Hormones play an important role in the three phases of your menstrual cycle: the follicular, ovulatory, and luteal phases. Learn more about the menstrual cycle and your hormones here!

How do hormones impact the way you feel?

Throughout your cycle — which can last between 25 to 35 days — hormones such as estrogen, progesterone, and luteinizing hormone can affect how you feel, the foods you crave, your sleep patterns, and more. Understanding how hormones fluctuate throughout your cycle can give you a better sense of what to expect during each phase.

Learn more about your menstrual cycle and hormones.

Learn more about the hormones in the menstrual cycle

Estrogen

During the follicular and menstruation phases, estrogen plays a dominant role. Estrogen levels will decrease as you begin menstruating, which can leave you feeling fatigued. When your period ends, estrogen will increase and you’ll likely regain your energy. As the follicular phase continues until ovulation, estrogen levels increase and you might notice glowing skin. Estrogen levels peak right before ovulation, which is also your fertile window for pregnancy. If an egg isn’t fertilized, estrogen levels will drop while progesterone increases. 

Progesterone

During the luteal and ovulation phases, progesterone plays a dominant role. Progesterone levels rise during the second half of your menstrual cycle (the luteal phase) as the egg prepares for a possible pregnancy. If you become pregnant, progesterone levels will continue to rise to grow and thicken the uterine lining for a developing baby. If you don’t, progesterone will dip, your uterine lining will shed, and you’ll start bleeding. Rising levels of progesterone are also responsible for PMS symptoms.

Follicular Stimulating Hormone

Follicular Stimulating Hormone (FSH) rises during menstruation and follicular phase and hits its peak during ovulation. FSH stimulates the growth of follicles in the ovary. One of these follicles will become an egg that will be released during ovulation. Though there aren’t many main symptoms from FSH that you may feel, it is an essential component of the menstrual cycle. 

Luteinizing Hormone

Luteinizing hormone (LH) remains low throughout the menstrual cycle with the exception of the LH surge around mid-cycle which triggers ovulation. You may notice ovulation pain, or mittelschmerz, due to the LH surge. After ovulation, LH helps to create the corpus luteum that releases progesterone which helps to maintain a potential pregnancy if the egg is fertilized. 

Testosterone

Testosterone affects your skin, hair, and other physical features. A decrease in testosterone can lower your sex drive. An increase in testosterone can suppress your normal menstruation and ovulation. It can also be an indicator for polycystic ovary syndrome (PCOS), a common hormonal disorder in women. Testosterone increases during the luteal phase and peaks during ovulation, which can make you feel more energized. 

Reviewed by the Ovia Health Clinical Team

Read more

• How the menstrual cycle impacts your mood
• How the menstrual cycle impacts your sleep

Sources

• E. Sterling. “Hormone Levels and PCOS.” Contemporary OB/GYN. November 8, 2011. https://www.contemporaryobgyn.net/view/hormone-levels-and-pcos

More often than not, menstruation gets a bad rap. We often hear, “Are you PMSing?” or “Do you have your period?” as insults. Because of these catch-all phrases, periods have become synonymous with moodiness and carry a harmful stigma. While you can develop mood swings before or during your period, there’s much more to this side effect than meets the eye.

What causes mood swings during your menstrual cycle?

PMS (premenstrual syndrome), which describes symptoms including mood swings and irritability, starts about a week before your period and generally subsides about four days after the first day of your period. PMS symptoms can occur up to 14 days before menstruation, which is when your body releases an egg, causing estrogen and progesterone levels to drop. This hormonal shift can cause your serotonin levels to drop and bring about feelings of sadness and irritability. According to a study published in the Journal of Women’s Health in 2011, mood swings are the most common symptom of menstruation. 

How to manage mood swings

When it comes to managing PMS mood swings, no one remedy fits all. Regulating your mood when you’re experiencing PMS symptoms is similar to how you’d regulate your mood any time of the month. Exercise, nutrition, and supplements can increase your serotonin levels, the key hormone that stabilizes your mood. 

Nutrition: Limit your caffeine intake during your period since it’s known to decrease sleep, which can  increase moodiness. According to the Academy of Nutrition and Dietetics, calcium such as low-fat milk, yogurt, almonds, and kale have been proven to reduce fatigue and moodiness during PMS. 

Exercise: According to a 2019 study published in The Journal of Education and Health Promotion, aerobic exercise and yoga movements are effective in treating PMS symptoms, like improving mood and behavior. Any exercise that gets your heart rate up will release endorphins (body chemicals that relieve stress and pain) and may counteract the hormone changes induced by PMS. Additionally, the Office of Women’s Health encourages physical activity during your menstrual cycle to help you feel better emotionally and physically.

