Understanding Your Menstrual Cycle: Insights from Dr. Hazel Wallace

Understanding the menstrual cycle is essential for women to manage their health effectively. Dr. Hazel Wallace provides a comprehensive overview of menstrual health, detailing the typical phases of a cycle, common symptoms, and potential disorders such as PMS and endometriosis.

Exploring the Menstrual Cycle

A typical menstrual cycle lasts around 28 days and is divided into two main phases: the follicular phase and the luteal phase. Ovulation, which usually occurs around day 14, separates these two phases. According to Dr. Wallace, “Day one of the cycle is the first day of bleeding. The last day is the day before your next period.”

During the follicular phase, menstruation takes place, characterized by low levels of the hormones estrogen and progesterone. Dr. Wallace explains, “That’s so we can shed the lining of our womb.” Following menstruation, estrogen levels rise, while progesterone remains low. This increase in estrogen can enhance physical performance, making the days leading up to ovulation optimal for intense workouts.

After ovulation, estrogen levels briefly decrease, before both estrogen and progesterone rise together during the luteal phase. While estrogen continues to provide benefits, the presence of progesterone may lead to symptoms such as water retention and mood fluctuations. Dr. Wallace notes that women might experience decreased motivation during this phase. Recognizing where one is in the cycle can help manage exercise and overall well-being.

Identify Normal and Abnormal Symptoms

Determining what constitutes a normal menstrual cycle can be challenging, as every woman is different. Dr. Wallace emphasizes that while variations exist, certain symptoms should not be overlooked. “Red flags include very painful periods, heavy periods, irregular bleeding, and severe mood changes,” she states. If symptoms disrupt daily life, such as affecting work or relationships, it may be time to consult a healthcare professional.

Indicators of a healthy cycle include a duration of 21 to 35 days and a bleeding phase lasting between three to seven days, with five days being the average. Occasional cramping is normal; however, it should not hinder daily activities.

Understanding PMS and PMDD

Premenstrual syndrome (PMS) affects many women, with symptoms ranging from mild mood swings to more severe physical discomfort. Dr. Wallace describes PMS as including bloating, irritability, and breast tenderness. “If your symptoms are affecting your daily life, that is called premenstrual syndrome,” she explains.

On the more severe end of the spectrum is premenstrual dysphoric disorder (PMDD), which impacts 3 to 8 percent of women. Symptoms of PMDD can include significant mood swings, irritability, and even suicidal thoughts. Dr. Wallace advises those experiencing severe symptoms to track their experiences for three cycles and consult a doctor for potential diagnosis and treatment options, which may include medication and therapy.

Managing Symptoms and Related Conditions

To alleviate PMS symptoms, Dr. Wallace recommends maintaining a balanced diet with regular meals. Avoiding large gaps between meals can help stabilize blood sugar levels and energy. Furthermore, she suggests limiting caffeine, alcohol, and salt to reduce bloating and sleep disturbances. While the link between PMS and sugar is not fully established, consuming complex carbohydrates like whole grains and vegetables may provide steadier energy levels.

Exercise has been shown to relieve PMS symptoms, with even gentle movement having a positive impact. Supplements such as chasteberry, calcium, vitamin D, and magnesium may also help ease symptoms.

Skin issues, particularly acne, often arise during the premenstrual phase due to hormonal fluctuations. Increased progesterone can heighten sebum production, leading to clogged pores. Treatments like salicylic acid and topical retinol may be beneficial; however, persistent acne should be discussed with a healthcare provider.

Common Disorders: PCOS and Endometriosis

Polycystic ovary syndrome (PCOS) affects approximately one in ten women. Symptoms include irregular cycles and excessive hair growth in atypical areas. Diagnosis typically involves blood tests and ultrasound scans, and lifestyle changes can greatly improve symptoms.

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, often resulting in debilitating pain. Dr. Wallace notes that women may experience severe menstrual pain and other symptoms, including pain during intercourse. Diagnosis usually requires keyhole surgery, and while treatment options exist, including hormonal medications and surgery, the condition can recur.

Adenomyosis, a condition where endometrial tissue grows into the muscular wall of the uterus, also leads to heavy bleeding and chronic pain. Dr. Wallace highlights the need for more research into this condition, which can be diagnosed via ultrasound or MRI. Treatment may involve hormonal or surgical options.

In summary, understanding the menstrual cycle and its associated symptoms can empower women to take charge of their health. By recognizing normal variations and seeking medical advice when needed, women can better manage their menstrual health and improve their quality of life.