The menstrual cycle depends on the level of hormones that affect our entire body - from the condition of our uterus, through the values indicated by the scale, to our attitude to the world (this was partially discussed in the previous post ). To put it simply, the aforementioned hormones are mainly progesterone and estradiol. Their concentrations depend on FSH and LH, secreted by the pituitary gland, and these in turn on gonadoliberin, secreted by the hypothalamus. In a word, everything is "in the hands" of the hypothalamus-pituitary-ovary axis.
Today we will focus more on our emotional and social life, because this topic is often omitted and trivialized. However, I do not want this to be an excuse to blame everything on hormones and consider women as creatures dependent only on the action of a few chemical compounds. I want you to know your body better, and therefore be able to catch moments when it may not be worth acting too impulsively. Sit comfortably in your armchair and let's start our journey, which lasts exactly as long as your menstrual cycle (which is different for different women - I pointed this out in the previous post ;) )
The first day of menstruation, or the first day of the menstrual cycle. For some women, this is the day when the tension finally subsides, for others, the "fun" is just beginning. Progesterone and estradiol levels drop significantly, which causes the uterine lining to shed, and as a result, bleeding. During these days, we usually feel tired and not in a good mood. For these few days, it is worth being understanding with yourself and not pushing your body. Ideally, it would also be good to skip stressful situations (e.g. job interviews, exams) or super important outings. However, this is not always possible, which is why it is very important to provide yourself with maximum comfort during these days (hygiene products, comfortable clothes or more sleep). This is not the time when we feel the best, but we have to function somehow. There are women who do not fully understand this, because the only difference for them is usingtampons or pads . Unfortunately, there are also girls for whom functioning during these first days of the cycle is almost impossible. And it's not just about fatigue or feeling unwell, but also abdominal pain, often radiating to the back, headaches or even vomiting. Where is the limit at which you should see a doctor? It all depends on you and the intensity of your symptoms. If you find that they are already impairing your functioning too much, go for a visit and together with your doctor you will make a decision about further treatment (remember, however, not to blame everything on your period and not to miss the symptoms of other diseases).
Also read our article on all the symptoms of your period .
About a week after the bleeding begins, the level of estrogen begins to rise - a hormone responsible for our better well-being and desire for sex. We feel more and more energy to act, and our complexion looks radiant. Seriously, we simply feel prettier, and the tasks ahead of us seem much easier than a few days ago. We want to cuddle, be close to a loved one - our skin is much more sensitive to touch, and orgasms are easier to achieve. The crowning moment of this period isovulation , during which we feel the best and our libido reaches its maximum. This is related to our fertile days - nature knew exactly how to "program" us. I mentioned orgasms, so it is impossible not to make a short insert about oxytocin, which causes those characteristic, pleasant contractions in the reproductive organ. But here, nature also cared about the survival of our species - contractions are needed to transport sperm towards the egg. The day of ovulation is one of the most pleasant days in our cycle, but here too we have exceptions. Some of us have periovulatory bleeding during this time, which can last one day, but sometimes it can last up to 5 days. It is related to the drop in estrogen levels (similar to when taking the pill, when we don't have a period, but withdrawal bleeding , which is caused by the withdrawal of estrogen - more on that later).
