What Really Happens During Your Menstrual Cycle

menstrual cycle

By Katherine Melzer Ross, MD, GENESIS Fertility & Reproductive Medicine

This article is the first contribution in a series that will address female fertility and gynecologic issues that women face.

While many of us received standard health education classes during our formative years, I frequently encounter patients seeking more information about the basic concepts of female fertility, as well as the more complicated matters. Let’s start with the basics… 

Here’s what really happens during your menstrual cycle:

Our monthly cycle can seem like a hormonal roller coaster, but it’s actually a carefully timed sequence of synchronized events tightly regulated by signals from the brain. Each month, our brain sends signals to the ovaries to begin recruiting eggs, which are found within fluid-containing pockets called follicles in the ovaries.

Eventually, one egg follicle becomes the strongest of them all (we call this a “dominant follicle”), and this is the egg that becomes destined to ovulate and be released that month. (In rare instances, two egg follicles win the race and two eggs are released – this is how non-identical twins occur naturally.) Once the egg is released from the ovary, it is picked up by the nearby fallopian tube. The fallopian tube serves as a transporter, bringing the egg into the tube, where it can be fertilized by sperm.

If fertilization occurs, the resulting embryo is further transported through the fallopian tube into the uterus (the womb) where it implants and grows into a pregnancy. During the time that the ovary has been growing an egg, the uterus has had its own responsibility: to grow a healthy uterine lining where an embryo can implant. Since the uterus serves to provide growing pregnancies with nutrients and blood supply, it is important that the uterine lining develops properly.

In the absence of pregnancy, the uterine lining is shed each month and this is where the menstrual cycle comes from.
There are a lot of hormones involved behind the scenes, which is why women generally experience moodiness, breast tenderness, headaches and bloating (among other symptoms) at certain times of the month. These are all side effects of fluctuations in your body’s hormones.

For certain women, a regular monthly cycle does not occur. This can happen with conditions such as polycystic ovarian syndrome, hypothalamic amenorrhea, and thyroid disease (among other reasons). Or women can have very heavy periods with conditions such as fibroids. These are topics that will be addressed in future contributions. If there is anything you would like to learn more about, message BELLA NYC on Facebook or leave us a comment below.

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