Menstrual Cycle
During menstruation (a period), a woman’s body sheds the lining of the uterus (womb). Menstrual blood flows from the uterus through the cervix and out of the body through the vagina. Most menstrual periods last from three to seven days.
Menstruation is part of the menstrual cycle, which prepares a woman’s body for pregnancy each month. Hormones rise and fall (sometimes dramatically) during the month to make the menstrual cycle happen.
According to the US Department of Health and Human Services, in the first half of the cycle, levels of estrogen (the female hormone) start to rise and make the lining of the uterus grow and thicken. At the same time, an egg in one of the ovaries starts to mature. About halfway through a typical twenty-eight-day cycle, the egg leaves the ovary in a process called ovulation.
The egg then travels through the fallopian tube to the uterus. Hormone levels rise and prepare the uterine lining for pregnancy. A woman is most likely to become pregnant the three days before ovulation or on the day of ovulation. If the egg is fertilized by a man’s sperm cell and attaches to the uterine wall, the woman becomes pregnant. If the egg is not fertilized, it will break apart, after which hormone levels drop and the thickened uterine lining is shed.
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During the menstrual cycle, many women experience symptoms associated with premenstrual syndrome (PMS), a normal part of the cycle. Typically PMS is characterized by anxiety, irritability, and mood swings. Most likely, these symptoms are related to the balance between estrogen and progesterone produced in the body. If there’s more estrogen, anxiety occurs. If there’s more progesterone, depression may be a bigger factor.
Cramping is one of the most common discomforts women have during menstruation. There are two kinds of cramping, spasmodic and congestive. Spasmodic cramping is probably caused by chemicals that affect muscle tension. Some of these chemicals cause relaxation and some cause constriction. Congestive cramping causes the body to retain fluids and salt.
Fatigue, headaches, and sugar cravings are also related to PMS. Women may crave chocolate, white bread, white rice, pastries, and noodles as well. (Judging from these symptoms, I’m guessing I might frequently suffer from PMS.) These food cravings may be due to higher hormone levels before menstruation, which cause increased responsiveness to insulin, at which point women may experience symptoms of low blood sugar. In these circumstances, a consistent diet that includes complex carbohydrates can provide a steady flow of energy to the brain and counter the ups and downs of blood sugar variations.
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Other symptoms of PMS include acne, bloating, weight gain, tender or swollen breasts, cramping, constipation, nausea, and mood swings. During pregnancy and for some time after childbirth, menstruation is normally suspended, although not always. (However, pregnancy carries with it its own series of delightful complications, including swollen and tender breasts, fatigue, tiredness, nausea and morning sickness, backaches, headaches, frequent urination, stretch marks, and food cravings.)
There are also several complications that can make menstruation very painful for women or girls. Premenstrual water retention frequently accompanies menstruation for many women. Water retention makes a woman feel bloated—it causes her breasts to become uncomfortably enlarged, her feet or ankles to swell, and her stomach to feel thick.
According to the website Medline Plus, while some pain (cramps) during menstruation is normal, excessive pain is not.
The medical term for excessively painful periods is dysmenorrhea. There are two general types of dysmenorrhea. Primary dysmenorrhea refers to menstrual pain that occurs in otherwise healthy women. This type of pain is not related to any specific problems with the uterus or other pelvic organs. Secondary dysmenorrhea is menstrual pain that is attributed to some underlying disease or structural abnormality, either within or outside the uterus.
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The hormone prostaglandin, produced in the uterus, is thought to be a factor in primary dysmenorrhea. This hormone causes the uterus to contract, and levels tend to be much higher in women with severe menstrual pain than in women who experience mild or no menstrual pain.
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With all that complicated activity going on, I’m pretty glad I’m a man. About all I have to do is make sure I’m fed and maintain my body and I’m generally okay. Because of all those complex goings-on in a woman’s body, significant side effects can manifest themselves during her cycle.
Hormone Mania
The hormone fluctuations a woman experiences frequently cause her to act easily hurt, angry, irritable, unreasonable, or illogical at times. I don’t know if this cycle contributes to or promotes disharmony in the home, but I have my suspicions. I haven’t done any scientific studies to confirm my theory, but after having had a wife and a teenage daughter in the home together, I do know there were specific times each month when things seemed pretty chaotic and frazzled around the home front. Much like coming face-to-face with a grizzly bear in the wilderness, there have been times where I had to follow the “do not make eye contact—back away slowly” strategy to escape physical harm. Real or perceived slights and hurts were magnified, and expectations seemed (at least to me and my son) unrealistic. The women in our home were irritable, easily hurt and offended, defensive, and even downright angry during this time. They acted illogically and irrationally and even appeared to suffer from temporary insanity. It’s no mystery to me why ancient tribes used to segregate women from the clan during this time of the month.
