Menstrual cycle diagram. Click to enlarge.
Let’s face it—our bodies don’t come with instruction manuals, but the menstrual cycle would likely be one of the more complicated chapters if they did. Whether you’re just starting your first period, trying to conceive, want to understand why your mood, skin, or energy levels fluctuate each month, or are concerned that your period is abnormal, knowing what happens during your cycle is empowering.
So, What Is the Menstrual Cycle?
The menstrual cycle is the monthly series of hormonal changes a woman undergoes to prepare for a potential pregnancy. If pregnancy doesn’t happen, the body sheds the uterine lining (aka your period), and the cycle starts over.
On average, a cycle lasts about 28 days, but anywhere between 21 and 35 days is considered normal.
Let’s break it down into four key phases:
Menstrual Phase (Days 1–5)
A.K.A.: Your period
This is the part of the cycle we’re all most familiar with. The menstrual phase begins on day one of bleeding, when the uterus sheds the lining it built up in the previous cycle.
- What’s happening: Hormone levels (estrogen and progesterone) drop, triggering the shedding of the uterine lining.
- What you might feel: Cramps, fatigue, mood swings, or just a general “I’d like to stay in pajamas today” vibe.
- Self-care tip: Stay hydrated, use a heating pad, and try light exercise to help ease cramps.
Follicular Phase (Days 1–13)
A.K.A.: Pre-ovulation
This phase overlaps with your period but continues afterward. The brain sends FSH (follicle-stimulating hormone) to help your ovaries mature follicles (tiny sacs holding an egg). One lucky follicle will become “the chosen one” and prepare for ovulation.
- What’s happening: Estrogen levels start to rise, helping rebuild the uterine lining and support egg development.
- What you might feel: Increased energy, clearer thinking, better workouts—your hormones are climbing!
- Fun fact: Your skin may glow a little brighter during this phase. Thanks, estrogen.
Ovulation Phase (Around Day 14)
A.K.A.: The main event
Ovulation typically occurs around the middle of your cycle when a surge in LH (luteinizing hormone) causes the ovary to release an egg. This is the window when you’re most fertile.
- What’s happening: The egg is released and begins its journey down the fallopian tube, waiting to be fertilized.
- What you might feel: A slight twinge on one side of your lower abdomen (called mittelschmerz), increased libido, and cervical mucus that’s stretchy like egg whites—ideal for sperm travel.
- Fertility tip: If you’re trying to conceive, this is go-time.
Luteal Phase (Days 15–28)
A.K.A.: The two-week wait
After ovulation, the follicle becomes the corpus luteum, which produces progesterone to support a potential pregnancy. If no embryo implants after about 10-14 days, the corpus luteum stops producing hormones, and the uterus gets ready to reset.
- What’s happening: The uterine lining thickens, preparing for implantation.
- What you might feel: PMS symptoms—bloating, mood swings, cravings, or breast tenderness.
- Cycle tip: Track your symptoms! Understanding your luteal phase can help you recognize hormonal patterns (and prepare accordingly).
And Then… It Starts All Over Again
If pregnancy doesn’t occur, the corpus luteum degenerates and becomes the corpus albicans—a small, fibrous scar on the ovary, mostly made of collagen. It’s sort of like the “ghost” of ovulation past—no longer active, but a sign that your body completed a full cycle. The uterine lining is shed (your next period), and the cycle repeats. If you are pregnant, your hormone levels will stay elevated to support the pregnancy, and your period will take a nine-month vacation.
Tracking Your Cycle
Tracking your cycle helps you understand your body, spot patterns, and recognize when something’s off. Here’s how to start:
What to Track:
- First and last day of your period
- Flow intensity (light, medium, heavy)
- Symptoms (cramps, mood, bloating, sleep, energy)
- Cervical mucus changes
- Basal body temperature (if tracking ovulation)
- PMS patterns
Helpful Cycle-Tracking Apps:
- Flo – Great for period and fertility tracking; includes symptom logging and health insights.
