By Jandra Mueller, DPT, MS, PHRC Encinitas
In case you missed it, here is Period Health 101: Everything You Should Have Learned in 6th Grade, But Didn’t, Part 1.
What are your hormones doing throughout the various phases?
To understand this, refer to the chart below. It is actually helpful in understanding the hormonal shifts throughout the various phases of your cycle and how these hormonal shifts affect your body.
This chart is referring to someone with an average 28 day cycle, so if your cycle is shorter or longer, these phases will also shift. At the bottom of the chart it is depicting the days of your cycle from day zero to day 28. Day one through seven is your menses or your period. Day zero to 14 is your follicular phase, your menses fall into this range, day 14 is ovulation, and day 15 to 28 is the luteal phase.
In the column above this, you are looking at the lining of the uterus, followed by the ovarian hormones, the pituitary hormones, body temperature, and events in the ovary.
From day one through seven the egg that was not fertilized gets shed out of your body along with the uterine lining, and your sex hormones (estrogen and progesterone) are at their lowest levels. This is what stimulated the shedding of your lining and your period in the first place. At the same time, your pituitary gland is releasing low levels (of varying amounts) of LH and FSH which is stimulating the ovarian follicles to mature and create a new dominant follicle which will go on to release an egg at ovulation.
As the follicle grows and matures, it is releasing estradiol so you can see that begin to rise during day 10 to 14 and you may notice some of that cervical mucus or fertile mucus as discharge during this time; this is getting into your fertile time. Beginning around day 11, you see that your LH begins to steadily rise and peak at about day 13 or 14 and drop suddenly. This is what stimulates the follicle to release an egg, the event of ovulation. There is also a peak of FSH at this time. LH may continue to rise even if you don’t ovulate for various reasons, so if you are using ovulation strips, you may see this peak, but still not ovulate.
On day 14, once the follicle releases the egg, that follicle now quickly changes and in four short days, it is a completely different structure with its own blood supply and is the only structure producing progesterone. As Dr. Lara Briden reminds us in her book many times, if you don’t ovulate, you do not produce progesterone. Your body temperature spikes at ovulation because progesterone helps to elevate body temperature and this is in part thanks to your thyroid gland. This is the basis of taking your temperature every morning before you get up when you practice the fertility awareness method which we will discuss in a later blog.
After ovulation, your estrogen levels lower somewhat but progesterone continues to elevate until the very last days and then they both dip down to low levels if pregnancy does not occur. The drop in these hormones then signals the uterine lining to become thin and shed and you are back at day one, your period. This cycle will continue to repeat itself until it is disrupted with pregnancy, menopause, hormonal birth control, or other conditions.
So, that is normal. There are SO many factors that make this process run efficiently and deficiencies or excess can cause problems. So before you run to your doctor and get on OCPs to regulate your period, take a look at the chart below and see where exactly you’re having issues, track your cycle, and be a detective and gain more insight as to the possible causes of why you are having these issues in the first place.
- Briden L, Prior JC. Period Repair Manual: Natural Treatment for Better Hormones and Better Periods. Place of publication not identified: Greenpeak Publishing; 2018.
Are you unable to come see us in person? We offer virtual physical therapy appointments too!
Due to COVID-19, we understand people may prefer to utilize our services from their homes. We also understand that many people do not have access to pelvic floor physical therapy and we are here to help! The Pelvic Health and Rehabilitation Center is a multi-city company of highly trained and specialized pelvic floor physical therapists committed to helping people optimize their pelvic health and eliminate pelvic pain and dysfunction. We are here for you and ready to help, whether it is in-person or online.
Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. The cost for this service is $85.00 per 30 minutes. For more information and to schedule, please visit our digital healthcare page.
In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Master’s degree in Integrative Health and Nutrition. She offers services such as hormone testing via the DUTCH test, comprehensive stool testing for gastrointestinal health concerns, and integrative health coaching and meal planning. For more information about her services and to schedule, please visit our Integrative Health website page.
PHRC is also offering individualized movement sessions, hosted by Karah Charette, DPT. Karah is a pelvic floor physical therapist at the Berkeley and San Francisco locations. She is certified in classical mat and reformer Pilates, as well as a registered 200 hour Ashtanga Vinyasa yoga teacher. There are 30 min and 60 min sessions options where you can: (1) Consult on what type of Pilates or yoga class would be appropriate to participate in (2) Review ways to modify poses to fit your individual needs and (3) Create a synthesis of your home exercise program into a movement flow. To schedule a 1-on-1 appointment call us at (510) 922-9836
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