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The term ‘menstrual cycle’ refers to the changes that occur naturally in a woman’s body to prepare it for pregnancy.

In a normal menstrual cycle, women experience menstruation (also known as a period) followed by the release of an egg. During menstruation blood, cells and mucus are discharged from the uterus.

The menstrual cycle starts on the first day of the menstrual period (referred to as day one) and ends the day before the next period begins. While the length of the menstrual cycle is often 28 days, it can vary between women and from one cycle to the next. It is common for women to experience cycles that last anywhere from 20 to 40 days. Cycles longer than six weeks are considered unusual.

The length of a women’s menstrual cycle can change throughout her life. Irregular periods are common among adolescent women, and in women approaching menopause. Factors such as stress, extreme emotion (good or bad), weight changes, excessive physical activity and travelling can also cause irregularities in a woman’s menstrual cycle.

Contents

Phases of the menstrual cycle

The menstrual cycle has four distinct phases: menstruation, the follicular phase, ovulation, and the luteal phase.

Although menstruation is considered to be the first phase of the cycle, in order to properly understand menstruation, it is necessary to first explain the other phases.

FOLLICULAR PHASE
During this phase, the pituitary gland releases follicle-stimulating hormone (FSH), which causes between 10 and 20 follicles (cells that contain immature eggs, known as ova) to begin developing in the ovary. They produce the hormone oestrogen, which causes the lining of the uterus (endometrium) to become thick in preparation for the possible embedding of a fertilised egg (1).

Usually only one follicle develops into a mature egg (2). This follicle moves towards the surface of the ovary, while the others break down and are reabsorbed by the body. The follicular phase begins on the first day of menstruation and ends with ovulation. It can vary considerably in length, depending on the time of ovulation.

OVULATION
The term ‘ovulation’ refers to the release of a mature egg from the ovary. During the follicular phase, the rise in a woman’s oestrogen levels causes gonadotropin-releasing hormone (GnRH) to be released from her brain. This in turn causes the pituitary gland to produce increased levels of luteinising hormone (LH). The abrupt rise in LH, known as the LH surge, triggers ovulation. Following ovulation, the egg is swept into the fallopian tube and moved along towards the uterus. If fertilisation does not occur, the egg disintegrates within 6-24 hours.

Cervical mucus and position
Just before ovulation, a woman’s cervical mucus becomes clear and slippery, resembling raw egg white; it is very elastic and can be stretched into a string between two fingers. This kind of cervical mucus is known as ‘fertile mucus’ because a woman is considered fertile when it is present. Fertile mucus assists and nourishes sperm as they travel up the vagina towards the opening of the cervix.

When a woman is in a non-fertile phase of her cycle, her cervical mucus differs in colour and texture. It might be sticky, crumbly, gummy or creamy (like lotion) in texture, and white, milky or yellow in colour (3). This mucus cannot be stretched between the fingers and may have a sour smell. It is important to note that secretions related to sexual arousal, semen, lubricants, spermicides, vaginal infections (e.g. thrush), and certain medications can all interfere with the appearance of cervical mucus.

The positioning of the cervix and its opening also change throughout a woman’s cycle. At about the time of ovulation, the cervix moves into a higher position and its opening widens. Some women may experience aches or pain around the time of ovulation. This pain can vary from cramps or a general ache in the abdomen to sharp pains in one side. Spotting (light bleeding) can also occur at this time.

Time of ovulation
Women often believe that ovulation occurs mid-cycle. It actually occurs 12-16 days before the next period starts. So, although a woman with a 28-day cycle may ovulate mid-cycle (between day 12 and day 16), a woman with a 36-day cycle will ovulate between day 20 and day 24.

For women with regular cycles, an easy way to approximate the time of ovulation is to subtract 16 from the number of days in the cycle and then add 4. This will calculate the span of days in which ovulation is most likely to occur. For instance, a woman with a 22-day cycle is most likely to ovulate between days 6 and 10 of her cycle (22-16 = 6 (+4 =10).

Ovulation and conception
Following ovulation, the egg’s lifespan can be up to 24 hours, but is usually between six and 12 hours (4). In contrast, sperm generally survive for three days, but can live inside the vagina for up to five days if optimal fertile cervical mucus is present (5). Pregnancy can therefore result from intercourse that occurs within a woman’s fertile window (from as early as five days before ovulation, until up to 24 hours following ovulation).

THE LUTEAL PHASE
During this phase, the remnants of the follicle that released the egg (now called the corpus luteum) release large amounts of the hormone progesterone as well as some oestrogen. These hormones contribute to the further thickening and maintenance of the uterine lining. If fertilisation does not occur, the corpus luteum breaks down and progesterone levels decline, leading to the disintegration of the uterus lining. During the luteal phase, women may experience physical and emotional changes including tender or lumpy breasts, fluid retention, bloating, mood swings, tiredness or anxiety (see Premenstrual syndrome).

MENSTRUATION
Menstruation occurs when the broken-down lining of the uterus flows out through the vagina. Menstruation generally lasts from three to seven days. Some women regularly have periods that are shorter or longer than this. The length can also differ from one cycle to the next. In addition to blood, menstrual fluid is made up of several components including endometrial cells, cervical mucus and vaginal secretions (6). The amount of menstrual fluid lost varies between women and from one cycle to the next, but a woman generally loses about 50-100ml of fluid each time she has a period (7).

Menstrual flow may be heaviest or lightest at the beginning of menstruation or may change throughout. The colour can range between black, brown, dark red, bright red and pink. Menstrual fluid only tends to have an unpleasant odour after it has been in contact with air for a period of time.

Age of first and last period (menarche and menopause)
In Australia, menarche (the onset of menstruation) occurs most often in girls aged from 11 to 14. Menarche usually occurs a year or two following the appearance of other puberty related changes, such as breast development and pubic/underarm hair growth. Genetic factors and social influences, as well as a girl’s ethnicity, size, and weight, can influence when menarche occurs (8). Girls with a higher body mass index (BMI) are likely to begin getting periods earlier than those with lower BMI scores (9). Girls who are highly physically active (such as athletes) tend to have slightly delayed menarche.

Research suggests that the average age of menarche has fallen during the last century. This can be attributed to a number of factors including improved nutrition, better healthcare and possibly the increase in oestrogen-like substances in the environment (e.g., pesticides and plastics) (10). Recent studies suggest that the age of menarche is often slightly reduced in girls who are subject to emotional stressors, such as family disruption or childhood adversity, and in girls who consumed high intakes of animal proteins, such as cow’s milk, during childhood (11).

It is recommended that if a young woman has not had her period by the time she is 16, she should consult a doctor to ensure that she does not have a medical condition that is preventing menstruation from occurring (12).

When young women first start menstruating, they are often anovulatory (not ovulating) and, therefore, not fertile. However, it is important for sexually active young women to remember that as soon as they start menstruating, pregnancy can occur. Therefore, they should use contraception if they wish to avoid becoming pregnant.

Menstruation without ovulation can also occur at other life stages, such as before menopause. Menopause, the ending of periods, typically occurs in women who are in their late 40s or early 50s. In the time leading up to menopause, the menstrual cycle and/or flow may change, becoming lighter, heavier or longer. While irregular bleeding is also common at this time, it can be a symptom of gynaecological cancer so women experiencing this should consult their doctor. Even though women may be unsure as to whether they are ovulating prior to menopause, contraception still needs to be used if pregnancy wants to be avoided.

Sex and menstruation
Some women avoid sexual activity when they have their period for personal, cultural or religious reasons. However, there are few physical reasons why women should avoid sex during menstruation. One consideration is that the risk of transmitting blood-borne infections such as hepatitis C and HIV is higher when having unprotected sex at this time. It is possible for pregnancy to occur if women have unprotected sex during menstruation. Women who want to avoid pregnancy should use contraception at this time.

The Pill and menstruation
The Pill contains synthetic oestrogen to prevent the development of an egg (and therefore, ovulation), and synthetic progesterone to increase the thickness of cervical mucus (to slow the movement of sperm) and prevent the complete development of the uterine lining.

Women who do not ovulate do not experience changes in cervical mucus or ovulation pain. Their ‘period’ is actually a withdrawal bleed resulting from the stopping of the synthetic hormones (during the four to seven days of inactive/sugar pills) rather than a natural menstruation.

Women taking the Pill can use it to miss or delay a withdrawal bleed. This can be convenient for women planning travel or special occasions. Women who experience health problems such as endometriosis, menstrual migraine and heavy bleeding may use the Pill to reduce the number of withdrawal bleeds they have a year (and, therefore, the number of times they experience symptoms). Women taking a monophasic Pill (a version of the Pill that delivers the same dosage throughout the cycle) can miss or delay a withdrawal bleed by simply missing the inactive/sugar pills and going straight on to the active hormones in the next pill packet. However, women on a triphasic Pill (a version of the Pill that delivers different dosages throughout the cycle) may experience spotting if they do this, due to the change in hormone levels at the start and end of the pill packet. Women on triphasic Pills who wish to miss a withdrawal bleed should seek advice from their doctor.

