How Will My Menstrual Cycle Change Throughout My Life
From your first period…
The average age of getting your first period is just over 12 years, but this usually ranges from 9-15 years. It takes a while for your body to adjust and get the balance of all the hormones right, but after about a year, your periods should be regular, says Dr Rosén.
Through potential pregnancy and later life…
With the exception of pregnancies and breastfeeding, and occasional skipped periods if youre very stressed, your periods should continue regularly until youre in your mid-40s.
As we get older, the quality of our eggs declines, which is why the risk of miscarriage and chromosomal abnormalities increases. The corpus luteum also becomes less effective at producing progesterone, so your menstrual cycle might become shorter, says Dr Rosén. This is usually the very first sign of perimenopause.
Ending with perimenopause and menopause…
After a while, you start to run out of eggs, and you wont have your cycle every month. Despite not ovulating, your ovaries will still produce oestrogen, causing your uterus lining to grow. But as youre not ovulating, youre not producing progesterone and so eventually the lining becomes so heavy it just falls out.
Thats why you can get very irregular but heavy, long-lasting bleeds until around the age of 51. After this time, if you havent had a period in a year, then youre officially in menopause.
Difference Between Fsh And Lh Levels
The roles of FSH and LH are different, but they work together to regulate fertility. These two hormones are so vital that a normal menstrual cycle can be divided into distinct phases, using an FSH and LH surge as reference.
Similarly to FSH, LH is a glycoprotein hormone secreted by the anterior pituitary. If youre undergoing fertility testing, your doctor might order both FSH and LH blood tests. These tests can be used to:
- Determine what is causing your fertility problems
- Discover abnormalities in your ovarian function
- Establish the cause for irregular or absent menstrual cycles
- Confirm whether youre entering perimenopause or menopause
Doctors might also use the LH-to-FSH ratio to diagnose polycystic ovary syndrome , a relatively common hormonal disorder. The diagnostic criteria for PCOS is a 3:1 LH-to-FSH ratio .
How Can I Maintain Healthy Estrogen Levels
You cant always prevent the conditions associated with hormone imbalances. Still, you can put good practices into place to help maintain your overall health.
- Get enough sleep. Getting adequate, uninterrupted sleep each night helps your body maintain the healthy hormone levels needed to carry out important functions.
- Manage your stress. High stress can cause your body to produce too much of the stress hormones cortisol and adrenaline. Excess stress hormones can cause a hormone imbalance that negatively impacts your estrogen levels.
- Get the right amount of exercise. A healthy amount of exercise can help you regulate how much you eat and how much body fat you have. It can help you sleep better, too.
- Limit your alcohol intake. Alcohol can raise your estrogen levels. Over time, too much exposure to estrogen may raise your cancer risk.
- Practice good eating habits. Monitor your food intake to help balance your hormones. Reducing foods with sugar and eating foods high in fiber and healthy fats can help with hormone balance.
A note from Cleveland Clinic
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How The Follicular Phase Might Feel
Many people report a positive mood between days 6 and 14 of their cycle. For some, their confidence grows slightly between days 6 and 13 of their cycle due to increased estrogen and testosterone levels. If you notice this is true for you, you can plan your schedule so youre feeling your most confident during meetings or job interviews.
Hormone levels on days 614 of the cycle can affect the skins scent, which can affect how fragrances and perfumes interact with each persons personal chemistry.
How Menstruation Might Feel
Many people feel uncomfortable, tired, and have a negative mood during menstruation. Fortunately, there are lots of medicines and foods that can help with this.
Some people who have intense cramps during their period often use pain-relieving medication. Others apply heating pads on their lower back and abdomen to ease cramping pains.
Your period might last longer than average or be more intense. This is typically nothing to worry about, but its a good idea to talk to a health care provider about it to confirm that there arent any health issues affecting your periods. Dietary changes can help compensate for the loss of nutrients from heavy bleeding.
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Where Is Estrogen Located In The Body
Your ovaries make most of your estrogen during your reproductive years. Your adrenal glands and adipose tissue secrete estrogen, too. The placenta secretes estrogen during pregnancy.
Once its released, estrogen travels through the bloodstream until it reaches the part of your body that needs to be spurred into action. There, estrogen binds to a protein, called an estrogen receptor, that gets the process moving. Estrogen receptors are located throughout your body.
When Am I Most Fertile
During ovulation. The timing of this varies, but its usually 14 days before the first day of your period, says Dr Rosén.
Getting to know your body throughout the menstrual cycle can be helpful, especially if youre trying to conceive. Pay attention to your vaginal discharge, have a feel of your cervix and notice if your breasts are starting to feel tender, Dr Rosén adds. Youll get to know the signs.
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How Long Does A Menstrual Cycle Last
The average menstrual cycle is 28 days, but it can last anywhere between 21 and 45 days.
Irregular menstrual cycles are common too, especially if youre experiencing mental or physical stress, or significant fluctuations in weight. The body is clever it wont allow ovulation if its not ready for a pregnancy, says Dr Rosén.
