What Your Period Is Trying To Tell You
How your menstrual cycle works
Luckily, the conversation around periods is starting to change. It is no longer taboo to talk about or something that is brushed off when irregularities happen. Period tracking apps are more common than ever and women are starting to find other methods to work with their menstrual cycle as a natural alternative to hormonal birth control. Not to be cliche but I honestly believe that knowledge is power when it comes to how your body works, especially when it comes to the fluctuations in hormones that women experience every month until menopause or pregnancy. Knowing how these stages work and why can give you leverage over how to react to symptoms or even timing certain events so that you feel at your best! It can be something to lean into instead of run away from.
Your menstrual cycle is broken down into 2 phases. Phase 1 is considered your follicular phase that begins with your period. The second phase is called your luteal phase which begins when you ovulate. There is often a misunderstanding that there are 4 phases but really there are these two main phases with your period and ovulation being the two major events that kick off the phases. It may be more accurate to say there are 4 stages to your menstrual cycle.
The day you start to bleed is considered day one of your cycle. The length of your cycle is determined by the number of days between day one of bleeding and when you begin to bleed again in the next cycle. The follicular phase can vary in length to be anywhere from 10 -16 days whereas your luteal phase is more consistent with a length of around 14 days.(1) This comes out to an average of a 28 day cycle with a range of 25-30 days being considered normal. (1) If your cycle is every 21 days or less or is 35 days or more, this may be considered irregular and is a great indicator that working with your doctor may be needed. (1) With that being said, the length of your menstrual cycle can vary each month based on what could be going on in your life. It is best to look more closely at your patterns over the course of at least 2-3 periods to see what your potential cycle length could be.
Key terms for fertility and menstrual cycle testing: (1-3)
These are often referred to when you get labs to see how your hormones are doing.
Follicle Stimulating Hormone (FSH) - stimulates the growth of eggs, highest right before ovulation and triggers estrogen production. When tested can help understand ovarian function and the number of eggs available.
Luteinizing Hormone (LH) - works with FSH and helps with the release of an egg, low levels may indicate irregularities with fertility. Testing can help understand hormonal imbalances such as PCOS.
Corpus luteum - group of cells formed temporarily in the ovary once the egg is released (ovulation) to support healthy progesterone levels for potential pregnancy.
Estradiol Metabolite (E3G) - estrogen metabolite found in urine and used to indicate/predict your fertile window. This will begin to rise around 3 days before ovulation and helps with increasing LH for egg release. When tested helps to understand egg quality and how your ovaries are functioning.
Progesterone - hormone that increases after ovulation to support a healthy uterine wall aka environment for a potential fertilized egg. When low, strong PMS symptoms may show up. Testing can help with understanding if ovulation takes place.
Pregnanediol 3 Glucuronide (PdG) - metabolite of progesterone found in urine that can be used to indicate progesterone levels.
Gonadotropin releasing hormone (GnRH) - hormone in your brain that signals the release of LH and FSH.
Prolactin - when high, can interfere with ovulation and hormone release during the menstrual cycle. This is also released after delivery for milk supply in the breast. Testing can help determine a potential cause of fertility irregularities or lack of ovulation.
Androgens - such as testosterone are evaluated if there is a potential for PCOS.
A Breakdown of the 4 stages
Menstruation
Day one of menstrual cycle
Averages 5-7 days of bleeding
Hormones:
Follicle stimulating hormone (FSH) begins to rise until dominant follicle is chosen
The dominant follicle grows by day 8 (this holds the egg that could be fertilized)
Estrogen and progesterone are low at the beginning of your period, their drop in levels is what signals your period to start
Main activity: shedding of the uterine lining
Mood: may feel more low at the beginning of your period
Energy: low, self-care and relaxation are key
Key nutrients: Iron, vitamin C, magnesium, zinc, b-vitamins (lower inflammation with ginger, turmeric and omega-3 fatty acids)
Follicular phase
Begins day 1 of bleeding until ovulation
Averages around 10-16 days
Hormones
Estrogen begins to increase as the dominant follicle increases
FSH stimulates luteinizing hormone (LH) which releases a small amount of progesterone
FSH slowly begins to decrease until ovulation
LH slowly begins to rise until ovulation
Estrogen rises and drops right after ovulation
Main activity: Growth of dominant follicle that has the egg that will be released at ovulation + increase in uterine lining thickness
Mood: slowly increases with the rise of estrogen
Energy: slowly begins to rise
Key nutrients: fermented foods, fiber, vitamin C, zinc, cruciferous veggies
Ovulation
Happens 10-12 hours after LH peaks at the middle of your cycle (exact day is different for many women)
Averages up to 24 hours but your fertile window begins up to 5 days before and 1 day after ovulation *sperm can live up to 5 days in the female reproductive tract
Hormones
Progesterone begins to rise after ovulation
Estrogen peaks right before ovulation and drops afterwards
FSH spikes right before ovulation
Main activity: Release of egg from either the left or right ovary
Mood : peak energy, great time to get things done!
