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.

Michelle Matos-BecerraOvia Health Contributor

This month: women’s history with birth control and healthcare before 2021

As women have pressed forward as leaders in career, family caregiving, community, and beyond, key advancements in health have evolved with her. While there is still a ways to go to improve many aspects of women’s healthcare, we want to take a moment to celebrate four key healthcare milestones that have played a role in leveling the playing field.

Putting control in her hands

In 1914, public health nurse Margaret Sanger coined the term “birth control” as part of her decades-long campaign to make contraceptives legal and available to women. Her mother was pregnant 18 times, bearing 11 children, and suffering 7 miscarriages, resulting in health problems that led to her death at the age of 49. While working as a nurse in New York’s Lower East Side, Sanger witnessed the effects that lack of birth control had on poor immigrant women’s health, many dying from childbirth and self-induced abortions. These experiences fueled her determination to inform and equip women with birth control access.

Together with her sister Ethel Byrne and activist Fania Mindell, Sanger opened the country’s first birth control clinic in Brownsville, Brooklyn, on October 16, 1916, directly defying the “Comstock Laws” forbidding birth control. Sanger’s work as President and Chairman of Planned Parenthood of America culminated in her partnership with MIT graduate and philanthropist Katherine McCormick to support and fund the organization’s research development of the birth control pill in the 1950s.

“The Pill” was FDA-approved in 1960 and made legal years later, allowing generations of women to achieve greater social and economic freedom simply by being able to plan their reproductive futures.

Oral contraceptives are effective in helping women manage the symptoms of chronic reproductive conditions such as endometriosis and PCOS, reducing menstrual cramps, regulating periods, and preventing menstrual-related migraines. And they have opened the door to alternative forms of contraception, such as intrauterine devices (IUDs), implants, injections, rings, and more.

The Affordable Healthcare Act lowered costs, eliminated denial of care and coverage due to preexisting conditions, including pregnancy, and expanded access and coverage of preventative care services such as birth control.

Many women still struggle to find effective birth control due to lack of healthcare coverage, so providing low-cost opportunities and continued information for all women is critical in helping all women have reproductive freedom.

Improving breast care and survival for generations

Mammograms were first performed using traditional X-ray machines, which exposed women to high doses of radiation. In 1969, technical innovations focused on bringing low-radiation mammograms to patients.  With safer, more accurate screening, mammograms have become the best practice in women’s healthcare. The new screening option catalyzed conversation and education around prevention and genetic predispositions, creating a higher awareness and support of new research and treatment options. This technology also allowed a higher percentage of cases to be detected earlier, improving survival rates. In 2000, digital mammography and 2011 3D mammography innovations advanced the effectiveness of the screenings.

Regular and widespread screening, especially for underserved communities where education and access contribute to care inequities, is still a challenge today. Research also needs to become more inclusive to address the needs of women of color. While Black women have a lower incidence of breast cancer than other racial/ethnic groups, they have a high mortality rate, shorter survival rate, and are more likely to be diagnosed with triple-negative cancer, which is more aggressive and difficult to treat. They are also more likely to be diagnosed before the age of 50 and have dense breast tissue, which is a predictor of breast cancer risk and hinders the sensitivity of a mammogram.

Expanding the joy of parenthood

Experimentation with in vitro fertilization (IVF) dates back to 1800, when embryologist Samuel Leopold Schenk collected ova and sperm from rabbits and guinea pigs and noted that cell division was possible. The first recorded birth of a baby conceived through artificial insemination was in the late 1880s. Over 12 million babies have been born worldwide since Louise Brown, the first test tube baby, was born in 1978.

As much as these technologies have helped us grow as a society, most people struggle with the costs of undergoing treatments and lack of coverage by health plans. However, as more advancements are made in technology and research, we are poised to see more opportunities for families.

Acknowledging and treating her silent pain

One of the many advances in maternal care is postpartum depression (PPD) screening. PPD was once noted as a form of “hysteria” or “insanity” with many women undergoing societal scrutiny for “not accepting the role of motherhood”. Painful electroshock therapy and institutionalization were the “cure” for most severe cases. And for many, suffering in silence led to broader mental and emotional traumas impacting the whole family unit.

Today, awareness and PPD screenings are integrated into prenatal and postpartum care. In 1987, The Edinburgh Postnatal Depression Scale was developed to help doctors predict the onset and severity of depression in mothers after birth. Pediatricians now screen women for signs of depression during early well-baby visits. Thanks to advocacy and awareness groups, women are now able to voice their battles with PPD to a larger community ready to support their journey to wellness.

