Do you record your last menstrual period each month? Do you know how long each period lasts? If not, start paying attention today, tracking your menstrual cycles can help you understand what’s normal for you, the time you ovulate as well as identify significant changes or unpredictable menstrual bleeding. The good news is menstrual cycle irregularities usually aren’t serious, though they can signal health challenges. Knowing your cycle may just be your only treatment for inability to conceive. I guess you find that hard to believe, read on.

What is a menstrual cycle?
A menstrual cycle is the monthly changes in a woman’s body as the body prepares for the possibility of pregnancy. Hormonal changes control this cycle and prepare the uterus for gestation. Every month one of the ovaries releases an egg; this process is called ovulation. At this time, hormonal changes prepare the uterus for pregnancy. If ovulation takes place and the egg is unfertilized, the lining of the uterus sheds through the vagina, and this is a menstrual period.

How do you count your menstrual cycle?

Count your menstrual cycle from the first day of one period to the first day of the next. It is different in for every woman and sometimes in the same woman. The menstrual flow might occur every 21 to 35 days and last two to seven days. At puberty when menstruation begins, long cycles are typical and could be 21 – 45 days but will regularize with time. The monthly rise and fall of your hormones control your menstrual cycle.

Your menstrual cycle might be regular that is about the same length every month — or it could last longer or shorter. Normal is subjective because your period depends on your level of physical activity, nutrition or starvation, fasting or diarrhea as well as your stress levels, even exam stress can affect your periods. Therefore, your periods may be light or heavy, painful or pain-free, long or short, and still be considered normal. “Normal” is thus what is normal for you.

Remember if you use certain types of contraception, such as extended-cycle birth control pills, your menstrual cycle will be altered.

Do you know how to track your menstrual cycle?
Start by keeping a record of your menstrual cycle on a calendar or with the help of a smartphone application – Google free menstrual tracker to download. Begin by tracking your start date every month for several months in a row to identify the regularity of your periods.

Do you know what happens during the menstrual cycle?
In the first half of the cycle, levels of estrogen start to rise. External factors easily influence this part of the cycle. Estrogen makes the lining of the womb grow and thicken while preparing to nourish the embryo if a pregnancy occurs. This increase in the level of estrogen in your body causes a rapid rise in another hormone called luteinising hormone (the ‘LH surge’). This LH surge causes the release of a mature egg from the ovary, from where it enters the Fallopian tube. This process is known as ovulation.

The egg then travels to the uterus; it survives for only 24 hours. For a pregnancy to occur, the egg must be fertilized by a sperm during this time and the embryo attaches successfully to the uterine wall. Menstruation happens if the egg is unfertilized. The egg breaks apart, hormone levels drop, and the thickened lining of the uterus and extra blood is shed and flows out as menstruation. You can also get pregnant if you have sex three days before your period, this is because sperm can survive 3 to 5 days in the vagina.
Most menstrual periods last from 3 to 5 days, although anywhere from 2 to 7 days is normal. The duration varies between different women and even in the same person. The total amount of blood a woman loses during an average period is between 30 and 60 ml.

What is a fertile window?
Ovulation typically occurs midway through the cycle, and this is the most fertile time in your menstrual cycle; this means you are most likely to conceive. It’s somewhat difficult to pinpoint exactly when ovulation happens unless you’re practicing fertility awareness. Fertility awareness involves daily monitoring and keeping records of your menstrual cycle, cervical secretions, your basal body temperature, to help pinpoint the time ovulation is likely to be happening.

A fertile window is a brief period around ovulation when a woman can get pregnant. It is wrong to say that all women are fertile on day 14 of the menstrual cycle except for women who have a regular, 28-day cycle. As mentioned earlier, some women have cycles that are shorter or longer, and ovulation happens around ten to 16 days before the next period.

A lot of women believe that ovulation occurs mid-cycle. For a lady with a 28-day cycle, ovulation may occur 12-16 days before the next period starts. For a woman with a 36-day cycle, ovulation may occur between day 20 and day 24.

To approximate the time of ovulation for a woman with a regular cycle, subtract 16 from the days in the period and then add 4. This calculation is used to estimate the days in which ovulation is most likely to occur.
For example, a woman with a regular 22-day cycle is most likely to ovulate between days 6 and 10 of her cycle that is 22-16 = 6 (+4 =10).

