The beginning of the cycle is what phase. The menstrual cycle in women: what is it, a description of each phase. When does this process start?

Every month, the reproductive system of a woman undergoes certain changes that leave an imprint on both her physiological and psychological state. They are necessary so that the female body can prepare for conception - and then for the onset of pregnancy. Such changes are regular and are called the menstrual cycle - which, in turn, consists of several phases.

Let's take a closer look at how they go, how long they last, and what signs indicate the onset of each phase.

The first phase of the menstrual cycle is called the menstrual cycle.

What should you know about menstruation?

Its duration is approximately 3-7 days.

It is characterized by the following symptoms:

1. Bloody discharge from the vagina.
2. Breast augmentation.
3. Pain in the abdomen.
4. Irritability.
5. Pain in the lumbar region.
6. Changeability of mood.
7. Nausea and sometimes vomiting.
8. Headaches.

Optionally, all of the above signs will accompany "critical" days. In many girls, they pass quietly, and the only thing that indicates menstruation is the presence of uterine bleeding.

The cause of painful and heavy periods, nausea, chills, headaches may be an increased level of prostaglandins in the blood in this phase. These chemicals are produced by uterine tissue and cause it to contract.

The menstrual cycle begins from the day the bleeding started from the genitals. During it, the old endometrium is rejected.

Uterine bleeding indicates that pregnancy did not occur in the previous cycle.

At the same time, the ovaries begin to develop follicles. The so-called bubbles filled with liquid. Each of them contains one egg. Under the influence of follicle-stimulating hormone, they begin to ripen.

How thick should the lining of the uterus be during menstruation?

What happens during the second, follicular (proliferative) phase of the cycle?

After the end of menstruation, the female body begins to prepare for the possible conception of a baby. All processes occurring during this period are called follicle stimulating hormone which, in turn, is produced by the pituitary gland.

So, FSH has a huge impact on the level of estrogen in the blood. Starting from the 1st day of menstruation, it rapidly grows upwards. Due to this, the endometrium, which has grown in a new cycle, is saturated with blood and various nutrients. This is necessary so that, in the event of a successful conception, the fertilized egg can receive everything in the uterus that it needs for further growth and development.

Immediately after the end of menstruation, one follicle “overtakes” its comrades in its development, as a result of which the latter stop growing and return to their previous state. The "winning" vial of liquid continues to grow the egg.

The size of the bubble with liquid in diameter

About the well-being of a woman during this period

During the second phase, the girl:

1. Efficiency increases.
2. The mood improves.
3. Increased sexual desire.

Thickness of the endometrium in the proliferative phase

Third, ovulatory phase of the cycle

The ovulatory phase, unlike the others, lasts very little - approximately 24-36 hours. It is during it that women have a chance to become pregnant.

The level of the hormone estrogen in the third phase is at its highest level. During ovulation, the content of luteinizing hormone in the blood increases, but the concentration of follicle-stimulating hormone decreases.

What happens to the mature egg during this phase?

First, it destroys the wall of the follicle - and, with the help of the villi of the epithelium, begins to move into the fallopian tube.

Then, if it meets with a spermatozoon, then it is fertilized.

Otherwise, the egg dies a day after leaving the ovary, after which it dissolves in the uterine mucosa.

In addition, you can determine the presence or absence of ovulation using home tests.

The beginning of the ovulatory phase can also be detected on ultrasound examination, during which the doctor will have to find out what the size of the ovaries and cervix are, and in what condition they are now.

The thickness of the endometrium in the ovulatory phase should be within 1-1.3cm.

The fourth phase of the menstrual cycle is the phase of the corpus luteum, or luteal

Its duration is fourteen days.

After the egg leaves the vial with liquid, a body begins to grow at the site of its rupture, which has a yellow color. It produces estrogens, androgens, as well as the "pregnancy hormone" progesterone.

If the corpus luteum produces a small amount of progesterone, then fertilization of the egg may not occur for a long time.

So that a woman can become pregnant and then give birth to a child on time, doctors can prescribe her to take special hormonal preparations.

What other function does progesterone perform?

Thanks to him, the endometrium softens, becomes loose, increases in thickness. This is necessary so that the fetal egg can penetrate into it.

