The one lesson we had on our periods pretty much went…you’re a girl and this is what happens every 28 days and here’s how you deal with blood flow, end of lesson. I don’t recall if anything else was covered (like, what it actually means to have a period – it being related to reproduction and having a period means you’re not pregnant), nor that it goes on for the best part of 40 years and is often more symptomatic than they let on. I do remember, that following this lesson all the girls were eagerly anticipating their periods and entering this stage of womanhood. However, so many of us, me included, were left very disappointed, in lots of pain and managing a range of symptoms we had no idea how to control.
We see the period as the beginning and end of a cycle but our bodies are continually going through changes to get us to our period. By getting to know your cycle and what goes on, you can take control over symptoms, spot changes that may need addressing, and take control of your fertility. We welcome back Dr Sarah Cooke who talks us through the Menstrual Cycle and just what goes on during a typical cycle.
A typical cycle
The length of your cycle is the time between the start of your period and then next one. The average cycle is 28 days, although this can vary between 24 and 35 days.
The menstrual cycle can be divided into two phases: the follicular phase (the first phase) and the secretory or luteal phase (the second phase). A period occurs during the first phase, where the womb lining (endometrium) is shed, and both oestrogen and progesterone levels are low.
During the first phase, ovaries are stimulated by hormones from the pituitary gland to produce follicles (eggs which have grown and are contained in a fluid-filled sac). These follicles release oestrogen, which acts on the womb to thicken it. During this process (days 5-14) oestrogen is the predominant hormone, and many women report improved mood, heightened sex drive, less water retention and breast tenderness during this time.
The second phase of the cycle (days 14-28) is considered the progesterone-predominant phase (luteal phase). After the release of the egg (around day 14), the follicle produces progesterone (as well as oestrogen) which causes the womb lining to swell and be ready to receive a fertilised egg.
If the egg is not fertilised, the levels of progesterone and oestrogen begin to fall, and the womb lining sheds (the start of a period).
Most women find that the first two days of their period is their heaviest and can lose between 20-60ml 4-12 teaspoonfuls) of blood. The average length of a period is 5 days, although this can vary between 3-7 days.
The changing levels of progesterone and oestrogen, particularly the falling levels seen in the latter half of the second cycle can cause symptoms known as premenstrual syndrome. Symptoms of PMS include: water retention, breast swelling and tenderness, bloating, constipation, mood changes (generally lower mood), irritability, changes in appetite and sex drive. PMS can happen any time following ovulation (14 days into your cycle), though typically these symptoms are more noticeable around 1 week before your period and they can last around 5 days after menstruation.
There are many apps, journals and website that can help you keep a track of your menstrual cycle. It can be helpful to not only track your periods to know when your period is due – after all, it won’t arrive on the same day every month because it operates on a 28-day cycle, but it can help you to spot and be proactive on symptoms, and even harness your energy and sex drive.
If used routinely, you can get a good indication of the kind of symptoms you experience and when (as not all come with your period, you could expect a range of symptoms throughout the month), when ovulation is due to take place and therefore when you’ll be most fertile; ensuring you take extra precautions if you’re not wanting children at this time, or understanding the opportune moment to have children; it can help you to know when you’ll be on your period and what a typical duration is for you- allowing you to plan holidays and spa days with comfort, and even spot changes that need review – like experiencing a heavier than normal flow month after month, more debilitating symptoms, or going 45+ days between cycles or experiencing no periods at all.
You’ll also be able to take advantage of the time when your sex drive is higher and you’ll likely have more energy (days 5-14), tailoring to undertake projects or trips during this phase. Additionally, it’ll allow you to be better prepared to get things in place to help you feel better if you struggle with low mood, pain and even sleep disturbances, planning healthier meals that provide comfort and more space to aid rest and relaxation.