Returning to ovulation - the egg is released and here we have two options: a) it is fertilized and we get pregnant, b) it is not fertilized and we slowly approach the next period. In both cases, at the very beginning, a corpus luteum is formed in our ovary, which produces progesterone. Among other things, we start storing water. Did you know that in the second phase of the menstrual cycle we can "gain" up to 3 kg!? And don't panic - in a few days there will be no trace of it. If you have a problem with swelling in the luteal phase, I recommend nettle tea, lots of parsley (e.g. in blended cocktails), little salt and regular exercise (moderate intensity - yoga, stretching, etc.). Migraines are also associated with a drop in estrogen concentration in the second phase of the menstrual cycle, to such an extent that a disease entity such as menstrual migraine has been distinguished (source below). At this point I would like to additionally point out that patients with migraines have a higher risk of stroke when taking combined pills (especially those with a large amount of estrogen) and smoking, which is why they should be mentioned during the interview with the gynecologist. In addition, in the luteal phase our skin produces excess sebum, and as a result, we are more likely to have that favorite pimple in the middle of the forehead or nose :)
About a week before the onset of menstruation, all of these symptoms (and more) can intensify and cause PMS (premenstrual syndrome) . Its exact definition is "physical, behavioral, and psychological symptoms, without organic or mental disease, that regularly return in the luteal phase of each menstrual cycle and disappear or significantly weaken with the end of menstruation" (Magos, Studd "The premenstrual syndrome" 1984). It's brilliant - apart from the fact that pimples have appeared, we have gained 2 kg, we don't feel like doing anything, we are nervous, we don't feel like having sex, and when we somehow find ourselves in bed, intercourse is often more painful because we produce less cervical mucus. Great! How to live? When it comes to treatment, we have to adjust its type and intensity to how much the above-mentioned symptoms bother us. Many scientific societies recommend physical exercise to alleviate the symptoms of PMS (I mentioned it with the swelling), which is confirmed by scientific studies, although the exact mechanisms of this help are not fully understood. Personally, I believe that physical activity is good for everything bad, because it increases the production of endorphins, or "happiness hormones". However, if we cannot cope with ourselves, it is worth considering relaxation techniques or going to psychotherapy to better understand the mechanisms that drive us. This is a very current topic in scientific research, which is why you will find several works below. It turns out that the more internally we are in order with ourselves, the easier it is for us to endure these days. And I do not mean any specific pathologies here, but about accepting ourselves and getting to know our own interior. If we are talking about pharmacotherapy for PMS, both hormonal drugs and drugs used standardly in psychiatry are involved, but their introduction requires a doctor's consultation. There are also randomized studies that prove that regular supplementation with zinc or vitamin B6 improves our functioning during this difficult period. As you can see, there is a wide range of PMS procedures, so I am also including a link to the guidelines below so that interested parties can expand their knowledge.
Ok, so what happens in our uterus? For some time after ovulation, progesterone prepares our endometrium for a possible pregnancy, but when the body realizes that we haven't gotten pregnant (there is no embryo to produce chorionic gonadotropin), the corpus luteum loses hope and dies, and with it the progesterone level drops. The endometrial cells die and slough off - the blood flows again ;)
I realize that some of the symptoms I mentioned above accompany girls when using contraception. I mentioned this in the post about contraception , but I want to emphasize one important thing here again: if mood swings, tearfulness and nervousness accompany you during the first 3 months of taking the pills - ok, this is the time when our body has to "get used to" the new hormonal status. However, if after this time something strange is still happening with your emotions, ask your doctor to change your contraception. As you read above, the concentrations of progestogens and estrogens are important for our well-being. Maybe you just need slightly different doses of these components and the fact that some pills do not completely suit you does not rule out the possibility of using another preparation.
Of course, the description above is greatly simplified and does not include any connections to FSH and LH (an axis that operates on the principle of negative feedback), but this is not a biology lesson. The hormonal system has many variables and in fact each of us goes through our cycle phases a little differently. Observe your body, be sensitive to certain signals, and then learn to live in harmony with yourself. And if you can't do it yourself, it's not a bad thing. Contact a specialist (gynecologist, psychologist, psychotherapist, psychiatrist) who will help you learn to live with this ocean of emotions and hormones.
- Ecochard, R., Bouchard, T., Leiva, R., et al. (2017). Characterization of hormonal profiles during the luteal phase in regularly menstruating women. Fertil Steril. 108(1), pp. 175-182.
- Kammoun, I., Ben Saâda, W., Sifaou, A., et al. (2017). Change in women's eating habits during the menstrual cycle. Ann Endocrinol (Paris). 78(1), pp. 33-37.
- Pearce, E., Jolly, K., Jones, L. L. (2020). Exercise for Premenstrual Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. BJGP Open (June 10, 2020).
- Jafari, F., Tarrahi, M. J., Farhang, A., & Amani, R. (2020). Effect of zinc supplementation on quality of life and sleep quality in young women with premenstrual syndrome: a randomized, double-blind, placebo-controlled trial. Archives of gynecology and obstetrics.
- Başoğul, C., Aydın Özkan, S., & Karaca, T. (2020). The effects of psychoeducation based on the cognitive-behavioral approach on premenstrual syndrome symptoms: A randomized controlled trial. Perspectives in psychiatric care, 56(3), pp. 515–522.
- Guidelines Committee Royal College of Obstetricians and Gynaecologist. Treatment of premenstrual syndrome. Gynaecology after Diploma, 03/2011. https://podyplomie.pl/publish/system/articles/pdfarticles/000/013/028/original/97-108.pdf?1472203596
- Kalidas, K. Migraine in women, Gynecology after Diploma, 01/2018.
Created at: 06/08/2022
Updated at: 06/08/2022