Breakthrough bleeding can sometimes occur in women on the Pill, particularly in the first few months of taking it or if the woman is using a triphasic Pill. A woman is still covered contraceptively if she has not missed any active pills and has a breakthrough bleed. However, she should consult her doctor to review the choice of Pill and to ensure the bleeding is not related to another condition (see Bleeding between periods section).

Return of periods after childbirth
The length of time before a woman’s period returns following pregnancy largely depends on whether she is breastfeeding or not. This is because the hormone that stimulates milk production, prolactin, also inhibits ovulation and the return of menstruation. Therefore, women who are fully breastfeeding may not have a period for several months after childbirth or until they finish breastfeeding. The return of menstruation in breastfeeding mothers depends upon the frequency and duration of breastfeeds a day.

In women who are not breastfeeding, and women who are combining breastfeeding with bottle feeding, menstruation can return as soon as five-to-six weeks following childbirth. It is important to be aware that women will ovulate, and therefore be fertile, before the return of their first period following delivery/breastfeeding. It is also important to note that even though breastfeeding can delay the return of periods, it is not a reliable form of contraception.

Common menstrual problems

Some of the most commonly reported menstrual problems are an absence of periods, painful periods, heavy bleeding, bleeding between periods, and premenstrual syndrome (PMS).

ABSENCE OF PERIODS (AMENORRHOEA)
Outside of pregnancy, amenorrhoea is usually the result of hormonal disturbances. These disturbances can be caused by a wide range of factors including weight gain or loss (body weight and body fat percentage are directly related to ovulation and menstruation), being chronically underweight (16), over-exercising, extreme emotion (both good and bad), anxiety or stress, travel, dietary changes, and conditions such as polycystic ovarian syndrome (17). Often, amenorrhoea is temporary, with menstrual periods returning in time. Women who are not pregnant and have not had a period for longer than six months should consult their doctor.

PAINFUL PERIODS (DYSMENORRHOEA)
While some women experience only mild discomfort when they have their period, other women suffer from severe, incapacitating pain. This kind of pain is not normal and women should consult their doctor if the pain they experience interferes with their ability to function normally.

Women might get pain a few days before their period or during the first few days of bleeding. The pain can be a cramping-type pain, caused by the contraction of the uterine muscles, or a heavy dragging pain in the pelvic region. Pain in the legs and back, headaches, nausea, constipation and diarrhoea are also common.

Period pain can be the result of prostaglandins, the substance that causes the uterus to contract during a period. Severe period pain might also signal the presence of conditions such as pelvic inflammatory disease or endometriosis. Popular remedies for mild pain include analgesics (aspirin or paracetamol), warm baths, heat packs, gentle exercise and rest. Treatment for more severe period pain includes the use of antiprostaglandins (e.g., Nurofen, Ponstan) and oral contraceptives. If women do not find relief with these treatments they should consult their doctor.

HEAVY BLEEDING (MENORRHAGIA)
Because it is hard to measure the amount of menstrual fluid lost, it is difficult to define what constitutes heavy bleeding. However, the degree to which a woman’s period interferes with her everyday life can provide a guide (e.g., having to change a pad or tampon every hour can indicate that bleeding is heavy).

Heavy bleeding can be caused by a number of factors including hormonal imbalances, fibroids, polyps, endometriosis, or, less commonly, bleeding disorders. Excessive blood loss through heavy periods can lead to iron deficiency and anaemia. The Pill and/or antiprostaglandins can be used to treat heavy bleeding. Other treatment options include inserting a Mirena intra-uterine device (IUD), or undergoing endometrial ablation (a procedure that causes the destruction of the uterine lining)..

BLEEDING BETWEEN PERIODS
Bleeding or spotting between periods can be a symptom of a number of conditions including sexually transmitted infections, endometriosis, fibroids, gynaecological cancer, or a thyroid disorder. It can also be a side effect of some contraceptives or medications (see The Pill and menstruation section). If a woman experiences bleeding between periods she should consult her doctor.

PREMENSTRUAL SYNDROME (PMS)
Premenstrual syndrome (PMS) refers to a number of symptoms some women experience before each period (18). Physical signs of PMS include tender or lumpy breasts, fluid retention, bloating, food cravings and headaches. Psychological signs include mood swings, tiredness, and feelings of anxiety, anger, and sadness. Women who suffer from mild premenstrual syndrome might find exercise, dietary changes, yoga, relaxation techniques, and herbal remedies useful.

PREMENSTRUAL DYSPHORIC DISORDER (PMDD)
A small percentage of women suffer from a severe form of PMS called premenstrual dysphoric disorder (PMDD). Women with PMDD experience symptoms so severe that they greatly impact their everyday functioning. Treatments for PMDD include lifestyle changes, the Pill, cognitive behavioural therapy, and, if other treatments are unsuccessful, a type of antidepressant known as selective serotonin-reuptake inhibitor (SSRI) may be prescribed.

MENSTRUAL MIGRAINE
About half of all women who suffer from migraine can clearly link at least some of their attacks to their periods. Some women have migraine attacks only related to their period, not at other times of their menstrual cycle. It is thought that the drop in oestrogen that occurs just before a woman has a period is a migraine trigger. Women who think their migraines may be related to their menstrual cycle are recommended to keep a diary tracking their menstrual cycle and migraine attacks for three months to show to their doctor.

For help understanding this fact sheet or further information on menstruation or menstrual problems, women in Queensland can contact the Health Information Line on 3216 0376 (within Brisbane) or 1800 017 676 (toll free).

Last Reviewd: June 2018

Last updated: January 2015

© Copyright Women’s Health Queensland Wide. This fact sheet was last updated in January 2015.

We should be experts on our periods by now. I mean, the red tide visits us 12 times a year for an average of 38 years. That’s 456 periods — and that’s also super depressing. Point is, most of us just go with the flow and wake up to the gifts Mother Nature has for us that day. But, let’s take a step back and look at the big picture.

Most menstrual cycles run for 28 days, with periods lasting about five days. But some women run on a 32-day clock, with anywhere between a three-day (lucky!) and a seven-day (sorry) period.

To help keep track of your cycle — or remind you to take the pill — there are . But generally, here’s what you can expect each day during a 28-day series.

Phase 1: Menstrual

Day 1: Ready, set, go! The first day of your cycle begins with the day your period starts. Estrogen is at its lowest, and since estrogen is responsible for increasing serotonin (the “feel-good” chemical), you may be feeling pretty lousy today.

Day 2: Gettin’ heavy with it. On average, the second day yields the heaviest flow. But even though you may be at high tide, you may be feeling a bit more relaxed as estrogen levels start climbing again.

Day 3: pH roller coaster. With all those tampons and extra blood flow, your vaginal pH has increased, which can lead to increased susceptibility to yeast infections.

Day 4: Light at the end of the tunnel. Today your period is a helluva lot lighter — the end is near! The number of your scowled looks continues to decrease too as estrogen climbs higher, and we are nice to our boyfriends again.

Day 5: Crossing the finish line. Thank the heavens, and shove your tampons to the back of the cabinet. You won’t be needing those for a while.

More: 14 Dazed things you will say on your period

Phase 2: Follicular

Day 6: One in 100,000. After your period ends, the most dominant follicle in your ovaries continues to grow in preparation to eventually release an egg.

Day 7: Carpe diem. You should be your normal self now but possibly a bit more optimistic than usual. You can thank the increasing levels of estrogen for your newly found motivation to ask for a raise.

Day 8: Mirror, mirror on the wall. You’re the fairest of them all. Your skin is glowy and bright, you feel good, and you have the confidence to strike up a conversation with that male model at the bar.

Day 9: Making bed for baby. While you’re chatting it up with all the cute guys at work, your uterus lining is thickening to make the softest and comfiest bed for your golden egg.

Day 10: Oh, happy day! Every cup is half full, and everything is coming up in roses. Your levels of optimism may be making your friends sick but are making you count every blessing.

Day 11: Let the baby-making begin. OK, ovulation is just around the corner, and since your ovulation day can change from cycle to cycle, it wouldn’t hurt to start the baby-making process now. That is, if you want a baby — otherwise, you had better use protection.

Day 12: Got that lovin’ feeling. Some say you are actually most fertile a couple of days before ovulation, which would make sense that your libido is at an all-time high.

Day 13: Estrogen reaches Mount Everest. Your estrogen levels peak right before ovulation and then drop suddenly right after. So take this as your last day to make lemonade from life’s lemons.

Day 14: Ovulation! The dominant follicle releases the egg for its journey down the fallopian tube. The egg will live 12 to 24 hours, while sperm can survive three to five days.

More: Beyoncé’s reportedly battling fertility problems, like so many other women

Phase 3: Luteal

Day 15: Hello, progesterone. Goodbye, estrogen. Estrogen levels plummet as progesterone levels begin to take its place. You may be a bit irritable, but don’t worry — estrogen will be back soon.

Day 16: It’s getting hot in here. With increased amounts of progesterone, you may notice your body temperature sits a little higher than usual.

Day 17: Don’t waste your money. Anxious to see if you’re pregnant? It might be too early to tell just yet. Hang in there, and check back in next week.

Day 18: Back for round two. Estrogen levels begin to rise again, along with the increasing amounts of progesterone.

