Stages of Menstrual Cycle: Menstruation, Ovulation, Hormones

Ever wondered why a woman's menstrual cycle follows a distinct pattern of stages? From menstruation to ovulation and beyond, these stages are driven by hormones, creating a natural sequence in the female reproductive system. Let's explore this cycle and understand the role of hormones in this fascinating process.

What is a Menstruation Cycle?    

It's a natural, but complex process that is essential for reproductive health. The Menstrual cycle typically lasts about 28 days, however, there are variations depending on the female’s body factors.

The menstrual cycle is divided into several stages, including menstruation, the follicular phase, ovulation, and the luteal phase. These stages are regulated by various hormones produced by the ovaries and the pituitary gland. By understanding these stages and recognizing any irregularities, women can take control of their menstrual well-being and make decisions about their fertility and overall health.
Let’s explore these stages in depth to understand this natural and essential process of a woman's reproductive system.

Menstruation 

Menstruation, which we all know as period, is the first stage of the menstrual cycle. It usually lasts for 3 to 7 days, although it does vary from case to case. It involves the monthly shedding of the uterine lining when pregnancy doesn't occur.

This shedding is caused by a decrease in the levels of hormones called estrogen and progesterone. When the hormone levels drop, the uterus contracts to expel the lining, resulting in bleeding. Menstrual blood is a combination of blood, tissue from the uterine lining, and mucus. The color and consistency can vary but are generally shades of red

The age at which typically menstruations occur in girls is between 9 to 16 years. The first period that a girl gets is termed as menarche. The average age for menarche can vary depending on many aspects like genetics, nutrition, and other health factors.

Common Symptoms of Menstruation

• Cramping: Many women experience mild to severe abdominal cramps during menstruation. Applying a heating pad, taking over-the-counter pain relievers such as ibuprofen, and practicing relaxation techniques can help alleviate discomfort.
• Mood Swings: Hormonal fluctuations during menstruation can affect mood. Engaging in stress-relieving activities and maintaining a healthy lifestyle can help manage emotions during this phase.
• Bloating: The fluctuation in estrogen and progesterone levels leads to water retention, leading to bloating which is a feeling of fullness or swelling in the abdomen.
• Breast Tenderness: During the menstrual days, the breast tissue to become more sensitive and tender. This makes the breasts feel swollen, sore, or even lumpy. This tenderness usually resolves as the menstrual cycle progresses. 
• Tiredness: The body releases energy in the process of shedding the uterine lining, which leads to tiredness and fatigue. Also, the body loses iron through blood which affects the energy levels in the body.

Follicular Phase

The follicular phase commences on the first day of menstruation and continues until ovulation. During this phase, the pituitary gland in the brain releases a hormone called follicle-stimulating hormone (FSH). This hormone stimulates the growth of several egg-containing follicles in the ovaries. As these follicles develop, they produce estrogen, which helps thicken the uterus lining.

As the follicular phase progresses, one leading follicle emerges and continues to mature. The increased estrogen levels in the body trigger a surge in luteinizing hormone (LH), leading to ovulation.

The Significance of the Follicular Phase

The follicular phase is a critical time in a woman's menstrual cycle. It sets the stage for ovulation and plays a vital role in reproductive health.

• Understanding Fertility: By tracking the changes that occur during the follicular phase, women can have an understanding of their fertility. 
• Evaluation of Hormonal Health: Irregularities in the follicular phase can indicate underlying hormonal imbalances, such as polycystic ovary syndrome (PCOS) or hypothalamic amenorrhea. 
• Predicting Menstrual Symptoms: Many women experience symptoms, such as bloating, breast tenderness, and mood swings during the follicular phase. Being aware of these changes can help women better manage their monthly symptoms.

Ovulation

The next phase is Ovulation. It occurs usually around day 14 in a 28-day cycle. During ovulation, one of the ovaries releases a mature egg, which travels down the fallopian tube, prepared to be fertilized by sperm.

The pituitary gland produces hormones called luteinizing hormone (LH) and follicle-stimulating hormone (FSH) which trigger the released egg. A released egg has a lifespan of about 24 to 48 hours, where it waits for fertilization.

Ovulation is a critical period in the menstrual cycle and is the most fertile time for a woman.

How to know you are Ovulating?

