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In this post, we will cover everything you need to know about your menstrual cycle hormones, the different phases and how your hormones change throughout.

Key points covered: 

  •  The menstrual cycle starts with the first day of the period and ends when the next period begins
  • The brain, ovaries, and uterus work together and communicate through hormones (chemical signals sent through the blood from one part of the body to another) to keep the cycle going.
  • The first part of the cycle (follicular phase) prepares an egg to be released from the ovary and builds the lining of the uterus
  • The second part of the cycle (luteal phase) prepares the uterus and body to either accept a fertilised egg or to start the next cycle if pregnancy doesn’t occur

Important:

  • The menstrual cycle is more than just the period. In fact, periods are just the first part of your cycle.
  • Understanding the menstrual cycle is important because it can impact the body from head to toe. You can see changes in your hair skin, bowel movements, mental health, physical strength, libido and so on.
  • Hormonal methods of birth control prevent some or all of the steps in the cycle from happening.

Sections in the article:

What is the menstrual cycle? 

By definition, the menstrual cycle begins with the first day of your period, which is counted as ‘Day 1’ and ends just before the next period (bleeding). 

It’s the female body’s way of preparing for a possible pregnancy every month. 

Understanding your cycle is very important as it impacts every aspect of female wellbeing. As the hormones in your cycle change throughout the month, your body and mind also go through a number of changes. 

How long is the menstrual cycle?

Menstrual cycles normally range from about 25 to 36 days. However, they can also be longer or shorter, in which case we have an ‘irregular cycle’.

How many women have regular cycles?

Only 10 to 15% of women have cycles that are exactly 28 days, and in at least 20% of women, cycles are irregular. 

Having an irregular cycle means that their cycle is either longer or shorter than the normal range of between 25 to 36 days. 

Usually, cycles are the most irregular in the years immediately after a woman starts to menstruate and before menopause.

What are the menstrual cycle phases?

There are 5 core phases in your cycle: 

Phase 1: The Follicular

When: Technically the follicular phase starts on the first day of the period until Ovulation. 

What happens: During this phase, oestrogen rises as an egg prepares to be released. After the period, the uterine lining builds back up again (aka the proliferative phase). 

The Follicular phase is characterised by two phases, Menstruation and Proliferative phase.

Phase 1.1: Menstruation (aka period):

When: Day 1 of your period until you stop bleeding

What happens: During this phase of your cycle, you shed your uterine lining (bleeding) and your oestrogen and progesterone levels are low.

Phase 1.2: Proliferative phase

When: Day after your period has ended up until ovulation

What happens: The uterus builds up a thick inner lining. While the ovaries are working on developing the egg-containing follicles, the uterus is responding to the estrogen produced by the follicles, rebuilding the lining that was just shed during the last period. This is called the proliferative phase because the endometrium (the lining of the uterus) becomes thicker.

brain and mood during the menstrual cycle

Graphic by elara.care

Phase 3: Ovulation:

When: About halfway through the cycle, around day 13-15  (but this can change cycle-to-cycle and you might even have the occasional cycle where you don’t ovulate at all).

What happens: The release of the egg from the ovary, mid-cycle. Oestrogen peaks just beforehand, and then drops shortly afterwards.

The dominant follicle in the ovary produces more and more estrogen as it grows larger. The dominant follicle reaches about 2 cm (0.8 in)—but can be up to 3 cm—at its largest right before ovulation (6,7). When estrogen levels are high enough, they signal to the brain causing a dramatic increase in luteinizing hormone (LH) (11). This spike is what causes ovulation (release of the egg from the ovary) to occur. Ovulation usually happens about 13-15 days before the start of the next period (12).

Phase 4: Luteal Phase:

When: The time after ovulation and before the start of menstruation. It normally lasts between 14 to 16 days.  

What happens: The body prepares for a possible pregnancy. 

Once ovulation occurs, the follicle that contained the egg transforms into a corpus luteum and begins to produce progesterone as well as estrogen, with progesterone levels peaking about halfway through the luteal phase.

If an egg is fertilised, progesterone supports the early pregnancy, alternatively, the uterine lining starts to break down resulting in menstruation.

amygdala gland

What hormones are involved in the menstrual cycle?

The menstrual cycle is regulated by a number of different hormones. But the main ones are:

  • Follicle-stimulating hormone (FSH): Stimulates egg development and the release of oestrogen.
  • Luteinising hormone (LH): Stimulates the release of the egg (called ovulation). Stimulates oestrogen and progesterone production.
  • Oestrogen: causes growth of the uterine lining. Inhibits FSH. Stimulates the release of LH and hence release of the egg. Inhibits LH after ovulation.
  • Progesterone: maintains the uterine lining. Inhibits LH after ovulation.

Breakdown of hormones and their functions in the menstrual cycle  

Follicle-stimulating hormone

What is follicle stimulating hormone?

Follicle stimulating hormone is produced by the pituitary gland. It regulates the functions of both the ovaries and testes. Lack or insufficiency of it can cause infertility in both men and women. 

