Hormones During the Menstrual Cycle

Nearly every woman will menstruate for approximately 40 years of her life. Yet despite this universal experience, most women lack a deep understanding of what's actually happening in their bodies each month. We're taught that periods happen, perhaps given basic information about hygiene products, but rarely are we educated about the intricate hormonal dance occurring throughout our cycle, how these hormonal shifts affect our energy and mood, or how we can actively support our bodies through nutrition and lifestyle choices during each phase. This knowledge gap means many women suffer unnecessarily through symptoms they assume are "just part of being a woman," when in reality, understanding your cycle can transform how you feel, help you recognize when something is wrong, and empower you to advocate for your own health.

Understanding your menstrual cycle is one of the most empowering things you can do for your health. Your cycle is a monthly symphony of hormones working together to prepare your body for potential pregnancy, and learning how to support your body through each phase can dramatically improve how you feel physically and emotionally.

The Menstrual Cycle

Menstruation, commonly called a period, is a natural biological process affecting women during their reproductive years. Each month, the body prepares for a potential pregnancy by thickening the uterus lining with blood and tissue. When pregnancy doesn't occur, this lining is shed through the vagina, typically lasting between 3 and 7 days.

This cycle usually begins during puberty (around ages 10-15) and continues until menopause (typically in the late 40s to early 50s). The average cycle lasts about 28 days, though anywhere from 21 to 35 days is considered normal.

Phase	What’s happening in your body	Your Feelings/Activities
Menstrual	Lining of the uterus is shed. Lasts 2-7 days (4-5 days is optimal). Progesterone levels drop. Estrogen is low. Unfertilized egg is released.	Low energy during this cycle. You feel withdrawn and tired.It’s a good time to take it easy. Introduce quiet into the day. Give yourself some down time and relaxation. Not a good time to make plans or to go on a first date. Listen to your intuition and gut. Feelings are heightened. It’s easy to multi-task, see facts and emotions, and make good decision. Stay away from intense exercise. Journal.
Follicular	Begins on 1st day of menstruation and ends at ovulation. At the start of the menstrual cycle, Follicle-Stimulating Hormone (FSH) is released by the pituitary gland to stimulate follicles in the ovaries to develop. Estrogen rises steadily and peaks during the proliferative phase as follicles grow. Progesterone is low.	There’s a boost in memory, mood and brain skills. Testosterone builds libido. Estrogen makes skin look better, makes you more social and wanting to get out. Good time to brainstorm, strategize, and plan. Ideal time to exercise (cardio and strength training).
Ovulatory	As estrogen levels increase, the pituitary gland releases Luteinizing Hormone (LH). A surge in LH triggers ovulation, which marks the release of a mature egg from one of the ovaries (2-3 days). There is a Pasty creamy discharge around ovulation.	High sex drive. You look and feel more attractive.High energy level. Great time to exercise (HIT and cardio), socialize, go on a job interview, have an important conversation, network, or ask for a raise.
Luteal	The luteal phase is the second half of the menstrual cycle, occurring after ovulation and before menstruation, characterized by high progesterone levels that thicken the uterine lining to prepare for a potential pregnancy. Estrogen drops. If an egg is not fertilized after ovulation, the ruptured follicle transforms into a structure called the corpus luteum, which produces progesterone. This is when PMS may hit.	Still on high from last phase. As progesterone increases, avoid the social scene. It’s a good time for nesting, organizing, taking care of the ‘to do’ list. Good time to complete tasks that require attention to detail. Take care of yourself through meditation, baths, sleep, yoga. PMS, cravings, and fluid retention are common. Do strength training.

Signs of a Hormone Imbalance During the Menstrual Cycle

Hormonal imbalances can be managed in a variety of ways once you know which hormones are affected. If you want your hormones tested and your physician does not think it is warranted, you can always have the test taken on your own at your own expense. Many of these are direct-to-consumer (DTC) tests processed by CLIA-certified labs, which means the results meet clinical lab standards. Keep in mind that a physician should review lab results, so make sure you bring them to your doctor for review. The symptoms below will give you an idea of what hormones might be off (without needing a test). There are plenty of ways to manage these symptoms through diet, exercise, lifestyle, and alternative therapies such as acupuncture.

• Changes in menstrual fluid (Bright red is ideal)

  • dark, heavy, clotting = high estrogen, low progesterone

  • Thin blood, pink in color =  low estrogen.

  • Brown = low progesterone

• Irregular or skipped periods- estrogen low

• Spotting between periods could indicate a growth in the uterus.

  • Fibroids and endometriosis – estrogen dominance

  • Medication can cause spotting.

  • Vaginal dryness can cause spotting (torn tissue)

• PMS symptoms that are disruptive- low progesterone or low thyroid function

• Abnormally long or short cycles- May be luteal phase defects due to low progesterone. Track your menstrual cycle (Period Tracker is a free app).

Menstrual Symptoms Requiring Physician Evaluation

These symptoms during menstruation signal potential underlying issues like endometriosis, fibroids, polyps, thyroid disorders, or bleeding disorders, and warrant prompt medical assessment to prevent complications like anemia or infertility.​

• Heavy bleeding (menorrhagia): Soaking through 1+ pad/tampon per hour for several hours, passing clots greater than a quarter-sized, or periods lasting more than 7 days.

  Potential Risks: severe iron-deficiency anemia; may indicate fibroids, polyps, or clotting disorders.

