menstrual cycle guide

What happens during your menstrual cycle?

Most females experience a “period” of bleeding approximately once a month, from around the age of 12 to age 50.1

But how clued in are you as to what actually goes on during the menstrual cycle?

Having a secure understanding of your body and the signs and symptoms of your period (or that of your partner) could help you identify key reasons behind health issues, including cramps and mood swings, and make you feel more in control at that ‘time of the month’.

Period cycle

The period cycle, ovulation cycle or menstrual cycle, is the body’s way of preparing for the possibility of bearing a child.

The main parts of the body involved are the ovaries, fallopian tubes, uterus and vagina.

Approximately every 28 days, hormones are released that prompt the ovaries to release a mature egg, which travels to the uterus along the fallopian tubes.

During this ovulation period of the cycle, the ovaries also release the hormone oestrogen (also known as estrogen), which thickens the lining of the uterus so it is ready to hold onto the egg, in the event of it being fertilised by a sperm.

However, if the egg is not fertilised, the hormone levels drop and the lining of the uterus dissolves as blood, or menstruation.2 It is worth noting that although most people’s cycle is around 28 days, anywhere between 21 and 40 days is considered normal.3

Period symptoms

The main symptom of a period is, of course, bleeding. This will usually happen for between 2-7 days each month.4

However, many people who menstruate get other clues from their body signaling that their period will start soon.

This is often referred to as PMS, or pre-menstrual syndrome.

Typical PMS symptoms include mood swings (such as feeling irritable or sad), tender breasts, bloating, loss of sex drive and spotty skin or greasy hair.

Not everyone gets PMS; some people only have one or two symptoms, while others get the full spectrum.5

Tracking your periods

It is worth keeping track of your periods using a journal or period or ovulation app.

It will not only help you get to know your body better, but will provide your doctor with lots of information should any of the symptoms become unmanageable. Keeping track of ovulation is also handy if you want to get pregnant.

Period pain and period cramps

Another period symptom that most people who menstruate suffer from at some point or another is pain and cramps during their period.

This sensation comes from the uterus contracting to get rid of the blood.

The most severe cramps are usually in the first couple of days of the period.6 Some people’s cramps are so severe that period pain is a leading cause of why women take time off work.7

It is worth knowing that some lifestyle factors have been found to increase the likelihood of cramps.

These include smoking, being overweight, drinking alcohol, having your first period before the age of 11, and never having been pregnant.8

Other types of discomfort experienced during menstruation include lower back pain, leg pain, and headaches.

The NHS recommends the over-the-counter painkillers ibuprofen and aspirin for period pain management (though not for anyone with kidney or liver problems; and aspirin should not be used by under 16s); paracetamol is less effective.

Ovulation pain

One further type of period pain that some people experience is painful ovulation.

It is usually harmless and manageable with over-the-counter analgesia, or relaxing activities like a hot bath.

However, in some cases it can be an indicator of other gynecological issues.9

If you experience any period pain that makes your day-to-day life unmanageable, you should see your doctor, as there are prescription treatments available.

Heavy periods and irregular periods

Two further potential issues with menstruation are very heavy periods or irregular periods.

If you have had heavy periods since your first menstruation, it is unlikely to indicate any other health problems.

Around half of those with heavy periods have no underlying cause.

However, if your heavy periods affect your day-to-day life, or suddenly start becoming heavier, it is definitely a good idea to track how many pads or tampons you are using and how long your periods last before talking to your doctor.10 If you cannot detect a clear pattern in your cycle, or if the number of days between your period changes each time or your period lasts for a different number of days each month, you might have what is known as irregular periods.11 This is most common during adolescence or menopause.

However, other conditions can cause irregular periods, including stress, weight change, contraception, or pregnancy.

Irregular periods can also be caused by some gynecological conditions, such as polycystic ovary syndrome.12

A period tracking app is a great way of keeping a record of irregular periods so you can seek medical advice if needed.

Last updated: 20 November 2020

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