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What is a Normal Menstrual Cycle?

While for many women, their period may seem like a monthly hassle, in the functional health community, it’s known as one of the five vital signs that reveal hints towards the true status of your health.

Irregularities in your menstruation cycle can point to much deeper health conditions. If your period is accompanied by debilitating cramps, excessive bleeding, and exhaustive mood swings, there is likely a deeper cause than just your monthly cycle.

Normal menstruation 101:

For most women, every month, their bodies go through a series of changes in preparation for the possibility of a pregnancy. This is called the menstrual cycle. While most people think of their cycle as beginning when the bleeding starts, it's actually a much longer, much more complicated process. The menstrual cycle first begins when the hypothalamus in the brain secretes gonadotropin-releasing hormone (GnRH). GnRH then stimulates the pituitary gland to release follicle-stimulating hormone (FSH), this hormone will cause estrogen levels to rise and will thus thicken the endometrium. This process is called the follicular phase. It ends when the egg is released from the ovary, a process also known as ovulation.

The next phase is a 10-16 day period in which the corpus luteum gland forms from the follicle that released the egg. This follicle releases progesterone and further prepares your body for pregnancy. If you don’t get pregnant, the uterine lining will begin to break down and separate from the uterus, causing the blood flow to begin.

It actually takes 100 days for the egg follicle released during ovulation to fully develop in the ovaries. Those 100 days of development are crucial to follicle development and integral in having a healthy menstrual cycle. This means sleeping well, eating a balanced diet, and stress management are all major factors in syncing all these complex hormonal processes. If stress is too high or you’re eating a diet high in processed foods, this can lead to hormonal imbalances that can affect your menstrual cycle.

But how do you know what is normal when it comes to your period? No period is alike and every woman has a different menstrual cycle and menstrual symptoms. Luckily, doctors have created a range of symptoms that are considered to be normal:

  • A cycle from 24-38 days

  • Bleeding for a length of 4.5 to 8 days per cycle

  • A cycle length that varies by up to 20 days over a year

  • Losing 5 to 80 milliliters of blood per cycle

Moreover, if you’re period is often accompanied by debilitating cramps, intense emotional swings, excessive bleeding, or lasts longer than 8 days per cycle, it’s very likely there are underlying problems. Your period should not make you stay in bed for days, it should not show up erratically. If you have been struggling with crippling period symptoms for your entire life, know that this is not normal, and there are ways to solve these problems.

Period Abnormalities:

There are several menstrual cycle symptoms that can point to larger issues in your overall health:

Cycle irregularity:

A cycle shorter than 21 days or longer than 35 days should be noted as a red flag. If your period falls outside this 21-35 day window, you could potentially not be ovulating regularly, which will affect your fertility.

Imbalances in your thyroid hormones could also be a culprit behind irregular periods. An underproduction or overproduction of thyroid hormones can allude to an imbalance in estrogen levels. Severe PMS symptoms are another indication that thyroid imbalances could be affecting your periods.

But also keep in mind that irregular periods could also be caused by lifestyle factors. Researchers have demonstrated that shift and service workers have more irregular periods than people with occupations with “normal” hours. This is likely due to a disruption of their natural circadian rhythm and sleep cycle, which also affects the regularity of your periods.

Skipped periods:

Missed periods are often symptoms of being underweight, suffering from very high-stress levels, or undergoing intense physical stress (like being an endurance athlete). Moreover, if you’ve recently gone off or on hormonal birth control, it will likely take your body some time to adjust to such hormonal changes.

On rare occasions, frequently missing periods could mean there is something wrong with the pituitary gland in your brain. If the pituitary gland is not producing hormones like FSH that stimulate egg production in the ovaries, it would cause the period to not start at all.

Painful or heavy periods:

According to the CDC, a normal period flow will fill up a pad or tampon in less than two hours. This equates to around 50 milliliters of blood throughout the menstruation cycle. Good period health means you should only be soaking through 10 to 16 regular tampons or 5 to 8 super tampons per period.

Excessive period flow, which is typically considered to be above 80 milliliters of blood, could point to an excess of estrogen. An imbalance of estrogen would cause the uterine lining to be thicker. This would result in a much heavier period.

A debilitatingly painful period could be a symptom of endometriosis. Research has proven that endometriosis is linked to estrogen imbalances or poor detoxification of estrogen. If your body is not properly detoxifying estrogen in the digestion process, it will lead to a buildup of estrogen in the body. Vitamins and minerals like B vitamins, zinc, folate, magnesium, and selenium, are all essential in this detoxification process. If such nutrients are lacking, it can cause excess estrogen and affect your periods.

Estrogen Dominance 101:

Another potential culprit behind your irregular or painful periods could be estrogen dominance. It is characterized by estrogen levels that are elevated in comparison to other sex hormones. This hormonal imbalance could be caused by an overproduction of estrogen, or an underproduction of progesterone, which would result in an elevated estrogen-progesterone ratio. This condition causes a wide-reaching array of symptoms, from headaches and anxiety to heavy periods and fertility problems. This is due to the interconnected nature of our hormones. If one is out of whack, many will follow suit.