• Tracking Basal Body Temperature: A rise in Basal Body Temperature can indicate ovulation. By charting your BBT over several cycles, you can identify your most fertile days.
• Cervical Mucus Changes: Before ovulation, cervical mucus becomes thin, slippery, and stretchy, resembling egg whites. Keep an eye on these variations to help anticipate ovulation.
• Ovulation Predictor Kits: These kits detect the surge of LH (luteinizing hormone) in urine and can help pinpoint ovulation. They are available over the counter and can be useful for those trying to conceive.
• Ovulation Pain: Some women experience mild pain or twinges on one side of the lower abdomen during ovulation. This is known as mittelschmerz and may be an additional sign of ovulation.
• Changes in the Cervix: The cervix undergoes changes during the menstrual cycle. Around the ovulation period, it becomes softer, higher, and more open. Keeping track of these changes can give you an idea about fertility.

Luteal Phase

After ovulation, the luteal phase begins. In this stage, the broken follicle develops into an organ called the corpus luteum. The corpus luteum produces progesterone, which is essential for the maintenance of the uterus lining in anticipation of pregnancy. It also helps prepare the breasts for potential breastfeeding.

If fertilization does not occur, the corpus luteum shrinks, and progesterone levels decrease. This triggers the shedding of the uterus lining, and a new menstrual cycle begins. If fertilization occurs, the corpus luteum continues to produce progesterone to support the early stages of pregnancy. It usually lasts for around 14 days. 

Role of Hormones in Menstruation

Hormones play a vital role in regulating the menstrual cycle and prepare the body for conception and pregnancy. The primary hormones involved in this process are estrogen, progesterone, FSH, and LH.

• Estrogen: Estrogen is produced by the ovaries, and it stimulates the growth and development of the uterine lining during the first half of the menstrual cycle.
• Progesterone: The corpus luteum produces progesterone which gets the uterus ready for a fertilized egg to be implanted.
• FSH and LH: These hormones are produced by the pituitary gland and regulate the growth and maturation of ovarian follicles. LH triggers ovulation, and FSH starts the process of developing a new egg.

Effects of Hormonal Imbalances

Imbalances in hormone levels can lead to menstrual irregularities. Common conditions associated with hormone imbalances include:

• Polycystic Ovary Syndrome (PCOS) - High levels of androgens (male hormones) and insulin resistance can disrupt normal ovulation and cause irregular periods.
• Amenorrhea – Amenorrhea is missing periods for three or more consecutive menstrual cycles. This usually happens due to hormonal imbalances, increased stress levels or some other medical conditions.

When to Consult a doctor?

While most menstrual cycles are regular and without complications, there are instances when it may be necessary to consult a doctor.

• Absent or missed periods - If you have missed your period for more than three consecutive months and you are not pregnant, it is essential to consult a doctor. This could indicate an underlying hormonal imbalance or a medical condition.
• Heavy and prolonged bleeding - Excessive bleeding that lasts for more than seven days or soaks through sanitary pads quickly may require medical intervention. This could be a sign of hormonal imbalances, uterine fibroids, or other underlying conditions.
• Severe menstrual cramps - While mild cramps are common during menstruation, if it gets unbearable or if pain relief measures are ineffective, seek medical advice.
• Changes in menstrual flow - Sudden changes in the regular flow of your period, such as extremely light or heavy bleeding, should be brought to the attention of your doctor.
• Emotional disturbance – Mood swings are common but if it is leading to depression or anxiety, it is important to consult a healthcare professional.
• Unusual colour or odor – Any changes in the color and odor of your menstrual discharge should not be ignored. Foul-smelling discharge or blood with an unusual color may indicate an infection or other underlying issues that need professional interference.

Home Remedies to Ease Menstrual Pain

Many women experience menstrual pain which is known as dysmenorrhea, during their menstrual cycle. While severe pain may require medical attention, some home remedies may help alleviate mild to moderate menstrual cramps.

• Over-the-Counter Pain Relievers: Pain-killers such as ibuprofen or naproxen sodium, can help reduce pain and inflammation. Always follow recommended dosages and guidelines.
• Dietary Supplements: Omega-3 fatty acids, magnesium, and vitamin B1 (thiamine) supplements may help alleviate menstrual cramps. Consult with a healthcare provider before taking supplements.
• Acupressure: Applying gentle pressure to certain acupressure points may help relieve menstrual pain. However, it's essential to do this safely and consult with a practitioner for guidance.
• Heat Therapy: Apply a heating pad or hot water bottle to your lower abdomen. Heat helps relax the muscles and may reduce cramping.
• Hot Bath: Taking a warm bath can be soothing and help ease menstrual pain.
• Avoid caffeine: Avoid excessive caffeine, alcohol, and salty foods, as they can lead to bloating and discomfort.
• Exercise: Engage in regular, moderate exercise. Physical activity can help alleviate cramps by promoting blood circulation and releasing endorphins.