When should mood swings be addressed by a doctor?

Experiencing mood swings is the most common PMS symptom, according to a 2011 study published in the Journal of Women’s Health. But if you’re not feeling like yourself  for a significant amount of time after your period, then you may want to consult with your provider. There are many ways to treat symptoms of PMS including SSRIs and the combination birth control pill. 

As we mentioned, periods have been associated with mood swings, but they’re not always the source of those feelings. You deserve to get the help you need to feel like yourself. 

Reviewed by the Ovia Health Clinical Team

Read more

• How the menstrual cycle impacts your sleep
• How the menstrual cycle impacts your skin

Sources

• Freedman, Ellen. “Core Symptoms That Discriminate Premenstrual Syndrome.” Journal of Women’s Health. Web. 20(1): 29–35. January 2011. 
• Fathizadeh, Nahid. “Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome.” Iranian Journal of Nursing and Midwifery Research. Web. (Suppl1): 401–405. December 2010.
• “Physical activity and your menstrual cycle.” US Department of Health. US Department of Health. December 27, 2018. https://www.womenshealth.gov/getting-active/physical-activity-menstrual-cycle
• Veghela, Nirav. “To compare the effects of aerobic exercise and yoga on Premenstrual syndrome.” Journal of Education and Health Promotion. Web. 8: 199. 2019. 
•  Klemm, Sarah. “Premenstrual Syndrome.” Academy of Nutrition and Dietetics. Academy of Nutrition and Dietetics. April 5, 2021. https://www.eatright.org/health/pregnancy/fertility-and-reproduction/premenstrual-syndrome
• “Premenstrual syndrome (PMS).” Mayo Clinic. Mayo Clinic. February 7th, 2020. https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/symptoms-causes/syc-20376780

Are you pregnant or is your period just late? Here’s how to tell

Learn more about actual pregnancy symptoms before you start getting concerned.

The science behind symptoms

Pregnant or not, your body starts releasing progesterone after you ovulate. This hormone keeps getting released and is at its highest point around five to seven days after ovulation. If a woman is pregnant, her body continues to produce progesterone in high amounts to help sustain the pregnancy. If she’s not pregnant, her progesterone levels decrease, and she’ll start her menstrual period.

Thanks also to progesterone, the symptoms of early pregnancy and your period are nearly identical. Cramps, fatigue, dizziness, breast tenderness – all early signs of pregnancy, but also possible signs of your period coming.

What about light spotting a week after ovulation? It could indicate implantation bleeding, but most women don’t experience this symptom and spotting can happen for other reasons.

What about nausea? This symptom is typically attributed to hCG, the pregnancy hormone, but it can be caused by other things, too (including PMS).

In the weeks between ovulation and a pregnancy test, many women “symptom spot”; that is, they take note of certain physical symptoms and think that they are definitely signs of early pregnancy. Is symptom spotting so wrong? Absolutely not, and it can even be kind of fun, as long as you know that only a blood test can tell you for sure if you’re pregnant.

Is there anything I can look for?

Probably the most reliable physical symptom of early pregnancy is a missed period. Noticing that your breasts are getting increasingly sore, or experiencing symptoms that you don’t usually get around the time of your period, are also signs that you could be pregnant. But again, a blood test will be the best way to know for sure.

Final thoughts: things to keep in mind

The bottom line is that without a blood test, it’s nearly impossible to know for sure whether you’re pregnant or experiencing a late period. Even home pregnancy tests can sometimes give a false negative, if taken too early, so it’s really smart to wait to take a test until or after your expected period.

If you’re paying attention to your symptoms, just know that it can get a little stressful for some women. So if you find yourself symptom spotting, try to be aware of how often you do it, and how you feel – does it distract you or stress you out? If it starts to get emotionally taxing for you, look for ways to stop paying attention to your symptoms.

Finally, make sure you’ve scheduled a pregnancy blood test, and keep taking your prenatal vitamins! Whether it’s sooner or later, when you get that BFP, you’ll be glad you did!

Sources

• Mayo Clinic Staff. “Home pregnancy tests: Can you trust the results?” MayoClinic. Mayo Foundation for Medical Education and Research, Dec 2015. Web. Accessed 8/3/17. Available at http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/home-pregnancy-tests/art-20047940.
• Lori A Bastian, Haywood Brown. “Clinical manifestations and diagnosis of early pregnancy.” UptoDate. UptoDate Inc., Jul 2017. Web. Accessed 8/3/17. Available at https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-early-pregnancy?source=search_result&search=waiting%20for%20pregnancy%20test&selectedTitle=1~150.
• “Morning Sickness: Nausea and Vomiting of Pregnancy.” ACOG. FAQ126 from the American College of Obstetricans and Gynecologists, Dec 2015. Web. Accessed 8/3/17. Available at https://www.acog.org/Patients/FAQs/Morning-Sickness-Nausea-and-Vomiting-of-Pregnancy.

