The Menstrual Cycle
The menstrual cycle includes the shedding of the uterine lining, where blood flows from inside the uterus to the vagina. It begins during puberty in people assigned female at birth. The cycle can be irregular at first, but it typically stabilizes to 25-35 days.
The first phase of the menstrual cycle is menstruation, also known as “getting your period”. This stage is where the actual flowing of blood occurs, and can range from 3-7 days. The follicular phase beings at the start of the menstruation and continues into ovulation, typically lasting about 10-14 days. Here, the body’s estrogen levels start to rise, which causes the uterus lining to thicken in preparation for the egg. Ovary follicles, small sacs in the ovaries that contain fluid and immature eggs, also begin to grow during this phase. Ovulation begins on day 14, when one ovary follicle bursts open and releases a mature egg. Finally, the cycle ends with the luteal phase, where the mature egg travels down the fallopian tube and enters the uterus. If the egg is fertilized by sperm and implants itself into the uterine wall, pregnancy occurs.
Irregular Periods
Hormones are chemicals that the body produces in order to regulate different bodily functions. In the case of the menstrual cycle, the hormones estrogen and progesterone are responsible for the regulation of the cycle. Polycystic Ovary Syndrome (PCOS) is a condition that affects around 10% of women. The condition causes hormonal imbalance due to excessive androgen production by the ovaries. This can lead to irregular period cycles, excessive bleeding, unpredictable ovulation, infertility, and hormonal acne. Irregular periods can also be caused by stress, menopause, genetic diseases, eating disorders, or taking birth control.
Menstrual Cycle Regulation
If the irregular menstrual cycle is caused by an underlying condition such as high stress or eating disorders, treatment for the specific cause such as therapy may be beneficial. Different medical treatments can be used for menstrual cycle regulation.
Hormone-releasing Intrauterine Device
Some people struggle with heavy bleeding during menstruation, and they may decide to get a hormone-releasing intrauterine device (IUD). An IUD is a small T-shaped device inserted into the uterus by a healthcare provider, and the process typically takes from 5-10 minutes to undergo. It regulates periods by releasing the hormone progestin, similar to progesterone, thinning the uterine lining. This reduces bleeding during menstruation, and can sometimes cause the period to stop altogether.
Hormonal Patch
A hormonal patch is a small, sticky patch placed onto the skin that is changed every few days. It releases estrogen and progesterone into the bloodstream through the skin, which can help in regulating periods. The patch is known for lightening up menstrual cramps and decreasing bleeding. Hormone patches also help reduce common premenstrual syndromes (PMS) such as acne, fatigue, depression, and food cravings.
Cyclic Progesterone Therapy
Cyclic progesterone is common among biological women with PCOS or people going through menopause. These people typically have low levels of progesterone, affecting their ovulation. The treatment involves taking natural progesterone before bedtime for two weeks, followed by a two-week pause. This is meant to mimic the natural progesterone pattern in menstruating women, re-establishing hormone levels. Cyclic Progesterone Therapy can reduce period cramps and lighten bleeding during periods.
References
Better Health Channel. “Menstrual Cycle.” Better Health Channel, 2012, www.betterhealth.vic.gov.au/health/conditionsandtreatments/menstrual-cycle.
Cleveland Clinic. “Ovulation: Calculating, Timeline, Pain & Other Symptoms.” Cleveland Clinic, 7 Aug. 2022, my.clevelandclinic.org/health/articles/23439-ovulation.
Cleveland Clinic. “Polycystic Ovary Syndrome (PCOS) & Treatment.” Cleveland Clinic, 15 Feb. 2023, my.clevelandclinic.org/health/diseases/8316-polycystic-ovary-syndrome-pcos.
Cleveland Clinic. “Hormone Therapy for Menopause: Types, Benefits & Risks.” Cleveland Clinic, 28 June 2021, my.clevelandclinic.org/health/treatments/15245-hormone-therapy-for-menopause-symptoms.
“Cyclic Progesterone Therapy.” The Centre for Menstrual Cycle and Ovulation Research, www.cemcor.ubc.ca/resources/topics/cyclic-progesterone-therapy.
“Irregular Periods.” NHS Inform, 7 June 2024, www.nhsinform.scot/healthy-living/womens-health/girls-and-young-women-puberty-to-around-25/periods-and-menstrual-health/irregular-periods/.
“Menstrual Cycle: An Overview.” Menstrual Cycle: An Overview, 2019, www.hopkinsmedicine.org/health/wellness-and-prevention/menstrual-cycle-an-overview.
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