Today, I want to walk you through the four distinct phases of the menstrual cycle, explain what’s happening in your body during each one, and offer practical advice for managing symptoms. This knowledge becomes especially valuable as you approach perimenopause, when cycles often become less predictable.
Before we dive into the phases, let’s clarify what constitutes a typical menstrual cycle. While we often hear that a cycle is 28 days, the reality is much more varied. A healthy cycle can range anywhere from 21 to 35 days.
If your period arrives a few days earlier or later than expected occasionally, that’s usually nothing to worry about. However, if you notice your cycle length changing dramatically from month to month, or if you go three months without a period (and you’re not pregnant or on hormonal birth control), it’s time to schedule an appointment. Similarly, bleeding that lasts longer than seven days warrants a conversation with your healthcare provider.
It’s important to note that if you’re using hormonal birth control, your body isn’t actually going through these natural cycle phases. The bleeding you experience while on birth control is withdrawal bleeding, not a true period.
Now, let’s explore each phase of the natural menstrual cycle:
What’s happening physiologically: The menstrual phase begins on the first day of your period and continues until bleeding stops (typically 3-7 days). During this time, the lining of your uterus is shedding because the egg from your previous cycle wasn’t fertilized. This shedding is what causes menstrual bleeding.
From a hormonal perspective, estrogen, progesterone, and testosterone are at their lowest levels during this phase. Your body is also releasing prostaglandins, hormone-like substances that cause the uterus to contract.
Common symptoms:
Self-care tips: Here in central Indiana, where many of us juggle busy family and work lives, finding time for self-care can be challenging. However, this is precisely when your body needs extra support.
I recommend:
What’s happening physiologically: The follicular phase actually overlaps with the menstrual phase—it also begins on day one of your period but continues beyond it, typically lasting 10-14 days total. During this phase, your pituitary gland releases follicle-stimulating hormone (FSH), which signals your ovaries to prepare eggs for release.
As your period ends, estrogen levels begin to rise, peaking right before ovulation. The lining of your uterus also starts to thicken again in preparation for a potential pregnancy.
Common experiences:
Self-care tips: Many of my patients in Westfield and Carmel find this is their most productive time of the month. If this rings true for you, consider:
What’s happening physiologically: The ovulatory phase is brief—typically lasting just 24-48 hours around day 14 of a 28-day cycle. During this time, luteinizing hormone (LH) surges, triggering the release of a mature egg from your ovary into the fallopian tube.
This is when you’re most fertile, and your estrogen and testosterone levels reach their peak. These hormone peaks can increase libido for many people.
Common symptoms:
Self-care tips:
What’s happening physiologically: The luteal phase begins after ovulation and lasts approximately 10-14 days, ending just before your next period starts. After releasing an egg, the empty follicle transforms into what’s called the corpus luteum, which produces progesterone.
Progesterone levels rise significantly during this phase, preparing the uterine lining for potential implantation of a fertilized egg. If pregnancy doesn’t occur, both estrogen and progesterone levels drop toward the end of this phase, triggering the start of your next period.
Common symptoms:
Self-care tips: Many of my patients throughout Hamilton County find this phase the most challenging. Here’s what I recommend:
While cycle fluctuations are normal, certain symptoms warrant a conversation with your healthcare provider:
For those in Westfield, Carmel, Noblesville, and surrounding areas, our team at Via Women’s Health Collective specializes in addressing these concerns with compassionate, personalized care.
As you approach perimenopause (typically in your 40s), you may notice changes in your cycle length and flow. The phases we’ve discussed may become less predictable as your hormones fluctuate more dramatically.
Common perimenopausal changes include:
Understanding your typical cycle pattern now can help you recognize when these changes begin. At Via Women’s Health Collective, we support women through all reproductive transitions, from adolescence through menopause and beyond.
Your menstrual cycle is much more than just your period—it’s a complex interplay of hormones that affects virtually every system in your body. By tracking and understanding your unique patterns, you can better predict symptoms, plan activities, and recognize when changes might indicate a need for medical attention.
Whether you’re a teenager just beginning your menstrual journey, someone in their reproductive years trying to conceive (or avoid pregnancy), or a perimenopausal woman navigating changing cycles, this knowledge is a powerful tool for health management.
Have questions about your cycle or experiencing symptoms that concern you? Our team at Via Women’s Health Collective is here to help. Call our Westfield office at (317) 707-9446 to schedule an appointment.
Dr. Taylor Hahn is a board-certified OB/GYN specializing in women’s sexual health and menopause care at Via Women’s Health Collective. She is passionate about empowering women through education and compassionate care.
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