Day 19. Easy with the girls. The hormones in your system increase blood flow to your breasts and may cause them to be fuller but extra sensitive.

Day 20: You’re cut off. If your egg hasn’t been fertilized, then your body will call it quits on producing estrogen. Enter: PMS.

Day 21: Baby on board? Now is the time to visit your doctor or buy those pregnancy tests. If fertilized, the egg has had enough time to settle in, and your hormone levels should accurately answer your pressing “am I pregnant?” question.

Day 22: You’re getting sleepy. Today your progesterone levels are at their max, which may equate to an increased tendency to fall asleep in the middle of that super-exciting board meeting.

Day 23: Cool! Small pores. Progesterone activates the production of sebum and swells the skin, causing your pores to appear smaller in size. But the swelling is actually compressing your pores, and the sebum is building up underneath — a situation that will rear its ugly head in a few days’ time.

Day 24: Reschedule your waxing appointment. At this time, your body is more susceptible to pain than during other times of the month. Avoid tweezing, waxing or laser hair removal.

Day 25: Don’t you dare step on that scale. You will scare the crap out of yourself when you see that you are up to 10 pounds heavier. Please don’t think your time at the gym was wasted. With all the hormone changes, our bodies tend to hang on to extra water in our system. One of the most ironic cures? Drink more water.

Day 26: Burn, baby, burn. In the midst of your catastrophic mood swings, I’ll tell you some good news: Your body burns up to 11 percent more calories now than it does during any other time of the month.

Day 27: Me want food. If you go overboard with your cravings, you will lose the benefit of that extra-calorie burn. Hang in there a few more days, and you will reap the benefits of avoiding that box of Oreos.

Day 28: Hi, Acne, not nice to see you again. What better way to end your cycle than with a visit from the Whiteheads? Remember those small pores and sebum production? Well, here’s the result. Additionally, now that your hormones are at an all-time low, your constant testosterone level is actually higher than estrogen and progesterone, causing more stimulation of sebum and a higher chance of cystic acne — not to mention oil-slick skin and large pores.

More: Adult acne: What to do when your skin still thinks you’re a teen

mindbodygreen

So you’ve probably heard that your menstrual cycle should be approximately 28 days long. But what exactly does that mean? When are you most likely to get pregnant? When will PMS symptoms be at their worst? And what exactly is happening on each day?

Here’s a day-by-day breakdown of what’s actually going on inside your vital reproductive organs (plus a few tips on how to make the most of each day — whether you’re trying to conceive or not). And remember: a “normal” cycle can range anywhere from 21 to 36 days, so this is approximate.

Plus, the following only counts if you’re not on the pill. (Otherwise, it’s the pill talking, not your ovaries). Take notes. This information is crucial knowledge for all women. The more you know, the better you’ll be able to prepare for each phase of your cycle.

Day 1: The first day of your period is also the first day of your cycle. Unless you’re pregnant, hormone levels plummet and the blood and tissues lining the uterus break down and shed. The next 28 days are all about your ever-optimistic uterus prepping for the possibility of a nine-month house guest.

Day 2: The period continues. The second day of your cycle is generally a heavy one. And while your PMS symptoms have (probably) cleared, you might have some cramps that accompany the bleeding. This may be a day for super tampons that you’ll have to change regularly. If you find a small clot in your pad, don’t panic. That’s perfectly normal for this point in your cycle. But if you’re going through a box of tampons in a day and passing plum-sized clots, get checked out by a doctor.

Day 3: This is often the final “heavy” day of bleeding. You’ll probably continue to see red blood. You may also experience some changes in your vaginal pH around now, which could lead to yeast infections and bad odors. If so, try an over-the-counter vaginal probiotic like Pro-B to balance things out.

Day 4: Your period usually starts to lighten up, and may change in color from bright red to brown.

Day 5: If you generally have a five-day period, a panty liner will usually do it.

Day 6: For many, this is the first day you’ll be free from a period. Others have periods that last up to seven days, though, which is perfectly normal.

Day 7: By now, your period should be completely or almost gone. This means that your body is gearing up for next month. Small follicles (little cysts on the ovaries that will release an egg or two) are starting to form. Estrogen levels are starting to rise, testosterone is still low, and progesterone is still absent.

Day 8: Those follicles are growing and preparing to release an egg. As the eggs start to develop, they produce estrogen, so estrogen levels will start to rise. Testosterone and progesterone levels will stay the same.

Day 9: Over the next few days, one follicle will continue to develop toward reaching maturity. That extra estrogen causes the lining of the uterus, rich with blood and nutrients, to thicken, so it’s ready if a fertilized egg implants.

Day 10: Estrogen production should now be off the charts. And your endometrium, or the lining of the womb, continues its plans to house a potential pregnancy.

Day 11: If you’re trying to conceive, now’s the time to kick your efforts into high gear since you’re either ovulating or getting close to ovulation. If you’re not always in the mood, now would be a great time to introduce a lubricant into your routine, to make planned sex more enjoyable. Be sure to choose a fertility friendly one for best sperm motility, like Pre-Seed. Other lubes can harm sperm.

Day 12: Even though you may not be ovulating yet, your fertility levels are high due to increased estrogen production — and because sperm can survive a few days in the woman’s body. Your cervical mucous is flowing and stretchy, and the main follicle should be fully ready to release an egg while the others shrivel up. You may notice increased libido around this time as testosterone (The main libido hormone!) levels are surging. This is nature’s way of encouraging sex at peak baby-making time.

Day 13: Estrogen levels are peaking, and your body is about ready for the egg to emerge from the ovarian follicle (aka ovulation).

Day 14: You’re ovulating! The egg is released from the follicle. You may feel a twinge of pain or have a little spotting, which is perfectly normal. This is your best baby-making day, so if you’re trying, whip out the lube and get to it. If you’re not, don’t skip that condom.

Day 15: Your egg is starting its journey down the tube in hopes of a sperm rendezvous. If you don’t want that to happen, but had a condom mishap, it’s not too late to take emergency contraception.

If you are trying to get pregnant, intercourse on the day after ovulation (just in case) is good practice. If things start to get funky down there (a common occurrence with frequent intercourse), reach for RepHresh gel to keep your vaginal pH in check. Now your estrogen and testosterone levels are starting to drop, while progesterone levels are rising rapidly.

Day 16: The egg, ever hopeful, is still hanging out in the tube waiting for Prince Sperm.

Day 17: The lining of the uterus is getting thick. If the egg has successfully united with sperm, it will soon make its home there. If conception hasn’t taken place within 24 hours of ovulation, the egg will die. Estrogen levels are on the way down, while progesterone levels are sky high.

Day 18: Now estrogen will start to make its comeback. Progesterone levels are still up there.

Day 19: If you’re trying to get pregnant, or concerned that you might accidentally be pregnant, don’t head to the drugstore yet. It’s still too soon to take a pregnancy test.

Day 20: The end of your cycle is nearing, and it’s around this time that PMS symptoms will start to rear their ugly heads. You may feel slightly bloated and moody.

Day 21: If you’re trying to get pregnant and want to confirm that you’ve ovulated, this is the perfect time for your doctor to check to see if your progesterone is elevated.

Day 22: Time to check your tampon stash so you won’t have to make a midnight trip in a few days.

Day 23: PMS is in full swing. Treat yourself to a bubble bath or a nice bar of chocolate.

Day 24: About a week after ovulation, your progesterone levels will be at a high. Estrogen will start to drift down.

Day 25: This will probably be your worst PMS day. Expect major bloat. And don’t be surprised if running out of ketchup brings on unexpected weeping.

Day 26: Don’t, I repeat, don’t get on the scale. It’s not you; it’s that pre-menstrual fluid retention.

Day 27: Get excited: PMS symptoms are winding down.

Day 28: This is about the time that your cycle comes to an end. If you’re not pregnant, your period is on its way. The uterine lining is at its thickest to get ready to shed. If you start taking ibuprofen today, (the day before you bleed), it actually works better to reduce pain — and decrease your flow. Tomorrow, the cycle starts again.

Pinpointing the Signs of Perimenopause

Some call it a transition. To others, it’s a stage. But no matter what view you take, perimenopause is the period in a woman’s reproductive life that begins some years — anywhere from 2 to 10 — before menopause. Diana E. Hoppe, MD, a gynecologist at Scripps Memorial Hospital Encinitas in southern California, says, “For most women, perimenopausal symptoms show up in their 40s, although for some, the signs may start as early as their 30s.”

The average length of perimenopause is four years, and it ends when you’re officially in menopause, meaning that you have gone without a period for 12 consecutive months. As a woman nears the end of perimenopause — generally in the last year or two — she may begin to have menopausal symptoms, such as experiencing consecutive months during which she doesn’t have a menstrual period.

Many of the symptoms of perimenopause are like those of premenstrual syndrome (PMS). “The difference is that PMS is usually predictable and is based on your menstrual cycle,” Dr. Hoppe says. “Perimenopausal symptoms are based on hormones that aren’t necessarily still following a typical 28-day cycle.” Additionally, while many perimenopausal symptoms, including hot flashes and night sweats, are similar to those experienced in menopause, Hoppe says you can tell the difference because you’ll still have a period during perimenopause. “It may be erratic,” she says, “but until you’ve gone one full year without having a period, you’re not in menopause.”

