Female and Menstrual Cycles – Is it bad to lose it?

What’s so bad about not having a period? I mean, who really enjoys it anyway?
Well, the menstrual cycle is actually a great indicator of health. Let me tell you why.

A Quick Review of How the MENSTRUAL CYCLE Works

    •  A 26 to 35-day menstrual cycle is considered normal, meaning your period should come about once per month and last from 2 to 6 days.
    • Amenorrhea is the absence of vaginal bleeding for 3 or more consecutive months.

Follicular Phase (Days 1-14)

    • Day 1 of the cycle is marked by the first day of bleeding (not spotting). At this point all reproductive hormones are at a low.
    • Throughout the next 14 days estrogen levels gradually climb to rebuild the uterine lining.
    • When estrogen levels peak, the body is signaled to ovulate (release an egg from the ovaries).

Luteal Phase (Days 14-28)

    • Ovulation marks the start of the luteal phase.
    • Estrogen (from the ovaries) AND progesterone (from the corpus luteum of the newly released egg) start to build up. Important note: If no egg is released, progesterone is NOT produced.
    • Progesterone is really important because it maintains the lining of the uterus, which houses the baby when an egg is fertilized.
    • If the egg is not fertilized, progesterone and estrogen rapidly drop and the uterine lining is shed. This then, becomes the first day of the period, marking the start of a new cycle.

The Importance of the Menstrual Cycle

Estrogen is essential for:

    • Ovulation and therefore, fertility. 
    • Strong bones. Without the monthly surge of estrogen during the critical bone-building years (up until about age 30), susceptibility to stress fractures (especially athletes) is increased as is the risk of early onset osteoporosis.
    • Cardiovascular health. Estrogen is cardioprotective, improves arterial blood flow, and helps maintain healthy cholesterol levels.
    • A sudden decrease in levels or consistently low levels can, in turn, lead to low mood. This explains why mood can fluctuate throughout the menstrual cycle.
    • Skin health. Estrogen reduces the size and number of sebaceous glands and reduces sebum production. It also supports skin thickness, moisture, and elasticity to prevent wrinkles. Low estrogen or hormone imbalance may play a role in acne.
    • Optimal brain function. Estrogen promotes the growth, maintenance, and repair of nerve cells, receptors, and transmitters in the brain. It therefore promotes mental alertness, reaction time, verbal ability, and overall cognition.

Progesterone is essential for:

    • Preventing estrogen-dominant cancers (e.g., breast, ovarian, uterine). It counterbalances estrogen by preventing overgrowth of the uterine lining and tissues.
    • Maintaining the uterine lining, and therefore a successful pregnancy.
    • Good quality sleep. Progesterone produces a soothing calming, sleep-promoting effect.
    • Prevention of pre-menstrual syndrome (PMS). Progesterone and estrogen imbalance (e.g., estrogen dominance or progesterone deficiency) can cause symptoms of PMS such as mood swings, cramps, pain, and/or migraines.
    • Progesterone accelerates metabolic rate, assists in fat elimination, and relaxes smooth muscle to help with absorption of nutrients in the digestive tract.
      Important note: The absence of the period itself may not have detrimental effects on health but it may be the only presenting symptom of an underlying disorder that does require treatment.

Causes of Amenorrhea (= the absence of a period)

  • Over-training
  • Under-eating / calorie deficit
  • High levels of stress (physical, mental and/or emotional)
  • Excessive weight loss or weight gain
  • Birth control methods (the pill, Mirena IUD)
  • Medications
  • Drug or alcohol abuse
  • Thyroid disorders
  • Pregnancy and breastfeeding
  • Menopause
  • Polycystic ovarian syndrome (PCOS)
  • Acute or chronic illness
  • Scarring in the female reproductive tract
  • Blood sugar dysregulation, metabolic disease
  • Chromosomal defect
  • Disorders of the ovary, vagina, uterus, adrenal or pituitary gland
  • Trauma or injury

Signs of an Irregular Cycle

  • Frequent periods (e.g., bleeding every 2 weeks)
  • Infrequent or absent periods (e.g., bleeding every few months, 9 or fewer periods per year)
  • Irregular, unpredictable cycles (e.g., 27-day cycle then 42-day cycle then 30-day cycle)
  • Spotting (very light bleeding) prior to the period
  • Unusually heavy periods
  • Painful periods and cramps
  • Prolonged periods lasting greater than 8 days
  • Spotting between periods or during ovulation
  • Associated premenstrual symptom (e.g., tender breasts, mood swings, pain, bloating)

What can you do if your periods are irregular or go missing?

