Hormones and the Menstrual Cycle

by Dr. Michael Nowazek

What is a normal menstrual cycle?  I hesitate to even use the word “normal” when referring to menstruation because that implies that every woman’s cycle should be the same, and it isn’t.  Not every woman’s cycle runs with the precision timing of a Swiss watch. Instead, let’s call it “average” (which is a little more user-friendly than “statistically probable”).

The average cycle is 28 days, give or take.  The cycle can be broken down into three different phases or general events.  

The Follicular Phase

The first phase is called the follicular phase.  Follicles are small sacs of fluid found on the outside layer of the ovaries that contain the immature eggs, called oocytes or ovum.  A woman is born with all the follicles/eggs she will ever use.

In the follicular phase, which occurs roughly during days 1 through 14 of the cycle, the follicles grow to produce mature eggs.  Each follicle produces just one egg but around day 7 to 10, one of these follicles starts to outgrow the others. The exact reason for one follicle outgrowing the others is not known; science has not yet determined how or why this phenomenon occurs.  At day 14, the one follicle that has outgrown the others will release an egg. The remaining follicles disintegrate.

After the egg bursts from its follicle, the ruptured follicle stays on the surface of the ovary and transforms into a structure known as the corpus luteum.  During the follicular phase, estrogen is the dominant hormone released by the corpus luteum. Estrogen causes the cells in the uterus to increase in number.

The Ovulation Phase

The second phase, ovulation, is when the mature egg is released.  This occurs anywhere from day 10 to day 20 of the menstrual cycle.  The egg travels down the fallopian tube toward the uterus and if it is met by a viable sperm, pregnancy should occur.

Women will often see a change in cervical mucus during the ovulation phase in the form of a discharge and become needlessly concerned about it.  The purpose of this mucus, which has a consistency similar to raw egg whites and is rather stringy, is to provide an environment in which sperm can live and indicates that the woman is healthy and fertile.

The Luteal Phase

The third stage is the luteal phase, which occurs from day 14 to day 28 of the cycle. During the luteal phase, the corpus luteum secretes mostly progesterone.  Progesterone increases the thickness and swells the cells in the lining of the uterus which is then prepared for the reception of a fertilized egg. If a fertilized egg is not received in the uterus, the lining is sloughed in the process called menstruation.

Menstruation is the body’s system of getting rid of the unused uterine lining.  It lasts, on average, from three to five days.

Hormones Run the Show

Each phase of the cycle is regulated by different hormones.  Irregularities in the cycle, such as excessively heavy or light bleeding, late periods, short periods, missed periods, are all indications of hormonal imbalance.  If there is a hormone imbalance, a woman can have PMS symptoms including excessive bleeding or pain, infertility, acne, weight gain, water retention, mood irregularities, depression, and insomnia.

Tracking your cycle is important to helping pinpoint the root cause of irregularities:  what is your cycle length (the number of days from when you first bleed to the next time you bleed)? how long does the bleeding last? how heavy is the flow? what is the colour of the blood?  are there clots in the blood?

All of these details are important to note to give us an indication of which hormones are imbalanced.  For example, a short cycle (21 days, for instance) could be symptomatic of low progesterone. There are many detailed testing options available for women to determine which hormones should be addressed.

What About PMS?

Then there’s the dreaded premenstrual syndrome.  An alarming number of women are very familiar with that phenomenon – the bloating, the fatigue, the irritability, the insomnia, the appetite changes.  Statistics indicate that between 80 and 90 percent of women experience PMS symptoms, some of them severe.

PMS has become so common that there is almost a normalcy built around it, an attitude that it’s just a part of the menstrual cycle that a woman has to live with it.  She doesn’t.

PMS symptoms are not normal.  They’re common, but they’re not normal.  PMS symptoms are an indication that something is wrong, that there is some kind of hormonal imbalance that needs to be addressed.

Fertility issues and menstrual issues can be successfully addressed. Effective, natural remedies are available to those who wish to avoid pharmaceutical or surgical interventions.  The doctors at Green Apple Health Care are experts in treating such conditions, gently and naturally.

Call Green Apple Health Care at (780) 485-9468 today and find out just how good you can feel.

Click here for a downloadable version of this article.


Dr. Michael Nowazek

Dr. Michael Nowazek is the Clinical Director of Green Apple Health Care. He brings a wealth of knowledge from his extensive training and his many years experience as a naturopathic doctor.

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