When you’re trying to conceive, the similarities between symptoms of implantation and signs of PMS can sound maddeningly similar on paper, but in reality, there are differences you may be able to feel, and there’s a good chance you’ll have an idea whether implantation took place before a pregnancy test can even tell you.

Signs of implantation: A 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.

Implantation symptoms

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 milder than that from menstrual cramps.

Spotting

Implantation bleeding produces a lot less blood than your 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, your hormones during pregnancy can cause several different changes in your breasts. The other one 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 PMS, like nausea and morning sickness, increased urination, and 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

• “Pregnancy Symptoms.” American Pregnancy Association. American Pregnancy Assocaition. June 29, 2018. http://americanpregnancy.org/getting-pregnant/early-pregnancy-symptoms/
• Mayo Clinic Staff. “Symptoms of Pregnancy: What happens first.” Mayo Clinic. Mayo Clinic. Jan. 5, 2017. https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/symptoms-of-pregnancy/art-20043853

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/

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 

How long are eggs viable after ovulation?

Eggs are viable (available to be fertilized by a sperm cell) for about 12-24 hours after ovulation. However, sperm cells are viable in your reproductive tract for up to five days, meaning the fertile window can last six days total. It’s nearly impossible to know you’ve ovulated the moment you do, so it’s important to have regular intercourse in the days leading up to ovulation, not just that day.

During ovulation

During the first half of the menstrual cycle–known as the proliferative, or “follicular” phase–many eggs are developing in follicles in your ovaries, though this does not happen spontaneously. During the beginning of the proliferative phase, your body begins to produce a hormone known as GnRH (gonadotropin-releasing hormone), which signals for FSH (follicle-stimulating hormone) to begin stimulating your follicles to help mature your eggs, and prepare for ovulation.

Follicles produce and release estrogen as they grow, and when it becomes clear which egg is maturing best, the remainder will stop producing estrogen and disintegrate. This sole survivor has now solidified its place as the lone egg available for ovulation. At some point (usually about a day or two before you ovulate), the estrogen released by your dominant follicle reaches a certain threshold, which causes your brain to send instructions to release a new hormone, LH (luteinizing hormone). The surge in LH serves as instructions to your ovary saying, “hey ovary, release that egg!”

After ovulation

About a day or two after you notice the LH surge, your ovary will heed the hormone’s instructions, and release an egg into your fallopian tube, where it has plans to get together with your partner’s sperm cell–this is known as ovulation. At this time, your body will start producing the hormone progesterone, to help thicken your uterine lining and prepare it for pregnancy. If you had intercourse in the five days prior to ovulation, there may be a sperm cell waiting for your egg in the fallopian tube, although intercourse in the 12-24 hours after ovulation can also result in conception.

If your egg successfully meets a sperm and is fertilized within the day or so after ovulation, it will then travel towards your uterus, and implant in the uterine lining, where it will begin producing human chorionic gonadotropin (hCG), the hormone that pregnancy tests search for, and continue the progesterone production. Implantation tends to happen about 7-10 days after fertilization.

If your egg is not fertilized, estrogen and progesterone production will stop, and the thickened uterine lining will begin to disintegrate. When progesterone drops to a certain level, it triggers a menstrual period, and the start of a new cycle.

How do I know if I’ve ovulated?

Some women notice one-sided abdominal cramping or lower backaches when they ovulate, but it’s not always so clear. However, there are certain methods that you can use to determine whether you ovulated, including monitoring your basal body temperature, and using ovulation test strips.

Your basal body temperature (BBT) may vary throughout the menstrual cycle, but it often does so in a consistent way. Women may sometimes notice a slight dip in basal body temperature immediately before ovulation, but there is a quite strong correlation between ovulation and a spike in BBT in the days following ovulation, due to the elevated level of progesterone. Tracking your BBT across multiple cycles can help you figure out how consistent your ovulations are from cycle-to-cycle.

Ovulation tests are another tool you can use to determine if ovulation occurred. Ovulation tests search your urine for the presence of LH, the hormone that spikes in the day or two before ovulation, so ovulation tests can help you identify up to three of your fertile days, as an egg is viable for up to 24 hours after ovulation.

Tracking your basal body temperature and ovulation tests, as well as your symptoms, moods, and cervical fluid are excellent methods of pinpointing your ovulation so that you’re able to have the intercourse needed to conceive while your egg is still viable.

Sources

•  “Determining Your Fertile Window” American Pregnancy Association. American Pregnancy Association. June 12, 2018. http://americanpregnancy.org/getting-pregnant/fertility-window/