Sex hormones produced in the ovaries and adrenals like estrogen, progesterone, testosterone, DHEA, and cortisol are in constant interaction with other critical hormones like thyroid, melatonin, and insulin. Further, all of your organs, including the brain, heart, blood vessels, lungs, and gut contain estrogen receptors designed specifically for estrogen. This means when estrogen gets out of balance, all of these areas can be affected.

Unfortunately, as of now, estrogen dominance is not an official diagnosis, so there are no statistics on how many women this condition really affects. However, Dr. Johnson sees it in many of her female patients, of all ages. Though, women who are pre-and perimenopausal and women who carry extra weight or body fat are most likely to have a form of estrogen dominance.

Symptoms of estrogen dominance:

Over 400 crucial processes in our body are driven solely by estrogen. There are hundreds of more hormonal processes that act upon and in conjunction with estrogen. The effects of estrogen dominance are far-reaching and can cause a very wide range of symptoms. The most important signs of estrogen dominance are as follows:

  • Intense PMS and heavy periods- Estrogen dominance can exacerbate the unpleasant symptoms normally associated with PMS. Bloating, heavy periods, weight gain, breast tenderness, and mood swings are an example of symptoms commonly heightened by estrogen dominance. This is because the vagina, breasts, and uterus have the most estrogen receptors in the body.

  • Anxiety and depression- Estrogen plays a role in the formation of mood controlling neurotransmitters like dopamine and serotonin in the gut and brain. Too much estrogen can cause an imbalance in the neurotransmitters, thus contributing to symptoms of anxiety and depression.

  • Headaches and cold hands and feet- These symptoms all relate to blood vessels, which all contain estrogen receptors. Estrogen is vital in dilating or opening up blood vessels. But too much estrogen can alter blood flow enough to cause poor circulation and migraines.

  • Fatigue and poor sleep- Excess estrogen in the body can decrease melatonin levels. Melatonin is essential in proper sleep patterns. Too little melatonin will cause you to have trouble falling and staying asleep, which will contribute to symptoms like fatigue.

  • Low thyroid symptoms- Examples of such symptoms include chronic fatigue, weight gain, dry skin, hair loss, and constipation. Estrogen and thyroid are two hormones that are intrinsically linked, when one is imbalanced, the other is soon to follow. Too much estrogen can cause the thyroid hormone to bind and limit production.

Causes of estrogen dominance:

Estrogen dominance can be caused by an array of contributing factors. And for some women, a genetic component could also be a factor. Some of the most common causes are below:

  • Chronic stress

  • Chronic inflammation

  • Poor diet

  • Excess alcohol consumption

  • Hormone-disrupting chemicals

  • Poor sleep

  • Hormonal birth control

  • Constipation

Testing for estrogen dominance:

There is no perfect way to test for estrogen dominance, due to its multifaceted effects throughout the body. The Johnson Center takes a multipronged approach towards estrogen dominance, starting with understanding a patient’s diet, movement habits, sleep cycle, and symptoms. This will help to deduce what type of testing should be undergone.

Most commonly, a blood test will be used to determine estrogen, progesterone, DHEA’s, and cortisol levels. This will display imbalances throughout the sex hormones. Urine tests can also be used to demonstrate how well estrogen-eliminating processes are functioning. If these processes are out of whack, it is likely there is too much estrogen in the body. Together, this data will help to determine if you have estrogen dominance and what type of treatment will be best.

Treating estrogen dominance and irregular periods:

While treating irregular or debilitating periods and estrogen dominance will likely require hormonal supplements, there are other steps you can take to help naturally balance your hormonal imbalances behind such conditions. These approaches all work towards living a healthy lifestyle and achieving optimal health.

  1. Eat a diet full of vegetables, fruits, and other plant-based foods. Eating a healthy and balanced diet will increase your overall fiber and nutrient intake. This will assist in the detoxification process to rid the body of excess estrogen.

  2. Prioritize sleep and stress management.

  3. Eat more cruciferous vegetables and bitter greens. Cruciferous vegetables like arugula and broccoli contain compounds that further help streamline the detoxification process of estrogen. Bitter greens also contain detoxifying elements.

  4. Incorporate supplements into your daily routine.

  5. Prioritize organic meat products. Meat from animals not organic or pasture-raised are often fed antibiotics and injected with hormones to increase profit. These added chemicals and hormones can work to further promote estrogen dominance in your body.

  6. Use organic personal care and household cleaning products. Many non-organic cleaning products contain chemicals like parabens and phthalates that are classified as xenoestrogens. This term refers to synthetic substances that mimic natural estrogen and can wreak havoc on normal hormonal function.

If you've been dealing with debilitating periods throughout your life, know that you shouldn't be. And it doesn't have to continue.

If you think you’re suffering from irregular period symptoms or estrogen dominance, contact our office at or call 276-235-3205 to schedule your complimentary 15-minute discovery call.

The Johnson Center for Health services patients in-person in our Blacksburg and Virginia Beach locations. We also offer telemedicine for residents of Virginia and North Carolina!


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