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You are viewing: H4H Monographs - The Menstrual Cycle - Level 2

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H4H Natural Fertility Management (NFM)
The Menstrual Cycle

Natural Fertility Management (NFM)

Natural Fertility Management (NFM)
Hormone Testing

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An Introduction

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The Menstrual Cycle

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Conception Management

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Ovulation Prediction

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H4H Natural Fertility Management (NFM)
The Menstrual Cycle


Understanding your body's physiological functions will empower you with the knowledge to understand your body better. More especially the understanding about normal menstruation will place you in a better position to understand abnormal menstruation and to decide about possible treatment options and their consequences.


The menstrual cycle is the term for the physiological changes that occur in fertile women. It is the females rite of passage and necessary for reproduction. It is the miracle that allows her to create life and what marks her out as separate to a man.


The menstrual cycle extends from the first day of bleeding (menses) and ends when the menses of the next cycle commences. The word "menstruation" itself is etymologically related to the "moon" with the terms "menstruation" and "menses" being derived from the Latin mensis for month which in turn relates to the Greek mene (moon). The length if the lunar cycle is 29.5 days the same as the average menstrual cycle. However although even today it is commonly referred to as monthly the menstrual cycle does not necessarily take place once a month. Its length varies from woman to woman and can also vary within the lifetime of the same individual. The average for a complete cycle is 29.1 days but it may vary anywhere from 20 to 37 days and still be considered normal.


The hormone (endocrine) system controls the whole menstruation sequence through the pituitary gland located in the brain. The complete sequence is commonly divided into three phases: follicular, ovulatory, and the luteal phases respectively.


1. The Follicular Phase
This phase may be further sub divided into two: the menses and pre ovulatory stages respectively

a) The Menses Stage
(aka catamenia, period, climacteric, menstruation)

The menses stage lasts from between 3 - 7 days and is the start of the whole menstrual cycle. Throughout every cycle the uterus builds up a fresh new lining (endometrium) the purpose of which is to help nourish a developing foetus. If fertilisation has not taken place however the endometrium becomes surplus to requirements as a consequence of which it is shed and expelled through the uterus and cervix and finally exits through the vagina. It is this process of endometrial shedding and expulsion that takes place during the Menses stage and during which a certain amount of bleeding ensues (known as menstrual bleeding).  


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This stage is often accompanied by painful cramping in the abdomen, back, or upper thighs. Severe uterine pain during menstruation (dysmenorrhea) may also be experienced especially among adolescents and younger women (about 67% of adolescents). Every cloud has a silver lining however and there is an upside in that symptoms of premenstrual tension (PMT) such as breast tenderness and irritability generally decrease.


b) The Pre-ovulatory Stage

It is during this stage as a result of low blood oestrogen levels that the pituitary gland triggers secretion of follicle stimulating hormone (FSH) which in turn stimulates the initial growth and development of eggs (follicles) in the ovary. One or two follicles soon assume dominance and produce their own hormonal oestrogen secretion the function of which is two fold


i) To form a comfortable bed on which the shed folicle (ovum) can implant following successfull fertilisation. In order for this to happen the endometriasl lining which mmediately after the menses stage is very thin must both grow much thicker as well as be equiped with a more efficient blood circulatory system. 

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During this early part of endometrial redevelopment a woman may notice a thick and sticky cervical mucus exiting her vagina. This is a sign of the commencement of endometrial redevelopment. As folicular secretion increases however the mucus becomes thin, watery and clear an event which should be taken as an indication that folicular secretion is successfully raising blood oestrogen levels. Eventually during the post ovulation stage the exiting viginal mucus becomes thick and cloudy once more. 

ii) To create a sufficiently high level of blood oestrogen so as to trigger the pituitary gland into secreting leutinising hormone (LH) the presence of which weakens the wall of the follicle causing its ovum to be shed into the fallopian tube. The high blood oestrogen level is the signal the pituitary gland uses to determine that a mature follicle has fully developed and has moved to the surface of the ovary ready for release. Over the course of a woman's lifetime about 500 ovum may be so ovulated each with the capability of developing into a foetus.


The leutinising hormone surge (LH surge) is the hormone that ovulation detection kits (ODCs) use to determine time of ovulation. Ovulation generally takes place some 12 - 36 hrs after the initial release of LH (ie a positive reading on the ODC).


