What is a Period, Hormonally Speaking?

Asking for a friend…

But seriously…let’s be honest.  How many of you actually know what the heck happens in a period?  Like where is the blood from? What causes the egg to be released?  Is an egg always released? What causes you to bleed?    

Hey there! 🌸 Dr. Kelly Sadauckas here (said-OW-skiss, thanks for asking), one of a handful of Double Board Certified Doctors of Physical Therapy IN THE WORLD, and YOUR go-to pelvic health expert. Today, we're diving into the mysterious world of periods—hormones, cycles, and all that jazz. Let's break it down in a way that doesn't require a PhD to understand.

I'll start with explaining the main hormones of your monthly flow, then I'll explain the phases of the menstrual cycle.  You're welcome :) And if this helps you, please share with your friends and family, because we all need to understand this better!  

What the Heck is a Period, Hormonally Speaking?

Ever wondered what's going on inside during that time of the month? I've got the scoop, minus the confusing medical jargon. Buckle up!

Meet the Royal Hormones:

Queen Estrogen

She's the queen bee, responsible for all things traditionally feminine. From developing body parts (boobs and labias) to prepping for potential pregnancy, estrogen is the MVP.  However...she requires balancing by Lady Progesterone as she goes about her Queenly duties--and if Estrogen is unchecked (aa it sometimes is in early adolescence and in perimenopause), you can have erratic, heavy periods with LOTS of premenstrual pain symptoms (sore boobs, cramps, etc).  

It is Estrogen's unchecked dominance that can be responsible for negative perimenopausal symptoms of hot flashes, increased irritability, more frequent and heavy periods, and even mood dysfunction, and Estrogen's eventual landslide drop to low levels that are responsible for menopause (eventual stopping of periods). 

Lady Progesterone

This lady is all about preparing the uterus for a possible baby, and controlling and balancing the effects of Queen Estrogen. Too much or too little can mess with your mood and cycle.  

As noted above, a drop in Progesterone during perimenopause (the 10-year period before menopause; perimenopause usually begins around 37 years old) results in uncontrolled Estrogen, and is the main driver of perimenopausal symptoms of hot flashes, mood imbalances and period changes.  It can also be associated with elevated pain levels, which is interesting.

Dame Luteinizing Hormone (LH)

No, it's not "damn" luteinizing hormone; it's DAME LH! Every month, immediately after "your bleedy phase" of your cycle, your body begins to ripen a few eggs in one of your ovaries...luteinizing hormone is what chooses the biggest egg to become the dominant follicle.  

Duchess Follicular Stimulating Hormone

After your bleedy phase, Follicular Stimulating Hormone tells the ovaries to start prepping eggs for the next cycle. The show must go on!

How Period Hormones Control the Monthly Flow:

I've crafted a masterpiece—a graph to show you the hormonal dance during a menstrual cycle. Yes, autographs will be available later.

The Phases of the Menstrual Cycle:

Menstrual Phase (The Bleedy Phase)

When a fertilized egg is not implanted into your endometrium (lining of your uterus), your body releases chemicals, as well as actually contracts the uterus, to shed the unused uterine lining. That shedding of the lining is your monthly flow, and the only symptom of your period should be 3-4 days of moderate bleeding.  Periods should not hurt. Truth. If they hurt, seek help. If you miss school or work due to period pain, talk to a medical provider about possible endometriosis.

After Your Period, Before Ovulation: The "Follicular Phase"

After your Menstrual Phase (the bleedy phase), the cycle repeats with "the follicular phase". In this phase, the ovaries (parts that hold our eggs) gear up, and a few follicles (immature eggs) enlarge.  The uterus, meanwhile, immediately begins to prep for a potential future egg implantation by building up the endometrial lining again.

Ovulation (the egg is released) 

At the end of the follicular phase, Luteinizing Hormone (LH) triggers the release of the dominant follicle (the biggest, most perfect follicle all the ones that were growing)—and that event is ovulation!

Here it is, in visual form…

Meanwhile, at time of ovulation, the egg works it's way through a fallopian tube to the uterus (doesn't have to be on the same side as where the egg was released!), which is ready with a plush welcome mat of endometrial tissue.   

After Ovulation, Pre-Menstruation

If the egg isn't fertilized, the body releases prostaglandins--chemicals to stimulate uterine contractions and shedding of lining.  This cues menstruation, and the cycle repeats.

But what if the egg is fertilized?

If you're playing the baby-making game, and the egg is fertilized, the prostaglandins take a break, and the menstrual phase gets a rain check. The egg is fertilized, and hormones of pregnancy become the stars of the show, beginning with implantation of the egg into wall of the uterus...but the hormones of pregnancy are for another post :) 

Understand That Period Hormones Matter...& That Periods Are SUPPOSED to be Painfree!

Understanding these hormones gives you the keys to decode what your body is up to. It's like having a cheat sheet for your monthly cycle.   Understanding what is supposed to happen, and what is not supposed to happen, helps you identify areas of imbalance, and therefore areas you can work on addressing, to optimize your life.  

Remember that each human is unique. Some (like me), might require progesterone to get through perimenopause, others will not.  Find a skilled health care provider, trained in menstrual cycles, perimenopause, and menopause, to address your specific complaints, and be sure that your provider can explain to you why or why not they are recommending a particular treatment.

Thanks for reading!

Now that you've got the lowdown on periods, did you know they're supposed to be pain-free? Yep, it's possible! But what about Endo? The Pill? Menopause? We'll tackle those topics in future posts because, let's face it, they deserve their spotlight.

Explore my website, join my mailing list via the form below, or slide into my Insta for more fantastic, free tips on pelvic wellness. For a deeper dive, work with me in person or online, or check out my online programs designed just for you. From leaks to prolapse to poops, I've got a course that might just change your life, including the all new Dr. Kelly's Treasure Chest, which gives you world class lessons and workouts to optimize health, as well as address common pelvic problems, for one low monthly price. And remember, once purchased, all Pelvic Floored Courses are seamlessly streamable between your computer, phone and tablet via the FREE Kajabi app (Blue or Red K, wherever you get your apps, enter same email as you use to buy the program), so world class pelvic health information and exercises are never more than a single click away.

 Cheers to demystifying periods & pelvises! 🌈💪

xoxo, Dr. Kelly 😊

Follow me on Instagram!
Schedule an in-person or telehealth visit HERE!

www.pelvicfloored.com