  • Seek out a healthcare practitioner to identify the underlying cause. Successful management depends on an accurate diagnosis.
  • Ensure adequate fueling (hint: Nova Nutrition J). Eat a nutritious, whole food diet with enough calories to replete the exercise deficit. Adequate fat intake is also necessary for the production of hormones and to ensure satiety. Include plenty of grains, beans (especially soybeans), fruits, vegetables (especially dark leafy greens), nuts & seeds (especially flaxseeds), and fish (salmon, halibut, sardines, herring, mackerel, anchovies).
  • Develop an individualized exercise plan. If you are very lean and participating in high volumes of exercise you may need to reduce/stop intensive training or modify exercise type. If you are overweight you may need to incorporate exercise 5 days per week for at least 1 hour to assist regulation of blood sugar and hormone levels.
  • Reduce stress. Incorporate daily relaxation activities. This may include yin or relaxation yoga, deep breathing, journaling, meditation, time in nature, talking with friends or family, and more. Herbal nervines and adrenal support can also be supportive.
  • Consider hormone-balancing herbs (e.g., vitex, black cohosh, ashwaganda, rhodiola, maca), nutraceuticals (e.g., B-vitamins, zinc, vitamin C), and/or hormone replacement therapy as recommended by a healthcare provider.
  • Support associated risk factors such as osteoporosis if estrogen levels are low. One might consider supplementation (e.g., vitamin D, copper, zinc, calcium, vitamin K, protein, manganese, boron) and weightlifting 3 times per week for 30 minutes.

References

  • Bae, J., Park, S., & Kwon, J. (2018). Factors associated with menstrual cycle irregularity and menopause. BMC Women's Health, 18(1), 36-11. doi:10.1186/s12905-018-0528-x
  • Clue Period and Ovulation Tracker for iPhone and Android. (2019). Track your period and ovulation with Clue to understand how your body works. Retrieved from https://helloclue.com/
  • Hudson, T. (2008). Women's encyclopedia of natural medicine: Alternative therapies and integrative medicine for total health and wellness (Reviewed and updated.). New York: McGraw-Hill.
  • Innovative Compounding Incorporated. (2018, March). Vanessis female support: women’s hormones prescribers guide. Kennesaw, GA
  • Klein, D. A., Paradise, S. L., & Reeder, R. M. (2019). Amenorrhea: A systematic approach to diagnosis and management. American Family Physician, 100(1), 39.
  • Lim, H., Kim, T., Lee, H., Park, Y., Lee, B., Park, Y., & Kim, Y. (2018). Fast food consumption alongside socioeconomic status, stress, exercise, and sleep duration are associated with menstrual irregularities in korean adolescents: Korea national health and nutrition examination survey 2009-2013. Asia Pacific Journal of Clinical Nutrition, 27(5), 1146-1154. doi:10.6133/apjcn.032018.03
  • Pereira, K., & Brown, A. J. (2017). Secondary amenorrhea: Diagnostic approach and treatment considerations. The Nurse Practitioner, 42(9), 34-41. doi:10.1097/01.NPR.0000520832.14406.76
  • Romm, A. J. (2018). Botanical medicine for women's health (Second ed.). St. Louis, Missouri: Elsevier
  • Sawai, A., Mathis, B. J., Natsui, H., Zaboronok, A., Mitsuhashi, R., Warashina, Y., . . . Watanabe, K. (2018). Risk of female athlete triad development in japanese collegiate athletes is related to sport type and competitive level. International Journal of Women's Health, 10, 671-687. doi:10.2147/IJWH.S175446
  • Witkoś, J., & Wróbel, P. (2019). Menstrual disorders in amateur dancers. BMC Women's Health, 19(1), 87-6. doi:10.1186/s12905-019-0779-1
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