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Menstrual Cycle Guide + Practitioner Thoughts

Does your cycle feel like a rollercoaster of symptoms and emotions? Do you lack the understanding of what is going on with your own body each month? Don't worry, most women are in the same boat!

While most of us got at least a little bit of sex ed at school, none of us were taught what goes on inside our body or how to look after it.

Your menstrual cycle is far more complex than simply getting a bleed every 28 days. Only 13% of women have a 28-day cycle!

Let's take a look at what is happening inside your body with each cycle.

The menstrual cycle is a natural and essential process that occurs in the female reproductive system. It is a series of physiological changes that happen over anywhere from 24-35 days (shorter or longer than this can signify some issues). The menstrual cycle is divided into four distinct phases, each with its unique characteristics and hormonal changes. Understanding these phases can help individuals understand their body and support their overall health and well-being.


Phase 1: Menstruation (Days 2-7)

The first phase of the menstrual cycle is menstruation, commonly referred to as a period. During this phase, the uterus sheds its lining, and blood and tissue are expelled from the body through the vagina. Menstruation typically lasts between 3-7 days, this should be a pain-free process but for many, it isn't. Pain during your period can vary from mild to horrific.

During this phase, you may feel fatigued due to the loss of blood (and iron) and drop in oestrogen. It is essential to support the body during this phase with foods that are rich in iron, such as leafy greens, legumes, and red meat. Iron is essential for proper blood clotting, energy and preventing anaemia.

Pain and heavy bleeding can make this phase of the cycle hell for some people! If this is you then I highly encourage increasing the amount of anti-inflammatory foods in your diet like oily fish, flax seeds, and turmeric.

Practitioner thoughts: If a patient presents with fatigue, heavy bleeding, or pain during this phase of their cycle I will look into iron levels as iron plays a role in blood clotting and fatigue. I will also investigate their oestrogen balance over the cycle - are they making enough? Or do they need support to help eliminate oestrogen more effectively? High oestrogen levels can cause heavy bleeding, while low oestrogen can impact mood and fatigue badly during this phase. Pain is always a red flag and comes down to inflammation and/or endometriosis. You can read more about that here.



Phase 2: Follicular Phase (Days 6-14)

The second phase of the menstrual cycle is the follicular phase, which begins at the end of your bleed and lasts until ovulation. During this phase, follicle-stimulating hormone (FSH) is released from the pituitary gland (in the brain), which stimulates the development of follicles (your eggs live inside each follicle) in the ovaries.

During this phase, you may feel more energetic and experience an increase in libido. You can support this phase with increased intakes of B6 (found in chicken, avocadoes and bananas) and zinc (found in nuts seeds, meat and shellfish) - both are key nutrients to support ovulation.

Practitioner thoughts: The main issue I often see in this phase of the cycle is late or lack of ovulation. For some people there will be very little hormonal change and as a result no ovulation is triggered - as is the case with hypothalamic amenorrhea. For many more, there will simply be late ovulation, when ovulation occurs after day 19 or 20. The causes for late ovulation can be as simple as stress, or more complex as is the case with polycystic ovarian syndrome.



Phase 3: Ovulatory Phase

The third phase of the menstrual cycle is the ovulatory phase, which occurs approximately 14 days after the start of menstruation - if you have a textbook cycle! Many of you won't and ovulation may be from day 12-25. During this phase, the mature follicle releases an egg into the fallopian tube. If you are trying to conceive the egg might meet a sperm, or if you are not then it will simply be shed along with your next period.

During this phase, you may experience an increase in breast tenderness, bloating and headaches or may notice some ovulation pain.

Practitioner thoughts: a common complaint at this stage of the cycle is ovulation pain, which is often related to conditions like endometriosis and ovarian cysts. Identifying these kinds of symptoms is an important part of my assessment so that patients can be referred to specialists as needed for well-rounded healthcare.


Phase 4: Luteal Phase (Days 15-28)

The fourth and final phase of the menstrual cycle is the luteal phase, which begins after ovulation and lasts until the start of the next menstrual cycle. During this phase, the follicle that released the egg transforms into the corpus luteum, which produces progesterone.

During this phase, individuals may experience a range of symptoms, including mood changes, bloating, and breast tenderness. Taking time to slow down, feed yourself well and stock up on high iron foods like leafy greens and red meat during this time is key.

Practitioner thoughts: Once ovulation has been confirmed I am looking for adequate progesterone and oestrogen production and proper oestrogen detoxification to support reduced bleeding and pain in the upcoming menstruation phase. Another big part of supporting this phase is supporting mood. Mood changes can be minor and might just be a sign a patient needs to slow down a little. For others, the mood changes are extreme as is the case with PMDD (Pre-Menstrual Dysphoric Disorder). Supporting anti-inflammatory processes, the liver for hormone detoxification, and supporting mood through hormone and neurotransmitter support as needed is my focus.


Getting to know your body throughout the different phases is key to improving your hormonal health. Learning which symptoms are normal and which aren't is a big part of diagnosing issues and making improvements. Make it a priority for your next cycle to start tracking how you feel either with an app or in your diary. After you have a few cycles worth of data you will have a clearer idea of where to focus your efforts with changes to support hormonal function.

For an in-depth guide on how to track your cycle, monitor ovulation and carry out blood tests for key nutrients and hormones click here.

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