The period goes by many names:
that time of the month, the Crimson Tide, Shark week, just to name a few.
It gets a lot of attention in health class, and it must be said, the period has gotten a pretty bad rap—
but these days, more people are cluing into the entire menstrual cycle, rather than just that most visible part of it.
Because as it turns out, there’s a lot to discover and to celebrate.
Just before we dive in, when we’re talking about the menstrual cycle we’re not just talking about women. Because people of all gender identities have periods,
so that’s why I’ll be using terms like ‘people who menstruate’ rather than just ‘women’.
Periods may often be seen as an inconvenience. Like we discussed in our last episode, those without a menstrual cycle have long been considered
the health 'norm', while those of us with a menstrual cycle have to like compensate for it, as if it’s a weakness we have to work around.
But that is changing. Take the U.S. Women’s soccer team, for example.
They partially attributed their 2019 World Cup win to training programs that were tailored around each player's menstrual cycle.
Cycle tracking apps are more popular than ever, and back in 2018 the FDA even approved one for contraceptive use.
We know that paying attention to your menstrual cycle can help you do things like prep for your period,
improve your chances of getting—or not getting—pregnant, or just help you better understand what your body may be trying to tell you.
So your menstrual cycle is a key indicator of health. And getting to understand it and being aware of it and changes
allows you to discuss it as well as share anything that's atypical with a provider, if needed be.
But before we can talk about how you might be able to use this info to like ‘hack’ your menstrual cycle...what is it, exactly?
The menstrual cycle’s essential job is to prep the body for pregnancy.
It starts on the first day of your period, and lasts until the first day of your next period. The average cycle lasts about 28 days,
but everyone is different, and one person’s cycle will change over the course of their lifetime.
Cycles that regularly fall anywhere between 21 to 40 days are normal too. And by tracking the details of our cycle,
people who menstruate can better understand what is normal, or not normal, for our bodies.
Now, what actually happens between one period and another is a wicked exciting roller coaster that involves the ovaries, the uterus, the brain,
the circulatory system, and lots of hormones.
Estrogen and progesterone are the two you’ve probably heard the most about, and they’re produced by the ovaries.
We’ve also got the follicle-stimulating hormone, or FSH, and luteinizing hormone, or LH, both of which are made by the pituitary gland.
All of these hormones are interacting with each other to prep the body for pregnancy once per menstrual cycle, which is a lot of hard work.
You know, we have this sort of symphony, if we want to think of it that way of different instruments, and different hormones come in signaling different things to do:
shed the lining, release an egg, start building the lining.
There are four phases of the menstrual cycle: menstruation, aka the period, the follicular phase, ovulation, and the luteal phase.
And it all starts on that first day of menstruation, which is also when the follicular phase begins.
During this time, estrogen and progesterone levels are low and the uterus is shedding its lining, resulting in bleeding that typically lasts between 2 to 7 days.
Oh, and also comes with those frustrating symptoms like back pain and cramping.
And after your period ends, the follicular phase continues.
Right smack in the middle of your brain is the hypothalamus, which sends out gonadotropin-releasing hormone every 60-120 minutes,
depending on what point you’re at in your cycle. This causes the pituitary gland to make FSH, revving up follicle growth in the ovaries.
And a follicle is a fluid-filled sac that's surrounding an undeveloped egg. It's kind of like a nice padded envelope that says “FRAGILE: HANDLE WITH CARE”.
As the follicular phase winds down, FSH levels fall, and usually just one dominant follicle-wrapped egg is ‘chosen’ to continue developing.
I did not know this, but those of us with ovaries are actually born with millions of eggs, and we're losing a couple thousand of those
every month throughout our lifetime as a way to make sure only the healthiest eggs remain available.
Meanwhile, we have had an estrogen buildup during that phase which has created a nice lining within the uterus.
Around day 14 of the cycle, estrogen levels are at their peak, causing the release of more LH.