Pregnancy has come or not - you can find out only at the end of the luteal phase. Menstruation, if conception has occurred, will not begin. The basal temperature will be kept at around 37.3.

Can be done with homemade test, which can be bought at any pharmacy, or by donating blood at the clinic for the level of hCG.

Nausea, dizziness and other signs of a conception that has occurred appear much later.

Signs and symptoms of the luteal phase

If the egg was not fertilized by a sperm, then in the first days of the luteal phase, the girl will feel great. A woman “in position” will feel the same way.

The only sign that can indicate to her an accomplished conception is the appearance of a few drops of blood on her underwear - - 7-10 days after intimacy.

If pregnancy has not occurred, then a few days before menstruation, the woman's condition may change. She may have PMS syndrome, which is often associated with the irritability and anxiety of a woman. Her mammary glands may swell, as well as minor pains in the abdomen.

What should be the thickness of the endometrium during the luteal phase?

Menstruation is the result of cyclical changes in the hormonal background and physiology of a woman. In order for her to conceive a child, bear it and give birth, a complex system of transformations regulated by hormones is provided in the body. The phases of the menstrual cycle normally follow one another, ensuring the development of the egg and preparing the body for conception and pregnancy.

In medicine, a cycle is considered the period from the first day of regular bleeding to the start of the next one.

How many phases of the menstrual cycle? Depending on what changes the uterus undergoes, there are three phases of the cycle. The ovaries also work cyclically, and each cycle is conditionally divided into

• ovulatory

First phase of the menstrual cycle

The menstrual phase begins on the first day of menstruation and is externally manifested in the form of bleeding. This period brings the woman the greatest inconvenience, since the dying tissues of the endometrium are rejected, and they must be removed from the uterine cavity as soon as possible. Since they are rich in blood vessels, the process is accompanied by profuse bleeding and pulling pains due to smooth muscle contractions.

Discomfort lasts an average of 3 to 6 days. As such, blood in the secretions contains no more than 30%, the rest is the dead tissue of the inner lining layer, as well as the mucous secretion of the cervix and vagina. Regular blood loss is so small that it does not significantly affect the level of hemoglobin.

At this time, changes occur in the ovaries. During the first phase of the menstrual cycle, the brain starts the process of producing hormones that regulate the work of the ovaries. Several primary follicles begin to develop in them at once, normally from 5 to 15 pieces.

Within seven days, they increase in size by about 10 times and are covered with a multi-layered cell membrane. Normally, at this point, the most viable single follicle is determined, which continues to develop. The rest stop growing and atrophy. This behavior of the follicles is due to the minimum content of FSH and LH, however, if the balance is shifted for some reason, then the follicle will either not develop at all, or there will be several of them.

Second phase of the menstrual cycle

In the second phase of the normal menstrual cycle, the body actively prepares the egg. The uterus was cleansed of the dead endometrium, the inner layer was prepared and the blood supply was restored in it. New processes in the uterus are active cell division, which leads to tissue growth, which in medicine is called proliferation. The formation of the endometrium is associated with the action of hormones that are produced by the ovaries.

At this time, the first phase is completed in the ovary, the dominant follicle has already been determined. In the tissues of its shell, hormones begin to be produced. The production of these hormones is extremely high, they play a decisive role in the process of conception, gestation, childbirth and feeding. The production system of these hormones is commonly called the follicular apparatus. During this period, the egg finally matures and prepares for release into the abdominal cavity.

The proliferative phase ends with rupture of the follicular membrane. Since the onset of menstruation, it can take from 7 to 20 days, the process of maturation of follicles is very individual, for each woman it can change from cycle to cycle. This is influenced by general health, stress and lifestyle. The body is designed in such a way that it tries to choose the most favorable moment for conception. There are cycles in which it seems to cancel the maturation process, and the follicles simply do not develop, so ovulation does not occur. This is also considered normal.

Third phase of the menstrual cycle

At the beginning of the last, third phase of the cycle, ovulation occurs. By the time the egg was released, it had increased almost 20 times. The follicle shell is already fully formed, now it is a full-fledged organ of the endocrine system. After the release of the formed egg and its capture by the hairs of the fallopian tube, the follicle shell turns into an independent organ - and begins to actively produce estrogens - hormones that prepare the body for pregnancy.