• Severe cramps disabling daily activities: Pain not relieved by OTC meds (ibuprofen), lasting more than 2–3 days, or worsening over time.

  Potential Risks: Possible endometriosis, fibroids, or adenomyosis.​

• Bleeding between periods or post-menopause: Spotting/bleeding outside cycle or after menopause.

  Potential Risks: Possible endometrial hyperplasia (thickening of the uterine lining), polyps, cancer, or hormonal disruption; requires ultrasound/biopsy.​

• Irregular cycles with symptoms: Periods <21 or >35 days, absent for>3 months (not pregnant), combined with pain/bleeding.

  Potential Risks: May signal PCOS, thyroid issues, or premature ovarian insufficiency affecting fertility/health.​

• Pain radiating to legs/back or with nausea/vomiting: Severe lower back/leg pain or GI upset during flow.

  Potential Risks: Could indicate endometriosis implants or ovarian cysts pressing on nerves/organs.​

• Fever, chills, or foul discharge with pain: Systemic infection signs.

  Potential Risks: pelvic inflammatory disease (PID) or endometritis requiring antibiotics.​

• Sudden symptom worsening or new in adulthood: Cramps heavier after age 25–30 or new heavy flow.

  Potential Risks: Often structural (fibroids grow with age) or endocrine changes needing imaging/hormone tests.​

• Anemia symptoms with flow: Dizziness, rapid heartbeat, shortness of breath, and extreme fatigue.

  Potential Risks: Acute blood loss; ER if unstable, otherwise gynecology follow-up.​

  
  

If you want to learn more about fibroids or PCOS, check out my blogs on each at https://www.reformingyou.com/blog/categories/hormones

Nutrition that Supports Hormones During the Menstrual Cycle

Eating to support the menstrual cycle is primarily about maintaining steady blood sugar and adequate micronutrients, and making slight shifts in calories and macros as hormones fluctuate throughout the month.​

Big-picture principles

• Prioritize an overall whole‑food pattern: vegetables, fruits, high‑quality protein, healthy fats (especially omega‑3s), and high‑fiber carbs.​ (See my workshop on Nutrition at www.Reformingyou.com/Resources)

• Keep blood sugar stable with protein, fat, and fiber at each meal (eat each before eating carbs or sugar to lower the glycemic index); insulin sensitivity is higher in the follicular/ovulatory phases and lower in the luteal phase.​

• Adjust calories and carbs slightly up in the luteal phase to match higher energy needs and reduce binge‑type cravings.​

Phase	Emphasize	Reduce
Menstrual (bleeding days)	Iron‑rich foods (red meat, shellfish, legumes, leafy greens) with vitamin C sources to support absorption. Magnesium‑rich foods (pumpkin seeds, nuts, leafy greens, 70% or more dark chocolate) to help with cramps, tension, and sleep. Warm, easy‑to‑digest meals (soups, stews, slow‑cooked meats, cooked veggies) if cramps and GI sensitivity are prominent. Balance blood sugar by eating protein, fat and fiber before carbs. Vitamin rich foods and high-quality protein. Mineral rich bone broth is a great option. Fewer calories, more raw fermented plant based foods to metabolize estrogen efficiently.	Sodium, alcohol, and ultra‑processed, high‑sugar foods, which can worsen inflammation, cramps, and bloating. (You may crave these foods)
Follicular phase (from period end to ovulation)	Lean protein (fish, poultry, eggs, tofu) and plenty of non‑starchy vegetables; this supports muscle repair and gut health. Moderate, high‑fiber carbs (oats, quinoa, beans, fruit) to match better carb tolerance and support estrogen metabolism via the gut. Fermented foods and prebiotic fibers (kimchi, sauerkraut, asparagus, oats, flax) to support estrogen clearance. Higher carb intake if exercising more.	Ultra-processed foods and added sugar.
Ovulatory phase (around mid‑cycle)	High‑fiber vegetables (especially crucifers: broccoli, Brussels sprouts, cabbage) and fruits to help clear estrogen and support liver detox pathways. Adequate protein and omega‑3 fats (fatty fish, flax, chia, walnuts) to support ovulation, inflammation control, and egg quality if conception is a goal.	Caffein and alcohol are processed through the liver which is handling a higher estrogen load.
Luteal phase (PMS phase, post‑ovulation to next period)	Focus on complex carbs (sweet potatoes, oats, beans) plus protein and fat to match a higher appetite and reduce binges. High‑fiber, cruciferous and leafy vegetables support hormone metabolism and bowel regularity, which help with bloating. Magnesium and B‑vitamin–rich foods (pumpkin seeds, nuts, legumes, whole grains, eggs) for mood, sleep, and water balance. Omega-3 rich foods such as Salmon and walnuts. For cravings: choose “upgraded” options like dark chocolate, fruit, nuts, and seeds over ultra‑processed sweets; this supports blood sugar and mineral intake.	Ultra-processed foods and added sugar.

If all of this seems overwhelming, I am offering a free optimal health strategy session on my website at: https://www.reformingyou.com/service-page/free-optimal-health-strategy-session.

I will educate, listen to, and support you on your journey to optimal health!

Moving Forward

Understanding how to manage your hormones during the reproductive years can make menopause significantly easier. Hormone imbalances are managed at age 20 in similar ways as they are at age 50. The only difference is that the hormone changes vary. Knowledge is power, and we all need to learn to be our own advocates for our health.