Key Symptoms of Perimenopause

Experiencing any, or all, of these typical and common symptoms, says Hoppe, is a tip-off that you may well be in perimenopause:

  • Irregular cycles, shorter intervals between cycles (every 24 to 26 days instead of every 28 days)
  • Skipped menstrual cycles (cycles every two to three months, then bleeding for two full weeks, rather than a normal flow each month)
  • Hot flashes
  • Night sweats
  • Trouble falling or staying asleep
  • Mood swings and/or irritability
  • Depression
  • Breast tenderness
  • Worsening of premenstrual syndrome
  • Decreased libido (sex drive)
  • Increased fatigue, which may cause difficulty concentrating or memory problems
  • Vaginal dryness; discomfort during sex
  • Urine leakage when coughing or sneezing
  • Urinary urgency (a pressing need to urinate more frequently)

Perimenopause: When to See Your Doctor

Abnormalities in menstrual bleeding during perimenopause may be the result of other conditions, such as hormonal imbalances or fibroids (noncancerous growths on the uterus). If any of the following situations occur, see your doctor to rule out causes other than perimenopause:

  • Much heavier than normal periods, or periods accompanied by blood clots
  • Periods lasting several days longer than usual
  • Spotting between periods
  • Spotting after sex
  • Periods occurring much closer together (by several days or weeks)

If you suspect you’re in perimenopause, it’s important to talk with your gynecologist. “Usually doctors can make a diagnosis based on symptoms,” Hoppe says. “They can also discuss possible treatments to alleviate those symptoms.” Although many physicians say they’re not necessary, there are diagnostic blood tests that may help determine whether you’re in perimenopause. Hoppe, though, warns that these tests are not always accurate: “A perimenopausal woman’s hormone levels are very erratic.”

Perimenopause and Fertility

Missed periods and recurring hot flashes are hard to overlook, but one indicator of perimenopause that is not so easy to spot is a decline in fertility. Although a woman in perimenopause may still get pregnant, the odds are greatly reduced. Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology at Yale University School of Medicine, emphasizes that if you don’t want to get pregnant, you must continue to use birth control until you officially hit menopause. “But if you do want to get pregnant,” she says, “you should see a doctor as soon as possible to preserve fertility in this stage.”

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Top things to know:

  • The length of your cycle is the number of days between periods, counting the first day of your period until the day before your next period starts
  • For adults not using any form of hormonal contraceptive or IUD, a typical cycle length ranges between 24 to 38 days
  • Using hormonal birth control or an IUD may change the length and variation of your cycle

The menstrual cycle is more than just your period—it’s the rhythmic changes of the your reproductive system. The changes throughout the menstrual cycle are governed by hormones, which include estrogen, progesterone, follicle stimulating hormone, testosterone and others. They trigger the growth of follicles in the ovaries, the release of an egg (ovulation), and the growth and shedding of the uterine lining (the period).

Having a menstrual cycle is like having an additional vital sign, like your blood pressure or your pulse (1). Your cycle can let you know when everything is working as usual, when your body is going through a change, or when something’s not as it should be. Some variation in your cycle is completely normal, but a cycle that is consistently out-of-range may be the first noticeable symptom of a treatable health condition.

What is a normal cycle length for people not on hormonal birth control?

Adult cycle length

A normal menstrual cycle length for an adult who is not using any form of hormonal contraceptive or IUD usually is between 24 to 38 days (2). This means that an adult will have between 11 to 13 menstrual cycles per year (2).

Variations of cycle lengths are normal (3). Within the same year, the length between the longest cycle and the shortest cycle can vary up to 9 days and still be considered within normal ranges. For example, a normal variation can be that one cycle is 25 days long, followed by a cycle that is 33 days long (4).

The majority of your cycles should fall within this range, but it’s normal to have some cycles be longer or shorter. The length of your cycle can be affected by factors like stress, diet, jet lag, or exercise—anything that affects your reproductive hormones (5-11).

Adolescent cycle length

The menstrual cycles of adolescents around the time of menarche (the first menstrual period) can vary greatly (12). It’s common for cycles to be somewhat irregular for a few years after your first period (13). This means your periods may not always come at the same time every cycle, and they may be somewhat different cycle-to-cycle. As you progress through adolescence, cycles become more regular to reflect adult cycle ranges, but may still be somewhat variable (12-14).

A normal menstrual cycle length for an adolescent usually is between 21 to 45 days, but may sometimes be longer or shorter (14).

At the onset of menarche, you may not ovulate with every cycle. However, as you progress through puberty, ovulation will likely happen in most of your cycles, which will help regulate your cycle length (12). Anovulatory cycles (a menstrual cycle in which an egg is not released from an ovaries) may make cycle lengths irregular and longer (1).

What is a normal cycle length for people on hormonal birth control (e.g. the pill, the ring, the patch)?

Hormonal birth control (HBC)—like the pill, the vaginal ring, or the patch—control the regulation of hormones like estrogen and progesterone within your body (15). When used correctly, the hormones in your HBC prevent your ovaries from preparing and releasing eggs. This stops your body’s usual hormonal cycling rhythm, allowing the HBC to control of the growth and shedding of your uterine lining (your period).

Your cycle length will depend on the type of HBC you use.

The pill

The birth control pill is commonly dosed in packs which provide a 28-day cycle, with 21 to 24 days containing active hormones, and four to seven days containing pills with no hormones or not taking any pills during those days (16). Bleeding will happen during these “no-hormone” days, due to the withdrawal of hormones. This will make your cycle regular and be approximately 28 days every cycle (15). When you first start taking the pill or if you take your pills inconsistently, you may experience spotting or breakthrough bleeding (15,16).

Continuous cycle pill packages also exist, with 90-day pill packs, or 365-day pill packs (15). These will make your cycle 3 months or a year long.

The ring and the patch

The vaginal ring and patch are often dosed across a four week cycle (15). The vaginal ring contains both estrogen and progesterone and is inserted into the vagina for 21 days and then removed for seven days, which then stimulates bleeding (15). The contraceptive patch is also used on a four-week schedule, with a new patch being applied for three weeks in a row, followed by one week of “no-patch” which stimulates withdrawal bleeding. Both of these methods will make your cycle regular and approximately 28 days long when used correctly (15).

Some people also decide to skip any bleeding while using HBC, by skipping over the “no-hormone” days. This will extend your cycle length until the end of your next pack of birth control pills or when you remove your ring or patch. Breakthrough bleeding or spotting is common with extended use (17).

What is a normal cycle length for people on progestin-only birth control (e.g. the mini pill, the shot, the implant)?

There are many different types of hormonal birth control, all containing differing types and levels of hormones. Some types of birth control do not contain any estrogens and only contain progestin—a synthetic form of progesterone (16). These methods include progestin-only pills (the mini pill), progestin injections (the shot), or progestin implants (16,18).

The mini pill

When using progestin-only birth control pills, you may not have a typical menstrual cycle. Progestin-only HBC pills affects reproductive hormonal cycling by often preventing the ovaries from preparing and releasing eggs (18,19). They also decrease and thin out the typical growth of the uterine lining. Many people experience irregular bleeding, reduced bleeding, shorter cycles, or amenorrhea (no menstrual period) with progestin-only pills, especially when pills are not taken at the same time every day (18).

The shot and the implant

The injection and the implant both work to stop ovulation, which prevents hormone cycling (18,20). Both of these contraception methods often impact menstrual cycles by either prolonging or shortening cycle lengths (18,20). Many people, particularly those who are using the contraceptive shot, over time will even experience amenorrhea (18,20,21). Many people experience unpredictable bleeding or spotting, though the frequency of bleeding days decreases over time (18,20-24). All of these changes are normal with these forms of birth control.

Intrauterine devices (IUDs) and your cycle

Cycle length and the hormonal intrauterine device (IUD)

When using a hormonal IUD, you may not have a typical cycle. Your cycle length and period may change depending upon which hormonal IUD you have and how long you’ve had it. IUDs with a lower progestin dose are less likely to suppress ovulation in comparison to IUDs with higher doses of progestin (25,26).

Cycles may be longer, or the same as before your IUD. Periods often get lighter and many people stop having their periods completely with the hormonal IUD (16). It’s also common to have light, irregular spotting, especially in the first few months (16). Your cycle length is also likely to change over time on the hormonal IUD (16).

Cycle length and the copper IUD

Having a copper IUD shouldn’t affect your cycle length since copper IUDs are non-hormonal, so you will experience the same fluctuations of estrogen and progesterone across your cycle as you did when you weren’t using a copper IUD (27). That means the majority of your cycles should be 24–38 days long, which is the normal range for cycle length in adults. Some people using a copper IUD may notice that your period is heavier and longer, or they may experience unscheduled spotting, but these side effects often improve over time (16,28).