But there are times when irregularities may suggest that something else is going on. If your cycle is suddenly shorter than 21 days, its worth considering that it might not be a menstrual bleed but something else, which could suggest an infection in the uterus or changes to the cervix, Dr Rosén explains.
Similarly, an ovarian cyst can affect the fine balance of all our hormones, and conditions like polycystic ovary syndrome can cause your cycle to last longer than 35 days.
Later in life, irregular cycles are also the first sign of decreasing fertility and the start of perimenopause.
Overview Of The Cyclic Endometrium
The endometrium is one of the most sensitive organs to ovarian steroid hormones. The endometrium is composed of two layers. The most luminal layer is the functionalis which is thickened and sloughed in response to ovarian hormones. The basalis is closest to the myometrium and remains throughout the menstrual cycle1.
Endometrial lining throughout the menstrual cycle
The endometrial lining thickens in response to estrogen in the proliferative phase. After ovulation, the endometrium becomes decidualized in the secretory phase. The window of receptivity is 710 days after the LH surge, near the time of ovulation. After the cycle is finished, menstruation occurs and the cycle begins again.
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Whats The Outlook For A Hormonal Imbalance
If you have a hormone imbalance, there are various treatments to help bring your hormones back to appropriate levels and restore balance.
Depending on the underlying cause of the imbalance, as well as the specific hormones in question, treatments can vary, but there are ways to manage symptoms and bring hormone levels back to normal.
If theres an underlying condition causing the hormone imbalance, long-term management of the condition will help ensure hormonal balance.
Hormone levels change and fluctuate over time they dont remain static. Its important to be aware of your bodys symptoms.
Talk with your health care provider about any changes you might notice, especially after giving birth or while going through perimenopause.
How Does The Female Reproductive System Work
The female reproductive system provides several functions. The ovaries produce the egg cells, called the ova or oocytes. The oocytes are then transported to the fallopian tube where fertilization by a sperm may occur. The fertilized egg then moves to the uterus, where the uterine lining has thickened in response to the normal hormones of the reproductive cycle. Once in the uterus, the fertilized egg can implant into thickened uterine lining and continue to develop. If implantation does not take place, the uterine lining is shed as menstrual flow. In addition, the female reproductive system produces female sex hormones that maintain the reproductive cycle.
During menopause, the female reproductive system gradually stops making the female hormones necessary for the reproductive cycle to work. At this point, menstrual cyclescan become irregular and eventually stop. One year after menstrual cycles stop, the woman is considered to be menopausal.
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How Many Women Have Irregular Cycles
Only 10 to 15% of women have cycles that are exactly 28 days, and in at least 14% to 25% 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.
Your Menstrual Cycle And Your Hormones
Ovia Fertility helps you track your unique cycle and understand your body better. If you dont have the Ovia Fertility and Cycle Tracker app, you can .
You may have heard the term hormonal before in relation to your period. While its true that hormones are involved during menstruation, hormones also play an important role in the other three phases of your cycle: the follicular, ovulatory, and luteal phases. Learn more about the menstrual cycle and your hormones here!
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Phase : Follicular Phase:
When: Technically the follicular phase starts on the first day of the period until Ovulation.
What happens: After the period, the uterine lining builds back up again .
During this phase, oestrogen rises as an egg prepares to be released. The change in hormones during this time will affect your energy levels, strength, and mental focus.
It is therefore highly advised to include good nutrition during the follicular phase.
How Ovulation Might Feel
Ovulation is generally regular without any extra symptoms aside from changes in vaginal secretion. Cervical mucus increases in quantity and becomes clear and stretchy, like egg whites, during this phase.
Different types of vaginal discharge occur throughout the cycle, so discharge that slightly changes color and consistency may be normal. During ovulation, there may be mild soreness on the side of the body where the ovary is releasing an egg. This is called mittelschmerz and can last from a few minutes to one to two days. Mittelschmerz is completely normal, and its also normal not to experience it.
However, if theres a sharp pain in the belly during ovulation or an excessive amount of discharge, its possible that there are underlying health issues that need medical treatment.
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Phase : 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 oestrogen, 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.
This is the phase of the menstrual cycle in which symptoms of PMS can occur. It is there advised to have good nutrition during the luteal phase to avoid it.
Overview Of The Menstrual Cycle In Humans
Figure 1 shows a general overview of the key regulatory factors in the menstrual cycle. The hypothalamus secretes gonadotropin releasing hormone which stimulates the anterior pituitary to secrete both follicle stimulating hormone and luteinizing hormone . FSH and LH are heterodimeric members of the glycoprotein hormone family and have an :FSH and :LH non-covalent structure, respectively. The subunit is common to all glycoprotein hormone family members. The levels and timing of secretion of each gonadotropin is correlated by GnRH, feedback from sex steroid hormones, and other autocrine and paracrine factors such as inhibin and activin. The gonadotropins stimulate the ovary to produce the steroid hormones, estrogen or progesterone as well as several key autocrine, paracrine, and endocrine peptides. Similar to the pituitary, ovarian steroidogenesis is regulated by multiple factors. The ovarian steroid hormones in turn stimulate endometrial proliferation and affect many end organs. Although estrogen and progesterone have some feedback at the level of the hypothalamus, the more dynamic feedback occurs at the level of the anterior pituitary. Folliculogenesis, ovulation, luteinization, and endometrium growth and decline during the menstrual cycle depend on the above-mentioned autocrine, paracrine, and endocrine factors produced from this axis1.
