Over the last few years in my career, I have come to realize that so many of us have such little knowledge about how our bodies and hormones work. And I include myself into that grouping. I grew up attending public school which was very limited in what was taught in health class about our bodies. And a lot of what we learned was presented in a way that was heavily based in fear. Let’s scare all of the kids about their bodies so they never partake or engage in adult behaviors; and they never make mistakes or learn from those mistakes.

Fear mongering, in my opinion, is likely the worst way of educating individuals. I think we can give our young people a bit more credit and arm them with more accurate information. And thus, allow them to make decisions, make mistakes, and be supported along the way. That’s how we all learn right?

Any who, you’re probably wondering what any of this has to do with the menstrual cycle. I work with many adolescents who know very little about their bodies. They do not understand their hormonal shifts, and how that can impact their emotions, their feelings towards their bodies, their nutritional needs. They have no baseline for these changes that happen during puberty and thus their brains think everything is permanent. And that is a terrifying thought to them. For example, the thought “I am bloated, therefore that means my body has gained all this weight and I am now unworthy and need to diet”. When in reality they’re bloated because they are bloated and their hormones are shifting throughout the month. And in a few days their body will no longer be bloated. Or the idea that discomfort comes and goes in life, as the shifts in their hormones do and we are just along for the ride. Or even the idea of rest, and needing more of it during various times of the cycle and allowing our bodies to have that rest without trying to compare to others.

All of these are conversations are ones that I have with clients, adult or adolescent. Understanding our menstrual cycle is a large piece of being in tune with our bodies and recognizing their needs. I felt no greater joy than when one of my adolescent clients told me in session that she has learned more about her body with me than she ever has in her health class. We deserve to understand how our bodies work. And not just when we are trying to get pregnant or working towards fertility. Yes, it’s important then. But, not everyone wants to have a baby or is working towards fertility and they still deserve to know what’s going on inside.

For many years (too many in fact) research has been focused on those assigned male at birth. Research surrounding sleep patterns, nutrition, rest needs, exercise, etc. Has all been heavily based upon men and their hormonal shifts. Individuals assigned female at birth have a 28-41 day cycle of fluctuating hormones. Those assigned male at birth have a 24 hour cycle. It was just this year that scientists started using real blood in period products testing instead of some man made re-engineered blood. Tell me how that makes sense. I have to chuckle a little though because it’s so absurd it’s actually comical.

But, I digress, you came here to learn about the menstrual cycle so let’s dive into some hormone information instead of my rambling!

Types of Hormones and the Endocrine System:

The body has many hormones that take care of a slew of bodily functions. Here are a few for reference and where they are produced/released from:

1. Hypothalamus: GnRH (Gonadotropin Releasing Hormone)

2.Pituitary Gland: LH, FSH (Luteinizing Hormone, Follicle Stimulating Hormone)

3.Thymus: important during puberty for immune health (produces T-cells)

4.Pineal Gland: Melatonin

5. Testes: Testosterone

6. Ovaries: Estrogen, Progesterone

7. Thyroid: T3, T4, Calcitonin, responsible for metabolism

8.Parathyroid: Hormones responsible for bone development

9. Adrenal Glands: Cortisol, Adrenaline, responsible for blood sugar management

balance, and distribution of stored fat

10. Pancreas: Insulin, blood sugar balance, digestion

11.GI tract: Ghrelin, Gastrin, Motilin, Leptin, Serotonin

Hormone Hierarchy

There is a hierarchy of sorts when it comes to hormones.

Tier One, the foundation, consists of Oxytocin, Insulin and Cortisol.

Tier Two consists of Pregnenolone and DHEA.

Tier Three then consists of the remainders Thyroid Hormones, Melatonin, Progesterone, Estrogens and Testosterone.

All the hormones are connected in a delicate system. And the stability of the Tier Three hormones relies heavily on the balance of the hormones in the bottom two tiers.

Hormones are responsible for a multitude of functions including the following:

· Metabolism

· Brain function

· Cardiovascular Health

· Bone Density

· Appetite Changes

· Immune Health

· Reproductive Health

Hormones can be impacted by many variables and factors. These include the following:

· Alcohol Usage

· Liver Function

· Digestive Function

· Fiber Intake

· Blood Sugar Balance

· Inflammation

· Nutritional Deficiencies

· Exercise

· Stress Management

So why do I, a dietitian, care about hormones? Well, there is a lot that we can do with nutrition to help support balance our hormones. For example, Vitamin B6 helps produce some hormones and neurotransmitters. Magnesium is required to metabolize estrogen. Zinc aids in progesterone and sperm production. And Vitamin C supports adrenal function. Dietitians play a pivotal role in supporting clients with hormone concerns!

