BODY: Know Your Flow

It wasn’t until I started having problems tracking and managing my menstrual cycle that I realized I’d completely forgotten all of my sixth grade sex ed course and was forced to turn to Google for answers. After a few years of dealing with my period, I had reached a certain level of status quo and let it run its own course. A year and a half later, I can see the benefits of staying in tune with my body and monitoring changes in my cycle to help understand my body’s overall health.

Going back to the basics, having your period is not the only part of the menstrual cycle; in reality, the period is the first phase of the cycle, which stretches from the first day of one period and ends when the next period begins. Your body is going through a multitude of changes during this cycle and it’s important to know what’s going on inside your body because the effects are not limited to your uterus.

There are two cycles occurring at once; one in the ovaries and one in the uterus. The brain, ovaries and uterus work together and communicate via hormones to keep the cycle going on a steady schedule.

Typically a cycle lasts between 24 and 38 days, but it varies from person to person and sometimes from one cycle to another. Period length and intensity can also change as you age, especially when you factor in influences such as hormonal birth control. Between the stage of menarche (when the period starts during puberty) and menopause (when your periods permanently stop) you will often notice changes in your entire body.

As I mentioned, the menstrual cycle doesn’t just cause some bleeding and then quietly exit stage left; over the course of the cycle it is common for women to notice changes in their hair, skin, sleeping habits, mental health, moods and digestion. Your body is literally preparing to get pregnant ad nauseam, whether you like it or not, so it benefits you to track where you are in your cycle and how likely you are to conceive at any given time.

Certain birth control methods that put a hormonal influx into your body prevent some or all of the steps from happening in the uterus and ovaries. Non-hormonal ones, like the copper IUD (which I have and highly recommend) do not affect your hormonal levels but act as a physical barrier in your uterus, preventing anything from growing without affecting your body’s natural rhythm. Your birth control choice (or lack thereof) is yours and yours alone, but it’s always god to check in with your OBGYN and make sure you understand the implications.

Here is what to expect during the phases of your menstrual cycle:

Menstruation: This is where you get your period and where the uterine lining (endometrium) is being shed. Your levels of estrogen and progesterone are low at this point and your period can last up to 8 days but most women will have periods for 5 to 6 days.

Follicular phase: Within the ovarian cycle, this phase marks the time between the first day of the period and your ovulation. Your estrogen levels are on the rise as an egg is preparing to be released. The pituitary gland (a small area at the base of the brain which makes hormones) produces a hormone called the Follicle Stimulating Hormone. The FSH lets the ovaries know it is time to prepare an egg for ovulation (when it gets released from the ovary). Throughout the menstrual cycle, there are multiple follicles (fluid filled sacs containing eggs) in each ovary at different stages of development. Halfway through the follicular phase (as the period is ending) one follicle in only one of the ovaries is the largest of all the follicles – usually about 1cm long. This becomes the dominant follicle and it is the one that gets prepared to be released at ovulation. The dominant follicle produces estrogen as it grows, which peaks just before ovulation occurs. For most people the follicular phase lasts 10-22 days, but this can vary from cycle-to-cycle.

Proliferative phase: Within the uterine cycle, after the period, the uterine lining is built back up. While the ovaries are busy working on the egg-sac follicles, the uterus is reacting to the estrogen produced by the follicles and starts to rebuild the lining that was shed during the last period. The endometrium is at its thinnest during the period, then builds up to being at its thickest during ovulation; it does this in order to have ample support to implant and grow a potential fertilized egg.

Ovulation: During this phase, the egg releases from one of your ovaries into a fallopian tube around mid-cycle. Your estrogen will peak slightly beforehand and drop shortly after; studies have shown that women show facial markers as to when they are most fertile; faces appear more feminine, more symmetrical and take on a reddish “healthy” glow. The dominant follicle will reach about 2-3cm in length. When estrogen levels are high enough, they signal the brain causing an increase in luteinizing hormone (this hormone regulates the ovaries in women and testes in men). This spike is what causes ovulation – the release of the egg from the ovary and will occur 13-15 days before the start of the next period.

Luteal phase: In the ovarian cycle, this is between ovulation and before the start of menstruation, where the body prepares for the possibility of pregnancy. After ovulation occurs, the follicle that contained the egg transforms into a corpus luteum and begins to produce progesterone as well as estrogen. The hormonal changes of the luteal phase are often associated with common premenstrual symptoms such as mood changes, breast tenderness and swelling, acne, headaches and bloating. If the egg is fertilized, progesterone from the corpus luteum supports the pregnancy. If it goes unfertilized, the corpus luteum will start to break down 9 or 11 days after ovulation. The result is a drop in progesterone and estrogen, which causes the menstruation. It is common for the luteal phase to last between 9 and 16 days.

Secretory phase: In the uterine cycle, the uterine lining produces the chemicals necessary to support an early pregnancy should it occur; if the egg isn’t fertilized, it will break down and shed. Rising levels of progesterone cause the endometrium to stop thickening and start preparing for the attachment of an egg. The endometrium secrets chemical messengers, most importantly PGF2a and PGE2, which cause the uterine muscle to contract and “cramp” which in turn spurns on the menstruation. The amount of prostaglandins rise after ovulation and peak during menstruation. If a pregnancy occurs, the cramps will be halted to avoid interfering with the early pregnancy; if fertilization doesn’t occur, the hormone levels drop which causes cramps and the tissues of the endometrium to break down (1).

At this point, menstruation begins and the whole cycle starts again. In the last year I have used the Flo app to track my symptoms and as such I can tell where I am in my cycle down to the day by paying attention to my body’s signals. For example, I can always feel my ovulation as a slight twinge on my left or right side, but typically it is more prominent on my left. As well, I know that 2-3 days before ovulation I can expect to be restless and anxious over the course of the night, so it gives me fair warning to adjust my lifestyle habits stay away from caffeine and meditate for stress relief. Small changes over the course of your cycle and help relieve some of the more annoying side effects.

The body is going through so many changes during each cycle and many of the side effects that may seem cause for concern are actually commonplace; light fatigue, bloating, changes in your bathroom habits (either too much or not enough), and discharge are all fairly commonplace. Complications during the cycle can arise, especially with the rise of women with poly-cystic ovarian syndrome (PCOS), fibroids and endometritis. It is not normal to have debilitating pain or severe cramping from your periods as an adult, so if you feel as though your body is out of whack it is always best to check in with a gynecologist to ensure everything is functioning as normal. (2)

The better we understand our bodies, the happier and healthier we can live our lives.

Citations:
1. Ray, Laurie. “The Menstrual Cycle: More than Just Your Period.” The Menstrual Cycle: Phases of Your Cycle, Clue, 12 Dec. 2018, https://helloclue.com/articles/cycle-a-z/the-menstrual-cycle-more-than-just-the-period.
2. Darrisaw, Michelle. “5 Weird Things That Happen During Your Period That Are Totally Normal.” Essence, Essence, 25 June 2018, http://www.essence.com/lifestyle/weird-things-happen-body-during-menstruation/.

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