WEBVTT - 139. Quick Kick: Understanding Your Menstrual Cycle

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<v Speaker 1>The information in this podcast is provided for education and

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<v Speaker 1>research information only. It is not a substitute for professional

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<v Speaker 1>health advice.

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<v Speaker 2>Welcome everyone, I'm Brigid Maloney and today I've got a

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<v Speaker 2>quick kick for you, and it's all about the menstrual cycle.

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<v Speaker 2>So in twenty twenty two we released only one episode

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<v Speaker 2>for the entire year. It was a massive year for us,

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<v Speaker 2>both professionally and personally. Our eldest boy went off to

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<v Speaker 2>college and we were busy building our new women's health clinic.

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<v Speaker 2>And that is learning about your menstrual cycle for something

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<v Speaker 2>that is regular, and I'm going to say for most people,

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<v Speaker 2>having a great and full understanding of your menstrual cycle

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<v Speaker 2>is not common. The questions you ask us about how

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<v Speaker 2>to get pregnant is not in the high school curriculum.

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<v Speaker 2>What is, though, is how not to get pregnant. Which

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<v Speaker 2>I don't know about you, but in my high school learning,

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<v Speaker 2>it made me think that anytime I would have sex

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<v Speaker 2>it would lead to a pregnancy. It comes as a

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<v Speaker 2>surprise to some then when I are trying for a

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<v Speaker 2>baby that that actually isn't the case. The first step

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<v Speaker 2>to getting pregnant has to be to get to know

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<v Speaker 2>your menstrual cycle. So let's get into it. Pat suggests

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<v Speaker 2>you look at a chart of the menstrual cycle when

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<v Speaker 2>listening to this episode. You can find one on our

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<v Speaker 2>website grow mybaby dot com dot au or in the

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<v Speaker 2>link in the show notes of this app. Let's start learning.

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<v Speaker 1>So I think it's easiest to understand not worrying too

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<v Speaker 1>much about this phase and that phase that you'll see

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<v Speaker 1>in those diagrams and the year ten science textbook diagram

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<v Speaker 1>of the cycle, but really to think of it in

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<v Speaker 1>terms that ordinary people would experience, which is the cycle

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<v Speaker 1>itself and the days of the cycle. So day one

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<v Speaker 1>is the start of the cycle, and that's the first

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<v Speaker 1>day of bleeding. It's called the menstrual phase, if you

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<v Speaker 1>need to give it a name. And at the stage

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<v Speaker 1>of the cycle, all the hormones are sitting there pretty low,

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<v Speaker 1>the bleeding is actually happening. After a few more days,

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<v Speaker 1>a hormone starts coming out of your brain called FSH

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<v Speaker 1>follicle stimulating hormone, And what that hormone does is stimulates

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<v Speaker 1>some of those deep follicles, the little tiny sacs that

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<v Speaker 1>are going to eventually contain a mature egg. Now you've

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<v Speaker 1>got hundreds of thousands of those little follicles, and under

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<v Speaker 1>the influence of FSH hormone in those early days of

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<v Speaker 1>the cycle, one of them gets matured up above the

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<v Speaker 1>rest and becomes what I call the chosen one for

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<v Speaker 1>the month, and that's the one that's actually going to

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<v Speaker 1>have a mature egg inside it, mature enough to actually

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<v Speaker 1>be ovulated out in the middle of the cycle. During

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<v Speaker 1>that phase, when the follicle is developing and the chosen

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<v Speaker 1>one is chosen and the egg is maturing, the over

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<v Speaker 1>is also producing estrogen, and the estrogen is making the

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<v Speaker 1>lining of the uterus thicker. About day thirteen, a second

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<v Speaker 1>hormone kicks in from the brain called l H and

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<v Speaker 1>that's the one that those ovulation predicted gates can test for.

