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

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.

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