As cyclical beings, our internal terrain is in a constant state of flux – an ever changing, fluid rhythm existing within ourselves. As our body’s physical, mental, and emotional terrain change each day, our needs for care and nourishment change too. Knowing how to best care for our cyclical selves begins with gaining a deeper understanding of the cycles within us. In this journal, we offer insights into the different phases of the menstrual cycle, touching on what is occurring physiologically and hormonally within each.
Each month we navigate through four states of being - menstrual, preovulatory, ovulatory, and premenstrual. These four states are encompassed by two phases, the follicular phase and luteal phase. These phases have no distinct beginning or end, but flow into one another gently, just as the moon softly transitions from one phase to the next. In the truest sense, there is no separating each segment of our menstrual cycles, other than for the means of intellectualization. With that said, when first acquainted with the many aspects of the cycle, it is helpful to think of the follicular phase as the first half of the cycle that begins on the first day of bleeding, and the luteal phase as the latter half of the cycle, which begins just after ovulation.
The way we experience the world can radically change between these two phases, largely driven by hormonal fluctuations that are continuously shifting within us. The key hormones in our cycle include: follicle stimulating hormone (FSH), luteinizing hormone (LH), estrogen, progesterone and testosterone. Below we dive deeper into this hormonal dance and the role it plays in each phase of our monthly journey.
The follicular phase is roughly the first half of your cycle, beginning on day one of your cycle until the day before ovulation takes place. This includes your present menstrual bleeding time, as well as the period leading up to ovulation. The term ‘follicular’ is analogous to egg, as this is the time when a new follicle/egg is maturing for eventual release. The release of your egg, ovulation, marks the end of your follicular phase. This is typically day 14 in an average 28 day cycle, yet may range from day 12-16.
Take note that this is based upon a 29.5 day cycle, but not every menstruators cycle will be in synchronicity with the moon. Every cycle varies, and is not a representation of your cycle's health and balance.
Around day 1-5
Menstruation begins the day blood first falls, until your uterus finishes shedding. At this time, your body has accepted that there is no fertilized egg in your womb. Without the need to remain plump and full, your uterus will shed, releasing tissue that no longer serves the purpose of fetal cultivation. During this menses phase, hormonal production of both estrogen and progesterone are typically low. It is due to this hormonal low that we often feel an overall fatigue physically, mentally, and emotionally. Often this hormonal low translates into a more internally driven experience and less of an extroverted drive. This inward turning of energy carries the gift of heightened intuition and sensitivity, which can be channeled into powerful windows of healing. This same sensitivity, however, can become problematic if there is resistance to fully surrendering into the experience of menstruation. This resistance may bring up feelings of anxiety, overwhelm, depression, and significant tension in the mental/emotional terrain, as well as in the physical body. Sensations, such as menstrual cramping, may intensify in their presence if the body is being forced into activity when an act of restoration is being called for. Further, there are other anatomical and physiological attributes at play, which may govern the sensations you experience at this time. For example, stagnation within the circulatory system of the pelvis may lead to a stronger experience of pain during this time. Further, the health of your nervous system also plays an integral role in your body’s ability to relax into discomfort. While there are many intricate threads that weave into the experience of menstruation, a bleed that feels cleansing and relieving is possible and attainable.
Following the end of menstruation until ovulation day, around days 5-13
The follicular phase continues from here. The term ‘follicular’ typically refers to the first half of your cycle, when a ‘follicle’ (egg) is birthed and matured. The post-menstruum, or pre-ovulatory phase is responsible for growing the follicle and rebuilding the uterine tissue - which had recently shed during menstruation. This maturation phase is intertwined with hormonal shifts, including a large increase in production of estrogen, as well as a slight increase in progesterone. These hormones, released from the ovaries, are influenced by the brain, specifically the pituitary gland. This master-regulating gland speaks to your ovaries via hormones known as the luteinizing hormone (LH) and follicular stimulating hormone (FSH).
FSH is more dominant in the first half of your cycle, in order to prepare a follicle (egg), which will be growing until the completion of the follicular phase. LH is more active during the middle of your cycle. LH rises in response to the climbing estrogen levels, and signals the ovaries to produce more progesterone and androgens (many of which convert to estrogen). Its presence eventually triggers ovulation around day 12-16, when the egg is finally liberated.
Estrogen production is influenced by both FSH and LH. The proportion of estrogen/progesterone in the body is heavily due to the incoming messages from these master hormones. Estrogen is mainly produced in the ovary, as well as some secondary areas including fat tissue. While this chemical messenger has tremendous effects in many areas in the body, it is most relevant here for its role in stimulating growth of the endometrium (uterine lining following menstruation). As mentioned earlier, it also influences ovulation, as its presence leads to an increase in LH mid cycle. In short, estrogen levels climb throughout the follicular phase, peak near the time of ovulation, and decline throughout the luteal phase if fertilization does not occur.
