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Fertility Series #2: A Closer Look At The Menstrual Cycle

Updated: Apr 25, 2022

I have been trying to figure out a way to approach this topic, but it’s difficult to fully encompass in a package that is palatable for readers without being overwhelming. As I continue my journey through womanhood, I’ve learned to become more in-tune with my body. I must be honest and admit that it hasn’t been easy, and it definitely hasn’t been on purpose! A big driving force in getting more in-tune with my body has been my desire to improve my mental health. We often delineate mental health from physical health, but the truth is that every single one of our systems is interconnected! There were a few specific diagnoses that started with symptoms of a mental health disorder and ended up being a full-body need: Fibromyalgia and Premenstrual Dysphoria Disorder (PMDD). I have talked about Fibromyalgia in the past and you can check out my full video on the topic here!


I found out that I might have had PMDD after discussing my symptoms of depression to my therapist. She recognized that my symptoms were cyclical instead of constant and asked if I could track my symptoms for a while. Low and behold, we discovered that symptoms of depression almost always appeared around a week and a half before my period! She suggested that I speak to my doctor about possibly taking a prescription mood stabilizer during the second half of the month to help reduce symptoms of depression. I’ve had bad side effects with psych medications in the past, so I decided to do some research into natural alternatives before going the route of prescription medications. This led me on a journey to understanding my own fertility and my body as a whole! In this part of the series, I am hoping to help understand the fundamentals of female fertility and that starts with the menstrual cycle!



What is a typical menstrual cycle?


With everything that I talk about here, I do it with the understanding that there is a wide range of “normal” when it comes to menstruation. Some cycles are shorter or longer than others but, a cycle typically lasts somewhere around 28-30 days. A typical cycle contains four main phases: menstrual, follicular, ovulation and luteal.



Menstrual


If you’re an adult woman, you have a general understanding of at least the menstrual phase. The uterus sheds its inner lining of soft tissue and blood vessels which exits the body from the vagina in the form of menstrual fluid. The first day of bleeding signifies the first day of the cycle.



Follicular


This phase also begins on the first day of menstruation, but it lasts until the day before you ovulate, which for most women is around day 13-14. The following events occur during this phase: Follicle stimulating hormone or FSH (more on hormones in the next part of the series) rises and encourages egg cells in the ovaries to begin to grow in a sac-like-structure called a follicle. At the end of the period, the biggest of these egg cells begins to grow to maturity in preparation for ovulation. It takes about two weeks for the egg cell to reach maturity. While the egg cell matures, its follicle secretes estrogen, that stimulates the uterus to develop a lining of blood vessels and soft tissue called endometrium.



Ovulation

At the end of the follicular phase, a hormone called Luteinizing Hormone or LH causes the ovary to release the matured egg cell. The released egg cell is swept into the fallopian tube (the tube connecting the ovaries to the uterus) where it is likely to meet any sperm waiting to fertilize it. The now empty follicle then forms a structure called the corpus luteum, which pumps out two hormones into your body: progesterone and estradiol. These two hormones help estrogen in building up the lining in the uterus in preparation for a potential pregnancy.


The ovulation phase is incredibly important when discussing fertility because a woman cannot get pregnant if she does not ovulate. There must be a mature egg released for pregnancy to occur. Understanding when you ovulate is crucial whether you’re trying to get pregnant or avoid it! Because of all the hormones at work, there are a bunch of signs and symptoms to look out for that I will discuss in next week!



Luteal


This phase begins on the day after ovulation and lasts until the end of the cycle. During this time, the egg cell released during the ovulation phase stays in the fallopian tube for around 24 hours. I’ve read conflicting information; some experts say 24-48 hours. If a sperm cell reaches the egg at that time, estradiol, estrogen, and progesterone continue to rise to create an ideal environment in the uterus for the fertilized egg to implant. If a sperm cell does not impregnate the egg cell within that time, the egg cell disintegrates. The same three hormone levels begin to decline, the uterine lining sheds and the menstrual phase of the next cycle begins.



Discussion


I’ve realized that, in learning to understand my own body, I’ve grown a deeper respect for what it needs and doesn’t need; what it likes and doesn’t like! Being in tune with our bodies, being ‘in’ our bodies rather than in our heads, can give us more joy in every aspect of our lives, from finding joy in movement to easing heightened emotions through scent, touch, massage or meditation. I’ve witnessed many women transform themselves and their lives by fostering a deeper connection with themselves and the bodies that they inhabit. I mentioned a few different hormones that play a key role in the menstrual cycle. While I’m no endocrinologist, I think it’s important to discuss each hormone because they are key to understanding the physical (and mental) symptoms that you may notice throughout your menstrual cycle! That information will be available in next week’s post so be sure to check back in!


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