Menstruation and Menopause

Menstrual cycle

A complex process that prepares the female body for potential pregnancy. It typically lasts 28 days, but can range from 21 to 35

Menstrual phase

The first phase. It occurs from day 1 to 5. It is also known as periods; the endometrium sheds through vaginal bleeding, causing cramps (myometrium contractions), fatigue, headaches, and mood swings. The endometrium sheds due to low progesterone levels

Follicular phase

Occurs from day 1 to 13, overlapping with the menstrual phase. FSH is released to develop ovarian follicles. These follicles start to release estrogen. With more follicles, more estrogen is produced, which prepares the body for pregnancy. This shift in the hormone leads to more energy and clearer skin

Ovulation phase

Occurs on day 14. There is a surge in LH to trigger ovulation. After the graafian follicle bursts, progesterone is released by the corpus luteum which thickens the endometrium for implantation. Cervical mucus becomes clear and slippery to invite sperm

Luteal phase

Occurs from day 15 to 28. If fertilization doesn’t occur in the implantation window, then the corpus luteum becomes the corpus albicans and progesterone drops, causing the endometrium to not be maintained and it sheds in the following menstrual phase. If fertilization occurs, then the hCG from the embryo cells doesn’t degenerate the corpus luteum, which in turn increases progesterone levels.

Premenstrual symptoms (PMS)

In the luteal phase, due to high yet decreasing progesterone, symptoms like mood swings, irritability, and fatigue occur with emotional fluctuations.

Menopause

Phase of a woman’s life where her ovaries stop producing eggs, and estrogen and progesterone levels drop. This marks the end of menstruation and decline in fertility. Menopause typically happens in a woman’s 40s, and is identified when a woman doesn’t experience menstruation for a year stright. 

Perimenopause (pre-menopause)

Can start in 30s, around 4 to 8 years before menopause. Fluctuations in estrogen and progesterone cause irregular menstrual cycles. Symptoms include mood swings, sleep disturbances, irregular periods, and decreased libido

Postmenopause

After a year without menstruation, this phase continues for the rest of a woman’s life. Estrogen is low, but is still there from other sources like fat tissue. Severity of symptoms generally decrease over time.

Long term health considerations after menopause

Heart diseases due to a change in cholestrol levels due to low estrogen.

UTIs due to thinning of tissues in the urinary tract.

Osteoporosis due to accelerated bone loss.

Management of menopausal symptoms

Hormone replacement therapy (HRT) by supplementing the body with estrogen to alleviate vaginal dryness and hot flashes. However this has risks breast cancer and stroke

Changing lifestyle by eating balanced diet and vit. D for bone health, exercising, yoga and meditation, and consistent sleep schedule

Emotional support from therapists, family, and loved ones