Energy : Highest point
Key Nutrients : B-Vitamins (key), zinc, high quality fats (focus on omega-3 and monounsaturated fats), optimize hydration
Luteal Phase
Begins at ovulation
Lasts around 14 days until menstruation
Hormones
Estrogen drops after ovulation
Estrogen slowly begins to rise (not as high as in follicular phase) then drops again before menstruation
Progesterone is highest during this phase
Main activity : Progesterone increases to support health of uterine lining. If no pregnancy occurs then the body prepares for uterine shedding aka your period
Mood: slowly begins to decrease, great time to focus on admin or detail oriented tasks alone
Energy: may feel more relaxed or calm right after ovulation with an increase in progesterone, mood may slowly begin to decrease with a drop in estrogen before your period
Key Nutrients: protein, magnesium, folate, vitamin B6, calcium, vitamin C
Why having a regular period is important (5th vital sign)
The menstrual cycle for women is now commonly referred to as the 5th vital sign along with your blood pressure, body temperature, pulse and breathing rate. This complex hormonal release that involves your ovaries, uterus and brain all signal how your overall health is going. When irregular, this is a key signal from your body that things may not be operating as they should. This may indicate that further investigation is needed to understand the root causes for other things you may be experiencing like low mood, poor energy or weight fluctuations.
What does your blood color mean?
Bright red - healthy period, may darken towards the end of your period
Pink - potential for low estrogen/ could also mean egg implantation and early pregnancy
Dark Red - more common towards the end of your period or your heaviest days
Purple/blue - potential for high estrogen levels or sign of estrogen dominance
Brown - old period blood that took a little longer to leave the uterus
Grey/Black - potential sign of infection, could be from old period blood as well
Orange - possible infection, additional vaginal discharge
What does the length of your period mean?
*Sometimes the length of your period could be just normal hormone fluctuations, however, if you suddenly see a different pattern over 2-3 periods, please speak with your doctor.
Short
Period that lasts around 3 days, very light bleeding
Could indicate irregularities with ovulation, signals to look at LH and FSH levels
Potential sign of perimenopause that can happen for many women sometime starting in their 40s
Other potential causes: early sign of pregnancy, use of birth control pill, other medications, high stress, overexercising, undereating, dramatic sudden weight changes
Long
Period that lasts more than 7-8 days
Could indicate irregularities with your uterus such as uterine fibroids or endometriosis
Potential sign to look into thyroid function and signaling
Other potential causes: blood thinning medications, adenomyosis or excessive thickening of the uterine lining, excessive estrogen
What does the length of your whole cycle tell you?
Short
Period cycles that last 21 days or less between bleeding
Other potential causes: age, high stress, over exercising, undereating, weight fluctuations, and certain medications
May be a potential sign to look into thyroid health
Long
Period cycles that last 35 days or longer between bleeding
Could indicate low levels of progesterone
Could be a potential sign for PCOS, sometimes this can lead to fewer periods in a year
Other potential causes: uterine fibroids, endometriosis, estrogen dominance, birth control use, early sign of pregnancy, stress, excess weight or sudden weight loss, early sign of menopause or perimenopause
Mid-cycle spotting
Breakthrough bleeding that happens in the middle of your cycle
Could indicate estrogen dominance with low progesterone
Other potential causes: hormonal birth control, early signs of pregnancy, potential for fibroids, perimenopause
What does clotting mean?
Releasing a clot during your period can be very common since you are releasing tissue from the uterus. These should be less than the size of a quarter. Larger amounts could indicate heavy menstrual bleeding often referred to as menorrhagia and could result in needing to change your tampon or pad every two hours or less.
If this is the case, then your healthcare provider may look into possibilities of PCOS, endometriosis, thyroid irregularities, polyps, fibroids or ask you about your medication use. This can also sometimes happen with IUDs.
Estrogen dominance may be another factor in heavy menstrual bleeding with large clots. Both estrogen and progesterone play a role in the function of your uterine wall and when there are cases of imbalance, especially with higher than normal levels of estrogen compared to progesterone, there is a possibility that the uterine wall becomes thicker than normal.
terms seen with periods
Menorrhagia - period bleed that lasts more than 7 days or is heavier than usual
Amenorrhea - missing period for 3 months or longer
Dysmenorrhea - pain with menstruation
Metrorrhagia - spotting or bleeding between your menstrual cycle
Oligomenorrhea - infrequent menstrual bleeding
How does estrogen dominance show up in your period?
When in a state of estrogen dominance, there is a higher level of estrogen that is not fully regulated by adequate progesterone in the second half of the menstrual cycle. This can lead to a few symptoms that show up in your monthly bleed.
Heavy period bleeding
Painful periods
PMS symptoms leading up to bleeding
Potential for longer menstrual cycles
Potential for longer period bleed days
Blood that turns a darker color almost purple or blue
Possibility of larger blood clots
I go into more information about estrogen dominance in this article .
First steps to regulating your period
Before I dive into some of my favorite ways to naturally support your menstrual cycle I do want to say that if you feel there are things that are showing up as unusual for you or you have signs of an irregular period it is best to keep your doctor informed. They can help with early diagnosis or intervention if that is needed.
Determine your food sensitivities
Evaluate your stress levels
Look at your exercise (not enough, too much?)
Include protein with your breakfast, aim to get at least 20g of protein before noon
Hydrate
Limit caffeine and alcohol intake
Eat enough calories for your body to perform its job
The Fertility Cleanse for Estrogen Dominance
This three month program focuses on my three phase method for supporting estrogen dominance. The program starts with a 2 week reset to kickstart your results, a one month deep dive into your natural detoxification abilities and a one month masterclass series on using your menstrual cycle to achieve the results you desire.