Fertility

TTC – Menstrual Cycle and Hormones Explained

Andreia Trigo  |   23 Jan 2020


One of the hardest things about tracking your cycle when trying to conceive, is figuring out what should be happening when. It’s easy to self-diagnose an issue with cycle lengths, for example. without having any scientific proof of an issue. That’s why we’ve called upon expert registered nurse, Andreia Trigo to shed some light on the different menstrual phases. The aim is to help you get to know and understand your menstrual cycle better. If you’re currently charting your cycle (whether TTC naturally or undergoing reproductive assistance with a fertility clinic), we have some useful ovulation tracking devices and further BBT (Basal Body Temperature) information here.

Over to Andreia Trigo…

www.andreiatrigo.com | @andreiatrigorn

Ovulation tracking & the menstrual cycle explained

Even though the menstrual cycle is something most women have to live with for a large part of their lives, most of us are not aware of what is actually happening in our ovaries and uterus at every phase of the cycle.  If you are trying to conceive, and want to maximise your chances, it is important to learn about your body, how your menstrual cycle works and what is happening inside you week by week.

MenstrualCycle-diagram

The menstrual cycle is regulated by hormones, including estradiol, progesterone, LH and FHS. These hormones will trigger different events throughout the cycle, allowing the follicles to grow, the eggs to mature and ovulate and the uterus lining to prepare for implantation. These changes also bring different feelings and emotions throughout the cycle. In this article we explain your menstrual cycle week by week and give you tips to cope with changes that are happening in your body. The menstrual cycle has four phases: menstrual phase, follicular phase, ovulation and luteal phase. In most literature, we read about 28-day cycles, but every woman is different, and some may have longer or shorter cycles, that are more or less regular.

Menstrual Phase

The menstrual phase is characterised by the menstrual bleeding, abdominal cramps and bloating.  Your temperature is low. During this phase, our hormone levels are also low and you may feel tired. Here are some tips to cope with the menstrual phase:

  • Take it easy and rest more than you usually do
  • Use heating pads for aches and discomfort
  • Use painkillers like paracetamol or ibuprofen to ease the pain
  • Avoid caffeine as it constricts blood vessels and increases tension.

Follicular Phase

During the follicular phase, your FSH levels increase slightly, stimulating the development of several follicles in the ovaries. Later in this phase, as the FSH levels decrease, only one follicle continues to develop. This follicle produces estrogen.  Increased hormonal activity means you may have a heightened sense of smell, along with clearer thinking and better coordination. Many women report feeling their best at this time of the month — physically and mentally.

Positive sensations such as relief, release, euphoria, new beginning, invigoration, connection with nature, creative energy, exhilaration, increased sex drive and more intense orgasms. Here are some tips to help cope with the follicular phase:

  • Consider brainstorming or problem-solving during this phase, as well as doing things that capitalise on your creative energy.
  • Be social and go out with friends!

Ovulation

During this phase there is a surge in LH and FSH levels. LH stimulates egg release (ovulation), which usually occurs 16 to 32 hours after the surge begins. The estrogen level decreases during the surge, and the progesterone level starts to increase. Your temperature increases with ovulation. Right around ovulation is also the time when many women experience acne, breast tenderness, weight gain, headaches, and water retention. You can track ovulation with ovulation predictor kits. Tips to cope with ovulation:

Your fertile window are the 5 days before ovulation and the day of ovulation. Time to try to reconnect with your lover!

Luteal Phase

During the luteal phase, LH and FSH levels decrease. The ruptured follicle closes after releasing the egg and forms a corpus luteum, which produces progesterone. Progesterone and estrogen cause the lining of the uterus to thicken more, to prepare for possible fertilisation. Progesterone acts on the temperature regulating area of the brain so you may feel feverish during this time of the cycle. It also relaxes the smooth muscle of the uterus as well as your gallbladder, sphincter and intestines, and you may feel bloated.

Tips to cope with the luteal phase:

  • Avoid salty foods, sugar and processed foods which can make you feel more bloated.
  • Walking, swimming or any mild to moderate exercise has a positive effect.

If implantation does not occur, progesterone levels decline and your temperature drops. An imbalance of estrogen and progesterone can affect your levels of serotonin and bring on strong PMS symptoms (anxiety, depression, irritability and mood swings).

Menstrual cycle tracking calendar

Knowing how your body works and paying attention to your cycle can help you identify your fertile window and maximise your chances of pregnancy. It can also help you notice any changes and clues into what might be preventing you from getting pregnant. If you are tracking your cycle and notice that your LH levels don’t surge, that there is no ovulation, or that you get recurrent miscarriages, the answer might be your hormone levels.

Andreia Trigo RN BSc MSc is a multi-awarded nurse consultant, author and TEDx speaker.  Combining her medical experience and her own infertility journey, she developed unique strategies to help people undergoing similar challenges achieve their reproductive goals. Her mission is to improve accessibility to fertility care and support worldwide at minimal cost to populations. She is the founder of the Enhanced Fertility Programme, the evidence-based programme that improved help for fertility, currently in use by several clinics and patients worldwide.

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