In this phase of the normal menstrual cycle, a woman feels a slight increase in weight, perhaps an increase in breast size due to increased blood supply. The body is preparing for conception, and the uterus can already accept a fertilized egg. The corpus luteum produces hormones that maintain the integrity of the endometrium - progesterone and estrogen.

If pregnancy occurs, they will start the process of forming the placenta. If conception does not occur, after a short time it dies off, the production of hormones stops and the uterus rejects the endometrium, that is, menstruation comes. The life expectancy of the corpus luteum is approximately the same for all women and is about 10 - 13 days.

A woman is the guardian of the family, since the main goal of her life is to endure and give life to a child. An egg can only be fertilized in a certain phase of the menstrual cycle - the ovulatory phase, after which the luteal phase (progesterone, corpus luteum phase) begins.

In this topic, we want to tell you in detail what the luteal phase is in women, on which day of the cycle it comes and how long it lasts. In addition, we will analyze luteal phase insufficiency, its symptoms and treatment.

The luteal phase of the cycle is the period that begins at the moment of ovulation and continues until the onset of menstruation. During this phase, the follicle ruptures, and its cells accumulate pigment and fats, which stain it yellow. Because of the color, this follicle is called the corpus luteum. This also explains the second name of the luteal phase - the corpus luteum phase.

The main function of the corpus luteum is the production of androgens, estrogen and, which are sex hormones. Progesterone is also called the “pregnancy hormone” because it prepares the endometrium for the attachment of a fertilized egg.

When pregnancy occurs, this hormone keeps the uterus in a relaxed state, preventing miscarriage or premature birth. If the woman does not become pregnant, then the synthesis of hormones by the corpus luteum stops and menstruation comes.

You also need to know what the follicular phase is. The menstrual cycle goes through several stages, the first of which is the follicular phase, that is, the period from the beginning of menstruation to the onset of ovulation.

How long is the luteal phase?

Normally, the corpus luteum phase takes 12-16 days. But you need to understand that the length of the luteal phase directly depends on the duration of the menstrual cycle, the duration of the functioning of the yellow follicle and the characteristics of the woman's hormonal background.

For example, in a 28-day cycle, the luteal phase is 14 days long, but it may come one day earlier or later.

A longer duration of the luteal phase may manifest ovarian cysts. Pregnancy is also characterized by the lengthening of this stage of the menstrual period.

A short luteal phase can be the cause of infertility, so in no case should such a violation be ignored.

To calculate the duration of the corpus luteum phase, you need to know the duration of the menstrual cycle, which can be calculated according to the calendar, where the beginning and end of menstruation are marked. The simplest calculation method is the following: the duration of the female cycle is divided by two and the day of ovulation is obtained. Accordingly, the period from ovulation to the onset of critical days is the luteal phase.

This method, of course, is simple, but not entirely accurate, since many women may experience cycle failures, so ovulation does not come on time.

A more accurate method for determining the duration of the luteal phase is to recognize the day of ovulation by the temperature in the anus (above 37 ° C) or monitoring using gynecological ultrasound. The calculated duration of the corpus luteum phase using this method will be accurate, unlike the previous method.

What is the rate of progesterone in the luteal phase?

The level of progesterone in the blood of women varies not only throughout life, but also throughout the month, depending on the phase of the cycle. The norm of this hormone is in the range from 6 to 56 pmol / l. During the corpus luteum phase, progesterone levels peak.

If the level of progesterone during the luteal phase is lowered, then, most likely, this means that some kind of failure has occurred in the body.

The level of progesterone in the blood is determined using a blood test, and blood must be donated during the expected luteal phase, that is, in the second half of the cycle.

