At this point, you have probably read our other blogs in this series on the female menstrual cycle and hormonal contraception. Now for some reason or another, you may feel that your cycle is not working as well as it is supposed too, correct?
Our bodies are both complex and wonderful things, and if they are not taken care of properly (consciously or unconsciously), there tends to be a shift away from the body’s self-regulating mechanisms. In most cases, there is a reason for this, and when we address the root cause, we can start to see change and improvement.
Differing cycle lengths, absent periods and the like, can be tricky to know how to manage and correct because the causes can be so varied. The tragedy is when we see women turning to ‘solutions’ such as the birth control pill, which is not addressing the root cause of the problem, and can many times worsen the effects in the long term.
A large reason why most women start to investigate their cycles, especially their cycle length, is when they want to determine their fertility and they are trying to conceive. To find out a bit more about your cycle, go read our blog ‘Your Cycle’, just to familiarize yourself with the basics. One of the biggest questions when it comes to our cycles and fertility is: Am I ovulating? We do have a blog on what our cycle tells us about our fertility if you would like to go check that out first as well, but otherwise, let’s dive right in to see the potential causes or long or short periods, and more importantly, how to fix them!
Long Menstruation Cycle:
A long cycle tends to be a cycle that lasts longer than about 33 days. It would mean that you would most likely be having too much time in the follicular stage of your cycle (day 1 of bleed to ovulation), and this can throw into question whether you are ovulating at all or if your body is making multiple attempts to ovulate (neither of which are normal by the way).
Typically, the type of people that have these tend to have a lot of self-imposed stress or a tendency to ‘yoyo’ diet. Whether this is a restrictive diet (usually without a lot of animal products) or up and down binge eating periods, neither of these are good for you. The other type of women that tend to have long cycles are women with the tendency to expect a lot from their bodies. Especially when they are very fit as younger girls and expect the same things from their body in their later years, tend to be in a common category of long cycles. This ambition, although being trait of great mental-resilience, tends to mean that we impose a lot of stress on ourselves, and this can not only affect our hormones but also can get into our mental state and cause things like anxiety and depression.
Give yourself a minimum of 3 months when rebalancing your hormones, it takes 100 days for an egg to mature once the ovaries have been re-nurtured back into balance, so again give yourself time.
We know it is easier said than done but if there is a way that you can ‘surrender’ to divine timing, letting go of expectation supports fertility. Meaning that the emotional toil and pressure to conceive tends to hinder a lot of couples from getting pregnant. As we age, our bodies need a little bit of extra TLC. Something to be especially wary of is that thyroid issues and medical interventions can seriously mess with our hormones at a base level. Things like this aren’t going to go away and be fixed by just meditating, or just fixing our diet. It needs to be a combined effort.
It is important to acknowledge your body for what it is (other than incredible and beautiful), it is unique. In terms of a long period, there tend to be four categories that may cause this outcome. Depending on where you fit, this will influence how you manage it.
Category 1: Metabolic causes. These are things such as undereating (usually coming along with overexercising) or overeating. Undereating tends to bring about insulin resistance and hypothalamic amenorrhea, usually presenting in long bouts of no periods and then the occasional period here and there. With fewer nutrients, this can bring about low levels of many important hormones used throughout our body, but specifically in our reproductive systems. Especially DHEA, LH, FSH, cholesterol, insulin and progesterone.
Macronutrients are a good way to go about making sure you are getting enough nutrients into your system, but eating enough for you Body Mass Index (BMI) is essential, as is eating the right things, making sure to include fibre and plenty of starchy veggies for ovulation.
On the other hand, overeating, particularly sugar and processed foods, leads to increases in the enzyme aromatase, whose job it is to transfer testosterone to oestrogen. Excess oestrogen is a problem in itself. Not only does it have massive effects on fertility, but it may result in thyroid problems, histamine intolerance, PCOS, immature follicles, FSH blocking, insulin resistance, weight gain, fatigue, and increased likelihood of stroke. Who would have thought that poor eating, and over-eating could influence oestrogen so significantly?
It’s important to consider what works best for you rather than simply following a trend. We liken it to using the Goldilocks principle, find out what is right for you, your body, and your lifestyle. Make sure you get plenty of food diversity, cyclical nutrition is so important, especially when so many of us just recycle the same meals every week, usually high in carbs or sugars. Our body needs variety for its nutrition.
