Periods can be a challenging time of the month – cramps, bleeding, low energy, mood swings, cravings… but I think understanding what is going on in your body and understanding why this may affect you in so many ways can help cope with some of the symptoms.
The menstrual cycle is a complex series of physiological changes the female reproductive system goes through each month, due to variations in the female reproductive hormones: FSH, LH, oestrogen and progesterone. For ease, a menstrual cycle is defined as 28 days, but variety from 21 to 40 days and still be considered ‘normal’ and regular. The cycle starts with menstruation (a period) and is split into 2 phases – the follicular phase (days 1-13) before ovulation occurs, and then after ovulation – the luteal phase (day 15-28).
So what is happening at each stage?
Day 1-5: Menstruation
The lining of the womb breaks down and sheds the muscles of the uterine wall contracts which results in a bleed (usually alongside some unpleasant cramps!). The volume of a ‘normal’ bleed is approx 80ml, although some women have lighter or heavier periods, which may be normal for them.
There is a bit of stigma surrounding periods, but they are entirely natural and period blood is not ‘dirty’ or something you should feel embarrassed about. Some women feel they need to excessively clean during this time, but remember you only need to cleanse your intimate area max once per day (even when on your period) to not disrupt the vaginal/vulval microbiome! During your period, levels of hormones oestrogen and progesterone are at their lowest so you might notice your skin feels more dry and sensitive at this time and excessive cleansing will not help this! If your skin is more sensitive, try cleansing with just warm water or a gentle, pH balanced wash, such as Femfresh 0% sensitive wash. Avoid washing more than once a day as this may exacerbate symptoms and never clean the inside of the vagina! Femfresh wipes are a great on the go alternative to stay fresh throughout the day if you’re worried!
Day 1-13: Follicular phase
This phase also begins on the first day of menstruation, alongside the bleed. The pituitary gland in the brain secretes a hormone called FSH (Follicular Stimulating Hormone) which stimulates eggs in the ovaries to mature and develop into a follicle, ready for ovulation. As the follicle develops it release oestrogen which helps prepare the uterus lining in case an egg is fertilised, gives you more energy and increases your pain threshold leading up to ovulation!
Day 14: Ovulation
The mature egg is released from the ovary and from the follicle due to a rise in LH (Luteinising Hormone) and begins its journey to the uterus to be fertilised by a sperm. Some women get some pain during ovulation which is entirely normal. You may also notice a change in your normal vaginal discharge, becoming thicker and whiter as more cervical mucus is produced. Progesterone levels are higher during this time so skin may feel oily and sex drive is often highest around ovulation (which makes sense as this is the time you are most fertile!)
Day 15-28: Luteal Phase
After the egg is released, the follicular sac it matured in becomes the corpus luteum. This produces progesterone and maintains the lining of the womb ready for an egg to implant. When progesterone levels are at their highest you may experience symptoms of PMS (pre-menstrual syndrome) such as mood swings, feeling emotional, increase appetite, bloating, headaches, tiredness, breast tenderness, spotty spin or more greasy hair and reduced libido. Oestrogen levels drop quickly after ovulation and remain low until menstruation, so energy levels can be lower, meaning you may feel more tired and sluggish than usual. If the egg is not fertilised by a sperm during the luteal phase, the corpus luteum degrades, the level of hormones drop and a bleed occurs ready for the whole cycle to start again!…
Dr Frankie