The Menstrual Cycle and Hormonal Health (2024)

Written by: Ryah Nabielski, MS, RDN

It’s time to reframe your period. Instead of a monthly nuisance or dreaded experience, embrace the menstrual cycle as a sign of health, vitality, and fertility. Even if having kids isn’t a goal, a healthy menstrual cycle provides nourishing hormones to the entire body, which impacts overall health and your health even after your periods stop.

In school, we learn some basics about puberty and safe sex, but we aren’t informed about how the menstrual cycle works and the clues it can tell you about your health. Nor do we learn how understanding your cycle can help you conceive or avoid pregnancy. Or how you can harness the power of your hormones to optimize your metabolism or exercise performance.

Today’s article will help fill in some of these education gaps. We’ll cover what a normal menstrual cycle should look like, what can go wrong, and how to support healthy hormonal balance as a cycling person.

Keep reading to learn more about:

The menstrual cycle as a vital sign
Normal menstrual cycle and hormonal changes
Period problems and hormone imbalances
How to optimize hormonal health with lifestyle strategies

Let’s dive into this essential topic!

The Menstrual Cycle as a Vital Sign
A healthy, regular menstrual cycle is a marker of overall health. Just like you’d check your temperature, pulse rate, or blood pressure, the menstrual cycle is a vital sign. When the cycle falls out of a normal range – if it’s irregular, painful, or absent – it’s your body’s way of telling you something is going on and can help you (and your healthcare team) uncover what’s driving the changes in your hormones.

We typically think of an optimal menstrual cycle as a sign of fertility, which it absolutely is. Beyond fertility, the female hormones (estrogen and progesterone) produced as part of the cycle are critical hormones throughout the body, playing a crucial role in the health of the brain, heart, bones, muscles, skin, and more. Optimizing your menstrual cycle and having circulating estrogen and progesterone (in balance) for as long as possible is beneficial for your health.

What’s a Normal Menstrual Cycle?
The average cycle length for an adult woman is 28 days, but anywhere between 21 and 35 days is considered normal. Start counting on day 1, the first day of bleeding, and start over at the next period.
The menstrual cycle depends on the HPO axis (hypothalamus-pituitary-ovarian axis), the communication from the brain to the ovaries. The cycle has two phases: follicular and luteal.
The follicular phase, the first half of the menstrual cycle, includes the period (3 to 7 days of bleeding is normal) up to ovulation. During the follicular phase, the brain releases follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which signal the ovaries to produce estrogen and develop follicles.
Estrogen (specifically estradiol) helps build the uterine lining and release cervical mucus, creating a welcoming environment for sperm. In the later follicular phase, FSH, LH, and estrogen will surge, leading to ovulation, the release of a mature egg.

It’s often thought that the period is the main event of the menstrual cycle, but ovulation is the star of the show!

Fun fact: you can only get pregnant in the five or so days leading up to ovulation when cervical mucus is present and for around 24 hours after ovulation.

The luteal phase, the second half of the menstrual cycle, lasts from after ovulation until the next cycle begins. During this phase, progesterone levels rise to maintain the uterine lining. Progesterone is associated with a higher body temperature and metabolic rate.
You must ovulate to produce progesterone, and if the egg is fertilized, progesterone will continue to rise. Otherwise, progesterone levels will fall, and the cycle will start over.

Period Problems and Hormonal Imbalances
It’s normal to experience physical changes during the menstrual cycle. For example, you may have more energy and focus in the follicular phase and need more rest and alone time in the luteal phase.
Because hormones cycle, you’ll notice some fluctuations in how you feel. However, your cycle or period shouldn’t be painful, debilitating, or affect your quality of life or ability to work. If it does, there could be underlying factors to address.
Let’s look at some common conditions and hormone imbalances:

PCOS – Polycystic ovarian syndrome is the most common endocrine disorder in reproductive-age women that can include insulin resistance and elevated androgens (“male” hormones.) Common symptoms are weight gain, irregular cycles, and acne, but the syndrome can present differently in different women.

Estrogen Dominance – Estrogen dominance is an imbalance between estrogen and progesterone. It can occur when estrogen is high relative to normal progesterone, when estrogen is normal and progesterone is low, or from exposure to chemical estrogens (xenoestrogens.) The imbalance causes symptoms of high estrogen, like weight gain, heavy periods, PMS, and painful breasts.

Amenorrhea – Secondary amenorrhea is the absence of the menstrual cycle when you used to have it, but you aren’t pregnant. Women who are underweight, undereat, have increased stress, or overexercise are at risk of not ovulating and losing their menstrual cycle. There can also be other causes.