To exclude an erroneous result of a blood test for sex hormones, it is necessary to properly prepare for the test, namely:

• a few months before the test, you need to count the duration of the menstrual cycle in order to find out the date of ovulation and choose the optimal day for blood sampling;
• 24 hours before blood sampling, it is required to remove foods that contain a lot of fat, fried and spicy foods, coffee and alcoholic beverages from the diet.
• a day before the analysis, you should limit physical activity and protect yourself from nervous shocks;
• the analysis is carried out strictly on an empty stomach, so the last meal should be no later than eight hours before blood sampling;
• if you are taking any medications, you should tell the doctor who referred you for this study, as progesterone levels can be affected by oral contraceptives and other drugs.

The consequences of low progesterone in the luteal phase can be infertility, spontaneous miscarriages, premature birth and other pathological conditions.

Based on the results of the blood test, the gynecologist may consider hormone replacement therapy.

In the case when progesterone is elevated in the luteal phase, drugs are used that restore the balance of sex hormones in a woman's body.

If a pregnant woman has a low level of progesterone in the blood, then progestins are also prescribed, since a deficiency of this hormone can lead to an abortion or premature birth.

Also, when examining blood for a hormonal sex panel, the level in the blood is necessarily determined. The norm of this indicator in the corpus luteum phase is 91-861 pmol / l.

Increased estradiol in the luteal phase is also a sign of a hormonal failure in the body or some kind of disease.

Insufficiency of the luteal phase of the menstrual cycle: causes, symptoms and treatment

Low progesterone in the luteal phase can be due to the following reasons:

• failure of the hypothalamic-pituitary system against the background of psycho-emotional shock, traumatic brain injury or infectious diseases with brain damage;
• diseases of the adrenal glands;
• diseases of the ovaries and fallopian tubes;
• hyperprolactinemia;
• diseases of the thyroid gland, which are accompanied by hyper- or hypofunction of the organ.

Progesterone deficiency in the luteal phase can only be manifested by a failure of the monthly cycle, that is, a woman will not have any external signs of a hormonal failure.

Before you start treatment for progesterone deficiency, you need to determine the causes of its occurrence.

Treatment of progesterone deficiency in a woman's body is carried out with the help of hormone replacement therapy (luteal phase support), which stimulates the onset of ovulation. The drugs of choice in this case may be Utrozhestan, Injesta, Endometrin, Lutein and others.

The treatment will be more effective if it is combined with physiotherapeutic methods (intravaginal phonophoresis), acupuncture and spa rehabilitation.

A timely appeal to a specialist and strict implementation of his medical recommendations will help a woman successfully become pregnant and find the happiness of motherhood.

High progesterone in the luteal phase: when does it happen?

Progesterone in women can increase for several reasons, including such as:

• pregnancy;
• failure of the monthly cycle;
• cystic corpus luteum;
• diseases of the adrenal glands;
• kidney dysfunction;
• stimulation of ovulation with progestins.

Women who have high progesterone may have the following symptoms:

• hypersensitivity of the mammary glands;
• lability of the nervous system, which is manifested by tearfulness, nervousness and a sharp change in mood;
• bleeding from the vagina;
• headache;
• complete absence or decrease in sexual desire;
• flatulence.

What is 17-OH progesterone?

17-OH progesterone is an adrenal hormone that controls sexual and reproductive functions. In the female body, the amount of this hormone is much lower than in the male. Therefore, any changes in its level should not be ignored and require the advice of specialists - an endocrinologist and a gynecologist.

In the follicular phase of the cycle, the synthesis of 17-OH progesterone is at a minimum level, but increases by the onset of ovulation and remains at this level until the onset of menstruation.

If 17 OH progesterone is elevated in a woman, this means that pathological changes occur in the adrenal glands or ovaries, for example, a benign or malignant tumor has formed.

As a result, we can conclude that the corpus luteum phase is one of the most important periods of the monthly cycle, and changes in the level of progesterone in this phase may indicate female infertility.

Each representative of the fair sex has to deal monthly with the phases of her menstrual cycle, with their own characteristics and characteristic symptoms. These phases are significant stages that are responsible for the reproductive function of the female body. The duration and nature of the menstrual phases are more individual, but the basics and sequence of their flow remain unchanged and have their respective names. This whole significant process is cyclical, and begins with the advent of menstrual bleeding, which is considered to be the first of the three phases of the menstrual cycle.

