What you need to know about your menstrual cycle ...
When I say the words “menstrual cycle” what pops into your mind?
I am going to take a wild guess and assume that words like vital, flowing, ease, monthly report card, excited, natural, celebration, don’t pop in?
Am I right?
The reality is that so many women today either a). don’t have a regular menstrual cycle or b). experience physical and or emotional discomfort and or pain, with their menstrual cycle.
I find this concerning and I don’t accept that this is “ok” or “normal” or “just live with it.”
Let me share why …
A regular, uneventful, menstrual cycle, is a vital sign of your overall health.
As women we have a built in menstrual biorhythm, that is cyclic in nature, that of course, plays a critical role, in the ripening of an egg and subsequent release of menstrual blood or pregnancy.
That enormous job alone should tell us this whole process is kind of a big deal.
Even if you aren’t too phased by the whole egg release/pregnancy thing right now, I need you to know that this natural cycle is how you produce your primary sex hormones each month.
What do these sex hormones do?
Well I am glad you asked - short answer, a hell of a lot!
Estradiol is an important oestrogen that gets released from your follicles.
Beyond it’s important role of thickening up your uterine lining in prep for a baby and stimulating fertile cervical mucous, it also plays a role in:
Boosting mood
Influencing libido
Stimulating bone formation & preventing breakdown
Keeping skin supple and hair luscious
Protecting heart health
Enhances your sensitivity to insulin
Supporting brain health
All stuff we want right?
Progesterone, is released from the corpus luteum (a temporary endocrine gland that forms from the emptied ovarian follicle) , as a result of ovulation (when a follicle ruptures and releases an egg).
An important note on this new formed gland - it takes 100 days for your follicles to mature from their dormant state all the way to ovulation. Hence, the health of the corpus luteum depends on everything that affected your follicles during those 100 days. This is why, pre-pregancy prep, should start at least 90 days prior but ideally, 6-12 months prior to conception.
Progesterone’s biggest job is pro-gestation; gestation = pregnancy. It helps to hold and nourish a pregnancy. But, like oestrogen it does so much more:
counterbalances oestrogen eg. thins the uterus lining, lightening periods
Stimulates thyroid hormone which raises body temperature, energy and metabolic rate
Promotes sleep
Calms the nervous system, anti-anxiolytic
Nourishes hair and skin
Reduces inflammation
Protects against heart disease
Supports bone and muscle growth
As you can see, these primary sex hormones, are critical to so many different areas in our body, beyond reproduction.
When things are humming along nicely, we should experience all the wonderful benefits that these hormones bring.
What does “normal” even look like?
Here are 5 key things I want you to track each month, to get to know your body a little better:
Cycle Length: Measure this from the first day of bleeding (referred to as Day 1) to the first day of bleeding in the next cycle. On average we are looking for a cycle length that is between 24-35 days consistently (remember: this is different for teenagers & in peri-menopause).
The Menses (or period): this should last between 3-7 days (average is 5 days). The volume of total blood loss over the course of the period should be around ~ 50ml in total (10 fully soak regular tampons or pads). Less than 25ml is a scanty period and can be due to low oestrogen and more than 80ml of menstrual fluid 🩸, is excessive and may be due to excessive oestrogen and or low progesterone.
Pre-ovulatory phase: We want to identify cervical fluid. It can look like creamy white moisturiser and progress into clear stretchy, raw egg white fertile mucous. We are typically looking for 2-7 days of this with at least one day of the clear stretchy (usually occurs during the days prior to ovulation).
Ovulation (the main event, and remember this is how you produce progesterone): This can occur between days 10-23 (count back 14 days from the first day of your next expected period). Eg. for a 28 day cycle, this is around Day 14. If you are temp. tracking you will see a rise in basal body temp. of about 0.3C, this stays elevated until you get your period.
Because lots of things can influence temperature, I also get clients to use ovulation test strips to detect the surge in luteinising hormone which precedes ovulation by 36 to 40 hrs.
Other signs of ovulation: mild twinging pain, fluid retention, and breast tenderness.
Luteal Phase, this is the phase from ovulation until your menstruation and should last at least 12-16 days. It is determined by the lifespan of the corpus luteum. A luteal phase less than 11 days, is short and results in less than optimal progesterone.
