The menstrual cycle is the monthly series of hormone-driven events in the body that culminates in either a
menstrual period or pregnancy. Each menstrual cycle starts on the first day of a period (menstruation) and ends on the day before the next period.
The length of the typical menstrual cycle is 28 days, but there is some variability. A cycle can be anywhere from 21 to 35 days long and still be considered normal.
The menstrual cycle is divided into four phases: menstrual, follicular, ovulation, and luteal. Rising and falling levels of hormones released by the pituitary gland (in the brain) and ovaries (which store your eggs) direct the menstrual cycle and lead to the monthly shedding of the uterine lining, or menstrual period.
The menstrual cycle starts the first day of a period. When a pregnancy doesn’t occur, levels of the hormones estrogen and progesterone drop, causing the lining of the uterus to shed.
The average period lasts for three to five days, although a period lasting seven days isn't unusual.
Symptoms like bloating, moodiness, breast soreness, and fatigue are common during periods. To manage these symptoms:
- Do moderate-intensity exercises like walking or yoga for 30 minutes a day.
- Get at least eight hours of sleep each night; seven to nine hours are generally recommended for adults.
- Eat a well-balanced diet with extra fruits, vegetables, lean proteins, and whole grains, and less sugar, alcohol, and caffeine.
- Relieve stress with techniques like deep breathing, yoga, or meditation.
- Don't smoke, which can worsen period symptoms.
Medications and supplements that may help include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain from cramps or breast tenderness
- Antidepressants, anti-anxiety medications, and diuretics to relieve symptoms such as moodiness or bloating
- Hormonal birth control to relieve symptoms
- Some vitamins or supplements, such as curcumin, St. John’s wort, or evening primrose oil, but check with your doctor first, as they may interfere with other medications you’re taking or affect other medical conditions.
This phase starts simultaneously with the first day of the menstrual period and continues until ovulation. It lasts for about 14 days in total. During this phase, eggs mature in the ovary in preparation for ovulation and possible fertilization (pregnancy).
The hypothalamus in the brain releases gonadotropin-releasing hormone (GnRH), which stimulates the pituitary gland to release follicle-stimulating hormone (FSH).
FSH causes the follicles — fluid-filled sacs in the ovaries that house the growing eggs — to develop. One follicle and its egg will mature the fastest. That dominant follicle releases estrogen, which causes thickening of the uterus lining in preparation for a possible pregnancy.
The rise in estrogen also makes FSH levels decline, which causes the nondominant follicles to shrivel up. Then the pituitary gland releases luteinizing hormone (LH), which readies the mature egg to leave its follicle.
Because the start of the follicular phase overlaps with a period, the same steps to manage symptoms apply. It’s a good idea to get more iron from foods like spinach, chicken, eggs, lean beef, and broccoli to replenish what you lose through menstrual bleeding.
These foods will also give you energy, which you should start to have more of toward the end of this phase because of higher estrogen and progesterone levels. Take advantage of that extra energy boost to add some higher intensity aerobic exercises to your workouts.
This is the point in the cycle when the follicle releases a mature egg, thanks to a surge in LH. Ovulation happens at around the middle of the cycle — day 14 of a 28-day cycle. This is the time in the cycle when a pregnancy can occur. Some women
track their menstrual cycles to determine when they're ovulating, and are therefore most likely to conceive.
During ovulation, the basal body temperature (the temperature of the body at rest) increases slightly — about 0.5 to 1 degree Fahrenheit. Vaginal fluid called cervical mucus will look clear and feel slippery.
Some people have symptoms like these during ovulation:
It's also common to have
ovulation pain, also called mittelschmerz. This feels like discomfort in the lower belly during ovulation. Over-the-counter pain relievers like NSAIDS can help to relieve the discomfort.
Ovulation may be skipped (anovulation) or irregular in some women who experience certain health conditions or life events, such as:
This phase lasts from day 15 to day 28 of the menstrual cycle.
