What an inappropriate headline, right? What about: menstruation is annoying, shameful and disgusting? This is how many, if not most, of us still view menstruation. Equally shocking, or not?
So, today, I invite you to set these negative ideas aside and look again—with fresh eyes—at what menstruation really is: a vital expression of the body’s cyclical intelligence.
Menstruation is part of the body’s ongoing, intelligent effort to prepare for potential life, restore balance, and renew itself. It is an essential aspect of female fertility—without which human life could not exist. Despite all our technological advancement, we still cannot create a human outside the female body. Isn’t that awe-inspiring?
What is menstruation, really?
We all kinda know what menstruation is: a woman bleeds. But few realize the finely tuned symphony of events that is required to make that bleeding happen. What appears simple is actually the result of an intricate monthly dance involving many players:
- Hypothalamus
- Pituitary gland
- Ovaries
- Granulosa cells
- Ova
- Corpus luteum
- Fallopian tubes
- Uterus
All of the above rely on and respond to the others. Their performance is influenced not just by hormones and genes, but also by diet1, lifestyle, emotional state, and how a woman relates to her body.
The Hormonal Orchestra Behind the Cycle
Our story starts on cycle day 1: the first day after a woman’s last period or at the start of her very first cycle. The hypothalamus (the master hormonal regulator) releases GnRH (gonadotropin releasing hormone) in pulses.
The pituitary gland responds to this by releasing LH (luteinising hormone) and FSH (follicle stimulating hormone). In these first days of the cycle, when the pulse frequency of the hypothalamus is still slow, the pituitary will favor FSH release.
A 100-Day Journey to Ovulation
FSH stimulates the ovaries to mature follicles. It takes about 100 days for a follicle to fully mature, but each month one becomes dominant, “the chosen one” who has the chance to be fertilized and make the journey to the womb. The chosen one reveals herself around day 7.
The Intergenerational Miracle
A woman has her maximum amount of follicles when still in her own mother’s womb (at about 6 months into gestation, after which they start to decline). This means that a pregnant woman’s physical and mental wellbeing influence the health of her own children as well as the health of her daughters’ children2.
Men, by contrast, create new sperm continuously from puberty onward, though sperm quality is still shaped by lifestyle.
Building a Home for Potential Life
While the follicles mature, the granulosa cells that surround them increase in number and synthesize aromatase which is converted to the hormone estrogen. The chosen follicle can produce massive amounts of this.
Estrogen then triggers the uterus to build its lining—a soft, nutrient-rich mucosal layer ready to receive a fertilized egg. This lining is not unlike those in your nose or digestive tract and has an important immune-modulating role. It helps to make sure that the uterus doesn’t reject the embryo. Also, in the beginning of pregnancy, it nourishes the embryo until the placenta is formed.
As estrogen rises, the hypothalamus pulses faster, causing the pituitary to increase LH production while reducing FSH. Granulosa cells pick up this increased LH level and start to prepare for ovulation, the release of the egg (ovum).
After the ovum has burst from the granulosa cells, it moves to one of two fallopian tubes, where fertilization may occur.
Fertilization Fact
Sperm cells do not really penetrate eggs. They merge with the membrane of the ovum, and then their genetic material is absorbed3.
Once the ovum has left the ovaries, it leaves behind its jacket of granulosa cells. These become the corpus luteum, which secretes progesterone to maintain the uterine lining. When, within about 14 days, the uterus hasn’t confirmed that an embryo has implanted, the corpus luteum disintegrates. This causes a sudden halt in progesterone production, which was keeping the uterine lining intact. Therefore, the lining will begin to break down.
And Then Comes the Bleed
Because the uterine lining is embedded with blood vessels bringing nutrients and oxygen, this mucous layer comes out through a woman’s vagina, mixed with blood: menstruation. And none of this is dirty. This is the same blood that will come out of a cut in a finger. It’s the same blood that flows through all of our body—a clean, oxygen-rich, life-giving substance.
And the slimey consistancy? That’s mainly the uterine lining, an absolute miracle of life! Successful pregnancies would not occur without it!
What Symptoms Are Normal—and What’s Not?
Several processes help the body to release the lining, blood vessels and blood. Muscles in the uterus contract and inflammation occurs, which is one of the body’s natural ways of expelling things. It is therefore normal to experience some cramps during these days. However, debilitating pain is not. In certain cases these pains can be relieved with some dietary adjustments.
A healthy menstrual cycle lasts 27 to 35 days. Bleeding typically lasts 3 to 7 days, with 25–60 ml of blood lost. A healthy woman may have less energy during her period, feel the need to rest, and spend time on her own. This is due to hormonal shifts but also simply because they lost nutrient- and energy-rich blood.
Menstruation ≠ Fertility
Though it is a small facet of the many events happening during a woman’s monthly cycle, menstruation is a vital event. It cleans the womb and enables a new cycle to begin—it gives us a new chance to create life.
While menstruation is essential to fertility, it isn’t the same as being fertile. A woman can menstruate regularly and still face difficulty conceiving. For example, if her cycle is very short, her uterine lining may start breaking down before a fertilized egg has time to implant. The egg, once reaching the uterus, will be shed along with the lining and its blood vessels.
There are also structural or hormonal factors that specialists must assess. But this complexity only adds to the miracle: that so many things must go right for life to emerge. And my firm belief is that, if we lived healthier lives and thought in more positive terms about the natural processes of the female body—menstruation, conceiving, giving birth and menopause—it would greatly improve our experience of these processes.
The Emotional Side of the Cycle
Just as menstruation is not purely physical, neither are menstrual challenges. The entire cycle responds to the way we eat, move, rest, relate, and think. The body isn’t separate from the mind—it’s in constant dialogue with it4.
That’s why it is so important that we change the way we view and speak about women’s natural physiological processes.
So now, go back to the title of this post. How do you feel about it now?
Cover image by Polina Zimmerman on Pexels
Cycle diagram by Isometrik on Wikicommons