Is it important to become intimately familiar with our cycles even if we don’t have any problems?
Being aware of our cycles, especially ovulation, not only helps us to form a positive relationship with our bodies, but it also may protect us from diseases such as breast cancer. Evidence shows us ovulation is vitality important for many aspects of long term health.
What is your cycle telling you?
It’s easy to become concerned when menstruation is late, early, too long, too heavy, a wierd colour, or any number of other issues, but do you know anything about ovulation? Even women with regular cycles and minimal symptoms could be experiencing a lack of ovulation and today we know that this could pose quite a serious health issue.
To understand what is going on in our body’s we can take a thorough look at the research paper “OVULATORY DISTURBANCES: THEY DO MATTER” published in The Canadian Journal of Diagnosis February 1997. It was written by Jerilynn C. Prior, a professor of endocrinology at the University of British Columbia, Canada and Scientific Director of the Centre for Menstrual Cycle and Ovulation Research.
“Strong evidence suggests that lack of cyclic normal progesterone is detrimental to good health. When cycles that are ideal in length (averaging 28 days) are explored for progesterone levels and not just estrogen production, a surprising finding emerges. Approximately one-third of regular, asymptomatic menstrual cycles of healthy women will have disturbances of ovulation that, based on biologic principles, could lead to significant health risks.This study showed that ovulation disturbances are common. When the 66 women kept daily basal temperature records, well over one-half experienced some disturbance of ovulation. These disturbances occurred despite the fact that only 3% of all cycles were abnormal in length.”
In other words even if we don’t have symptoms it’s important to nourish our feminine needs and keep our hormones thriving.
“Cycles of a mean 28 days in length may vary markedly in progesterone production and ovulatory characteristics.”
The term ‘ovulation disturbance’ is used to both refer to anovulatory (when an egg is not released) and short luteal phase cycles (when the time between ovulation and menstruation is less than 10 days long, commonly called ‘short luteal phase defect’).
“Occurs when hypothalamic-pituitary stimulation of the ovary is decreased, it is usually silent and subclinical. These women will be the hardest to detect clinically, but may be found to have spine fractures near or shortly after menopause.”
“In the understimulated ovulation disturbances, usually asymptomatic, the primary health consequence results from inadequate progesterone production. Without adequate progesterone to stimulate bone formation, normal levels of bone resorption result in bone loss. This is probably the major consequence of understimulated ovulation disturbances. Our study of normal-weight women observed this most subtle kind of ovulation disturbance in which estrogen levels were normal or only minimally decreased, yet bone loss was measurable and significant. Epidemiologic data in a large, population-based study confirmed our observation.”
Understimulated is Classified by:
- Luteinizing hormone – normal
- Oestrogen – normal
- Progesterone – low or absent
- Testosterone – low
- Weight – normal or low
- Skin – normal
- Hair – normal
- Breasts – normal
- Ovaries – cystic or normal size
- Accelerated bone loss or low bone density
Here the follicle usually produces the minimum estrogen levels necessary to stimulate endometrial shedding at normal intervals (often longer cycle). However, ovulation often does not occur or there is shortening of the luteal phase. Leutenizing Hormone (LH) also increases dramatically to stimulate ovulation, which increases ovarian androgen production. The result is low progesterone, high estrogen, high testosterone and scarce ovulation.
This kind of ovulation disturbance can be understood by visualizing several follicles per cycle being stimulated, enlarging and each producing its own compliment of estrogen. (This situation can also be created by ovulation-induction therapy for infertility using LH injections.)
This form of ovulation disturbance is known as polycystic ovarian disorder (PCOS). Multiple cysts can form in the ovaries from stimulated follicles that did not ovulate.
Overstimulated ovulation disturbances result in:
- Irregular unpredictable flow or spotting
- Menstruation – heavy
- PMS mood swings
- Weight – normal or increased
- Skin – Hirsutism – Oily skin – Acne
- Hair – Androgenic alopecia (male pattern balding)
- Breasts – Mastalgia or fibrocystic breast disease
- Ovaries – cystic/enlarged
- Oestrogen – high
- Progesterone – low or absent
- Testosterone- normal or high
- Luteinizing hormone – increased
- Endometrial hyperplasia or cancer
- Increased risk for breast cancer
- Potential cardiovascular risks or androgen excess (maybe from lack of progesterone)
“If anovulation and high estrogen levels are chronic, endometrial hyperplasia and cancer risks are substantial, and the risk for breast cancer also appears to increase.” A saving grace for bones is the fact that androgen excess appears to protect against low bone density.
Dieting is can easily cause or aggravate this condition. “The belief that one must limit food intake to prevent obesity is such a stressor. This phenomenon, called dietary restraint, has been shown in three different groups of women to occur in association with luteal-phase defects.”
Hormonal contraceptives create major disruption in our delicate endocrine orchestra an suppress essential ovulation. “Following use of OCPs, the hypothalamus-used to suppressive high levels of exogenous hormones-may need time to find its own cyclic rhythm, especially if ovulation was never firmly established before starting OCPs.” It is not uncommon for a woman to come off hormonal contraception, such as the Pill or the mirena, only to discover they now have PCOS.
Promoting a healthy ovulatory cycle during your reproductive years is the first and foremost protection against bone loss in later years. “The healthy women in our study who experienced only one nonovulatory cycle during the year lost an average of 4% of their spinal bone while those with consistently normal ovulation tended to gain bone have no loss.This is the strongest evidence that lack of cyclic normal progesterone is important for health.”
Blood tests are not a reliable diagnostic. “The second reason is that estrogen, progesterone, testosterone, LH and FSH are pulsatile, so a single value may be misleading. Daily serum samples for progesterone are necessary to make the diagnosis of a short luteal phase.”
Because progesterone causes an average luteal phase basal temperature increase of O.3° C, documentation of temperature is a reliable way of confirming the presence of ovulation and the duration of the luteal phase.” Temperature testing is best done in the morning before it is obscured by food, activity or circadian changes in temperature.
Another sign useful for diagnosing ovulation is the characteristic time pattern of normal cervical mucus.” Increasing estrogen levels stimulate cervical glands to produce a characteristic clear, glistening, stretchy mucus. Mucus typically increases from a few days after flow to a maximum in volume and stretchiness at the midcycle estrogen peak. The amount of stretch is roughly proportional to the estrogen level. Mucus that stretches 4 cm to 5 cm is diagnostic of estrogen levels in the range of 800 pmol/L to 1,000 pmol/L, typical midcycle peak levels. Progesterone inhibits the cervical glandular secretions. The presence of stretchy mucus, therefore, is a way to diagnose high estrogen levels and anovulation.”
Reading Your Body
When learning information like this it is easy to fall into fear or obsession but that isn’t the point of this article. As many conscious doctors are now saying, the female cycle is the 5th vital sign of health for a woman. For thousands of years we were encouraged to pay attention to subtle changes just was we pay attention to our weight, heart or breathing capacity today.
Monitoring a healthy cycle is really just about spending a quiet moment to check in with ourselves and appreciate the exquisite intelligence that makes up our gorgeous physical bodies.