Any girl or woman in the age range from puberty to menopause must understand the work of her body and understand the purpose of all three phases of the menstrual cycle. With the help of this knowledge, you can easily calculate the favorable period for conceiving a child or, on the contrary, protect yourself from unwanted pregnancy and some health problems.

The main phases of the cycle

Every month, with a regular cycle in the body of a woman, three successive phases of the menstrual cycle occur. They are characterized by a logical sequence and serve one big goal - creating favorable conditions for the fertilization of the egg and procreation. The menstrual cycle is divided into three main phases:

• Follicular (first phase);
• Ovulation (second phase);
• Luteal (third phase).

These stages perform the functions according to their name. These phases are based on hormonal regulation, which promotes the process and controls its outcome. The beginning of the menstrual cycle is the beginning of the very first phase - the follicular, it is she who starts such an important process as the formation and.

The first is the follicular phase

The initial phase of the menstrual cycle is characterized by intensive growth of follicles and the formation of an egg in them. The first day of menstruation kicks off a new follicular phase of the cycle and begins intensive production of follicle-stimulating hormone and estrogen. During this period, there is a growth of follicles, which a little later will become a receptacle and a place for the maturation of the egg.

Estrogen provides support to the follicles and this lasts about 7 days, until one of the follicular vesicles reaches the necessary parameters for the maturation of an egg in it. Further, the focus of growth is only on the egg, and the "extra" follicles stop functioning. A high concentration of estrogen gives a signal to start the production of luteinizing hormone, which, in turn, prepares for future ovulation. The duration of the first phase is individual for each woman, but it should not exceed 20 days.

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The second phase is ovulation

The second phase of the menstrual cycle is quite short, but at the same time very significant. Ovulation is the achievement for which the menstrual cycle actually exists. It is intended for the possibility of fertilization and the realization of the main purpose of a woman - procreation. The ability and possibility of fertilization is possible in just 48 hours, and sometimes less. During this short period of 2 days, the woman's reproductive system is faced with a responsible task, and if fertilization does not occur, the egg dies.

An increased concentration of luteinizing hormone contributes to increased maturation and subsequent release of the egg from the follicle. Under its action, important processes occur that ensure the preparation of the walls of the endometrium. When the egg reaches full maturity and is ready for fertilization, the follicular vesicle ruptures and a full-fledged egg enters the fallopian tube to merge with the sperm. In the cavity of the ruptured follicle, an intensive growth of the corpus luteum begins, which, in turn, leads to an intensive production of progesterone and provides favorable conditions for successful fertilization and implantation of a fertilized ovum into the uterine wall. The next cycle can have 2 outcomes, depending on whether fertilization has occurred or not.

Third phase - luteal

The development of the third phase of the menstrual cycle can take place according to two scenarios: with a fertilized egg or if fertilization has not occurred. This time, special attention is paid to the formed corpus luteum. It, in case of successful conception, leads to the active production of luteal hormone, which supports and nourishes the fertilized egg until the placenta is formed. Due to the importance of the purpose of this hormone, the third phase has its characteristic name - luteal. Together with the luteal hormone, during this period, the active production of progesterone, which is also actively involved in supporting the fetal egg, continues. Ultimately, the harmonious and mutually beneficial production of female hormones provides complete preparation for fertilization, fusion, and subsequent nutrition and protection of the already fertilized fetal egg.

If fertilization still does not occur, the corpus luteum stops its development and atrophies. The prepared loosened uterine mucosa and the dead egg are rejected and come out in the form of menstrual bleeding, which, in turn, already means the beginning of a new, first phase, and the entire described process is repeated anew.

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Cycle phases by day

The phases of the menstrual cycle by day are conditionally divided into 3 intervals. The first and third phases are considered the longest. At the same time, it is interesting that the follicular and ovulation phases have an individual and unfixed duration, and the luteal phase always corresponds in duration - 2 weeks or 14 days. As many people know, the entire menstrual cycle can last from 20 to 35 days, and this will be considered the norm. Menstrual bleeding is also individual in nature, but it is necessary for every lady.

To understand what and when happens during these +/- 28 days, it is necessary to consider the duration of each specific phase.