Irregular cycles while using hormonal birth control

It’s not uncommon to have light spotting when you’ve just started using hormonal birth control or when you’ve recently switched to a new hormonal birth control. If you’ve been using your HBC for over three months and are still having common breakthrough bleeding, you might talk to your healthcare provider about switching your type or brand of HBC. Spotting can also occur if you have chosen not to skip your period while using HBC (17).

Using your HBC inconsistently or incorrectly can cause irregular bleeding. This will affect the length of your cycle and the heaviness of your period. People who use HBC incorrectly are also at an increased risk of pregnancy compared to people who use HBC correctly. Forgetting to take your HBC pills, taking placebo pills early, or removing a ring or patch early can increase pregnancy risk.

Why cycles vary

The length of your typical cycle is determined by your age, genes, health, body mass index (BMI), behaviors, and birth control methods (16,29).

If you’ve had your period for a few years, your cycle should generally be about the same length each cycle. You may still notice changes from time to time— the length of your cycle depends on your hormones, which can fluctuate due to factors like diet, stress, shift work, or taking an emergency contraception pill (the morning-after pill) (5-11,30).

Menstrual cycles can fluctuate when ovulation doesn’t occur. This is one reason why cycles vary greatly during adolescence, after giving birth, during breastfeeding, and during perimenopause (the menopausal transition) (31,32). People are less likely to ovulate consistently during these times.

Exercise, smoking cigarettes, and drinking alcohol may also affect cycle length and variation (33-38).

to track your menstrual cycle length.

Here’s what happens on every day of your menstrual cycle (roughly)

The average menstrual cycle is about 28 days.

There are also 28 days in the average month of February, which is handy enough considering we’ve decided to dedicate an entire month to all things periods.

And despite learning it off by heart for Leaving Cert biology, so many of us are still mildly confused as to what actually happens on each day of the menstrual cycle.

Questions like ‘when do I actually start ovulating?’ and ‘how long does it take the lining of the womb to build up?’ are specific to each person and the length of their individual cycle, but once you’ve got an idea as to the order in which these things happen, keeping track of your cycle can actually end up being really easy.

As we all know, no two menstrual cycles are going to be exactly the same.

So while the length of the average cycle is about 28 days, and the things that happens inside of the body are probably going to be similar enough to the below, some people have longer cycles and some people have significantly shorter ones.

The order of things that happen, however, is going to be very much the same irrespective of the how long or short your cycle is.

So, buckle up, brace yourself, work out what day you’re on in your cycle – and get ready to know exactly what’s going on in your uterus right now.

It’s good to track these things, y’know?

Day 1: The lining in your uterus starts breaking down and leaving the body. This is the first day of your period and your flow is probably going to be pretty heavy.

Day 2: Your hormone levels are fairly low at this stage, so you’re likely to be more irritable and easily annoyed. Your period, of course, continues.

Day 3: A lack of oestrogen can make you feel pretty upset, annoyed, and generally unhappy. Your period, of course, continues.

Day 4: During your period, follicles full of fluid start to appear on your ovaries. Each of these follicles contains an egg waiting to be released.

Day 5: One follicle containing an egg grows a lot larger than the rest. She waiting. She ready.

Day 6: The other follicles become smaller and disappear back into your ovaries, while the larger one containing an egg keeps growing.

Day 7: Your oestrogen levels continue to rise while the follicle containing the egg grows even larger.

Day 8: Your period has probably stopped by now. More oestrogen is finally starting to make you feel less irritable, thank god.

Day 9: Increased levels of oestrogen continue to make you feel less irritated, while also start to build up the lining in your womb again.

Day 10: The uterine lining starts preparing itself to nourish any incoming egg that might be fertilised. It thickens with the intention of latching an egg to it.

Day 11: The days just before the egg is released – and the day it is released – are your most fertile. So, usually between days 11 – 14, but again, this depends on how long your cycle is.

Day 12: Your oestrogen levels are probably at their highest now, making you feel pretty good, emotionally and physically. And fertile. Very fertile.

Day 13: The follicle is about to burst to release your egg.

Day 14: The egg is released – you’re ovulating! You’re also most likely to get pregnant if you have sex on this day (or the three days before).

Day 15: The burst follicle makes the uterine lining even thicker. Your egg begins its journey through the fallopian tube.

Day 16: Your egg is traveling along the fallopian tube.

Day 17: Your egg is traveling along the fallopian tube.

Day 18: Your egg is traveling along the fallopian tube.

Day 19: Your egg is still traveling along the fallopian tube.

Day 20: Your egg is still traveling along the fallopian tube.

Day 21: If your egg is joined by a sperm while travelling in the fallopian tube, boom – the egg is fertilised.

Day 22: If your egg is fertilised, it and the sperm continue along the fallopian tube to the uterus together. Remember, sperm can survive up to five days inside the female body.

Day 23: Your egg is almost at its destination – the womb.

Day 24: The fertilised egg attaches itself to the lining of the womb. If the egg isn’t fertilised, it breaks up.

Day 25: If your egg is fertilised, it will start to grow inside the womb. Massive congrats to all involved, you’re pregnant!

Day 26: Your hormone levels will have dropped a lot by now if you’re not pregnant. You’ll feel irritable (again) as your oestrogen decreases.

Day 27: The egg and uterine lining realise there’s no pregnancy. There’s no need for them anymore.

Day 28: Your unfertilised egg is waiting to be released in the form of your period.

Aaaand then you’re back to Day 1: the beginning of your menstruation cycle – and it’s time to do it all over again.

For the month of February, Her will be #OnTheRag.

We’ll be chatting all things periods, products, and pain as we delve deep inside the uterus to figure out why we bleed and – more importantly – how we cope.

We’ll also be talking to the experts about some of the period related conditions you have heard of – and all of the ones that you haven’t.

You can follow the rest of the #OnTheRag series here or follow our Instagram account for more period related content.

Want to get in touch? Email us at [email protected]

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Everything You Need to Know About Implantation

If you’re trying to get pregnant, you’ve probably done your fair share of Googling around implantation. And who could blame you? There are so many facts, questions and misconceptions swirling around about this incredible part of early pregnancy, it can be confusing. It’s time to set the record straight.

From timelines and testing to signs and symptoms, welcome to your one-stop shop on all things implantation.

What is implantation?

Though you won’t know you’re pregnant until you see those two pink lines, your body has been hard at work from the moment conception occurred. There’s a lot going on behind the scenes, and it all starts with implantation.

Implantation is the time when the fertilized egg successfully attaches and implants into the lining of the uterine wall. Although the egg may have been fertilized over a week before, it’s only after implantation that your body starts producing hCG—human chorionic gonadotropin, also known as the hormone that’s picked up by pregnancy tests.

When does implantation occur?

Sperm meets egg, and 40 weeks later, boom—it’s baby time! Sounds simple, right? Let’s back things up a bit, Biology 101 diagram-style.

Your ovary will release an egg into your fallopian tube, and if you had sex up to about a week prior to ovulation, sperm will be waiting in your fallopian tube. If fertilization is successful (yay!), the egg will begin to divide and travel down your tube toward your uterus. This process usually takes about a week; after that, implantation happens.

On average, implantation occurs about 8-10 days after ovulation, but it can happen as early as six and as late as 12. This means that for some women, implantation can occur around cycle day 20, while for others, it can be as late as day 26. This is part of the reason why counting your pregnancy weeks can be confusing.

How long does implantation last?

Although most pregnancies are 40 weeks, the process of implantation represents only a fraction of that time. Implantation typically lasts only a few days.

Once it’s complete and the fertilized egg—now called an embryo—is burrowed snugly inside your uterine wall, it will begin to produce hCG. Your body’s progesterone levels will also begin to rise, nourishing your uterine lining and preventing your period from beginning.

When to take a pregnancy test

Congratulations are in order, because now you’re officially pregnant! But don’t start peeing on a stick quite yet.

At the very earliest, the most sensitive of pregnancy tests will begin to show a positive result around 10 days past ovulation. Remember—ovulation, fertilization and implantation all work together in a perfect storm to result in a viable pregnancy. Each process has its own timeline, and each timeline differs for every woman, so what’s the norm for one woman may be different for another.

Even after an embryo successfully implants and begins producing hCG, it still takes a few days for the hormone to build to a high enough level to be detected by a pregnancy test.

Bottom line: save yourself time and money (not to mention your nerves!) and do your best to wait until the first day of your missed period to take a home pregnancy test in order to get an accurate reading.

What does implantation feel like?

There are a lot of misconceptions around whether or not a woman can actually feel implantation, so let’s set the record straight.

For most women, implantation feels like nothing at all. Some women report feeling implantation symptoms like mild cramping right around the time of implantation, but doctors aren’t certain if there’s even an association between the two. Do you best to stay cool, calm and collected during that two-week wait—just because you’re not feeling any implantation symptoms doesn’t mean it’s not happening.

Implantation symptoms

Since there’s no real correlation between when implantation happens and actual implantation symptoms, it’s best to think instead about implantation symptoms and how they relate to early pregnancy.

