The menstrual cycle is a fundamental part of a woman’s reproductive health, yet many women feel uncertain about what’s normal and when something might be off. Understanding the different stages of your cycle, along with the common issues that can arise can empower you to take better care of your body and seek help when necessary.
The Stages of the Menstrual Cycle
The menstrual cycle typically lasts 28 days, though it can range from 21 to 35 days in adults. It’s divided into four key phases, each marked by unique hormonal changes and physiological processes. Here’s a closer look at each stage:
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Menstrual Phase (Days 1-5)
The cycle begins with menstruation or your period. During this phase, the uterine lining which has thickened in preparation for a potential pregnancy, sheds if no fertilisation has occurred. This results in menstrual bleeding which usually lasts between 3 to 7 days. For most women this phase can cause cramping, fatigue and mood swings due to the drop in estrogen and progesterone.
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Follicular Phase (Days 1-14)
The follicular phase overlaps with menstruation starting on the first day of your period. During this phase the body prepares for ovulation. Follicles in the ovaries begin to mature and the hormone estrogen rises stimulating the growth of the uterine lining to support a potential pregnancy. Many women feel an increase in energy during this phase and it is typically when libido is at the highest.
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Ovulation (Day 14)
Ovulation occurs around the midpoint of the cycle (on day 14 for a 28-day cycle) when an egg is released from the mature follicle and travels down the fallopian tube. Hormones such as estrogen peak and luteinizing hormone (LH) triggers the release of the egg. This is when a woman is most fertile. Some women may experience mild cramping, bloating or an increase in cervical mucus during ovulation.
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Luteal Phase (Days 15-28)
After ovulation the luteal phase begins. The ruptured follicle transforms into the corpus luteum which produces progesterone to support a potential pregnancy. If the egg is not fertilised the corpus luteum breaks downleading to a drop in progesterone and preparing the body for menstruation. This phase is often characterised by PMS (premenstrual syndrome) which can include symptoms like mood swings, breast tenderness, bloating and fatigue.
Common Menstrual Issues
While the menstrual cycle is a natural and healthy process, some women experience discomfort or disruptions. Here are some common issues associated with the menstrual cycle:
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Menstrual Cramps (Dysmenorrhea)
Cramps are a normal part of menstruation for many women caused by the contraction of the uterus to shed its lining. These can range from mild to severe and typically last for a few days during the menstrual phase. However, if cramps are intense or last longer than usual it may be a sign of an underlying issue like endometriosis or fibroids. Fibroids are non-cancerous growths in the muscle layer of your uterus (womb). Fibroids are very common. They are also known as myomas. Fibroids can vary in size, from being tiny to being the size of a melon. It's possible to have one or many fibroids.
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Heavy Periods (Menorrhagia)
Heavy periods, characterised by bleeding that lasts more than 7 days or requires frequent changing of pads/tampons, can indicate a hormonal imbalance or other conditions such as fibroids, thyroid disorders or polycystic ovary syndrome (PCOS). If you find that heavy bleeding is affecting your quality of life it is worth consulting a healthcare provider. Getting on top of these issues early can help prepare for when you’re ready to start planning for children.
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Irregular Cycles
Irregular periods where the cycle length varies greatly from month to month may be normal in adolescence or approaching menopause. If you experience sudden changes in cycle length, skipped periods or extremely light or heavy periods, it’s a good idea to speak with your doctor. Hormonal imbalances, PCOS or thyroid problems could be underlying causes.
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Premenstrual Syndrome (PMS)
PMS is a set of symptoms that occur after ovulation and before menstruation. It includes mood swings, irritability, fatigue, bloating and headaches. While mild symptoms are normal, severe PMS (sometimes called PMDD, or premenstrual dysphoric disorder) can interfere with daily life and may need medical treatment. At Pharmacy 4 Less we can help you relieve the symptoms of PMS with nonsteroidal anti-inflammatory drugs (NSAIDs)like ibuprofen which can relieve cramps, headaches and breast tenderness. Some women find relief from herbal treatments such as evening primrose oil, Vitex and calcium supplements. Always consult one of our friendly Pharmacists before starting any supplement.
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Painful Intercourse
Pain during or after intercourse can sometimes be related to menstrual issues like pelvic inflammatory disease (PID), endometriosis or fibroids. If this pain persists or is new, it’s essential to get evaluated by a healthcare provider.
When to Seek Help
While many menstrual issues are common and manageable there are certain red flags that indicate it’s time to seek help from a healthcare provider. Here’s when you should consider getting professional advice:
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Severe or Prolonged Pain
While cramps are normal, severe pain that disrupts daily activities or lasts for an extended period could signal an underlying condition like endometriosis, fibroids or pelvic inflammatory disease.
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Abnormal Bleeding
If you experience bleeding that’s excessively heavy (soaking through a pad or tampon in less than an hour) bleeding between periods or spotting, it’s important to consult with your doctor.
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Irregular Cycles
If your menstrual cycle is consistently shorter than 21 days or longer than 35 days or if periods become unexpectedly irregular it could be a sign of a hormonal imbalance or an issue like PCOS or thyroid dysfunction.
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Sudden Changes in Period Symptoms
Any sudden changes in your menstrual cycle or symptom, such as an unexpected increase in pain or a sudden stop in periods, should be addressed with a healthcare provider.
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PMS or PMDD Symptoms
If PMS symptoms are so severe they affect your ability to function or if you suspect you have PMDD, a healthcare provider can help you explore treatment options such as hormonal therapy, antidepressants or lifestyle changes.
Your menstrual cycle is a key indicator of your overall health and understanding what is normal for your body is crucial. By tracking your cycle and recognising what is typical and what might be a sign of an underlying issue you can take proactive steps toward maintaining your reproductive health. If you experience any concerning symptoms don’t hesitate to consult with one of our friendly Pharmacists in store or a healthcare provider. Early intervention can often lead to more effective treatment and improved quality of life. Taking care of your menstrual health is an essential part of taking care of yourself.