1. The follicular phase is the period from the beginning of menstruation to the full readiness for the release of the egg from the follicle (ovulation). Depending on the characteristics of the body, it can last from 7 to 20 days. At the beginning of this phase, a woman experiences malaise and discomfort in the lumbar region and lower abdomen. Later, strength is restored and unpleasant symptoms recede.
2. - the time when the egg is ready for fertilization. This phase is the shortest and most important. The ability of the egg to merge with the sperm and fertilize lasts from 20 to 48 hours, which is also purely individual and depends on many factors. Some women feel ovulation and even observe characteristic discharge on their underwear.
3. . Regardless of whether fertilization has occurred or not, this phase continues for the last 14 days. If pregnancy has not occurred, then its end and, therefore, the beginning of a new cycle will be monthly bleeding. During this period, many ladies suffer from premenstrual syndrome () and experience not the most pleasant physical and psychological symptoms and sensations in their body. If, nevertheless, the menstrual cycle has fulfilled its intended purpose, and fertilization has taken place, then pregnancy occurs and further actions of female hormones will focus on the growth, nutrition and development of the fetus.

What can affect the shift of the cycle

The considered phases of menstruation are a very clear and fragile mechanism that can be broken due to many factors. The main promoters of these phases are hormones that mutually benefit each other to achieve a common goal - the conception and birth of a child. Violation of the production of any of the hormones will lead to a break in the sequential chain and will affect the final outcome and the duration of the cycle.

Each of them is responsible for certain processes of the reproductive system. The follicular phase usually includes the first two weeks of the cycle. It is characterized by the preparation of all organs for process.

What is it?

The follicular phase got its name from structural components of the ovary- follicles. They are located in its cortical layer. Under the influence of hormones, the follicles increase in size after the end of menstruation. Then the dominant one is determined from them. In it, which in the future should be fertilized.

The follicular phase of the cycle is characterized by the process of preparing the genital organs for. It depends on how correctly all the processes of this period will be carried out, female fertility.

The main engine of the process is the hormone FSH. It stimulates the growth of follicles, thereby making conception possible.

Along with the follicles, and increases. He is structural surface located in the area of ​​the uterus.

In women with standard cycle in 28 days, the moment of transition to the next stage is considered to be 14–15 days. In other cases, the period may be shorter or longer and range from 7–22 days.

The norm of hormones in the follicular phase

Hormones have a huge impact on the processes occurring in the female body. They are closely related to each other. If there are deviations in the amount of one of them, other hormones will also undergo changes.
All hormones produced in the pituitary gland. The active hormones of the first phase include:

• Prolactin.
• Estradiol.

The process occurs under the influence of the hormone FSH. The parameters of the norm are indicators of 1.37 to 9.90 mIU / ml.

FSH production can be affected by an overgrowth of prolactin. With high results development is slowing down. in this case, it is delayed or does not occur at all. The norm of prolactin in the follicular phase is in the range from 109 to 557 mU / ml.

The right amount of estradiol is formed in the presence of a balance between FSH, LH and prolactin. Under its influence increases. This will allow the embryo to easily attach to the surface of the uterus. The results of the analysis in this case should correspond to the norm - from 68 to 1269 pmol / l.

LH in the first half of the cycle is present in the body in a small amount. Its increase is observed shortly before the release into the abdominal cavity. The success of conception depends on the amount of the hormone. The ideal parameters in the first phase are numbers from 1.68 to 15 units.

ON A NOTE! At the end of the first stage of the cycle, there is a sharp release of the LH hormone. It may be accompanied by the appearance of a large amount of mucous secretions.

How does follicular phase deficiency manifest itself?

Hormone disorders can lead to insufficiency of the follicular phase of the cycle. This is fraught with the development of various forms of infertility.
There can be many reasons for this phenomenon. The main symptoms of pathology include the following:

• the presence of delays;
• profuse spotting in the middle of the menstrual cycle;
• impossibility of conception;
• lack of signs by ultrasound;
• signs of multifollicular ovaries.

Treatment of diseases caused by hormonal disorders occurs with the use of medications. With polycystic disease, laparoscopic surgery is very often prescribed. In this case, the lack of hormones is caused thickened ovarian walls who do not release . This prevents the completion of the first stage of the cycle.