Where can things go wrong …
You’re on hormonal contraception
And hence, you are not cycling naturally, or producing your own beneficial sex hormones.
The primary mechanism for most combined hormonal contraception (eg. combined oral contraceptive pill, Nuvaring, Patch) is to give the body a synthetic form of oestrogen and progestin that shuts down communication between your brain and ovaries and therefore inhibits ovulation. Hence, shutting down our natural cyclical release of sex hormones.
Progesterone only contraception (eg. depot injection, Mirena IUD, implant, mini pill) contain different progestin medications, NOT, progesterone, that we produce after ovulation. They works to prevent pregnancy by thinning the uterus lining, impairing cervical fluid, and can inhibit ovulation in most cases (but not always).
Unfortunately, these hormone-like medications, do not elicit the same benefits in our body as our own natural oestrogen and progesterone. Which explains why so many women experience such a wide variety of side effects and can react very differently to different types of hormonal contraception.
2. Your cycle is MIA
Well friend, first and foremost, are you pregnant, breastfeeding or in menopause? If yes, then this is totally normal. Enjoy it.
If you aren’t you are going to want to dig deeper to find out WHY:
Have you recently stopped hormonal contraception? If yes, it can take time for your brain to re-estalbish communication with your ovaries. Investigate further if nothing happens in 4-6 months. I like to get to work with women prior to coming off the pill to support their liver, gut, and replenish nutrients that the pill is known to deplete.
Are you under large amounts of stress? If yes, keep reading.
Are you overtraining and or not consuming enough calories for your activity level? If yes, you NEED to increase calories and or reduce your training.
Do you have a diagnosis of PCOS or symptoms of PCOS (see below)?
Do you have hypothyroidism? Or symptoms of low thyroid function (cold hands and feet, fatigue, stubborn weight gain, brain fog, anxiety, low mood)?
This is not an extensive list but please go and investigate this ASAP! It is a sign something is up.
3. Your cycle is irregular ie. cycle length varies widely from month to month eg. 21 days, then 45 days, then 60 days
There are three situations in a woman’s life when this can in fact be normal:
Teenage girls: for several years after their first period as their body tries to establish the communication between the brain and ovaries and she begins to ovulate more regularly (we don’t want to shut down this communication system whilst it’s trying to establish itself).
Peri-menopause: the 10 years prior to ovulation stopping for good and your last period.
* Both these situations can lead to irregular cycle lengths, increased bleeding, and other symptoms associated with lack of ovulation and or lowered progesterone.
Postpartum: When you give birth you produce prolactin which brings on breastmilk and suppresses ovulation, so if you don’t ovulate you won’t have a period. This lasts a different length of time for every women.
Other major causes of irregular periods include:
Polycystic Ovarian Syndrome (PCOS)
too much oestrogen and testosterone, which disrupts ovulation and leads to lowered progesterone.
This is often driven by insulin resistance and inflammation.
Symptoms include: excessive hair growth on face or chest, hair loss on head, acne, mid section weight gain, insulin resistance, polycytic ovaries on ultrasound, elevated androgens in blood.
Diet and lifestyle are SO important.
Taking the contraceptive pill will not regulate or fix your hormones, however it will mask the symptoms of PCOS. If you plan on having children, work on the underlying causes ASAP.
Thyroid dysfunction
Heavily influences ovulation and your menstrual cycle
Disrupts ovulation resulting in irregular periods by disrupting Follicle Stimulating Hormone (FSH), Luteinising Hormone (LH) and Prolactin which messes with the ovulatory process, beginning in the brain.
Hypothyroidism deprives your ovarian follicles of the thyroid hormone they need to develop
Work with a practitioner to rule out thryoid dysfunction.
This is SO prevalent in the female population and especially postpartum and is also a major common missed caused of recurrent miscarriage.