- Natural Cycles – FDA-cleared for fertility awareness (requires daily temperature tracking).
- Eve by Glow – Stylish interface emphasizes sexual and emotional wellness.
- Apple Health App – Built-in period tracker that can log symptoms and receive cycle predictions.
Tracking consistently for a few months can reveal a lot about your hormonal rhythm—and help you advocate for your health.
Why It Matters
Understanding your menstrual cycle is more than just managing your period. It’s a window into your overall health. Irregularities in your cycle can signal underlying issues like hormonal imbalances or other abnormalities. Your menstrual cycle is a powerful health indicator, not just a monthly inconvenience. Understanding your cycle can help you tune into your body, plan your life more comfortably, and identify when something needs attention.
“Is This Normal?” – Let’s Talk About Abnormal Menstrual Bleeding
When your cycle starts showing up like an uninvited guest (too often, too long, or way too dramatically), it’s time to check in. At Virginia Beach Obstetrics & Gynecology, we believe that no one should suffer in silence with abnormal menstrual bleeding or wonder if what they’re experiencing is “just part of being a woman.” Every woman’s menstrual cycle is unique, but significant changes or irregularities in bleeding can indicate an abnormality. Abnormal menstrual bleeding is one of the most common reasons women seek gynecologic care. Understanding what is—and isn’t—normal is an important step toward protecting your reproductive health.
What Is Abnormal Menstrual Bleeding?
Abnormal menstrual bleeding, also known as abnormal uterine bleeding (AUB), refers to any bleeding that differs from your regular menstrual cycle. This may include:
- Heavy bleeding (needing to change a pad or tampon every 1–2 hours)
- Bleeding that lasts longer than 7 days
- Bleeding between periods
- Skipping periods (especially if you’re not pregnant or menopausal)
- Bleeding after sex
- Bleeding after menopause
Common Causes of Abnormal Bleeding
There are many potential causes of abnormal bleeding, some of which are minor, while others may require prompt treatment:
- Hormonal imbalances (common during adolescence, perimenopause, or due to thyroid disorders)
- Uterine fibroids or polyps
- Polycystic ovary syndrome (PCOS)
- Endometriosis or adenomyosis
- Pregnancy-related complications
- Infections or sexually transmitted infections (STIs)
- Certain medications, including blood thinners or hormonal contraceptives
- Cancer of the uterus, cervix, or ovaries (less common, but important to rule out)
When to See a Provider
You should contact your OB/GYN if you experience:
- Bleeding that interferes with daily activities
- Severe cramping or pelvic pain
- Dizziness, fatigue, or signs of anemia
- Bleeding after menopause
- Irregular cycles that persist for several months
Prompt evaluation can help determine the cause and ensure appropriate treatment. At Virginia Beach Obstetrics & Gynecology, we use a combination of thorough history-taking, physical exams, imaging (such as ultrasound), and lab tests to identify the underlying issue.
Treatment Options
Treatment depends on the cause of your abnormal bleeding, your age, and whether you are planning to become pregnant in the future. Options may include:
- Lifestyle changes and hormonal therapy (e.g., birth control pills)
- Non-hormonal medications to reduce bleeding
- In-office procedures such as endometrial ablation
- Surgical options like hysteroscopy, myomectomy, or in some cases, hysterectomy
Your Health Matters
While abnormal menstrual bleeding can be disruptive, it is often treatable once the underlying cause is identified. If you’re experiencing irregular bleeding, don’t wait. Our Virginia Beach Obstetrics & Gynecology team is here to listen, evaluate, and guide you toward a personalized treatment plan supporting your long-term health and wellness.
At Virginia Beach Obstetrics & Gynecology, we’re here to support you through every phase, symptom, and cycle. Whether you’re tracking your period, planning for pregnancy, or just want fewer surprises from your uterus, we’ve got your back.
Call us at (757) 425-1600 to schedule an appointment.