The most common implantation symptoms of early pregnancy include:

  • Implantation cramps. Some women may notice some minor cramping right around the time implantation is taking place. Though there’s no way to know for sure what’s actually going on, what we do know is that this cramping is due to the rise in progesterone that occurs during the second half of your cycle, whether you’re pregnant or not.
  • Implantation bleeding. Defined as a small amount of bleeding or spotting that can occur after conception and a few days before your menstrual cycle, implantation bleeding is light, stops on its own and doesn’t require treatment. It’s experienced by about a third of all pregnant women, although there’s no scientific data that proves the correlation between implantation and bleeding.
  • Nausea. Often some of the first tip-offs that something might be up, nausea and vomiting are popular—and unpleasant—implantation symptoms in early pregnancy. You may also start noticing changes in your appetite or that you’re getting grossed out by foods you previously loved.
  • Tender breasts. As your hormones change, you may start to notice your breasts starting to swell and feeling a lot more sensitive than usual.
  • Constipation and bloating. Things feeling like they’re starting to slow down? You can thank those pregnancy hormones yet again for constipation, a common implantation symptom. You may also notice you’re looking extra bloated during this time, so it might be time to break out the leggings.
  • Fatigue. Growing a baby is hard work! If you’re feeling more tired than usual, that’s often a sign of early pregnancy, caused by a rise in progesterone and increased blood volume.
  • Headaches. Another side effect of your increased blood volume during pregnancy, headaches are a common implantation symptom.
  • Mood swings. Notice yourself getting extra bothered by even the smallest of things? Mood swings are a common implantation sign during early pregnancy.

While implantation can be a bit of a mystery, you’ll know when it’s happened when you get that positive pregnancy test!

9 Early Signs of Pregnancy Before a Missed Period

You’ve ditched the birth control, started tracking your basal body temperature, and are hitting the sheets with your partner on the regular. Now you’re wondering: Are those symptoms you’re experiencing just PMS…or a tip-off that a bun’s in the oven?

If you just can’t wait to take a home pregnancy test, here are a few early signs of pregnancy before a missed period that may signal you’ve conceived.

Early Signs of Pregnancy

What are the early signs of pregnancy before a missed period?

Until you’ve produced a positive pregnancy test, there’s no way to know for sure you’re expecting. But experiencing any of these early pregnancy symptoms before your period normally arrives could mean you’ve hit baby bingo:

    • Tender breasts. Breasts are often the first body part to get the message when sperm meets egg. Some women’s breasts may feel tingly, sore, full and even painful to the touch within days of conception as estrogen levels start to rise. That said, these changes may not feel a whole lot different from PMS breasts — the changes simply stick around after your missed period.
    • Darkening areolas. Here’s one change in your breasts that can’t be confused with PMS: You may notice that your areolas (the circles around your nipples) darken and increase in diameter in the weeks following conception. You may also spot tiny goosebump-like bumps on your areolas (glands that will eventually lubricate your nursing nipples). Both of these changes can only be chalked up to pregnancy. That said, these early pregnancy signs can take weeks to show up, and not all women will notice them.
    • Fatigue. With all that work that goes into baby-making, plus higher levels of pregnancy hormones, the first four months of pregnancy can leave you feeling sluggish and sleepy. Keep in mind, though, a case of the sleepies can also mean you’re PMS-ing, over-stressed or not getting enough sleep.
    • Nausea. Just days after conception, you might start to get the queasies (a.k.a. morning sickness) due to a rush of new pregnancy hormones — although nausea is more likely to rear its ugly head four weeks later, when you’re around 6 weeks pregnant. Again, not everyone gets nauseous; it could also be a sign of PMS, a stomach bug or food poisoning.
    • Sensitivity to smell. Some newly pregnant women report a heightened sense of smell early on due to increased levels of estrogen. Once again, however, a keener-than-usual nose could also be a side effect of PMS.
    • Bloating. As all women know, bloating is one of the least-loved PMS symptoms — but it can also be a sign of increased pregnancy-induced progesterone that slows down your digestive tract, trapping gas inside your intestines.
  • Urinary frequency. If you suddenly find that you need to pee, like, all the time, it could be an early sign of pregnancy before your period. As soon as two weeks after conception — around the time you’d normally be getting your period — your kidneys start gearing up to filter out the extra waste in your blood from the baby on board. Your growing uterus also starts pushing on your bladder and your progesterone levels increase, resulting in a frequent (or constant) need to pee during pregnancy.
  • Elevated basal body temperature (BBT). If you’ve already been tracking your temperature, you know that it typically increases around the time of ovulation as progesterone levels rise; both drop when you have your period. But if you conceive, your body temperature will remain elevated from ovulation throughout your pregnancy. Count 18 or more consecutive days of elevated temperature post-ovulation, and it’s a good sign you’re plus-one.
  • Cervical mucus. Become a student of your cervical mucus? Then check it out now: If it becomes creamy and stays that way after ovulation, it’s a good sign you’ll have a positive pregnancy test.

Keep in mind, just because you’ve experienced some of these symptoms doesn’t mean you’re expecting. You could also have none of them at all and still go on to have a perfectly healthy pregnancy. Every woman is different, as is every pregnancy, so the only way to know you’re expecting for sure is to pee on a stick (sometimes more than once).

More on Getting Pregnant

Ovulation 11 Reasons You Might Miss Your Period Ovulation Trying to Have a Baby? Knowing How You Really Get Pregnant Can Help Ovulation 11 Reasons You Might Miss Your Period Ovulation Trying to Have a Baby? Knowing How You Really Get Pregnant Can Help

How soon can I get pregnancy symptoms before I miss my period?

Some women experience common early pregnancy symptoms like tender breasts, nausea, fatigue, sensitivity to smell or bloating within days after conception, or about a week-and-a-half before your period is scheduled to arrive. Other symptoms, like urinary frequency, may not show up until around the time your period’s supposed to make its appearance. You may not notice or be able to confirm other early pregnancy symptoms — like changes in your areolas, a consistently creamy vaginal discharge, and an elevated BBT — for a few weeks. And remember, plenty of women don’t experience any of these symptoms.

What’s the difference between pregnancy symptoms and PMS?

Most early pregnancy symptoms before your period are strikingly similar to the side effects of PMS. However you’ll only notice changes in your areolas (they’ll look darker, wider and bumpy) if you’re pregnant. A consistently elevated BBT and creamy vaginal discharge post-ovulation are also both relatively reliable signs of conception, but they’re certainly not fool-proof.

Otherwise, the only way to know if other early pregnancy symptoms (nausea, tender breasts, fatigue, bloating, sensitivity to smell, etc.) are due to a baby or PMS is to hold out until you can take a pregnancy test.

How long after I start feeling pregnancy symptoms can I take a home pregnancy test?

Although you may start to feel early pregnancy symptoms before your period, most women have to wait for an average of two weeks from the time they ovulate for a positive home pregnancy test result. Home pregnancy tests measure levels of human chorionic gonadotropin (hCG). This placenta-produced hormone makes its way into your urine almost immediately after an embryo begins implanting in your uterus, between six to 12 days after fertilization. You can start using most home pregnancy tests as soon as hCG can be detected in your urine — and hCG levels usually aren’t high enough to be picked up by a home pregnancy test until your period’s expected.

Can’t wait until then? Some HPTs promise 60 to 75 percent accuracy four to five days before you expect your period. Wait until your period and the rate jumps to 90 percent; wait another week and the results are 99 percent accurate.

Know that false negatives are much more common than false positives, so if the time for your period comes and goes without your monthly flow, check in with your health care provider. Either way, you’ll want to get a blood test to confirm your pregnancy status.

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Do I have to miss my period to be pregnant, or is it possible to be pregnant and get my period?

It’s possible to have light spotting and be pregnant. In fact, some newly expectant moms experience what’s known as implantation bleeding six to 12 days after conception. Here’s how to tell it’s implantation bleeding and not your period: Implantation bleeding is usually medium pink or light brown — it’s rarely period-red. It’s also spotty (much lighter than your period) and not continuous, lasting a few hours to a few days.

Spotting, however, can sometimes be a mid-cycle blip before your usual period, especially if you have an irregular or disrupted cycle. Mid-cycle brown discharge may also happen when you’re not pregnant because you’re reacting to a vaginal exam, a Pap smear or rough sex.

To make things even more confusing, you might even miss your period without being pregnant for a number of reasons, including being stressed, sick, working out too much or having a hormonal imbalance.

When in doubt, whip out that HPT and schedule a visit with your health care practitioner for a definitive answer. That way, you’ll know for sure whether you have a baby on the way!

Your Menstrual Cycle Phases—Explained

When it comes to your period, every month seems to look the same: Aunt Flo arrives on relatively the same day, allowing you to stock up on tampons and Midol to weather her visit. And once that week passes, you have three weeks of smooth sailing until you do it all over again. (Sigh.)

But your menstruation cycle is about more than just Mother Nature punishing you for five days and then giving you a free pass to wear white pants and avoid bloating for 23 days. In fact, there’s something different happening to your body practically every day of the cycle. And it’s generally the same for all women-at least those that aren’t on birth control. “When you’re taking birth control pills-or any form of hormonal birth control for that matter-it’s the BC talking, not your ovaries,” says Lauren F. Streicher, M.D., author of Sex Rx: Hormones, Health, and Your Best Sex Ever.

