Menstruation is a natural part of the lives of girls and women, yet it is still surrounded by many myths, uncertainties and sometimes shame. It is not just about a few days of bleeding each month. Menstruation is one part of the menstrual cycle – a complex process during which hormone levels in the body change and the body prepares for a possible pregnancy.
We count the menstrual cycle from the first day of menstruation to the day before the next menstruation begins. It is often said to last 28 days, but in reality its length is highly individual. In adults, a regular cycle of roughly 21 to 35 days is considered normal. Menstruation itself usually lasts two to seven days. A large study of more than 600,000 cycles in women also showed that exactly 28 days applied to only 13 % of them. The "textbook" cycle is therefore by no means the only correct norm.
What happens during the cycle?
The menstrual cycle is usually described in four phases. Each of them is accompanied by certain hormonal changes, which can also affect energy, mood, concentration or the need for rest. Their course is, however, highly individual – some women perceive the changes strongly, others hardly at all.
The menstrual phase begins on the first day of bleeding. If pregnancy has not occurred, oestrogen and progesterone levels fall and the uterus begins to shed its lining. In this phase, lower energy, fatigue, pain in the lower abdomen, greater sensitivity or mood changes may appear. Some women may therefore also feel an increased need for rest, while others function without significant limitations.
The follicular phase begins together with menstruation and continues until ovulation. During it, an egg matures in the ovary and oestrogen levels gradually rise. This may be associated with more energy, better mood or easier concentration. It is the length of the follicular phase that tends to be the most variable and significantly influences the overall length of the cycle.
Ovulation refers to the release of a mature egg from the ovary. Oestrogen levels are high during this period and testosterone levels also rise briefly. Some women may perceive more energy, motivation or confidence, others notice no significant change. Ovulation is often associated with the fourteenth day of the cycle, but in reality its timing varies and may shift from one cycle to another.
The luteal phase follows ovulation. Progesterone levels in particular rise and the uterine lining prepares for a possible pregnancy. If it does not occur, progesterone and oestrogen levels begin to fall. Especially towards the end of this phase, fatigue, a greater need for sleep, mood changes, breast tenderness, cravings or water retention may appear. We refer to this set of physical and psychological difficulties as premenstrual syndrome, or PMS.
Every cycle can be different
The course of the cycle is influenced by age, genetics, health, stress, sleep, diet, illness, significant changes in body weight, and overall physical and mental strain. Especially in the first years after the first menstruation, the cycle may be irregular, because the hormonal system is still gradually settling.
The differences do not concern only the length of the cycle or the heaviness of bleeding. The physical and psychological manifestations are also individual. Some girls and women barely perceive the changes during the month, while others notice shifts in energy, mood, concentration, appetite or the need for rest. There is therefore no single universal course by which all should be judged.
It can be useful to track your own cycle and notice what is usual for a given person. It is advisable to pay attention especially when the cycle suddenly changes markedly, menstruation is repeatedly missed, bleeding is very heavy, or pain significantly limits everyday functioning. Such difficulties do not need to be merely "endured" – it is advisable to turn to a gynaecologist.
Menstruation is not an illness nor something to be ashamed of. It is a natural bodily process, a significant part of a woman's life, and at the same time important information about how the body functions. The better we understand it and the more openly we can talk about it, the more easily we can create an environment in which girls and women feel safe and have the opportunity to ask for support when they need it.
