Guest blog by Kymberly Kelly M.S., L.Ac. the founder of Ren Wellness.
Understanding the Phases of the Cycle
Menstrual cycles tell us a lot about general health and what is going on in the body that might not otherwise be obvious. It can reveal health issues that might be leading to a difficult time falling pregnant. Often, many think that their cycles are healthy just because they get a period every month, but truly tracking the cycle reveals that there are issues with the hormones or that ovulation is not actually happening when you think it is. The periods are the manifestation of a cascade of events that are happening all cycle long “under the surface.” In this overview, we are going to discuss what a healthy cycle looks like and how to track it.
Cycles can vary a bit in length. While 28 days is considered “textbook,” Anywhere between 26-34 days is healthy. However, knowing where ovulation falls, is key to understanding how long the phases are and if they are the right length to develop a properly mature follicle (where the egg is growing) and can then support an embryo through to implantation. It is also to crucial to understanding when your “fertile window” is.
Tracking your cycle with Basal Body Temperature (BBT) Ovulation predicator Kit (OPK) and checking fluids will give you the information you need to have intercourse at the right time, confirm ovulation is happening and make sure that all phases of the cycle are within a healthy range.
The cycle is divided into 4 phases:
The menstrual phase is the “period.” It should last between 3-7 days and will often start off with a slightly heavier flow that then reduces to a moderate-light flow until it tapers off. While it might start off a bit darker, the color overall should be a vibrant red, not too dark and not too pale. There should not be pain with the period! A “dull or heavy” sensation is normal as the lining sheds, but cramping that keeps you in bed or requires pain relievers is not healthy and should be addressed. Small, painless clots
(dime-sized) can be expected, but large or painful clots (larger than a quarter) can indicate stagnation in the uterus. Some spotting might appear in the hours before the full flow begins, but several days of spotting before or after the period, or at mid-cycle should also be addressed.
The Follicular Phase is named so because during this first half of the cycle, a follicle is growing in the ovary which houses the egg. As the follicle grows, estrogen will rise and signal the lining to grow and fertile fluids to appear. The entire follicular phase should be between 14-20 days. If it is too short or too long, the egg might not be mature enough, or might be overly mature and will not fertilize. You start counting from day 1 of the period through to ovulation.
The ovulatory phase is not a singular event. It is a phase lasting some days. Just prior to ovulation, you will notice watery fluids that turn into a stretchy consistency. This is normal and healthy and indicates your LH (Lutenizing Hormone) is surging, which will induce ovulation. This is the ideal time for intercourse if you are trying to conceive. In addition to checking for fertile fluids, you can monitor this surge with an OPK (Ovulation Predictor Kit) from the drug store. After ovulation, vaginal discharge will turn to a more whitish, opaque consistency (like lotion) indicating the fertile window is closed. The transition from LH surge until the ovulation takes place is 12-72 hours.
After ovulation, the luteal phase is named so because the “corpus luteum” is the sac that is left over after the egg has been released from the follicle. This sac releases progesterone throughout the luteal phase and sustains the second half of the cycle. During this phase, a fertilized embryo needs enough time to travel down the fallopian tube, find a nice place to implant, and embed itself in the lining as it’s cells multiply and grow. This phase should last between 12-14 days, so there is sufficient time for all of these processes to take place. You start tracking the luteal phase as soon as temperatures have risen, confirming ovulation.
How to Track the Cycle
Understanding how to track these phases is very helpful when you are trying to conceive. You may have 28 day cycles and think everything is as it should be, but when you actually break it down and start tracking, you discover that your follicular phase is long, the luteal phase is short and your ovulation has not been happening when you think it is, and you’ve been missing the window! This is not an uncommon scenario!
To track the cycle, get a Digital Thermometer and Ovulation Predictor Kit from the drugstore. There are several free apps which offer cycle tracking. Your basal temperature must be taken first thing in the morning, after at least 4 hours of uninterrupted sleep and before you stir or get up at all, so keep it on your bedside table. Take the temperature as soon as you wake up and record it. You will start each cycle on the first day of full flow of the period. This is considered day 1. Take your temperature every single day.
Around CD 8, you can begin using your Ovulation Predictor Kit. When the LH surge is detected, record that as well. Within 12-72 hours, you will notice your temperature rises about .4 degrees (F) which confirms the ovulation took place. This new, higher temperature should maintain throughout the second half of the cycle, and drop just before the next period begins. In the case of a pregnancy, it will stay up and may even rise a little more. You start tracking the luteal phase as soon as temperatures have risen, confirming ovulation.
Now, many things can affect your temperature such as travel, restlessness, sickness, etc., so don’t worry too much about each individual temperature. We are more concerned with tracking trends, patterns and confirming ovulation.
This is a basic overview of cycle tracking. For more in-depth information about cycle tracking, I recommend the book “Taking Charge of your Fertility” by Toni Weschler.
If you discover through tracking that any of the phases are too long or too short, or if you find that the temperatures are not rising after mid-cycle, or if you have a lot of symptoms in the pre-menstrual phase or during your period such as PMS, migraines or painful periods, it is best to see your doctor or acupuncturist to determine the cause and correct it. Hormones CAN be re-balanced so that the cycles are healthy and comfortable and your fertility is improved.
Kymberly Kelly M.S., L.Ac. is the founder of Ren Wellness, a Women’s Health and Fertility Center based in Chinese Medicine in New York City.