We’ve picked the minds of experts and scoured the latest research to give you a better understanding of how your body works during all 28 days of this cyclical process, offering everything from what color your blood should be to whether you’re ready to take a pregnancy test. Check it out.

Days 1 to 3

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Your menstrual cycle begins on the first day of your period. “The average menstrual cycle is 28 days, and the normal range is 21 to 35 days,” says Sara Gottfried, M.D., author of The Hormone Cure. Therefore, a full cycle is the first day of one period until the first day of your next period, she explains.

So why exactly are you bleeding? Simply put, if you’re not pregnant, your hormones are dropping and the lining of the uterus has reached peak thickness-so it’s time to shed. (Your homornes affect more than just your body. Read Your Brain On: Your Menstrual Cycle.)

Periods can be heavy, moderate, or light overall, but these first three days are typically the heaviest. “When menstrual blood is released, the body also releases anticoagulants-chemicals that allow the blood to flow and prevent it from clotting,” says Gottfried. “During the heaviest parts of your period, when there is a faster flow, sometimes there is not enough time for the anticoagulants to work, enabling clots to form.”

Days 4 to 6

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Every woman’s flow varies, but you should now be entering the lighter portion of your period. At this point in time, you may begin to notice the color of your blood changing from red to a shade that is closer to brown or black. “The color of period blood all has to deal with how long the blood has been sitting in your vagina,” says Streicher. The quicker it’s expelled, the closer to bright red it will be. (Didn’t get it this month? Find out if it’s Normal to Miss a Period?)

Days 7 to 10

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This is the day we all wait for. By day seven of your cycle, under normal circumstances, your period should be nearing its end, says Gottfried. Up next, she explains, is a complex interplay of hormones that cause egg-containing follicles to develop in the ovaries.

Over several days, these little follicles grow and prepare to release an egg. “As the eggs start to develop, they produce estrogen, so your overall estrogen levels will start to rise,” says Streicher. This increase in hormones causes the lining of your uterus to thicken in preparation for harboring a fertilized egg. And, eventually, one follicle will be recruited and mature in preparation for ovulation, says Gottfried.

Days 11 to 13

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Ovulation takes place in the middle of your cycle, typically day 14, so on day 11, you’re just days away from your most fertile span. “The best time to try for a baby is in the days leading up to and the day of ovulation,” says Gottfried. If you want to expand your family, now would be a good time to get busy, since sperm can survive for up to five days in a woman’s body.

“Estrogen is at its highest levels right before the midpoint of the average menstrual cycle-usually days 12 and 13,” says Gottfried. This means your fertility levels are high, your cervical mucous is changing, and the surviving follicle should be ready to release an egg. (But be sure you know these Fertility Myths: Separating Fact from Fiction.)

Day 14

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Your egg is released from the follicle-welcome to ovulation! “Testosterone levels are highest during the midpoint of the menstrual cycle, generally day 14, around the time of ovulation,” says Gottfried. Scientists believe testosterone levels rise around this time to increase and stimulate sexual activity in women and increase the likelihood of conception, she explains. (Women Become Mean Girls When Ovulating)

So how long are you fertile? While the exact number of prime days before or after ovulation is uncertain, research published in the New England Journal of Medicine states that estimates range from two days per menstrual cycle to 10 days or more (depending on whether your cycle is longer than the average 28 days). But it is known that you’re most fertile the day your egg is released, says Streicher.

Days 15 and 16

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Your egg is now on the move-typically taking several days to travel down the fallopian tube. “If the egg is fertilized by sperm on the way down, the fertilized egg will embed in the thickened lining of the uterus and a pregnancy will begin,” says Gottfried. “If the egg is not fertilized by the time it reaches the end of the fallopian tube, hormone levels change, signaling the next menstrual cycle to begin.”

Days 17 to 19

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“After ovulation occurs, estrogen levels drop, and progesterone levels start to rise in order to stabilize the growth of the uterine lining and to stimulate menstruation,” says Gottfried. Since you’re several days removed from ovulation, your progesterone levels are likely skyrocketing. “If embryo implantation doesn’t take place, progesterone and estrogen levels will plummet, signaling the body to shed the lining of the uterus and the remnants of the dead egg,” she explains.

Curious if you and your partner have conceived? Hold off on a trip to the drugstore-it’s still too soon for a pregnancy test to detect anything, says Streicher.

Days 20 to 23

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You’re now entering PMS territory. “PMS symptoms can start anywhere from one to two weeks before your period starts, and the symptoms usually go away once you start bleeding,” says Gottfried. That includes tender breasts, tiredness, bloating, headaches, changes in your appetite, irritability, depression, and-even though you’re not 13 anymore-acne flare-ups. In fact, 63 percent of acne-prone women experience premenstrual flares, according to a study published in the Archives of Dermatology. The zits begin to surface roughly a week before the onset of your period, and then subside as soon as bleeding begins. (Learn The Truth About PMS, Weight Gain, and “Fat Days.”)

Also worth noting: if you’re trying to get pregnant and want to confirm that you’ve ovulated, this is the perfect time for your doctor to check to see if your progesterone is elevated, says Streicher.

Days 24 to 26

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“The second highest peak of estrogen occurs around day 21 or 22 in a 28-day cycle,” says Gottfried. So while your progesterone levels will still be up there, around day 24, your estrogen levels will begin to dip again.

Unfortunately, the 25 and 26 days in your cycle tend to be a struggle because PMS is now in full force, explains Streicher-so don’t be surprised if feeling bloated is all you can think about. Just remember to stay calm because you’re not alone: Research published in the journal Human Reproduction found that it’s extremely common for women suffering from PMS to crave high carbohydrate sweets-and the cravings only increase as your symptoms worsen.

Keep in mind, though, that you’re probably not eating as much you think you are. Research published in the journal Physiology & Behavior found that during PMS most women only consume roughly 200 calories more per day than they normally would. (And food can actually work in your favor. Find out what to Eat to Beat PMS.)

Days 27 to 28

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The good news? Your PMS symptoms should pretty much be gone by now. The bad news is the bleeding starts very soon if you’re not pregnant. (Break out the tampons and Midol, again!) “Those surges of estrogen have been thickening the lining of the uterus, so if there is no pregnancy, it’s time for the endometrium (which is a fancy term for the top layer of your uterus) to shed,” says Streicher.

  • By Marie Gartee

The video below is a fantastic resource for girls and women of all ages and cultures, covering the changes that come with puberty and giving educational insight into why the period occurs and what they can expect when it does.

What is a menstrual cycle?

The menstrual cycle is a cycle of bodily changes controlled by female hormones that cause a regular bleed. This bleed, which usually occurs monthly, comes from the uterus (womb) and flows out from the vagina. ‘Period’, ‘menstruation’ or ‘menses’ are all words used to describe the blood loss women experience at this time.

The menstrual cycle begins at menarche (the first period) and ends with menopause (the final period). Every woman’s cycle is unique and individual. The average age of menarche in Western countries is 12-13 years, but it can start as early as nine and as late as 16. If your perio-ds have not started by 16-17, you should see your doctor to investigate why they haven’t started. Most women reach menopause between 45 and 55 years, and the average age of menopause for women from a Western country is 51-52 years.

Why do you have a menstrual cycle?

The role of the menstrual cycle is to prepare the body for pregnancy. When a pregnancy does not occur, a period results. On average, a woman in Australia will have 450-500 periods in her lifetime.

How does the menstrual cycle occur?

The menstrual cycle occurs because of a complex relationship between hormones from the brain and ovaries. This leads to the development and release of an egg from the ovary (ovulation) and growth of the internal lining (endometrium) of the uterus, to prepare it for pregnancy.

When the hormones signal to the uterus that there is no pregnancy, the lining starts to break down and separate from the wall of the uterus, beginning the period. Once the lining has separated from the wall of the uterus, the cycle starts again.

How long is a normal menstrual cycle?

Menstrual cycles vary between women and are measured from the first day of the period to the first day of the next period. In adolescents, a cycle might be as long as 45 days; however, by the time a woman reaches her 20s-30s, a cycle is usually between 21 and 38 days.

Periods change over a woman’s lifetime. Sometimes they change after pregnancy, and in some women they get heavier in perimenopause (the transition time from regular periods to a woman’s final period) and lighter and shorter closer to the final period or menopause.

What to expect during your period?

The bleeding during a period can vary from one cycle to another in quality and quantity, from a small amount to a heavy loss, and can vary in colour from black/brown to bright red. The period can last from four to eight days, and most women lose less than 80ml of blood (about one-third of a cup) in total.

The flow changes over the course of your period and can be heavier for the first three days and then lighter in the next few days. The blood colour will reflect this change in flow rate and can change from dark or bright red initially, to dark brown later in the cycle. The period contains blood, mucous and some cells from the lining of the uterus. Some small clots may be normal, but if the clots become frequent or larger, see your doctor.

In some women, at the time of ovulation (release of an egg from the ovary), which usually occurs about two weeks before the next period, there might be some slight spotting and/or pain. This is because of a normal change in some of the hormones with ovulation. If pain or bleeding at the time of ovulation frequently lasts longer than three days, you need to see your doctor.

