Speaker 1: The information in this podcast is provided for education and
Speaker 1: research information only. It is not a substitute for professional
Speaker 1: health advice.
Speaker 2: Welcome everyone, I'm Brigid Maloney and today I've got a
Speaker 2: quick kick for you, and it's all about the menstrual cycle.
Speaker 2: So in twenty twenty two we released only one episode
Speaker 2: for the entire year. It was a massive year for us,
Speaker 2: both professionally and personally. Our eldest boy went off to
Speaker 2: college and we were busy building our new women's health clinic.
Speaker 2: And that is learning about your menstrual cycle for something
Speaker 2: that is regular, and I'm going to say for most people,
Speaker 2: having a great and full understanding of your menstrual cycle
Speaker 2: is not common. The questions you ask us about how
Speaker 2: to get pregnant is not in the high school curriculum.
Speaker 2: What is, though, is how not to get pregnant. Which
Speaker 2: I don't know about you, but in my high school learning,
Speaker 2: it made me think that anytime I would have sex
Speaker 2: it would lead to a pregnancy. It comes as a
Speaker 2: surprise to some then when I are trying for a
Speaker 2: baby that that actually isn't the case. The first step
Speaker 2: to getting pregnant has to be to get to know
Speaker 2: your menstrual cycle. So let's get into it. Pat suggests
Speaker 2: you look at a chart of the menstrual cycle when
Speaker 2: listening to this episode. You can find one on our
Speaker 2: website grow mybaby dot com dot au or in the
Speaker 2: link in the show notes of this app. Let's start learning.
Speaker 1: So I think it's easiest to understand not worrying too
Speaker 1: much about this phase and that phase that you'll see
Speaker 1: in those diagrams and the year ten science textbook diagram
Speaker 1: of the cycle, but really to think of it in
Speaker 1: terms that ordinary people would experience, which is the cycle
Speaker 1: itself and the days of the cycle. So day one
Speaker 1: is the start of the cycle, and that's the first
Speaker 1: day of bleeding. It's called the menstrual phase, if you
Speaker 1: need to give it a name. And at the stage
Speaker 1: of the cycle, all the hormones are sitting there pretty low,
Speaker 1: the bleeding is actually happening. After a few more days,
Speaker 1: a hormone starts coming out of your brain called FSH
Speaker 1: follicle stimulating hormone, And what that hormone does is stimulates
Speaker 1: some of those deep follicles, the little tiny sacs that
Speaker 1: are going to eventually contain a mature egg. Now you've
Speaker 1: got hundreds of thousands of those little follicles, and under
Speaker 1: the influence of FSH hormone in those early days of
Speaker 1: the cycle, one of them gets matured up above the
Speaker 1: rest and becomes what I call the chosen one for
Speaker 1: the month, and that's the one that's actually going to
Speaker 1: have a mature egg inside it, mature enough to actually
Speaker 1: be ovulated out in the middle of the cycle. During
Speaker 1: that phase, when the follicle is developing and the chosen
Speaker 1: one is chosen and the egg is maturing, the over
Speaker 1: is also producing estrogen, and the estrogen is making the
Speaker 1: lining of the uterus thicker. About day thirteen, a second
Speaker 1: hormone kicks in from the brain called l H and
Speaker 1: that's the one that those ovulation predicted gates can test for.
Speaker 1: And what it does is cause the final maturation of
Speaker 1: the follicle and the egg such that the egg is
Speaker 1: ready to be released the following day. After the LHED surge,
Speaker 1: which is in a textbook cycle, about day fourteen, so
Speaker 1: out pops the egg on day fourteen. The egg starts
Speaker 1: its journey out towards the Filippian tubes, hoping that the
Speaker 1: fingers on the edge of the Filippian tubes will catch
Speaker 1: it and direct it down the tube, where if we're
Speaker 1: trying to get pregnant, might meet up with some sperm
Speaker 1: company other way in the tube. In the tube. Yeah,
Speaker 1: So when the egg pops out the surface of the ovary,
Speaker 1: the mature follicle that let go of the egg, the
Speaker 1: rest of it turns into a structure called corpus lute
Speaker 1: and the corpus lutine is a little structure on the
Speaker 1: surface of the ovary that's main job is to produce
Speaker 1: tons of progesterone. And the second half of the cycle,
Speaker 1: everything after the ovulation day is kind of dominated by
Speaker 1: a progesterone from the corpus luteum, and that progesterone's job
Speaker 1: is to stabilize the menstrual lining in the second half
Speaker 1: of the cycle and get it ready for the implantation
Speaker 1: of the egg. If the egg happens to get fertilized,
Speaker 1: so for fertilized egg implants, then the pregnancy is off
Speaker 1: from there. And assuming that pregnancy doesn't take place, then
Speaker 1: eventually the corpus luteum runs out of function, gets smaller,
Speaker 1: and disappears. The progesterone level goes right down and the
Speaker 1: bleeding starts again and that's the new day one. Whole
Speaker 1: process is repeated.
Speaker 2: So even though you know you said day one, at
Speaker 2: day one, yes, all the hormones are low, when did
Speaker 2: you say the hormones start kicking in again.
Speaker 1: Well, estrogen rises progressively through the first half of the
Speaker 1: cycle and peaks around the middle, and progesterone is the
Speaker 1: dominant hormone of the second half of the cycle.
Speaker 2: The whole thing, there's so many moving parts, isn't there?
Speaker 1: There are so understanding that explanation. One of the useful
Speaker 1: things you could do is get out that old high
Speaker 1: school science diagram of how the cycle works, and maybe
Speaker 1: we'll attach that to the show notes so that people
Speaker 1: could look at that diagram and listen to me explain how.