Pregnancy implantation signs and symptoms

Timeline

The first difference is in the timing of the symptoms. Implantation happens any time between about 5-10 days after you ovulate, while PMS usually sets in closer to two weeks after. So if symptoms start and it feels a little early to you for it to be menstruation, it might be a successful implantation.

Cramping

Mild cramping can be a sign of successful implantation, as the fertilized egg attaches to your uterine lining. These cramps don’t happen in every case, and they’re not, on their own, enough to say for sure that implantation has happened. When they do occur though, they’re different from menstrual cramps in that they only last for short periods of time, rather than continuously like menstrual cramps. The pain they cause also tends to be much more mild than that from menstrual cramps.

Spotting

Implantation bleeding produces a lot less blood than a menstrual period. Instead, it’s more like spotting, and is more likely to range from pinkish to brownish, instead of red like menstrual blood. If you have heavier-than-period bleeding, especially with extreme cramping, you should contact your healthcare provider.

Soreness

Both implantation and PMS can cause soreness in your breasts. The two types of soreness won’t necessarily feel that different from one another, but soreness from a period will usually go away after a few days, whereas soreness from implantation might stick around through your pregnancy. In fact, the elevated presence of progesterone and other hormones during pregnancy can cause several different changes in your breasts. Another change that you might notice around the time of implantation is a darkening of your areolas.

Other signs

There are other signs of implantation that don’t correspond to menstrual symptoms, like nausea and morning sickness, increased urination, and, of course, missing your period. Since everyone’s body is different though, you may not notice some or all of these signs. At-home pregnancy tests can provide a bit more confirmation, though they won’t reach their full accuracy until around your expected period date.

Sources

• “Is It Implantation Bleeding — Or Just My Period?” WhattoExpect. What to Expect, Apr 12 2016. Web.
• Margaret Scott. “Signs Of Successful Implantation: Why It Is Important To Stay Optimistic.” ImplantationSpotting. All About Implantation Bleeding, 2014. Web.

Here are the TTC acronyms you should know about

AF:

Aunt Flow. Your period.

Thanks for the invite, but my Aunt Flow’s in town. I’m gonna go home and treat her to some wine and reruns.

BBT:

Basal Body Temperature. BBT may spike right before ovulation, so many women track it to help them pinpoint their ovulation.

The very first thing I did this morning was grab my thermometer and take my BBT.

BCP:

Birth Control Pills.

In almost no time after I stopped taking BCP, I was pregnant.

BD:

Baby Dance. Sexual intercourse, usually done on the most fertile days of your cycle. (Can also mean baby dust, which is a phrase you use to wish someone good luck.)

My ovulation test is positive, which makes me want to dance – the BD, that is!

BFN/BFP:

Big Fat Negative/Big Fat Positive (on your pregnancy test).

Every time I buy a pregnancy test, I think about how it could be the one to show the BFP.

BOB:

Baby on the Brain!

I’m having a hard time shopping with BOB. All I can think about is tiny socks and pacifiers, which makes it impossible to keep track of my grocery list.

CD:

Cycle Day. A specific day in your menstrual cycle (or fertility treatment cycle). To track it, start by counting from the first day of your last menstrual cycle.

It varies each cycle, but normally I ovulate on CD 13, or 13 days after the first day of my period.

CM or CF:

Cervical Mucus or Cervical Fluid. Changes in cervical fluid indicate that a woman is at different stages of her cycle.

At the most fertile point of each cycle, my CM is clear and super stretchy.

CP:

Chemical pregnancy. A very early miscarriage.

My doctor recommended that I put off trying again until one cycle after my last CP.

DD:

Darling daughter. A daughter you already have.

DH, DD, and I go on vacation next week.

DH:

Dear husband.

I’m 42 and DH is 43.

DPO:

Days Past Ovulation, or Cycle Date Post Ovulation.

By 7DPO of the TWW, I’m already wondering if every little cramp is a sign of pregnancy.

DS:

Darling son.

It’s a challenge to care for DD and DS while also TTC.

ENDO:

Endometriosis. A chronic disease in which tissue that is supposed to grow in the uterus grows outside of it. Millions of women experience this condition and it can affect fertility.