Category 2: Polycystic ovary syndrome (PCOS). This is a huge causing factor, in terms of our hormones and reproductive health. Please read our blog on PCOS for more information on what this is, and how you may be able to navigate yourself out of this health challenge.
Category 3: Stress. Ah, our favourite. As busy women, stress tends to be second nature. It can also come in many forms but is most easily characterised as physical, chemical, and emotional. So, this can be excessive exercise, neglected diets, acute stress like a death in the family or chronic stress. Whatever the cause, stress can delay or even stop ovulation altogether, making you miss periods.
Category 4: Iatrogenic causes (medically induced). These can include all sorts of medical interferences from the oral contraceptive to medications like aspirin, blood thinners and antidepressants. Each of these has effects on our hormones in order to achieve their desired effect. At the same time, the ramifications of messing around with our hormonal system that knows what it’s doing can be enormous. In cases like the pill, we must remember that it works like a credit card. You could be taking on more credit year after year, but eventually, you will have to pay it all back. When you finally want to get pregnant, the pill has taken a toll on your body, and it won’t just bounce straight back to normalcy as soon as you stop taking it. There’s deficit’s and imbalances, that need to be addressed.
Short Menstrual cycle
A short cycle tends to be classified as a cycle that lasts less than 21 days, but any less than 26 days means that really good progesterone may not be made, thus affecting the rest of your cycle. It can also include spotting about a week before your period and is most commonly in conjunction with a deficiency of the luteal phase.
It usually means that your hormones are giving up halfway through your cycle and you are not getting that full months’ worth out of your hormones. A short follicular phase usually is indicative of approaching that perimenopausal stage.
A luteal phase deficiency can also cause or be an indicator of abnormal uterine bleeding, an anovulatory cycle (no ovulation), progesterone and other hormonal deficiencies, elevated prolactin (e.g. if you are breastfeeding or age), thyroid dysfunction and excessive testosterone (affects ovulation in multiple ways through not converting oestrogen and progesterone properly).
Progesterone is so important in terms of our cycle. It stabilizes our uterine lining, increases body temperature, and sedates our system to make the uterine environment optimal for fertilization.
The main consequences of a short cycle and low progesterone include PMS/PMDD, low egg quality, thin uterine lining, spotting, period pain, the propensity to anxiety and depression, fluid retention, breast tenderness, inability to sustain a pregnancy, recurrent miscarriage and early ovulation.
So, what causes a short cycle?
Aside from the hormone deficiencies and thyroid dysfunction, the number one thing is stress! Stress can come in many forms. It isn’t just emotional stress from jobs and lifestyle that can create crazy levels of cortisol that wreak havoc on our systems. It can also include chronic and systemic inflammation, poor diet, food intolerances, insulin resistance, too much sugar, systemic infections, and constant immune system activation (affects stress hormones). These all cause stress to our bodies.
Here’s the thing – we cannot survive without our stress hormone cortisol, others we can live without, albeit not happily, but cortisol is integral, and therefore takes precedents of all the others. The first hormone that tends to be sacrificed when cortisol gets out of whack however is progesterone. Learning some stress coping mechanisms and resilience techniques, are so important not only for our fertility and cyclical health but general health and wellbeing.
So How Do We Test What Is Going On With Our Bodies?
There are a few tests that we can do to see how hormones are going in terms of our short cycles. One is that a serum blood test on day 21 of our cycles (or 7 days after ovulation), should indicate over 40nm/L of progesterone, but the higher the better. For about 10 days, there is a rise in body temperature just before our period starts that indicates a healthy, working cycle.
At the same time in our cycles, salivary testing should indicate the ratio between progesterone and oestrogen to be 1:300. We really need good levels of progesterone in that mid-luteal phase! Make sure to specifically ask for progesterone when getting the test, many GPs skip by this specific hormone unless there are fertility problems or recurrent miscarriages.
When testing for progesterone, it can often be good to check out LH, FSH, androgen hormones, cortisol, and precursors to progesterone like DHEA. Thyroid function, Vitamin D and zinc status are quite essential for most women, and of course, there are a few more tests to do other than just the regular cycle and temperature charts that depend on what cases need to be addressed for each individual.