Speaker 2: That works opefully at the same time, Yeah, at the.
Speaker 1: Same time, and understand that process.
Speaker 2: All right, So does a woman's cycle sort of change
Speaker 2: throughout her life?
Speaker 1: Yeah? Absolutely so. It definitely changes throughout a woman's life.
Speaker 1: And that can also help us understand some of the
Speaker 1: ways in which menstreul issues might be causing a problem
Speaker 1: or might present if woman needs to go to a
Speaker 1: doctor about one of these issues. So let's look at
Speaker 1: the first stage of pre puberty. At that stage, those
Speaker 1: FSH and LH hormones are just not coming out of
Speaker 1: the brain to stimulate the cycle. So that's why it's
Speaker 1: no period. Anatomically, a woman's got ovaries and a young uterus,
Speaker 1: but they're not being stimulated. At puberty, FSH and LH
Speaker 1: start being produced in the brain stem, come down to
Speaker 1: the ovaries and start the start of a cycle. Now
Speaker 1: they will stimulate the ovary to start functioning hormonally, but
Speaker 1: they don't often result in full ovulation in the first
Speaker 1: couple of years, and that's because the hormonal processes here
Speaker 1: are pretty complicated and they take it quite a while
Speaker 1: to establish their full functionality. So you'll get some periods
Speaker 1: in that first couple of years that can be annalvulatry
Speaker 1: no egg, and it's often described as being an immature
Speaker 1: relationship between the brain and the ovaries. So when those
Speaker 1: cycles result without an egg, then just like any other
Speaker 1: annalvulatory cycle, they can be problematic, irregular, too heavy, and
Speaker 1: so we do see adolescent whemen for menstrual disturbances if
Speaker 1: they're quite significant, and sometimes we can treat those by
Speaker 1: replacing the lack of natural progesterone in the second half
Speaker 1: of the cycle because there's no egg, so there's no
Speaker 1: corpusly team, so there's no progesterone with some artificial registerone
Speaker 1: from a source like a contraceptive pill.
Speaker 2: Yeah right, just bank that information. They might be handy
Speaker 2: for all these women that are having daughters for later.
Speaker 1: Yeah. So the first couple of years, as few as
Speaker 1: ten percent of the cycles fully mature ovulatory cycle. So
Speaker 1: then we get past those first couple of years and
Speaker 1: just move into normal menstrual years, which might go from
Speaker 1: fifteen or so to about forty five forty six. And
Speaker 1: in those years, the menstrual cycle is working in a
Speaker 1: totally normal situation. It's working normally. The hormonal cascade that
Speaker 1: I mentioned before is functioning normally, and the cycle is
Speaker 1: functional and the woman is fertile. After that, in the
Speaker 1: late forties, so called perimenopause will change. We start to
Speaker 1: see the ovary being unable to fully respond to stimulation
Speaker 1: from the brain such that some months there's no egg.
Speaker 1: So we might have ten ovulatory cycles a year and
Speaker 1: two an olphilatory cycles. Those and ovulatory cycles will typically
Speaker 1: have issues with heavy bleeding or a cycle that's way
Speaker 1: too long, followed by a heavy period. We might be
Speaker 1: able to put up with the odd one. But as
Speaker 1: the ovary is increasingly unable to ovulate each month, then
Speaker 1: menstrual disturbance related to an ovulation becomes more common, and
Speaker 1: we're much more likely to see women at that time
Speaker 1: with issues of heavy or irregular menstrual periods. One more
Speaker 1: phase we didn't talk about, and that's metopause. So menopause comes.
Speaker 1: It's commonly thought of being when you run out of eggs,
Speaker 1: and it's not really running out of eggs, it's just
Speaker 1: when the ovary gets to the point where it can't
Speaker 1: respond at all to the stimulation from the brainstam. Once
Speaker 1: it's done, doesn't matter how much the FSH and LH
Speaker 1: hormones coming out of the brain say, come on, overdo something.
Speaker 1: It can't anymore. And so there may still be vollicles
Speaker 1: left in the ovary, but the over is no longer
Speaker 1: capable of maturing them up, so that at that point
Speaker 1: hormonal production from the ov receases, and I'll see women
Speaker 1: of course at that stage of life, not so much
Speaker 1: a problem that the ovary can't produce hormones anymore, but
Speaker 1: the rest of their body might miss the estrogen. So
Speaker 1: we sometimes see people who've sailed through the menopausal transition
Speaker 1: without an issue. But sometimes I'll see women who are
Speaker 1: having typical responses from the rest of their body to
Speaker 1: the lack of estrogen being secreted by the overary, so
Speaker 1: hot flushes, sleep disturbance, breast tenderness, drive vagina, and so forth.
Speaker 2: Thanks for joining us. If you have more questions about
Speaker 2: the menstrual cycle, we would love to hear them. Pop
Speaker 2: onto our website grow mybaby dot com dot you and
Speaker 2: put your question on speak pipe. There are no silly questions.
Speaker 2: We are all here to learn and if you have
Speaker 2: a question, chances are someone else will have the same question,
Speaker 2: so you'd be the brave one and ask it for them.
Speaker 2: For those who are trying for a baby, come and
Speaker 2: join our Getting Pregnant program. This is all the pre
Speaker 2: pregnancy information that you and your partner need to know
Speaker 2: to help you optimize your chance of for pregnancy. You
Speaker 2: can find the links to this on our website grow
Speaker 2: mybaby dot com dot AU and in this EPs show notes.
Speaker 2: Until next week, Keep well life now