After getting diagnosed with ENDO, I was able to find a huge and supportive online community of other women who had the same condition.

EWCM:

Egg White Cervical Mucus. When your cervical mucus looks like egg whites, it may mean that you’re at your most fertile point.

Nothing is as exciting as seeing EWCM when TTC!

FMU:

First Morning Urine. Most pregnancy tests require that women take them the very first time they pee in the morning. In the morning, urine typically has the highest concentration of Human Chorionic Gonadotropin, or hCG, an early pregnancy hormone.

I tested with FMU and got a faint BFP.

FP:

Follicular Phase. The phase of the menstrual cycle when follicles mature in the ovary. This phase begins on day 1 of your period, and ends with ovulation.

I’m so excited to try and get pregnant, I just want my FP to be over!

hCG:

Human Chorionic Gonadotropin. A hormone produced during early pregnancy that helps the baby grow.

I had a positive test, which means there was enough hCG in my urine to detect a pregnancy.

HPT:

Home Pregnancy Test. A pregnancy test that you can take at home. This morning my HPT showed a BFP – but I’m going to my doctor’s to take a blood test to confirm.

IUI:

Intrauterine Insemination. A specific kind of fertility treatment where sperm is placed directly into a woman’s uterus during ovulation.

After 2 years of TTC, we’ve decided to try IUI.

IVF:

In Vitro Fertilization. A procedure in which an egg is fertilized in a lab and then implanted.

We went through several rounds of IVF before getting a BFP.

LMP:

Last Menstrual Period. The first day of your last period.

I started my LMP on June 6th.

LPD:

Luteal Phase Defect. If the corpus luteum didn’t form properly, a luteal phase defect may occur, causing a short luteal phase. This can make it hard for a woman to get pregnant.

I’ve been really accurate with my charting, because I suspect I might have LPD and I want to have a lot of information to show my provider.

LSC:

Low Sperm Count. Commonly the cause of male infertility.

A semen analysis showed that my partner has an LSC.

M/C:

Miscarriage.

I got my first BFP a year ago, which ended in a really upsetting MC.

MF:

Male Factor Infertility.

To help with the MF issues, we found an infertility counselor who was covered by our insurance.

NTNP:

Not trying for pregnancy, not preventing pregnancy.

I just stopped taking BCP, so I guess that we’re NTNP.

O or OV:

Ovulation.

I O’ed on CD15 and BD on days 13 and 15.

OPK or OPT:

Ovulation Predictor Kit or Ovulation Predictor Test. These tests tell you when your body has a surge of luteinizing hormone (LH), which indicates the onset of ovulation.

I just got a positive OPK, which means BD as soon as possible!

PCO, PCOS, or PCOD:

Polycystic Ovaries, Polycystic Ovary Syndrome, or Polycystic Ovary Syndrome Disease. A condition in which a woman’s levels of estrogen and progesterone are unbalanced. Women with PCOS develop cysts on their ovaries, and the condition can cause infertility.

My doctor thinks I have PCOS, so I’m waiting to hear back about my blood work.

POAS:

Pee On Stick. Taking a pregnancy test (peeing on a stick), usually at home.

I’m 7DPO and it’s so hard to wait to POAS!

RE:

Reproductive Endocrinologist. A type of fertility specialist.

I’m meeting with an RE tomorrow to go over my fertility test results.

SA:

Semen Analysis. This is a test that providers can use to determine the quality and quantity of a man’s sperm.

The results of his SA show he has low sperm count, low motility, and poor morphology.

SO:

 Significant other.

My SO and I have decided that next month we’ll start TTC.

TWW or 2WW: Two Week Wait. The time period between when you ovulate and can take a pregnancy test.

 just started my TWW and I need to find some ways to distract myself!

TTC:

Trying to Conceive.

I haven’t decided who I want to tell that we’re TTC.

U/S:

Ultrasound.

Our first U/S is scheduled for the end of the month.