Having grown up with two sisters and then having a wife and daughter in my home, I’ve seen my share of irrational and illogical behavior over the years—much of it unexplainable even by the women themselves. Just recently I made the mistake of mentioning that a particular blouse my wife had bought was less than flattering on her—it made her look heavier than she actually was. You’d think that after twenty-seven years, I’d be smart enough to know better. However, I thought I was doing her a favor mentioning this just before we went out to dinner because she had previously gotten mad at me for
not
mentioning that an article of clothing didn’t look good on her. She had just lost a lot of weight and looked really good. I didn’t think she would want to wear something unflattering. But after reattaching my head from having it bitten off, I was pretty confused about what I’m supposed to say and what I’m not supposed to say (not to mention when).
Many women I speak with tell me funny stories about their friends’ behavior during this time of the month. This kind of irrational behavior seems pretty consistent in most women. One woman said:
Emotional Phases of a Woman’s Cycle
First Week (after her period)
• Self-directed, disciplined
• Task oriented and focused
Second Week
• Estrogen levels off and declines slightly
• Blue skies—summer-like feelings, happy, hopeful, easygoing
• Sense of well-being, inner strength
• Less assertive, more realistic goals than first week
• Peaceful, not bothered by small irritations, enjoys loveliness of environment
• Creative with positive energy
• Feels reasonable and tolerant of self and others
Ovulation (approximately ten days following end of period)
• Estrogen rising again, progesterone rising
• Passive, introverted, or patiently accepting and open-minded
• Content and nurturing feelings
• Especially amorous and interested in lovemaking
• Might have odd cravings (as in pregnancy)
Third Week
• Rising estrogen and sharp rise in progesterone
• Subject to variable feelings—some good, some bad, up and down
• Moody and gloomy—sense of feeling doomed, apprehensive without reason
• Slowing down—disliking pressure
• Feeling immobilized, doubting herself
• Discouraged, less friendly and outgoing
• Losing sense of well-being, longing for more peaceful life
• Impatient with others, losing interest in goals and plans, bored
• Lacking coordination and clarity of thought (PMS “fog”)
Fourth Week: Premenstrual (estrogen and progesterone levels fall)
• Very reactive, irritable, touchy, nervous, unable to concentrate
• Moody, unstable, quarrelsome, unpredictable outbursts of emotions
• Sensitive to noise, food binges, craves sweets or spices
• Childlike, unreasonable
• Lack of self-confidence, loss of interest in hobbies and tasks
• Melancholy, withdrawn, awkward, shaky
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Hormones do strange things to our bodies and minds. We feel ugly and fat, and our self-image and self-esteem are affected, sometimes dramatically. We don’t know why we feel sad or irritable. Our feelings are on our shoulders, ready to be hurt at any given moment or opportunity. There may or may not be a reason. Our emotions are all over the board. Logic does not have a place. So please just listen and empathize as best you can. Don’t try to fix it.
Our friends Ron and Terri tell the story of the time they were driving down the road on the way to church. They had not been married long and Ron was still learning the ways of Terri’s moods and cycles. For no reason at all Terri suddenly began crying. Ron asked her, “Why are you crying?”
“I don’t know,” she sobbed.
Nonplussed, Ron asked, “Well, what should I do?”
“I don’t know. . . . Ask God.”
After several minutes of solemn prayer, Ron looked at her in all seriousness and said, “He doesn’t know either.”
Terri burst into laughter and the storm soon passed.
Unexpected Behavior
A recent study conducted on the neurochemistry of the brain during menstruation shows there may be some significant biological causes for a woman’s erratic behavior during menses.
Using a technique called functional magnetic resonance imaging (fMRI), the scientists looked at blood oxygen patterns in women’s brains at two stages of their monthly cycle, just before menstruation and around a week after. The scans showed that all of the women in the experiment had more electrical activity in the frontal lobe of the brain during the premenstrual phase, the time when most women might experience PMS.
Most often when PMS was present, the scientists saw dramatic differences between the scans. They found that when a woman feels good, “her deep limbic system is calm and cool and she has good activity in her temporal lobes and prefrontal cortex. Right before her period, when she feels the worst, her deep limbic system is often overactive and she has poor activity in her temporal lobes and prefrontal cortex.”
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According to studies performed by Dr. Daniel G. Amen, PMS symptoms are detectable in brain scans. His studies show that two distinct PMS patterns occur that respond to different treatments. One pattern involved increased deep limbic activity, often accompanied by excessive activity in the temporal lobe. This activity correlates with cyclic mood changes.
When the limbic system is more active on the left side, it is often associated with anger, irritability, and expressed negative emotion. When it is more active on the right side, it is often associated with sadness, emotional withdrawal, anxiety, and repressed negative emotion. Left-sided abnormalities are more a problem for other people (outwardly directed anger and irritability), while right-sided overactivity is more an internal problem.
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