You will need to get a full thyroid panel (probably with a Functional Medicine Practitioner) that includes:
Thyroid Stimulating Hormone (TSH)
Free Thyroxine (T4)
Free Triiodothyronine (T3)
Thyroid antibodies (Thyroid Peroxidase (TPO) antibodies and Thyroglobulin (Tg) antibodies)
Stress
Chronic stress leads to Hypothalamic Pituitary Adrenal Axis Dysfunction (HPA-D)
I would say that 99% of females in this modern world would have some level of this
High cortisol brought on by chronic stress (perceived, mental, emotional, lack of sleep, blood sugar disturbances, inflammation from environmental toxins and gut etc), can inhibit the hypothalamus’s production of Gonadotropin Releasing Hormone (GnRH). This hormone talks to the pituitary gland to release LH and FSH. Both are critical for reproduction ovarian production
Cortisol also inhibits FSH and LH directly at the pituitary , to further attempt to suppress ovulation and potential pregnancy, hence oestrogen and progesterone and even testosterone are all affected
This is a safety / protective mechanism of the body , as it knows bringing another human into this situation isn’t wise for survival
You have to build relaxation and restoration into your life and create a state of safety in your body. You cannot out supplement this situation. You have to make changes.
Nutrient deficiences
Vitamin D: critical for proper ovarian production and progesterone production. Get 20 minutes of sun exposure per day
Magnesium: support liver detoxification from the body, helps to avoid oestrogen excess (associated with heavy periods, endometriosis)
Vitamin C: associated with higher progesterone
Zinc: helps follicles to mature, improves insulin resistance and hight testosterone and supports thyroid hormone production
Selenium: support healthy ovulation
Iron: important for production of thyroid hormone
4. You have a short cycle length <21 days
This may indicate an anovulatory cycle (anovulatory means no ovulation), a short follicle phase (common in early perimenopause), or a short luteal phase (often caused by stress and results in low progesterone).
5. You have a longer cycle length > 35 days
This too may indicate an anovulatory cycle or a longer follicular phase (stress, under-eating, PCOS, thyroid dysfunction, later in perimenopause years)
6. You have consistent heavy (>80ml) and prolonged bleeding (>7 days)
If prolonged, often means you didn’t ovulate. Common in PCOS, low thyroid, perimenopause
If heavy, also consider the above + endometriosis, and low progesterone and oestrogen excess (often caused by reduced metabolism via liver and the gut and or endocrine disrupting chemicals)
In my work, I like to check how oestrogens are being detoxified through your Phase 1 and Phase 2 detox pathways via functional tests like a Dried Urine Total Comprehensive Hormone Test and a comprehensive stool test to asses Phase 3, as well as assessing lifestyle factors, like diet, environmental toxins, alcohol consumption etc.
7. You experience consistent light (<25ml) or short bleeding (<2 days)
Check and make sure you are ovulating
If yes, it may be a sign you have lowered oestrogen.
Are you eating enough calories? Eating too much soy? Managing stress?
8. You experience period pain that disrupts your ability to function
Normal period pain usually doesn’t interfere with your daily function. You can get cramping that occurs just before and the day of your period.
This is caused by the release of prostaglandins in your uterus.
Having more oestrogen and less progesterone can contribute to high levels fo prostaglandins and more pain
Severe period pain needs to be investigated with a medical doctor to rule out things like endometriosis and adenomyosis.
Diet and lifestyle can make a huge impact on period pain that is caused by excess oestrogen and higher levels of inflammatory in the body.
Ditch the dairy, gluten, sugar and vegetable oil as a starter.
The first steps you need to take …
You have to begin to appreciate a new way of thinking about your monthly menstrual cycle.
Every single month your body is sending you a message to tell you about your health.
Whatever you are a experiencing isn’t a result of your body acting at random against you. It is simply your body’s way of communicating with you.
For as long as you ignore it, suppress, or neglect it, the more alarming the warning signs will become.
Just like a fever is a sign of an infection and gets your attention, your menstrual problems are also a sign of your body needing your attention.
The fix lies in first understanding how your body works and knowing what to do in order to nourish it.
This is not something we really haven’t been taught.
Which is why I wrote this and will continue to educate and work with women on this so you have an appreciation of what is possible. Your body is always working for you not against.
This is my work. Digging into discovering the root cause to your symptoms and working with you to educate and take action on the many things that you can control.
There is SO much that you can do to nourish your body and when you do, you start to celebrate and marvel at just how magnificent you are.
With love,
Chantel
If you are ready to work, one-one-one, you can visit my website HERE and reach out via email to chantelhutnan@gmail.com, as I am offering 20% my consultations, for the month of April 2020.
Everyone deserves to feel their best.