Early symptoms of pregnancy

• Fatigue: You begin to feel unexplainable and unusually extreme fatigue without exerting too much energy. Certain typical activities that once seemed like nothing now begin to feel like giant hurdles. Instead of trying to battle this fatigue with caffeine, try to stay well rested and take it easy!
• Food aversions: You open your fridge and the thought of eating last night’s leftovers makes you wince and gag. Out of nowhere it seems like the idea of foods you once loved make you sick to your stomach. On the other end of the spectrum, you may begin to crave certain foods at irregular times throughout the day.
• Sensitivity to smells: Like some sort of superhero, you begin to feel a heightened sense of smell. Different scents that you’ve smelled before, whether you enjoy them or not, begin to make you nauseous and sick to your stomach.
• Nausea and vomiting: Instead of springing out of your bed in the morning, you begin your day by hugging your toilet bowl and vomiting as if you’d partied like a rockstar the night before. Morning sickness, while not necessarily always in the morning, is a very common and early indicator of pregnancy. The good news is this sickness will only be around the earliest stages of your pregnancy and is likely to fade out by the end of the first trimester. In order to battle this it, try to eat smaller and more frequent meals throughout the day to ensure that your stomach is never too empty. It’s also good to have a small snack before bed. If you’re beginning to use prenatal vitamins, try to avoid taking them on an empty stomach.
• Breast swelling and tenderness: Your breasts may begin to swell and feel heavier. They begin to feel very tender to the touch and just putting on a bra feels like torture. You also may notice that the area around your nipples, or areola, begins to darken. In order to remedy this, try wearing either a sports or padded bra.
• Frequent urination: You may also start to notice that you’re taking more frequent trips to the restroom to pee. As the Uterus grows, it begins to push against the bladder in early pregnancy causing frequent urination. Always try to go to the bathroom before bed in order to get as much sleep as possible. It is not uncommon to wake up at least once in the middle of the night with the need to urinate.
• Shortness of breath: In addition to extreme fatigue, certain activities may begin to make you feel like you are out of breath and gasping for air. This is particularly common, as growing embryos need more oxygen in order to grow. As you go throughout your pregnancy, you may notice this shortness of breath to get more extreme. If you have a sudden shortness of breath unrelated to exercise, notice breathing becomes painful, or your breathing gets worse when you are lying down, you should consult a doctor.
• Physical changes: You may also begin to notice some physical changes to your body. If you begin to notice changes in your vagina’s color, see a physician for a pelvic exam. This is also accompanied by a softening of the cervix. It is important to look into these changes, as they are not just potential symptoms of a new pregnancy but also of other things such as premenstrual syndrome.
• Constipation: As hormones increase at an exponential rate, food may begin to move more slowly through your intestines. This may cause you to feel bloated and constipated. To battle this, make sure to get plenty of exercise, drink lots of water, and eat foods high in fiber.
• Mood swings: Things that used to be minor irritations start to feel like the beginning of World War III. High changes in hormone levels can cause sudden mood swings. Don’t stress over it, as these mood swings are extremely common in the first trimester.
• Headaches and back pain: It’s also quite common to notice headaches and sharp pain in your lower back. You can remedy these pains with over the counter acetaminophen. The back pain will only continue to get worse however as you gain weight and your center of gravity begins to change.
• Dizziness and fainting: You may also notice an uneasy dizzy feeling which in extreme cases can cause you to faint. This is caused by dilating blood vessels, lower blood sugar, and lower blood pressure so make sure to eat and drink plenty of water!
• Cramping and spotting: You might feel severe abdominal pain similar to when you begin your period. This cramping is not due to your period, but by your uterus stretching to get ready for a baby. You may also see some light spotting coming well before when you would expect your period.
• Elevated basal body temperature: An elevated basal body temperature (BBT) into the luteal phase may also be an early sign of pregnancy. The BBT typically stays elevated from the two weeks you are ovulating until you get your period. If it remains to stay at a high level after these two weeks, consider taking a pregnancy test.

Sources

• “Pregnancy Symptoms.” American Pregnancy Association. American Pregnancy Assocaition. June 29, 2018. http://americanpregnancy.org/getting-pregnant/early-pregnancy-symptoms/

Conception tracker? What to record when TTC

The majority of women don’t have exact 28-day cycles, so ovulation and the fertile window can be difficult to predict. Luckily, your body has certain ways of communicating when it’s fertile, and Ovia Fertility has developed an algorithm that can accurately predict your fertile window and ovulation date, based on a few different metrics.

Cervical fluid

Cervical fluid is the fluid that your body produces to help (or block) sperm moving through your cervix and up to your fallopian tube where it can fertilize your egg. Cervical fluid changes in consistency throughout the cycle, becoming most “fertile” (helpful for a sperm’s travel) during the fertile window and ovulation.

Cervical fluid tends to be dry right after menstruation, then thick and clumpy, then more watery, and finally thin, clear, and stretchy as you approach ovulation. Tracking your cervical fluid throughout the cycle is an excellent way to tell when ovulation might be near.

Basal body temperature

Basal body temperature is the lowest temperature attained by the body in the normal course of the day. It’s best taken right when you wake up in the morning, before you are active and start heating up. Basal body temperature can be a key indicator of your ovulation date, as it will quite often spike in the 24-48 hours after ovulation, due to a rise in the hormone progesterone.