2. The Ovulatory Phase

Ovulation is an event that occurs when a mature ova under the influence of (LH) is released from its ovarian follicle. The released ova is swept into the fallopian tube where in the case of being unfertilised it disintegrates or dissolves within a period of 24 hrs. Should however the ova become fertilised it at once undergoes development and passes down the fallopian tube into the uterus where it embeds into the previously prepared and thickened endometrium.


3. The Luteal Phase
The luteal phase is also called the secretory phase because of the significant amount of progesterone hormone (PH) secreted by the corpus luteum which continues to develop for some time after ovulation. The corpus luteuim is the "wound" or scar left behind in the ovary following ovum shedding. The function of (PH) is three fold

  • To increase the thickness and blood supply of the endometrial lining in order to optimise conditions for implantation by the ovum in the event of fertilisation.
  • To further encourage endometrial formation through the reduction of (FSH) and (LH) secretion and
  • To raise the woman's Basal Body Temperature.

 In the event of fertilisation and pregnancy the fertilised ovum slips down the fallopian tube into the uterus where it becomes embedded (implanted) in the endometrium. The time sequence from ovulation to implantation is around 6 days. Following implantation the production of

Scroll right for diagrammatic presentation >>>>>>>>>


human chorionic gonadotropin (HCG) commences. (HCG) is sometimes called the "pregnancy hormone" and is the hormone which pregnancy detection kits use for the detection of pregnancy. The significance of HCG is that it provides continual stimulation of the corpus luteum for progesterone production which in turn suppresses (FSH) and (LH) secretion thereby maintaining endometrial integrity.


It is progesterone which is responsible for the maintenance of the uterine lining. If the ovum is not fertilized the corpus luteum regresses about two weeks after ovulation. Because of this progesterone levels drop and the stimulation for the endometrium is lost. This causes the shedding of the lining and a new menstrual cycle to begin. Thus when fertilization does not occur, estrogen and progesterone levels fall, the endometrial lining sheds, and menstrual bleeding begins again. 

The number of days from the ovulatory phase to the commencement of a new menstrual cycle is usually a constant around 14 days unlike that of the pre-ovulatory stage which can vary between 11 - 16 days. Thus a complete menstrual cycle can range from 28 days (3 days menses + 11 pre-ovulation + 14 days luteal) to 37 days (7 days menses + 16 days pre-ovulatorty + 14 days luteal). As previously stated the average for a complete cycle is 28 days but it may vary anywhere from 20 to 37 days and still be considered normal. (This artiicle is continued below the chart)

Diagrammatic summary chart of Menstruarl Cycle

This condition occurs when there is no menses even though the woman is still within her reproductive years.

This refers to acute pain during menses which interferes with daily activity.         

This is the term for when there is very little blood flow during menses 

This is the name given to a girls first menstruation cycle the average age for which is 12 years but the event may occur anywhere between 8 an 16 years.


Sudden heavy flows of blood during menses.

This term refers to the cessation of all menses for a minimum period of 1 year. This event usually occurs at an average age fof 52 years but anywhere between 45 55 years is common.

Many women experience metorrhagia, or dysfunctional uterine bleeding (sometimes called spotting) between menstrual periods. Metorrhagia can have benign causes or can signal a serious problem.  Any type of bleeding between periods should be investigated.


This refers to someone having less frequent menses because of a long cycle length
of more than 37 days.

For further information
in order to make a fully informed choice contact 

Dr. Peter Darashah

Ph.D.,M.Sc (Lond), B.Sc., DIHom (Pract),FBIH, MARH

Nutrition Consultant & Homeopathic Physician

(087) 2621943
Consultations held at:
Dervish Holistic Cebtre, 50 Cornmarket Str., Cork.

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Endometrium shedding & blood vessels bleeding. CLICK IMAGE TO ENLARGE
Endometrium shedding & bleeding in Menses stage
(Click image to enlarge

Endometrium at commencement of Pre-ovulatory Stage CLICK TO ENLARGE
Endometrium at commencement of
Pre-ovulatory Stage
(Click image to enlarge)













Endometrium fully redeveloped and ready for implantation. CLICK IMAGE TO ENLARGE
Endometrium fully redeveloped and ready for implantation.
(Click image to enlarge)

Menses disconfort
Mensaes disconfort

period back pain
Period back pain


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