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<v Speaker 1>And what it does is cause the final maturation of

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<v Speaker 1>the follicle and the egg such that the egg is

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<v Speaker 1>ready to be released the following day. After the LHED surge,

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<v Speaker 1>which is in a textbook cycle, about day fourteen, so

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<v Speaker 1>out pops the egg on day fourteen. The egg starts

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<v Speaker 1>its journey out towards the Filippian tubes, hoping that the

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<v Speaker 1>fingers on the edge of the Filippian tubes will catch

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<v Speaker 1>it and direct it down the tube, where if we're

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<v Speaker 1>trying to get pregnant, might meet up with some sperm

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<v Speaker 1>company other way in the tube. In the tube. Yeah,

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<v Speaker 1>So when the egg pops out the surface of the ovary,

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<v Speaker 1>the mature follicle that let go of the egg, the

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<v Speaker 1>rest of it turns into a structure called corpus lute

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<v Speaker 1>and the corpus lutine is a little structure on the

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<v Speaker 1>surface of the ovary that's main job is to produce

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<v Speaker 1>tons of progesterone. And the second half of the cycle,

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<v Speaker 1>everything after the ovulation day is kind of dominated by

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<v Speaker 1>a progesterone from the corpus luteum, and that progesterone's job

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<v Speaker 1>is to stabilize the menstrual lining in the second half

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<v Speaker 1>of the cycle and get it ready for the implantation

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<v Speaker 1>of the egg. If the egg happens to get fertilized,

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<v Speaker 1>so for fertilized egg implants, then the pregnancy is off

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<v Speaker 1>from there. And assuming that pregnancy doesn't take place, then

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<v Speaker 1>eventually the corpus luteum runs out of function, gets smaller,

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<v Speaker 1>and disappears. The progesterone level goes right down and the

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<v Speaker 1>bleeding starts again and that's the new day one. Whole

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<v Speaker 1>process is repeated.

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<v Speaker 2>So even though you know you said day one, at

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<v Speaker 2>day one, yes, all the hormones are low, when did

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<v Speaker 2>you say the hormones start kicking in again.

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<v Speaker 1>Well, estrogen rises progressively through the first half of the

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<v Speaker 1>cycle and peaks around the middle, and progesterone is the

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<v Speaker 1>dominant hormone of the second half of the cycle.

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<v Speaker 2>The whole thing, there's so many moving parts, isn't there?

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<v Speaker 1>There are so understanding that explanation. One of the useful

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<v Speaker 1>things you could do is get out that old high

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<v Speaker 1>school science diagram of how the cycle works, and maybe

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<v Speaker 1>we'll attach that to the show notes so that people

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<v Speaker 1>could look at that diagram and listen to me explain how.

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<v Speaker 2>That works opefully at the same time, Yeah, at the.

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<v Speaker 1>Same time, and understand that process.

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<v Speaker 2>All right, So does a woman's cycle sort of change

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<v Speaker 2>throughout her life?

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<v Speaker 1>Yeah? Absolutely so. It definitely changes throughout a woman's life.

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<v Speaker 1>And that can also help us understand some of the

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<v Speaker 1>ways in which menstreul issues might be causing a problem

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<v Speaker 1>or might present if woman needs to go to a

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<v Speaker 1>doctor about one of these issues. So let's look at

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<v Speaker 1>the first stage of pre puberty. At that stage, those

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<v Speaker 1>FSH and LH hormones are just not coming out of

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<v Speaker 1>the brain to stimulate the cycle. So that's why it's

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<v Speaker 1>no period. Anatomically, a woman's got ovaries and a young uterus,

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<v Speaker 1>but they're not being stimulated. At puberty, FSH and LH

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<v Speaker 1>start being produced in the brain stem, come down to

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<v Speaker 1>the ovaries and start the start of a cycle. Now

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<v Speaker 1>they will stimulate the ovary to start functioning hormonally, but

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<v Speaker 1>they don't often result in full ovulation in the first

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<v Speaker 1>couple of years, and that's because the hormonal processes here

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<v Speaker 1>are pretty complicated and they take it quite a while

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<v Speaker 1>to establish their full functionality. So you'll get some periods

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<v Speaker 1>in that first couple of years that can be annalvulatry

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<v Speaker 1>no egg, and it's often described as being an immature

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<v Speaker 1>relationship between the brain and the ovaries. So when those

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<v Speaker 1>cycles result without an egg, then just like any other

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<v Speaker 1>annalvulatory cycle, they can be problematic, irregular, too heavy, and

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<v Speaker 1>so we do see adolescent whemen for menstrual disturbances if

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<v Speaker 1>they're quite significant, and sometimes we can treat those by

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<v Speaker 1>replacing the lack of natural progesterone in the second half

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<v Speaker 1>of the cycle because there's no egg, so there's no

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<v Speaker 1>corpusly team, so there's no progesterone with some artificial registerone

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<v Speaker 1>from a source like a contraceptive pill.