Conversely, basal body temperature may dip a bit right before you ovulate, so tracking your temperature from cycle to cycle can help you anticipate the dip and/or spike, and pinpoint your ovulation and fertile window.

Symptoms

Symptoms are your body’s way of communicating what’s going on inside of you, including an upcoming fertile window and ovulation. Tracking and paying attention to your symptoms can be extremely helpful in narrowing down your fertile window.

Certain symptoms, like backaches, cramps, and pelvic pain, are common indicators of ovulation. There may be some discomfort when an egg is released from the ovary, generally on just one side. This is known as “mittelschmerz” pain, which is German for “middle pain.”

Moods

Your moods can tell you a great deal about what is happening in your body, similarly to how symptoms can. The data that we have collected has found that certain moods, like feeling confident or frisky, may be positively correlated with an upcoming ovulation. Though moods alone may not be able to indicate that you are fertile (especially if you’re already a confident or frisky person to begin with!), but they can definitely contribute to and improve your fertility predictions

Period

Ovia Fertility uses many metrics beyond period data to predict ovulation and the fertile window, but entering your period data is a good way to set up a baseline for your predictions. Tracking your period will let you know how your cycle length and luteal phase length change from cycle to cycle, which could be crucial for helping you get pregnant faster.

Ovulation tests

Ovulation tests can confirm whether you are currently ovulating, but they can’t tell you that you’re about to ovulate, or already ovulated, only that you’re currently ovulating. It’s nice to have confirmation of ovulation, but it’s important to track other metrics in combination with with ovulation tests to best predict your fertile window and ovulation so you can plan ahead.

Predicting your ovulation and fertile window can be difficult, but Ovia Fertility makes it easy. Simply enter these data points above as often as you can, and let our algorithm do the rest!

Read more

• Tracking your physical symptoms
• Self-tracking devices and fertility

Sources

• Creinin MD, Keverline S, Meyn LA. “How regular is regular? An analysis of menstrual cycle regularity.” Contraception. 70(4):289-92. Web. 10/4/2015.
• D.F. Katz, D.A. Slade, S.T. Nakajima. “Analysis of pre-ovulatory changes in cervical mucus hydration and sperm penetrability.” Advances in Contraception. Volume 13, Issue 2-3, pp 143-151. Web. Jun-97.
• Stephen R. Pallone, MD and George R. Bergus, MD. “Fertility Awareness-Based Methods: Another Option for Family Planning.” Journal of the American Board of Family Medicine. vol. 22 no. 2 147-157. Web. March-April 2009.
• Pearlstone AC, Surrey ES. “The temporal relation between the urine LH surge and sonographic evidence of ovulation: determinants and clinical significance.” Obstetrics & Gynecology. 83(2):184-8. Web. Feb-94.

Wondering about your period as a trans, genderqueer, or non-binary person?

For some, it’s no big deal, but for other people, like those who are trans, genderqueer, or non-binary, getting and managing a period can be particularly stressful. Buying or using products marketed to only women, using or carrying menstrual products in public bathrooms, or experiencing body changes can heighten the stress of feeling like your body doesn’t match your gender — something called gender dysphoria.

If you experience this stress when you get your period, there may be a few things that can help:

• Use menstrual products that make you feel most comfortable. Everyone is different, but for you this might mean products that:
  • Don’t need to be inserted: pads or absorbent underwear.
  • Aren’t felt or seen once in place: a menstrual cup or tampon.
  • Don’t need to be changed frequently: a menstrual cup or absorbent underwear.
  • Are quiet and won’t draw attention in a bathroom: fabric pads or absorbent underwear.
• Use menstrual products that are gender neutral or that aren’t marketed as being especially feminine, like boyshort or boxer brief style absorbent underwear.
• Have menstrual products shipped to your home rather than buying them in a store.
• Manage cramps with heat therapy (a heating pad or hot water bottle) or over-the-counter medication (checking in with your healthcare provider about what’s best for you).
• Wear clothes that make you feel comfortable and confident to help offset symptoms like bloating or a swollen chest.

How hormone therapy or hormonal birth control could affect your period

It’s also worth noting that taking hormones can affect your period in some notable ways:

Testosterone: If you take testosterone or go through hormone replacement therapy, your period can get lighter and shorter over time or come unexpectedly before stopping. Testosterone injections (versus testosterone cream) can make this happen more quickly. After a period stops, occasional spotting or cramping might be normal. This is reversible, so a period can come back if you stop taking hormones.

Hormonal birth control: For people who use certain kinds of hormonal birth control, a period might become lighter or stop completely.