Fun Fact: All hormones are the same for males and females up until puberty. Once puberty hits nutritional needs and hormonal factors begin to go down different paths.

Nutrition and hormone restoration is incredibly important for individuals going through eating disorder recovery as well.

Reproductive Hormones and The Menstrual Cycle

Issues with our reproductive hormones can include the following concerns:

Infertility
Fibroids
Endometriosis/Adenomyosis
PCOS
Ovarian Cysts
PMS/mood fluctuations/PMDD
Low neurotransmitter production
Period pain
Acne
Hair loss/excessive growth
Reduced muscle mass
Reduced libido

The image you see here is the Female HPG axis (Right track). It visually presents the domino effect of how hormones are produced. Everything begins in the Hypothalamus in the brain. The Hypothalamus release Gonadotropin Releasing Hormone, or GnRH. GnRH acts on the Anterior Pituitary gland to produce Luteinizing Hormone and Follicle Stimulating Hormone. These two hormones act on the ovaries to produce estrogen and progesterone. Then the cycle continues.

*Obtained from The Food Medic book The Female Factor*

In the diagram above you can see how the hormones respectively shift throughout the menstrual cycle. The menstrual cycle is broken into 2 phases. The Follicular Phase (remember F for first) and the Luteal Phase (remember L for last).

In the Follicular Phase, the first half is the period bleed. During the period both estrogen and progesterone levels are low. Towards the middle of the Follicular Phase the FSH levels begin to rise and start stimulating the follicles in the ovaries, preparing them for ovulation. Ovulation is when an egg is released from the ovary for fertilization by sperm. Ovulation lasts for a few days and is the time of the month that an individual is the most fertile. The period will end before ovulation occurs. Some symptoms one may experience leading up to ovulation can include an increase in cervical mucus, basal body temperature, increase in sex drive, or bloating. After ovulation, the Luteal Phase begins. Estrogen levels drop and progesterone begins to increase. The increase in progesterone prepares the lining of the uterus for implantation. If an egg is not fertilized, then the lining sheds and you have a period, thus beginning the cycle again. If progesterone levels do not rise adequately, individuals can struggle w/ light periods and fertility issues.

General Review

Menstrual (Follicular): the period, all hormone levels are low as the body sheds the uterine lining

Follicular Phase: Hormone levels rise as the body prepares to release an egg for ovulation

Ovulation: Many hormones peak and rapidly drop to trigger the egg release

Luteal: Potentially pregnant (if engaged in sexual activity), the uterus lining thickens to nourish and grow a potentially fertilized egg

FSH (Follicle Stimulating Hormone): the hormone responsible for stimulating the ovarian follicles to prepare an egg for ovulation and estrogen to release

LH (Luteinizing Hormone): the hormone that triggers the ovary to release an egg at ovulation, leaving an empty follicle (called the corpus luteum)

Estrogen: hormone responsible for preparing the uterus lining for possible pregnancy and thinning the cervical mucus so the sperm can enter

Progesterone: hormone responsible for thickening and maintaining the uterine lining, turning off LH/FSH, and triggering the period bleed when it drops

Testosterone: hormone usually much lower in women than men but peaks around ovulation to increase sex drive

It is my firm belief that the period should be viewed as a vital sign because it is proof that the reproductive system is functioning properly. If periods are irregular it is something that should be explored and not ignored. Many medical providers will downplay irregular periods, attributing them to age (whether young or old), athletic status, and general “bodies are different”. However, as we reviewed earlier, the irregularities of the reproductive hormones are a result of irregularities of our other hormones. And hormones can effect everything. Be sure to advocate for yourself or your child regarding their hormones.

In future blogs I will discuss what nutritional changes can occur during the menstrual cycle.

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Note to Self Nutrition LLC is an outpatient dietetics practice specializing in the treatment of eating disorders, women’s health and fertility including PCOS, endometriosis, and hormonal imbalances, diabetes and prediabetes, disordered eating, along with other chronic health conditions such as heart health, hypertension, and kidney disease. Owner and dietitian Lauren Hirschhorn-Tieu is passionate about empowering individuals to build trust with their relationship with food and their body. Lauren provides multiple services including nutritional counseling, recovery coaching, supervision and nutrition presentations. In person availability is offered in Denver. Virtual telehealth services are offered in Maryland, Virginia, Washington DC, Colorado, and Florida. We would be honored to join you on your journey to discovering food and body peace!

Contact us for more information regarding our services offered. To schedule a discovery call please visit this link. Be sure to visit our website and sign up for our newsletter at the bottom of the page.

The Menstrual Cycle Explained & Hormone Production