The egg’s lifespan is usually between six and 12 hours but can last up to 24 hours. On the contrary, sperm survives for three days, but can live inside the vagina for up to five days if the optimal fertile cervical mucus is present. Thus, pregnancy can result from having sex from as early as five days before ovulation, until up to 24 hours following ovulation.

More often than not, one in six fertilized eggs result in a spontaneous miscarriage, and the woman may not even be aware she had been pregnant.

Can you become pregnant if you have sex while menstruating?
Although most women have regular 28- to 32-day cycles, if someone with this cycle has an average two to eight-day period, she is not likely to get pregnant during her period. However, a woman with a shorter menstrual cycle such as 21 to 24 days, ovulates more frequently. Assuming she bleeds for seven days and has intercourse on her final day of bleeding and ovulate three days later, she could get pregnant! Remember sperm live for three to five days.
A lot of women avoid sexual activity when they are their period for personal, cultural or religious reasons. That is not a bad idea because there are few reasons women should avoid sex during menstruation – the risk of transmitting blood-borne infections such as hepatitis C and HIV is higher when having unprotected sex at this time.

Period associated problems
There is a range of challenges related to women’s periods, these include but not limited to pain, heavy bleeding, and skipped periods; these will be discussed in subsequent articles.

Amenorrhea is a medical condition in which there is the absence of a menstrual period in either young women who hasn’t started menstruating by age 15 (primary amenorrhea) or a woman/girl who hasn’t had a period for 90 or more days (secondary amenorrhea).

What causes menstrual cycle irregularities?
Menstrual cycle irregularities can have many different causes, including:
• Pregnancy or breastfeeding, recent childbirth, miscarriage, or D&C: Pregnancy and recent childbirth are the commonest cause of delay or missed periods. Breastfeeding delays the return of menstruation after pregnancy.
• Eating disorders, extreme weight loss, excessive exercising or stress
Eating disorders such as anorexia nervosa, severe weight loss, and increased physical activity can disrupt menstruation. Severe weight loss resulting in weight 15% less than a healthy body weight reduces fat stores in the body. Decreased fat loss, in turn, reduce thyroid levels and increase levels of the stress hormone cortisol thus reducing reproductive hormones. In this state, reproductive hormones are insufficient to regulate the monthly menstrual cycle, thus the cessation of monthly periods. This suspension of the menstrual period could become reversed with weight gain, or when you stop the excessive exercising.
• Poor nutrition, smoking, drugs, excessive caffeine, and excessive alcohol use. Excessive alcohol interferes with the way the liver breaks down estrogen and progesterone
• Polycystic ovary syndrome (PCOS) and oestrogen dominance. This hormonal disorder is associated with high insulin in the blood, as well as cause small cysts to develop on the ovaries, excessive production of the male sex hormone testosterone; these cause irregular or absent menstrual periods. By the way, every woman produces testosterone but in small quantities and all men produce estrogen but in small amounts too. But conditions such as obesity, PCOS, tip this balance.

• Premature ovarian failure: Women who have premature ovarian failure also known as primary ovarian insufficiency lose their normal ovarian function before age 40. They present with irregular or infrequent periods for years.
• Hormonal imbalances related to perimenopause and menopause
• Medications, cancer treatment and dangerous medical conditions
• Pelvic inflammatory disease (PID) is an infection of the reproductive tubes and organs can cause irregular menstrual bleeding.
• Uterine abnormalities such as fibroids, cysts, polyps, endometriosis can cause heavy menstrual periods, no periods, and bleeding between periods.

Prevention of menstrual irregularities
For some women, lifestyle modifications can help regulate menstrual cycles; conventional medicine uses birth control pills to manage this condition. However, some menstrual irregularities can’t be prevented. When your menstrual cycles are regular, it means that important parts of your body are working normally.

Conclusion
Remember, if you track your menstrual cycle it can help you find out what’s normal for you and what isn’t. The menstrual cycle is sometimes different even with the same woman.
The menstrual flow might occur once in every 21 to 35 days and last two to seven days. At puberty, menstrual cycles can last between 21 and 45 days. Lifestyle modifications can be used to treat menstrual irregularities.

Thank you, please make your comments below, ask questions and contribute.

Wishing you good health and happiness,

Dr Nse

Author: Nse Karen

I offer virtual lifestyle coaching services as well as natural skincare products and services for busy African professionals who want to prevent or reverse chronic conditions holistically, look good and feel good from inside -out and outside-in