Puberty blocking hormones: Puberty blocking hormones will prevent the gendered changes that come along with puberty, including body changes like growing breasts and getting a period.

It’s also worth noting that if you haven’t had surgery to remove your reproductive organs, getting pregnant is still possible — even if your period is becoming more irregular. Ovulation will likely be blocked if you’re taking testosterone, but it is possible for individuals taking testosterone to get pregnant. So if you’re sexually active with someone who has sperm and you don’t want to get pregnant, be sure to take precautions and use birth control.

Find a healthcare provider who understands you

If you have questions about how to best manage your period or are experiencing gender dysphoria or distress surrounding your period, you should speak with your healthcare provider. Everyone deserves to see healthcare professionals who listen to their needs and can provide them with thoughtful care. If you’re currently looking for a provider who is better attuned to your unique needs and knowledgable about trans, genderqueer, and non-binary concerns, you might find the searchable provider databases from the World Professional Association for Transgender Health or the Gay and Lesbian Medical Association to be meaningful resources.

Self care methods to remember during your menstrual period

Depending on what’s normal for you, you should definitely plan to treat yourself with a lot of kindness during your period. Respect your own feelings, your degree of comfort or discomfort, and the pace you’re comfortable with.  This may mean that you carry on with life as usual, or it may mean you make a point to slow things down. This goes for everything from your physical activity to your social calendar to your sleep schedule.

When it comes to physical activity, pay attention to your comfort and energy levels. Some people carry on with their usual exercise routines – and, indeed, physical activity of this sort can actually help with cramping – while others prefer to take it a bit easier.

When it comes to your social life, do you feel like you want to carry on with your usual social schedule? Or do you want to use the opportunity to snuggle up at home with a heating pad and a good book? You know yourself best, so respect your body, your energy levels, and how you’re feeling.

The same goes for sex. Many people are down for being intimate in many of the same ways they would at other times of the month, maybe just with an extra towel on the bed or an extra shower added to the day. And other people, whether because of physical discomfort or preference, just prefer to take a break. There’s no right or wrong – you do you.

If you regularly experience period symptoms that get in the way of your usual daily life – like painful cramping, dizziness, or fatigue – you may want to try to plan to be extra proactive about self-care during that time. This can look different for everyone. It might mean you preemptively take an over-the-counter pain reliever at the start of your period (though do check with your healthcare provider to find out what’s safe for you). It might mean you keep a heating pad close or pencil in a relaxing warm bath for some heat therapy. And if fatigue tends to hit you hard, it might mean you don’t plan any late nights so you can really prioritize rest.

You can also try to be mindful of what you are and aren’t adding to your body during this time. It can help to stay hydrated and eat a nutritious diet, like veggies, whole grains, fruit, lean protein, good fats, and dairy. It can also help to avoid things like caffeine, alcohol, and smoking (the last of which you should always avoid), which can make cramps worse. And you may also want to avoid particularly salty food, which can dehydrate you. As with most things, you should see what seems to feel best for you.

There’s nothing wrong with respecting your body’s needs and listening to the rhythms of your cycle. It’s really amazing what our bodies are capable of and what they’ll communicate to us if we listen. Giving yourself a little extra love during this period is just one way to show yourself the kindness you definitely deserve.

But there is a difference being kind to yourself with period-focused self-care that can help make that time of the month more manageable for you and dealing with the sort of discomfort that you should really see your healthcare provider about. If you do have the sort of discomfort and symptoms that really impact your life in a negative way – meaning cramps that last longer than a few days, cramps that feel severe or unusual in any way, or any other symptoms that make life particularly tough for you, talk to your healthcare provider so they can help you find some relief.

You deserve to feel your best – throughout your cycle, and each and every day.

Sources

• Mayo Clinic Staff. “Menstrual cramps.” Mayo Clinic. Mayo Foundation for Medical Education and Research, April 14 2018. Retrieved February 25 2019. https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/symptoms-causes/syc-20374938.
• “Dysmenorrhea.” Cleveland Clinic. Cleveland Clinic. Retrieved February 25 2019. https://my.clevelandclinic.org/health/diseases/4148-dysmenorrhea.
• “Dysmenorrhea: Painful Periods.” The American College of Obstetricians and Gynecologists. The American College of Obstetricians and Gynecologists. January 2015. Retrieved February 25 2019. https://www.acog.org/Patients/FAQs/Dysmenorrhea-Painful-Periods.
• “What can I do about cramps and PMS?” Planned Parenthood. Planned Parenthood Federation of America. Retrieved February 25 2019. https://www.plannedparenthood.org/learn/health-and-wellness/menstruation/what-can-i-do-about-cramps-and-pms.