General overview of the important factors in the menstrual cycle
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The Hypothalamus And The Hormones That Influence The Menstrual Cycle
The hormones that influence the menstrual cycle start their process in the hypothalamus. The hypothalamus secretes the gonadotropins , whose main function is to stimulate the bodys production of other hormones that are necessary for the uterine cavity and the endometrium to be in a suitable state for conception.
In turn, the body also produces hormones that influence the menstrual cycle in the hypophysis or pituitary gland. The hypothalamus controls this gland and its responsible for secreting both the FSH and the LH hormones. Lets take a deeper look:
- FSH or follicle-stimulating hormone: the body secrets this in the first part of the menstrual cycle and contributes to the ovum forming and maturing. It also stimulates the bodys production of estrogen.
- LH or luteinizing hormone: this cycle contributes to the ovulation process, facilitating the bodys secretion of progesterone. And, if the sperm fertilizes the ovum, it protects the pregnancy during the first few weeks.
In fact, the FSH facilitates the ovum forming and eventually becoming fertilized. In turn, the body quickly produces the LH between 9 and 12 hours after this happens, the body releases the mature ovum and we get ovulation.
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Lactation And Resumption Of Ovarian Cycles
Menstrual cycles resume as early as 6 to 8 weeks after delivery in women who do not nurse their babies. With breast-feeding, however, the reappearance of normal ovarian cycles may be delayed for many months. This delay, called lactational amenorrhea, serves as a natural, but unreliable, form of birth control. Lactational amenorrhea is related to high plasma concentrations of prolactin, which appear to suppress the GnRH pulse generator. Delayed resumption of fertile cycles therefore is most pronounced when breast milk is not supplemented with other foods, and consequently the frequency of suckling is high. Ovarian activity is limited to varying degrees of incomplete follicular development even in those women who ovulate, luteal function is deficient. Hyperprolactinemia often results from a small prolactin-secreting pituitary tumor , and is now recognized as a common cause of infertility and abnormal or absent menstrual cycles. Treatment with bromocriptine, a drug that activates dopamine receptors, suppresses prolactin secretion, and restores normal reproductive function. The delay in resumption of cyclicity results from decreased amplitude and frequency of GnRH release by the hypothalamic GnRH pulse generator . Pulsatile administration of GnRH to lactating women promptly restores ovulation and normal corpus luteal function.
Paul. Terranova, in, 2017
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What Happens When Estrogen Levels Are Consistently Low
Low estrogen is often a tell-tale sign that youre approaching menopause. Low estrogen may also signify a fertility problem, a nutritional deficiency, a condition like Turner syndrome, etc.
Symptoms may include:
- Hot flashes and night sweats.
- Irregular periods or no periods.
- Headaches, trouble concentrating.
- Mood changes, irritability and depression.
- Vaginal dryness, leading to painful intercourse .
What Happens When Estrogen Levels Are Consistently High
Excess estrogen in your body can be associated with multiple conditions: polyps, fibroids, PCOS, endometriosis pain, ovarian tumors, etc.). Your levels may be high because you have too much estrogen in relation to your other sex hormone, progesterone. Medications youre taking that contain estrogen may cause you to have too much of it in your body.
Symptoms may include:
- Weight gain, especially in your waist and hips.
- Irregular periods .
- Worsening symptoms associated with PMS or PMDD.
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The Two Parts Of Your Menstrual Cycle
The first part of your menstrual cycle is called the follicular phase. This phase starts on the first day of your last period and continues until the day you ovulate. This phase of your menstrual cycle may be different for every woman . The second part of your menstrual cycle is called the luteal phase. This phase begins on the day of ovulation and lasts until your next period starts. The luteal phase usually has a more precise timelinefor most women, this part of your menstrual cycle typically lasts around 12-16 days.
How Do You Know Which Ovary Released An Egg
You might not know which ovary released an egg. The only way to know is to pay attention to how you feel when you are ovulating. Some people feel a slight tinge or cramp called mittelschmerz when they release an egg. Where you feel this pain could indicate which side released the egg that cycle.
A note from Cleveland Clinic
Your ovaries are a critical piece of your reproductive system. They produce hormones that help with your menstrual cycle and pregnancy. They also store and release an egg each cycle for fertilization. Some people develop conditions of the ovaries that require medical treatment. Symptoms of ovarian conditions include pelvic pain, vaginal bleeding and irregular menstruation. Talk to your healthcare provider if you experience any pain during ovulation or menstruation so they can check the health of your ovaries.
Last reviewed by a Cleveland Clinic medical professional on 05/13/2022.
References
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