Follicle stimulating hormone is essential to pubertal development. In women, this hormone stimulates the growth of ovarian follicles in the ovary before the release of an egg and it also increases oestradiol production. 

Oestrogen

What is Oestrogen

Oestrogen is one of the main female sex hormones. While both women and men produce oestrogen, it plays a bigger role in women’s bodies. 

It has many roles in the body, from controlling puberty to strengthening bones. Having too much or too little oestrogen can cause a range of different medical conditions.

There are three oestrogens – oestrone, oestradiol and oestriol – the most potent of which is oestradiol.

  • Oestradiol is produced in women of childbearing age, mostly by the ovaries.
  • Oestriol is the main oestrogen produced during pregnancy, mostly in the placenta.
  • Oestrone, produced by the adrenal glands and fatty tissue, is the only type of oestrogen produced after menopause.

Oestradiol

What is oestradiol?

Oestradiol is a steroid hormone made from cholesterol and is the main oestrogen found in women. It has a number of functions related to maturing and maintaining the female reproductive system.

  • it causes an egg to mature and be released (aka ovulation)
  • it thicken the lining of the uterus so that the egg can implant if it becomes fertilised.
  • it promotes the development of breast tissue
  • it increases both bone and cartilage density

In premenopausal women, oestradiol is mostly made by the ovaries and it’s at its highest at ovulation and lowest at menstruation.

Oestradiol levels in women reduce slowly with age, with a large decrease occurring at the menopause, when the ovaries ‘switch off’. In pregnant women, the placenta also produces a lot of oestradiol especially towards the end of the pregnancy. 

Also worth knowing that men also produce oestradiol; however, the amounts produced are much lower. Within the testes, some testosterone is changed into oestradiol and this oestradiol is essential for the production of sperm. 

Luteinising hormone

What is luteinising hormone?

Luteinising hormone, like follicle stimulating hormone, is released by cells in the anterior pituitary gland and is crucial in regulating the function of ovaries in women, and testes in men.

The luteinising hormone carries out different roles in the two halves of the menstrual cycle. In weeks one to two of the cycle, luteinising hormone is required to stimulate the ovarian follicles in the ovary to produce the female sex hormone, oestradiol.

Around day 14 of the cycle, a surge in luteinising hormone levels causes the ovarian follicle to tear and release a mature oocyte (egg) from the ovary (aka ovulation).

For the remainder of the cycle (weeks three to four), the remnants of the ovarian follicle form a corpus luteum. The luteinising hormone stimulates the corpus luteum to produce progesterone, which is required to support the early stages of pregnancy if the egg has been fertilisation occurs.

Progesterone

What is progesterone?

Progesterone belongs to a group of steroid hormones called progestogens. It is mainly secreted by the corpus luteum in the ovary during the second half of the menstrual cycle.

It plays important roles in the menstrual cycle and in maintaining the early stages of pregnancy. When an egg is released from the ovary (approximately day 14), progesterone is also released and, to a lesser extent, oestradiol.

If the released egg is fertilised, progesterone prepares the body for pregnancy. If the egg is not fertilised, the corpus luteum breaks down, the production of progesterone falls and a new menstrual cycle begins.

If the egg is fertilised, progesterone does the following:

  • stimulates the growth of blood vessels that supply the lining of the womb (endometrium)
  • stimulates glands in the endometrium to secrete nutrients that nourish the early embryo
  • prepares the tissue lining of the uterus to allow the fertilised egg to implant
  • helps to maintain the endometrium throughout pregnancy 

During the early stages of pregnancy, progesterone is still produced by the corpus luteum and is essential for supporting the pregnancy and establishing the placenta. Once the placenta is established, it then takes over progesterone production at around week 8-12 of pregnancy.

During pregnancy, progesterone plays an important role in the development of the foetus; stimulates the growth of maternal breast tissue; prevents lactation; and strengthens the pelvic wall muscles in preparation for labour. The level of progesterone in the body steadily rises throughout pregnancy until labour occurs and the baby is born.

 

References:

  1. Fraser IS, Critchley HO, Broder M, Munro MG. The FIGO recommendations on terminologies and definitions for normal and abnormal uterine bleeding. Semin Reprod Med. 2011;29(5):383-90.
  2. Munster K, Schmidt L, Helm P. Length and variation in the menstrual cycle-a cross-sectional study from a Danish county. BJOG. 1992;99(5): 422–9.
  3. Treloar AE, Boynton RE, Behn BG, Brown BW. Variation of the human menstrual cycle through reproductive life. Int J Fertil. 1967;12(1 Pt 2):77-126.
  4. Fehring RJ, Schneider M, Raviele K. Variability in the phases of the menstrual cycle. JOGNN. 2006;35: 376-384.
  5. https://www.yourhormones.info/hormones/luteinising-hormone/
  6. https://www.yourhormones.info/hormones/progesterone/