How To Fix Your Cycle (Without using the Pill)
Taking care of our bodies doesn’t have to be hard. Diet is integral. Fibre, protein, and starchy veggies are especially good for women’s fertility. Try to cut out sugar and gluten, they are both inflammatory and should be avoided, especially if you have a thyroid problem.
If you are over-exercising, stop it! You’re not doing yourself any favours in the long run, pardon the pun. Give yourself a break, don’t feel guilty if you miss a day at the gym, it can lead to even more mental and physical issues than what you started with. If you are not exercising enough, try to exercise at least 2-3 times a week, yoga is especially good for helping to regulate periods.
Improve stress tolerance or lower your stress load! This mostly speaks for itself; we know that sometimes, stress cannot be helped. We still must work. Life goes on, but it is all in how we look at it. Try meditation and breathing techniques as a good start to changing your stress handling. Have a read of our methylation blogs if you feel stress has taken the reigns for too long.
Traditional Chinese medicine and acupuncture have been shown to help massively with cyclical regulation. While chiropractic adjustments also assist from a physical, structural perspective with the correct alignment of the spine freeing up the nervous system to communicate efficiently and secondarily with adjustments helping to regulate unnecessary stress responses with the HPA axis.
Supplement good quality Vitamin C, Zinc and magnesium as general supplements for whatever category you find yourself in (do not substitute these for ANY of the above, no supplement in the world can fix you if you don’t have a good diet, exercise well, sleep and are overstressed). These both help with hormone production and just general health, please go check out our supplement blog to make sure that you are getting a good quality supplement that is right for you.
Vitex can help with pituitary function but should be used with caution especially if you have just come off the pill or if you are just a young girl, we really want our bodies to regulate its own HPA axis before we interfere. A good B complex, usually B6 tends to work wonders but again, it is dependent on your own individual situation.
Here’s a fun one: spend time with your girlfriends! That really close, quality time spent with good friends and loved ones having great D&Ms and heart to hearts has been shown to lift progesterone, this is especially important for those with short cycles.
Sleep! Have a good quality sleep and get enough sleep. Easier said than done? Sleep, however, is when our hormones are made! Most women ovulate at night, and for many – menstruation starts when we are sleeping as well.
While coffee may not have a direct effect on fertility itself, it does influence our HPA axis, adrenals, sleep-wake cycle, and other hormonal imbalances. Try to keep coffee intake to one a day, and make sure to have a glass of water (separately! Coffee does not count as water) with each one.
We would also highly recommend doing a hormone reset, there are many that you can find online, but we do detail one in our blog ‘coming off the pill’.
There are many wonderful practitioners who can help you determine if your cycle and hormones are out of balance. We’d recommend a Chinese Medicine practitioner who specializes in women’s health and fertility.
Barrett KE, et al. Reproductive development & function of the female reproductive system. In: Ganong’s Review of Medical Physiology. 26th ed. New York, N.Y.: McGraw-Hill Education; 2019. https://accessmedicine.mhmedical.com. Accessed March 22, 2019.
Hammer GD, et al. Disorders of the female reproductive tract. In: Pathophysiology of Disease: An Introduction to Clinical Medicine. 8th ed. New York, N.Y.: McGraw-Hill Education; 2019. https://accessmedicine.mhmedical.com. Accessed March 22, 2019.
Beall S, Shady Grove Fertility. What Does Your Menstrual Cycle Say About Your Fertility? [Internet]. Shady Grove Fertility Blog. 2019 [cited 17 August 2020]. Available from https://www.shadygrovefertility.com/blog/fertility-health/what-does-your-menstrual-cycle-say-about-your-fertility/
Meisel L. What Your Cycle Length Says About Your Fertility [Internet]. Ava. 2017 [cited 17 August 2020]. Available from: https://www.avawomen.com/avaworld/what-your-cycle-length-says-about-your-fertility/
Wellness Women Radio podcast:https://thewellnesscouch.com/wwr/wwr-177-how-to-fix-your-long-cycles
Wellness Women Radio podcast: https://thewellnesscouch.com/wwr/wwr-176-how-to-fix-your-short-cycle-without-the-pill