Which symptoms can each menstrual phase cause?
The Menstrual Phase
The symptoms of the menstrual phase of your cycle start on the first day you start to bleed - with the resulting blood loss. Most of the bleeding happens during the first three days of this phase. You may also experience period pain, which can involve cramping, dull aches or severe pain, which can also radiate into your lower back and legs.
Your oestrogen levels are at their lowest on the day your period begins, and from day one, your brain starts to produce Follicle Stimulating Hormone (FSH) in the pituitary gland, which tells your ovaries to start maturing a new egg,
The Follicular Phase
This is the longest part of your cycle. The follicles - fluid filled cavities in your ovaries - start maturing, stimulated by FSH. Over time, one follicle will normally become dominant and it’s in this follicle that a mature egg will grow.
While this is taking place, the lining of your uterus will be thickening with blood and nutrients for a potential baby. Around the time of ovulation, oestrogen levels are high and you will start to produce ‘fertile cervical mucus’, which you might notice as a thin slippery discharge in your underwear. The cloudy white mucus is designed to help sperm - they can swim through it and survive in it for 2-3 days.
The last five days, leading up to and including the day of ovulation (which marks day one of the next phase of the cycle) are your most fertile days, and so you’ll need to be extra careful if you’re not trying for a baby, as there is a higher chance of pregnancy if you have sex without using contraception.
Ovulation
Ovulation is when a mature egg is released from one of your ovaries. This can happen at any time from day seven to 22 in a normal menstrual cycle, although it usually happens around day 14.
You may notice a few symptoms around the time that you ovulate; it’s common for women to see red ‘spotting’ for a day and some women also feel discomfort in their pelvic area, which is called ‘mittelschmerz’ - this is nothing to worry about. If the egg is not fertilised, the cycle starts again with the menstrual period.
You may also notice that a day or so after you ovulate, your basal body temperature increases by a tiny amount, usually 0.1 - 0.2 degrees. This is because your body releases more progesterone to support the thickening of the uterus lining, which raises your temperature slightly. It usually stays elevated until the start of your next cycle, unless you become pregnant, in which case it stays higher for longer.
Luteal (premenstrual) phase
This phase follows ovulation. If conception has occurred, and the fertilised egg has implanted into the lining of your uterus, you are now pregnant, and the due date is calculated from day one of the cycle. If there is no pregnancy, the uterus lining starts to break down.
In most women, between their teenage years and the peri-menopause in their forties, the luteal phase, which takes you from ovulation to the start of the next cycle, lasts around 13 to 15 days. This premenstrual period can result in symptoms of Premenstrual Syndrome or PMS - mood changes (anger, tension, feeling emotional) and physical changes which can include:
- water retention
- bloating
- painful breasts
- acne and spots
- headaches
- diarrhoea
- constipation
- nausea
- dizziness
- fainting
PMS symptoms should improve when your period starts and will normally disappear a few days later. Over 100 different symptoms of PMS have been recorded, and they can change from cycle to cycle. If you’re concerned about your PMS, keep a diary of your symptoms for a few months and then speak to your doctor.