The below table shows when a woman with a 28-day cycle would most likely ovulate.

For a 28 day cycle:

Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7
Day 8 Day 9 Day 10 Day 11 Day 12 Day 13 Day 14
Day 15 Day 16 Day 17 Day 18 Day 19 Day 20 Day 21
Day 22 Day 23 Day 24 Day 25 Day 26 Day 27 Day 28

Odour (smell)

Most women have some odour related to bleeding, but little is known about why it is sometimes stronger. It might be related to the length of time you leave your sanitary pad on or tampon in. If the odour is so strong it worries you, discuss your concerns with your doctor.

Bowel habits

The body makes substances called prostaglandins (a natural body chemical), especially just before, and during the first few days of, the period. These prostaglandins cause muscle contractions in internal organs and, in combination with the hormonal pattern in the premenstrual week, can cause changes in bowel habits. Some women notice difficulty in opening their bowels just prior to their period, as if they are constipated, and then when the period starts the bowel motions become loose and more frequent.

Signs or symptoms before your period

Premenstrual symptoms may occur in the one to two weeks before your period. Symptoms can include irritability, mood changes, bloating, pimples and tiredness. Normally these symptoms might be irritating, but would not interfere with your day-to-day activities. More commonly, around two out of three women experience some breast pain during their cycle. Symptoms appear to peak in adolescence and again in perimenopause, possibly because of fluctuating hormone levels.

If you are having regular periods, but have spotting of blood for a week or so before each period, see your doctor, as there can be several reasons for this.

Premenstrual symptoms usually settle when the period starts, or during the first two to three days of the period. Period pain that interferes with your everyday life is not normal. Around 15-20% of women who have periods experience symptoms so severe that their lifestyle is affected and they cannot function properly. If this occurs, seek help from your doctor.

Sanitary products

Pads

Pads, sanitary pads or napkins are made of absorbent material and come in a range of thicknesses and shapes. Pads might need to be changed every three to four hours on the heaviest day. If you find that using pads irritates your vulva, you may need to use pads that are made from 100% cotton and are scent-free. Reusable, environmentally friendly pads are available.

Tampons

Tampons are absorbent ‘plugs’ made of cotton, or a combination of cotton and a synthetic material. Tampons are inserted into the vagina and are available in various sizes. They can be used by all ages and should be changed every three to four hours.

Very rarely, toxic shock syndrome can occur when using tampons. This is due to a rapid growth of normal bacteria releasing a toxin, which leads to symptoms of ‘shock’, such as feeling unwell, fever, rash, diarrhoea and headache. Never keep a tampon inserted in your vagina for more than eight hours and always wash your hands before inserting one.

Menstrual cup

The menstrual cup has been available for many years and is long lasting (up to 5-10 years), but is used by a very small number of women. Made from either rubber (latex), silicone or thermoplastic rubbers, the menstrual cup sits in the vagina over the cervix and collects the menstrual flow. It should be washed at least every 12 hours using only fresh or soapy water. Menstrual cups are considered environmentally friendly as they are reusable. There are several menstrual cups available, including Lunette and Femmecup.

When to see your doctor

There are many reasons you might need to see your doctor about your periods, including:

  • changes in the pattern of your periods
  • increasingly heavy periods
  • long periods of more than eight days
  • periods that come fewer than three weeks apart
  • periods coming more than two to three months apart
  • painful periods that cause you to stay home
  • bleeding between periods
  • bleeding after intercourse.

Your menstrual cycle is a normal process for your body. Each woman experiences her menstrual cycle differently, most without any difficulties. If there is any change in your cycle that worries you, see your doctor.

  1. Mihm M, Gangooly S, Muttukrishna S. The normal menstrual cycle. Anim Reprod Sci. 2011;124:229–36.

  2. Speroff L, Glass R, Kase N. Regulation of the menstrual cycle. In: Clinical gynecologic endocrinology and infertility. 7th edn. Philadelphia: Lippincott, Williams and Wilkins, 2005.

Last updated 26 September 2019 — Last reviewed 10 July 2018

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at July 2018.

Note: We’re using a 28-day calendar, but it’s completely normal for your menstrual cycle to last anywhere from 21 to 35 days.

Day 1 of your period marks the first day of your menstrual cycle. Many women believe their cycle starts at the end of their period, but this is not the case. On Day 1 of your cycle, estrogen levels are at an all-time low. Estrogen is a good thing; it’s associated with increased activity of serotonin, a feel-good chemical in the brain.

The average period lasts about five days — although anywhere from two to seven days is considered normal — and yields about 35 millilitres or just over an ounce of liquid.

As your estrogen levels slowly increase, you may feel more relaxed than you have over the last few days when PMS symptoms may have been wreaking havoc with your emotions.

By Day 7, your period is probably gone, and your mood should have returned to normal. In fact, you may be feeling a surge of energy as your ovaries release more and more estrogen. Higher levels of estrogen also make you feel more sociable, optimistic and motivated.

Estrogen levels will continue to rise from Days 8-11, and by Days 12-13, they’re at an all-time high. These high levels of estrogen give you more confidence, make your skin glow, and probably make you feel flirtier. It isn’t a coincidence: These high estrogen levels set off a surge of hormones that result in ovulation on Day 14.

The egg’s only goal is to get fertilized, so all kinds of things are happening with your mind and body around ovulation. Keep in mind that your libido is extra high, and you’re more adventurous and impulsive as your hormone levels max out and you start to search for a mate.

Research actually shows that women are attracted to men with more masculine facial features at this time in their cycle as they are subconsciously seeking a virile partner. Men also find women more attractive when they are ovulating.

But unless you’re trying for a baby, be sure to use contraception as you are highly susceptible to pregnancy. In fact, you’re most fertile one to two days before ovulation, so be sure you’re covered then as well. There’s a sudden drop in estrogen immediately after ovulation, which can make you feel irritable or emotional for a couple of days until estrogen and progesterone levels start to rise again.

The main purpose of progesterone at this point in your cycle is to help make your uterus a nice, comfortable place for an egg to implant. The combination of increased estrogen and progesterone levels often leads to breast tenderness.

If the egg hasn’t been fertilized, your ovaries will slowly stop producing estrogen and progesterone near the end of Week 3.

As progesterone and estrogen levels drop, some women experience symptoms of premenstrual syndrome, which can include irritability, anger or sadness. Some women experience mild PMS, others severe and some not at all.

Your body may be more susceptible to pain, so you’d be wise to avoid waxing, tweezing or getting tattooed at this time.

Hungry? At this point in your cycle, your estrogen — and therefore serotonin — levels are bottoming out. That means you’re craving carbohydrates, which increase serotonin. Luckily, your metabolism is working a little faster leading up to your period, which means you may consume 100 to 200 more calories guilt-free — but don’t overdo it.

Ouch! Many women experience menstrual cramps a day or two before their period begins. Your body has begun producing prostaglandins, which help your uterus contract. Over-the-counter meds like ibuprofen can really help as can heating pads and hot water bottles.

What a Short Menstrual Cycle Says About Your Pregnancy Odds

Flavio Coelho/Getty Images

We’ve all heard that women are supposed to have 28-day cycles between periods…but we also know that no two women are alike when it comes to matters like these. Case in point: Some of us got our first periods at age 9 while others went into the teen years having never menstruated.

But did you know that a woman who has a 26-day cycle might have a different level of fertility than someone who gets her period every 30 days? And that the age at which you had your first period could have an effect on your baby-making odds as well?

According to a 2016 study from Boston University, both length of menstrual cycles and onset of menstruation can affect fertility.

RELATED: Finding Your Most Fertile Days: A 3-Step Guide

These findings appear in Annals of Epidemiology and are based on the study of more than 2,100 women who were trying to conceive. The women responded to questionnaires detailing characteristics of their menstrual cycles, and after taking a good look at the data, researchers determined that women with short cycles (26 days or fewer) had lower odds of getting pregnant. Similarly, women who started menstruated before age 12 had reduced fertility when compared to women who started menstruating between 12 and 13 years old.

According to the study’s authors, a short menstrual cycle could signal a narrow fertile window or ovarian aging, and may also reflect a lack of ovulation (we don’t have to tell you how important ovulation is when you’re trying to get pregnant!).

RELATED: Get Pregnant Faster: Your 7-Step Plan

“In agreement with previous studies, we found that short menstrual cycles were associated with reduced fecundability among North American pregnancy planners, independent of age, irregular cycles, and history of reproductive illness,” the research team said, according to Futurity. “These results indicate that menstrual cycle characteristics may serve as markers of fertility potential among pregnancy planners.”

While the link between early onset of menstruation and fertility isn’t quite explained, it’s an interesting one to consider—and Boston University’s Pregnancy Study Online initiative is ongoing, so hopefully we’ll have a clear picture of how this works soon.

Does this mean that women who have short cycles or got their periods early in life can’t get pregnant? No! Like most other studies, this one represents one slice of the population and these results definitely shouldn’t get you down if you’re trying to conceive.

RELATED: 8 Facts About Your Cycle and Conception

  • By Zara Husaini Hanawalt

Day 26 menstrual cycle

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