Menstrual Cycle: What to Expect and How to Manage

The menstrual cycle is a natural process that involves the shedding of the lining of the uterus, known as the endometrium.

The menstrual cycle duration differs from one woman to another, with an average cycle length of 28 days.

However, it is normal for regular cycles to be shorter or longer than this, ranging from 23 to 35 days.

What is Menstruation?

Menstruation is the shedding of the endometrium, which is the lining of the uterus. This process occurs when an egg is not fertilised and the body prepares for another cycle of ovulation.

It is a sign that the reproductive system is functioning properly and that the body is ready for another opportunity to conceive.

It is a complex hormonal process that typically spans over 28 days but can vary from 21 to 35 days in adult women and 45 days in teenage girls.

The cycle is divided into four stages, each playing a crucial role in regulating hormone levels and reproductive functions.

Stages of the Menstrual Cycle

The menstrual cycle is a complex process that involves the interplay of hormones, the reproductive organs and the brain.

It is regulated by the hypothalamus and pituitary gland in your brain, as well as by your ovaries.

The menstrual cycle has four phases:

• Menstrual Phase 
• Follicular Phase
• Ovulatory Phase 
• Luteal Phase

Each phase is associated with specific changes in your body.

Menstrual Phase (Day 1 to 5)

The menstrual phase marks the beginning of the cycle when the uterine lining (endometrium) is shed, resulting in menstrual bleeding or a period.

Lasts for approximately 3-5 days.

Follicular Phase (Day 6 to 14)

This phase overlaps with the menstrual phase and continues until ovulation.

During the follicular phase, the pituitary gland releases follicle-stimulating hormone (FSH), which stimulates the growth of several follicles in the ovaries.

These follicles contain immature eggs or ova, with one maturing faster and becoming the dominant follicle.

Occurs from days 6 to 14.

Ovulation

Ovulation is the process where the mature egg is released from the dominant follicle into the fallopian tube.

The hormone luteinizing hormone (LH) surges, causing the dominant follicle to rupture and release the egg.

Ovulation marks the most fertile phase of the menstrual cycle.

This phase typically occurs around day 14 of a 28-day menstrual cycle

Luteal Phase

During the luteal phase, the ruptured follicle transforms into the corpus luteum, which produces progesterone to thicken the uterine lining in preparation for a fertilised egg.

If fertilisation doesn’t occur, the corpus luteum will disintegrate, leading to a drop in progesterone levels and the start of the menstrual phase.

This phase extends approximately from day 15 to day 28.

Symptoms of Getting Your Period

While some woman may not experience any noticeable symptoms during menstruation, others might experience a range of symptoms that can vary in intensity.

The most prevalent symptom associated with menstruation is cramping, which occurs in the pelvic region as the uterus contracts to shed its lining.

Additional signs that your period is approaching include:

• Mood swings: You may notice changes in your mood or increased sensitivity.
• Sleep disturbances: Difficulty falling or staying asleep can sometimes accompany menstruation.
• Headaches: Some women might experience headaches leading up to or during their period.
• Cravings for specific foods: It’s not uncommon to have a strong desire for certain foods, particularly sweet or salty snacks, before or during menstruation.
• A sensation of bloating: Hormonal changes can cause water retention, leading to a bloated feeling in the abdomen.
• Tenderness in the breasts: Hormonal fluctuations can result in breast swelling or discomfort.
• Acne: Hormone shifts may also contribute to an increase in acne during menstruation.

Common Misconceptions

Misconception #1: All women have a 28-day cycle

While a 28-day cycle is considered average, many women have shorter or longer cycles, which can still be healthy and normal.

Factors such as stress, illness or hormonal imbalances can influence the cycle’s length.

Misconception #2: Ovulation always occurs on Day 14

Ovulation can occur at different points in the cycle, depending on the length and individual hormonal fluctuations.

Some women may experience early or late ovulation, which makes tracking fertility signs essential for understanding one’s unique cycle.

Misconception #3: You can’t get pregnant during your period

Although the chances are lower, it’s still possible to conceive during your period, especially if you have a shorter cycle or irregular ovulation.

Sperm can survive inside the female reproductive tract for up to five days, increasing the likelihood of fertilisation if ovulation occurs shortly after the period.

Misconception #4: Menstrual pain is normal and should be tolerated

While some discomfort during menstruation is common, severe pain (dysmenorrhea) can be a sign of an underlying condition such as endometriosis, fibroids or pelvic inflammatory disease.

If you experience extreme pain, you should consult your doctor to discuss potential causes and treatment options.

Misconception #5: Exercise during menstruation is harmful

On the contrary, exercise can help alleviate menstrual symptoms such as cramps, bloating and mood swings.

Physical activity encourages blood circulation, releases endorphins and helps maintain overall well-being. However, it’s crucial to listen to your body and adjust the intensity of exercise according to your comfort levels.

Misconception #6: Using tampons can cause toxic shock syndrome (TSS)

While toxic shock syndrome (TSS) is a rare but severe condition linked to tampon use, the risk is significantly reduced by following proper hygiene guidelines and using tampons with the appropriate absorbency for your flow.

Changing tampons every 4 to 8 hours and alternating with pads can further minimise the risk.

What Causes Irregular Periods?

Irregular periods are characterised by unpredictable and inconsistent menstrual cycles.

The length, frequency and duration of bleeding may vary considerably from one cycle to another.

Irregular periods can be caused by a variety of factors, such as:

• Hormonal imbalances: Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can disrupt the balance of hormones in the body, leading to irregular periods.
• Stress: High levels of stress can interfere with the hormones responsible for regulating the menstrual cycle, resulting in irregularities.
• Weight changes: Significant weight gain or loss can impact hormone levels and cause irregular periods.
• Excessive exercise: Intense physical activity can sometimes lead to hormonal imbalances that disrupt the menstrual cycle.
• Birth control: Hormonal birth control methods, such as contraceptive pills, patches or intrauterine devices (IUDs), can affect the menstrual cycle and cause irregular periods, especially when first introduced or discontinued.
• Puberty and menopause: As the body goes through significant hormonal changes during puberty and menopause, it’s common to experience irregular periods.
• Medical conditions: Certain medical conditions, like endometriosis or uterine fibroids, can result in irregular menstrual cycles.

Do consult your doctor if you’re experiencing irregular periods, as he/she can help identify the underlying cause and recommend appropriate treatments or lifestyle changes to manage the issue.

Early diagnosis and intervention can significantly improve your overall reproductive health.

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Sources: Cleveland Clinic, Better Health Channel, NHS, Healthline (1, 2), Mayo Clinic, WebMD, NLM.