings for sugar, fat, and simple carbs, as well as bloating and cramping.
Many of the mood symptoms are related to the decrease in serotonin. Interestingly,
estrogen is a building block for serotonin so when estrogen drops, serotonin
follows. However, serotonin can also be made from carbohydrates, which is why
your incredible brain & body signals cravings for sugar and carbs.
Understand Your Hormones Better
By paying attention to these various signs as well changes in your mood, sleep,
cravings and energy levels throughout the month, you can gain valuable insight into
your overall hormonal landscape. These observations can help you to make choices
in your day-to-day life that honor your body and hormones.
For example, if you experience irritability or emotional sensitivity during your luteal
phase, make self-care a priority during this 1-2 weeks.
If you experience intense cravings for sugar, know your body is trying to produce
the “feel-good” serotonin and give it the proper building blocks – whole grains or
starchy vegetables such as sweet potatoes, squash, and peas. Dark chocolate can
also be a great choice!
When we pay attention to our natural cycles, we can detect when something is
amiss long before disorder or disease develops. The menstrual cycle is a window
into our general health and well-being. We know that abnormalities of the
menstrual cycle are linked to many chronic diseases including diabetes, heart
disease, cancer, depression, and more!
Schedule Your Appointment to Understand and Track Your Menstrual Cycle
If you are interested in learning how to monitor and chart your menstrual cycle or
need help interpreting what you are observing, call (308) 777-2476 and schedule an appointment today with Erica Ellicott, PA-C at Elevate Health!
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