Estrogen is the ‘vitality’ hormone for menstruators. It carries a powerful energy that often translates to an increase in stamina and drive mentally, emotionally, and physically. During this pre-ovulatory time, you may find your energy steadily rising, as this hormone climbs. An increase of physical activity, as well as mental/emotional endeavors are characteristic of this stage.
Begins the day after ovulation occurs and ends once menstruation begins
Once your follicle is liberated from the ovary, we enter the luteal phase. In this roughly two week luteal phase, your uterus is plumping up in preparation for potential implantation of an embryo. If no fusion of sperm and egg occur, eventually your follicular phase will begin again with a new cycle of uterine shedding. For most menstruators, this is between day 27-35. Most of the variation within the length of each individual’s menstrual cycle lives during the follicular phase, where a difference in it’s length may vary from person to person. The luteal phase is most likely to be about 14 days.
Occurs between days 12 - 16 approximately
As the post-menstrual phase progresses towards ovulation, estrogen levels are at their peak. This peak of estrogen signals LH to secrete, which then increases ten-fold. Hearing the LH messages from the pituitary, the ovaries are called to produce progesterone and androgens (which partially convert to estrogen). While the onset of this surge of LH occurs about 36 hours before ovulation, the peak of LH occurs about 9-12 hours before true ovulation (dropping egg). This event typically occurs around day 12-16. Testosterone, produced in relatively small quantities by the ovaries and adrenal glands, is also at its peak during ovulation. At this time, your body temperature will increase slightly, 0.4-1.0 degrees, due to the increase in progesterone. Pursuing interest in your basal body temperature shifts can be an insightful way in discovering when you are ovulating. You may notice that, as the follicle ruptures and your egg is liberated, your cervical mucus will change in consistency. The viscosity is often described as becoming more egg-white like. This is the time of fertility. In a 28 day cycle, your fertile window will typically be between days 9-17. While your liberated egg will only live in the fallopian tube, awaiting fertilization, for 12-24 hours, sperm can remain in the uterus, in search of an egg, for 5 days.
Ovulation is often marked by a great surge of fertile energy. You may find that your libido has increased, that your energy is more extroverted, and your mind feels clearer during this time. While these are characteristic elements of this phase, this is not always the case. Some menstruators may find that they are not ovulating regularly. If this is the case, there is a hormonal imbalance present at the level of your ovaries, pituitary, or hypothalamus and further investigation is warranted.
Between ovulation and menstruation, days 16-28 approximately
With ovulatory excitement coming to an end, we phase shift into the premenstrual/post ovulatory time. This segment of time is known as the Luteal phase. The term ‘luteal’ compliments the ‘corpus luteum’, which is born at the time of ovulation. The corpus luteum is an intelligent and important transient endocrine organ. This sacred structure is created each month and is responsible for the hormone production that follows. Interestingly, the corpus luteum receives the most bloody supply per capita of any tissue in the body! This blood surplus is necessary to nourish and promote progesterone production from the corpus luteum. In this luteal phase, estrogen levels reduce, while progesterone levels continue to climb for about 14 days. Progesterone directs the uterus to fill with blood vessels and secretory glands, creating a promising home for a fetus. If an egg was to fertilize, the corpus luteum would be responsible for continuing to produce progesterone, and a small amount of other hormones, for 12 weeks, until the placenta would eventually take over. If an egg is not fertilized, the corpus luteum will degenerate, just as leaves no longer needed will fall from a tree. All is temporary and cyclic, as a new corpus luteum will be born the following month.
During the premenstrual phase, you may find that you are able to sleep deeper, that you are better nourished by grounding foods, that your sensitivity gently begins to wax, and that your energy slowly begins to wane. This is a time that benefits greatly from nervous system restorative practices, like mindful movement and slow sips of tea. Many menstruators share an experience of increased stress, anxiety, depression, moodiness, and overall tension during this time. This may be due to the levels of cortisol, the body’s “stress” hormone, interfering with adequate production of progesterone. These signals are an opportunity to turn inward and assess what your main stressors are and how to find grace amongst the waves.
The figure below is a representation of the cyclical dance that transpires each month – a peaking and dropping of hormones in a predictable cadence, ensuring healthy growth and regression within our physiology. While each hormone highlighted is present at all times within one’s monthly cycle, the solid lines reflect when the hormone is most relevant to the physiological shifts at play. Each hormone reaches a peak, expressed through the solid dot.
This figure demonstrates, in a cyclical orientation, the hormonal dance between Luteinizing Hormone (LH), Estrogen, Progesterone, Follicle Stimulating hormone (FSH), and Testosterone. This figure is based upon a 28.5 day cycle. Take note that not every menstruator’s cycle will be in synchronicity with the moon, but can be celebrated as an internal lunar experience within their personal universe.
Authored by Caileen Vermilyea N.D.