And this tells the mature follicle that it’s go-time.The follicle starts talking to the fallopian tube, and the fallopian tube
scooches closer to surround the follicle, until the follicle goes—BLOOP, kind of like a bubble bursting, releases the egg into the abdominal cavity.
And then, the fallopian tube actually like reaches out with its fingerlike tips and scoops up the egg.
And that’s ovulation for you! Some people might experience a little twinge or cramp on one of their sides as the follicle bursts during an ovulation.
And after it’s big debut, your egg hangs around in your fallopian tube, just poking around for about 12 to 24 hours
to see if any sperm are gonna join the party, so if one isn’t already waiting, it better hurry up.
At my advanced age of 28 I did not know that eggs get fertilized in the fallopian tubes, so you learn something new every day.
And if an egg and a sperm do happen to meet in that little window of opportunity, they'll fuse
and they'll make their way down the fallopian tube towards the uterus, dividing into a multi-celled clump as they go.
And that’s just the first half of the process. Remember that follicle that released the star of our show, the egg?
It actually still has some work to do as we move into the luteal phase.
That burst follicle temporarily becomes a gland that produces progesterone, which is what sparks what happens next.
It’s all comin’ together.
The progesterone from that follicle is what thickens the lining of the uterus, producing all that good, comfy blood and tissue
that would keep a fetus happy if a sperm would happen to fertilize an egg and they implant in the uterus.
But if pregnancy doesn’t occur, the levels of estrogen and progesterone drop sharply, triggering menstruation,
the beginning where we started, that shedding of that uterine lining, and the cycle begins all over again.
If that sounds like a lot, it's because it is. I’ve been having my period for like, 13 years now, and every month I’m like...we’re doing this again?!
We just did this, like, last month—oh, right.
Now the luteal phase is when premenstrual syndrome, aka PMS, comes into the picture.
Cramping, back aches, headaches, nausea, fatigue, sore boobs, mood swings, acne breakouts, super fun stuff, said no one, ever.
But PMS and periods do affect everyone differently, and hopefully, as the research community learns more about all these complex dynamics
that make the menstrual cycle go ‘round, we can understand why there’s so much variability and what we might be able to do
about symptoms that can really disrupt peoples’ lives.
There’s actually been an explosion of exciting research into things like how brain function changes throughout the menstrual cycle,
and what that means for your health and your lifestyle at different points in your cycle.
People are looking more into the links between irregular periods and heightened risk of developing certain diseases.
And as more people track their cycles through apps, some of that data is being put to use.
Harvard University, the National Institute of Environmental Health Services, and Apple released initial results from a study involving 10,000 people;
6,141 of whom tracked their period symptoms.
This long-term study hopes to uncover new information about menstrual symptoms across all kinds of demographics,
and ideally, also break down some of the stigma that still surrounds periods, while we're at it.
One really important challenge in this ara is that sex education, which can include topics like puberty, STIs, contraception,
is still, shall we say, not the best. In the U.S. for example, federal oversight of sex education is extremely limited, and that means that
different states can exclude certain subjects. And only some states even require the material to be medically accurate.
I mean, I went to high school in rural Virginia. They didn’t teach us how to put a tampon in, much less tell us that seeing clumps of tissue in your period is normal—
which it is, by the way and could’ve saved me a teenage freak out or five if they had some comprehensive, medically relevant information, my goodness!
And it's a question of priorites, whether it's in education, whether it's in our pop culture,
whether there are songs written about it, like there, how many songs are there written about menstruation?
I mean at least half the population experiences it. So it's not prioritized culturally, it could be.
And that’s just it. Hopefully a more open conversation about periods and the menstrual cycle as a whole will inspire more research and
better answers to all of the questions we still have about them.
And on a more individual level, connecting with exactly what’s happening in your body as you ride out that menstrual cycle
can help you make decisions about your everyday and long-term health—
like what contraception to use, what impacts other medications may be having on your body, and more.
Thanks so much for watching Seeker’s new series Body Language. I hope you’ve enjoyed this video.
And if there’s another women’s health topic you want us to cover, leave us a comment. I'll see you next time!