Diet changes to consider that may help with symptoms of PMS

As you may have experienced, your life can turn upside down when Aunt Flo is coming to town! So when ibuprofen and some gentle physical activity won’t cut it, you might begin to wonder if changes to your diet can make things better. Here’s what we know about how diet can help with PMS symptoms.

Omega-3 fatty acids

Essential fatty acids may play a role in improving cognition, mood, and other PMS symptoms. But before you run out to buy supplements, you should know that science on the topic is mixed. While one study showed that after 90 days of supplementation, participants taking two grams of omega-3s had improved depression, anxiety, nervousness, concentration, and bloating when compared to a placebo group. Another recent study showed symptom improvements in both the treatment and control groups with no significant difference.

Since the jury is still out on how helpful these supplements may be, one idea is to try to mix healthy fats into your diet. Regularly eating foods like fish, fortified eggs, walnuts, flaxseed, and vegetable oils provides the omega-3s your body needs. It can be as easy as switching from butter to olive oil, throwing some flax meal into your smoothie, or topping a salad with some nuts. See if it makes a difference for you!

Avoid salty foods

Bloating and gas are common symptoms that can really ruin a good day. While this is mostly related to the hormones surging in your body during this time of the month, you could try reducing your salt (sodium) intake to see if it helps!

High sodium content is more prevalent in processed foods like store-bought sandwich bread, deli meats, canned soups, and many takeout meals. Finding a balance between comfort foods and those that help reduce the bloat might leave you feeling a bit more comfortable. To do this, focus on adding foods to your diet like fresh fruits and veggies, whole grains like quinoa, brown rice, and oat bran. Try preparing most meals at home from whole foods and be mindful of how much salt you add to see if it makes a difference for you..

Protein and complex carbs

When PMS cravings come knocking, be prepared to answer with a healthy snack. Pairing protein with a carbohydrate will maximize fullness and give you long-lasting energy. For example, try Greek yogurt with fruit, cottage cheese with whole-grain crackers, unsalted nuts with popcorn, or tuna salad in a whole-wheat pita. Having something nutritious to enjoy between meals can satisfy you while fighting fatigue.

Magnesium

You may not need another reason to enjoy dark chocolate, but here’s one: it’s a rich source of magnesium, which can help improve menstrual migraines. While it won’t completely eliminate a headache, increasing your overall magnesium intake can positively impact several factors that influence the frequency of migraine headaches. For instance, magnesium helps lower blood pressure.

If you’re looking to boost your magnesium levels, consider incorporating foods such as almonds and cashews (nuts), dark leafy greens like spinach and Swiss chard, and legumes including edamame, black beans, and peanuts into your diet. However, before starting any magnesium supplement, it’s important to consult with your doctor to determine if supplements are right for you.

Reviewed by the Ovia Health Clinical Team 

Read more 

• Your menstrual cycle and your hormones
• How perimenopause causes worsening PMS

Sources

• Behboudi-Gandevani S, Hariri FZ, Moghaddam-Banaem L. “The effect of omega 3 fatty acid supplementation on premenstrual syndrome and health-related quality of life: a randomized clinical trial.” J Psychosom Obstet Gynaecol. 2017 Jul 14:1-7. https://www.ncbi.nlm.nih.gov/pubmed/28707491.
• Grosso, et al. “Omega-3 Fatty Acids and Depression: Scientific Evidence and Biological Mechanisms.” Oxid Med Cell Longev. 2014; 2014:313570. https://www.hindawi.com/journals/omcl/2014/313570/.
• Maasumi K, Tepper SJ, Kriegler JS. “Menstrual Migraine and Treatment Options: Review. Headache.” 2017 Feb;57(2):194-208. http://onlinelibrary.wiley.com/doi/10.1111/head.12978/abstract.
• Sohrabi N, et al. “Evaluation of the effect of omega-3 fatty acids in the treatment of premenstrual syndrome: ‘a pilot trial.’” Complement Ther Med. 2013 Jun;21(3):141-6. https://www.ncbi.nlm.nih.gov/pubmed/23642943.
• Yonkers, K, et al. “Epidemiology and pathogenesis of premenstrual syndrome and premenstrual dysphoric disorder.” Up To Date. https://www.uptodate.com/contents/epidemiology-and-pathogenesis-of-premenstrual-syndrome-and-premenstrual-dysphoric-disorder. Accessed August 14, 2017.
• “About Sodium and Health.” Centers for Disease Control and Prevention. U.S. Department of Health and Human Services. https://www.cdc.gov/salt/about/index.html. Updated Jan 31, 2024