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<v Speaker 2>Yeah right, just bank that information. They might be handy

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<v Speaker 2>for all these women that are having daughters for later.

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<v Speaker 1>Yeah. So the first couple of years, as few as

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<v Speaker 1>ten percent of the cycles fully mature ovulatory cycle. So

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<v Speaker 1>then we get past those first couple of years and

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<v Speaker 1>just move into normal menstrual years, which might go from

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<v Speaker 1>fifteen or so to about forty five forty six. And

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<v Speaker 1>in those years, the menstrual cycle is working in a

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<v Speaker 1>totally normal situation. It's working normally. The hormonal cascade that

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<v Speaker 1>I mentioned before is functioning normally, and the cycle is

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<v Speaker 1>functional and the woman is fertile. After that, in the

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<v Speaker 1>late forties, so called perimenopause will change. We start to

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<v Speaker 1>see the ovary being unable to fully respond to stimulation

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<v Speaker 1>from the brain such that some months there's no egg.

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<v Speaker 1>So we might have ten ovulatory cycles a year and

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<v Speaker 1>two an olphilatory cycles. Those and ovulatory cycles will typically

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<v Speaker 1>have issues with heavy bleeding or a cycle that's way

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<v Speaker 1>too long, followed by a heavy period. We might be

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<v Speaker 1>able to put up with the odd one. But as

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<v Speaker 1>the ovary is increasingly unable to ovulate each month, then

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<v Speaker 1>menstrual disturbance related to an ovulation becomes more common, and

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<v Speaker 1>we're much more likely to see women at that time

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<v Speaker 1>with issues of heavy or irregular menstrual periods. One more

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<v Speaker 1>phase we didn't talk about, and that's metopause. So menopause comes.

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<v Speaker 1>It's commonly thought of being when you run out of eggs,

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<v Speaker 1>and it's not really running out of eggs, it's just

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<v Speaker 1>when the ovary gets to the point where it can't

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<v Speaker 1>respond at all to the stimulation from the brainstam. Once

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<v Speaker 1>it's done, doesn't matter how much the FSH and LH

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<v Speaker 1>hormones coming out of the brain say, come on, overdo something.

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<v Speaker 1>It can't anymore. And so there may still be vollicles

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<v Speaker 1>left in the ovary, but the over is no longer

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<v Speaker 1>capable of maturing them up, so that at that point

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<v Speaker 1>hormonal production from the ov receases, and I'll see women

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<v Speaker 1>of course at that stage of life, not so much

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<v Speaker 1>a problem that the ovary can't produce hormones anymore, but

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<v Speaker 1>the rest of their body might miss the estrogen. So

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<v Speaker 1>we sometimes see people who've sailed through the menopausal transition

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<v Speaker 1>without an issue. But sometimes I'll see women who are

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<v Speaker 1>having typical responses from the rest of their body to

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<v Speaker 1>the lack of estrogen being secreted by the overary, so

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<v Speaker 1>hot flushes, sleep disturbance, breast tenderness, drive vagina, and so forth.

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<v Speaker 2>Thanks for joining us. If you have more questions about

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<v Speaker 2>the menstrual cycle, we would love to hear them. Pop

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<v Speaker 2>onto our website grow mybaby dot com dot you and

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<v Speaker 2>put your question on speak pipe. There are no silly questions.

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<v Speaker 2>We are all here to learn and if you have

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<v Speaker 2>a question, chances are someone else will have the same question,

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<v Speaker 2>so you'd be the brave one and ask it for them.

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<v Speaker 2>For those who are trying for a baby, come and

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<v Speaker 2>join our Getting Pregnant program. This is all the pre

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<v Speaker 2>pregnancy information that you and your partner need to know

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<v Speaker 2>to help you optimize your chance of for pregnancy. You

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<v Speaker 2>can find the links to this on our website grow

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<v Speaker 2>mybaby dot com dot AU and in this EPs show notes.

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<v Speaker 2>Until next week, Keep well life now