Dysmenorrhea – Dysmenorrhea means painful periods. While a small amount of cramping is normal, excessive pain that interferes with daily life can often get better by addressing inflammation and lifestyle habits.

Fertility Issues – Many possible factors affect the menstrual cycle and the ability to conceive and have a healthy pregnancy. Understanding your menstrual cycle can help you pinpoint where you may need support. For example, is your cycle regular? Do you notice cervical mucus? Are you ovulating? Are you making enough progesterone? And so on.

Perimenopause – While perimenopause (the transition to menopause) is natural, it can be a reason for changing menstrual cycles and period problems. It’s a topic that isn’t discussed much and needs more attention. Perimenopause can start as early as the mid-30s and last for ten or more years. If you are in this age range, it’s helpful to determine if you’re experiencing perimenopausal symptoms or something else. And you don’t just have to live with perimenopausal symptoms; there are many solutions.

Since the menstrual cycle is a vital sign, changes in the menstrual cycle are worth paying attention to. You’ll need your detective skills. You don’t just want to know the problem (the diagnosis), but also why. Understanding the why can help you find lasting solutions and fine-tune your lifestyle for healthy cycles.

Always work with your doctor or another trusted healthcare provider for proper testing and support. If you’re concerns are brushed aside, find a provider who will listen and help you work towards easy, pain-free, regular menstrual cycles.

How to Balance Hormones and Support a Regular Menstrual Cycle
Our hormones respond to the environment and the inputs we give our body. So much of hormone balance comes back to foundational lifestyle pieces like sleep, stress management, exercise, and good nutrition. One way to think about menstrual cycle health is that the body will prioritize reproduction, fertility, and ovulation when it feels safe and nourished.

All hormonal systems are connected, and the two most critical hormones that influence the menstrual cycle and female hormones are insulin and cortisol. Insulin helps with blood sugar balance, and cortisol is a primary stress hormone.

As a foundation here, please read How to Balance Your Blood Sugar and Why it Matters, along with How to Support Your Adrenals and a Healthy Stress Response. Supporting insulin and cortisol balance will have downstream benefits for reproductive hormones.

Along with the foundations of blood sugar balance and stress support, here are some other strategies that will support a healthy menstrual cycle:

Prioritize nutrition – Eat whole foods most of the time and ensure you eat enough protein, healthy fats, and unprocessed carbs, as undereating can affect the menstrual cycle. This eating pattern helps reduce inflammation and increases the micronutrients (vitamins and minerals) you need for hormone production. Finally, don’t forget about good hydration!

Support liver and gut health – As crucial as hormone production is, it’s also critical to clear the hormones when you no longer need them. A healthy gut and regular bowel movements are essential. You can support liver detoxification with a nutrient-dense diet and specific food, such as cruciferous vegetables (kale, broccoli, cauliflower, collards, brussels sprouts, arugula, broccoli sprouts, etc.)

Track your cycle – We often track our periods, but not always other aspects of the menstrual cycle, such as cervical mucus, basal body temperature, and monthly symptoms. Consider this a way to collect data and become familiar with your body’s patterns. That way, when the pattern changes, you’re on top of it.

Adapt to your cycle – Did you know you need more food in the luteal phase? It’s true; the body burns around 300 calories (one hearty snack) more daily. As another example, you’ll get more benefits from strength training in the follicular phase when estrogen is higher. If you feel less motivated to exercise the closer you get to your period, it’s okay to shift to more walking or yoga during this phase to support your hormones.

Use supplements – In practice, getting all the nutrition you need through food alone is challenging, given the modern food supply and high-stress environment. Supplements can help fill the gaps. They aren’t just a good idea for fertility but for healthy menstrual cycles in general. Consider Twenty2Nutrition Prenatal Women’s Multivitamin, Omega 3 Fish Oil, and Probiotic as supplement foundations for happy hormones. From there, you can layer on targeted supplements as needed.

When hormones are out of balance, it’s a sign from the body about a deeper need. The challenge is listening to the signs. One sign can be changes in the menstrual cycle, alerting you to check with your healthcare provider and uncover what you may need to shift. Luckily, hormones are highly responsive to how we live. Simple lifestyle changes provide a foundation for optimal hormone balance and a healthy menstrual cycle.

This article is for educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider before changing your diet or beginning a new supplement, especially if you are pregnant or breastfeeding, take medication, or have a medical condition.

Ryah Nabielski, MS, RDN is a Registered Dietitian, functional nutritionist, writer, and recipe creator. Ryah helps clients use a natural, food-as-medicine approach to improve fertility, pregnancy, hormone balance, autoimmunity, and discover a healthy relationship with food and body. Learn more about Ryah and her private practice at econutrition.co.

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