The luteal phase gets its name from the corpus luteum, the group of cells that forms in the ovary after an egg is released. The corpus luteum releases progesterone and some estrogen. These hormones thicken the uterine lining in preparation to nourish a growing embryo.
The egg travels down the fallopian tube. If it meets with a sperm and conception (fertilization) occurs, the fertilized egg may implant in the uterus, resulting in pregnancy. An egg can only survive for one to two days. If the egg isn't fertilized, the corpus luteum dissolves, hormone levels drop, and a menstrual period starts.
Possible symptoms during the luteal phase include:
- Sore breasts
- Bloating
- Acne
- Appetite changes
- Mood changes
- Trouble sleeping
Though you might crave comfort foods right before a period, avoiding processed foods and sugar and instead eating more fruits and vegetables, as well as fatty fish like salmon, can help with symptoms. Limiting soda is another way to beat the bloat. Reducing caffeine and alcohol are helpful for improving mood and sleep.
These cycles don't always run like clockwork. "The menstrual cycle is intimately associated with a woman's physiologic balance, and there are many factors that can affect the menstrual cycle by disrupting this balance," says Christopher Domush, MD, an associate professor in the Duke University department of obstetrics and gynecology in Durham, North Carolina.
Hormonal imbalances, stress, extreme exercise, sudden weight changes, certain medications, and reproductive health conditions like PCOS and endometriosis can all affect the regularity of the menstrual cycles. "Age also plays a role, with irregular cycles being common in teenagers and perimenopausal women," says Tamara Guichard, MD, a gynecologist practicing in Forest Hills and New York City.
Here are a few things you can do to restore the balance and reduce symptoms from various stages of the menstrual cycle.
Eat a Cycle-Friendly Diet
An overall well-balanced diet with an emphasis on whole foods is a good strategy. These are some foods to eat.
- Omega-3 Fatty Acids Fatty fish like salmon, flax and chia seeds, nuts, soybean and canola oils, and fortified eggs, juices, and milk are rich in this nutrient. Omega-3s may make premenstrual syndrome (PMS) symptoms less severe.
- Iron You'll find this mineral in poultry, fish, oysters, eggs, beans, whole grains, and iron-fortified cereals. Extra iron in the diet will replenish what you lose while menstruating, especially if you get heavy periods. It also fights PMS-related fatigue.
- Calcium Foods like low-fat milk and yogurt, as well as salmon, are rich in calcium. Calcium not only strengthens bones but is also helpful for combatting mood swings, cramps, and other menstrual symptoms.
- Complex Carbohydrates The body burns whole grains like brown rice and oats, as well as legumes like beans and lentils, slowly. This keeps blood sugar levels steady and prevents hunger-related mood swings and food cravings.
Here are some things to avoid:
- Salt Cut back on sodium-rich foods like lunch meat and processed foods. Too much salt can contribute to bloating, sore breasts, and swelling in the body.
- Caffeine and Alcohol Drinking alcohol, soda, or coffee within a few hours of bedtime can disrupt sleep.
Stay Active
Energy levels rise and fall throughout the menstrual cycle. You might feel more energized right after a period, and more sluggish in the week before a period as hormone levels drop. Exercise can boost sagging energy levels, and it might make period cramps less severe.
Save more intense exercises for times in your cycle when you have the most energy.
Get Enough Sleep
Restful sleep is important to combat fatigue. Research also finds that good sleep helps improve mood during the menstrual cycle.
Many women have trouble sleeping, especially right before their period. To improve sleep, cut back on alcohol and caffeine, especially in the hours before bedtime.
Do something relaxing before bed, like reading or taking a warm bath.
Manage Stress
A body under stress produces excess
cortisol, a hormone that can disrupt the normal release of estrogen and progesterone and upset menstrual cycle regularity. Eating a well-balanced diet, exercising daily, and getting good quality sleep are ways to reduce stress. Also try calming techniques like
meditation,
deep breathing, and
yoga.
