The Rise and Fall: Understanding Hormones Through Your Menstrual Cycle

The Rise and fall of hormones during your cycle

Your menstrual cycle is much more than just your period. It’s a complex process directed by the rise and fall of key hormones. These fluctuations can influence everything from your mood and energy levels to your appetite and sleep.

Understanding what’s happening inside your body can empower you to navigate these changes with more confidence and self-awareness.

Mini Somasundaram, MD, an OB-GYN at OhioHealth, breaks down the hormonal changes that happen each month, explains how they impact your body and shares practical tips to help you feel your best.

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Understanding the phases of your menstrual cycle

The menstrual cycle is characterized by distinct phases, each marked by unique hormonal patterns. The two primary hormones are estrogen and progesterone, but other hormones also have important roles.

Follicular phase (Days 1-14 of your cycle):

This phase begins on the first day of and happens concurrently with your period. Follicle-stimulating hormone (FSH) stimulates the formation of follicles — small sacs of fluid that contain developing eggs — in the ovaries. After your period is over and you move toward the middle of your cycle, your estrogen and progesterone levels gradually go up. 

Ovulation (Days 14-15 of your cycle): 

Estrogen levels peak right before ovulation which, along with a surge of luteinizing hormone (LH), triggers ovulation —the release of an egg from the ovary.

Luteal phase (Days 15-28 of your cycle):

 During this phase, your body is waiting to see if you get pregnany or not. Progesterone levels rise to help prepare the uterine lining for potential pregnancy and peak around day 21. If you don’t get pregnant, both estrogen and progesterone levels fall, leading to your period and the start of a new cycle. 

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How hormonal shifts affect your body

Hormonal fluctuations are responsible for many of the physical and emotional symptoms you experience throughout your cycle. These changes are a normal and often predictable part of the menstrual process.

The drop in your estrogen and progesterone levels before your period is often the cause of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) symptoms. The withdrawal of estrogen and progesterone can make you feel more irritable or agitated. 

“We often overlook the fact that estrogen and progesterone are steroid hormones just like testosterone is,” Dr. Somasundaram explains. “Steroid hormones make us feel a little better, and when we have low levels of them, we see changes to our mood and energy levels.”

Physical symptoms are also common. When your hormone levels are lower right before your period, you can experience menstrual migraines due to the hormones’ effects on your vein elasticity. 

While pelvic pain and bloating are common during menstruation, these symptoms aren’t directly related to your hormonal changes. Your hormones trigger the shedding of you uterine lining, meaning the cells in that lining die. Bloating, inflammation and pelvic pain are a result of this cell death in your lining, rather than a direct result of your hormonal shifts. 

Progesterone can also play a role in your energy levels. “Peak progesterone levels can also result in a sense of fatigue. For example, during early pregnancy people have high levels of progesterone which is one of the reasons they feel tired during that time. So, starting around day 21 of your cycle, you can have fatigue due to elevated progesterone levels.”

While these changes are a normal part of the cycle, it’s also important to remember that your environment and daily life play a part, too. Dr. Somasundaram reminds us, “It’s not just what the hormones are doing — what’s going on in the rest of your life also impacts how you feel during the month.” For instance, if you are experiencing more stress or less sleep than usual, it could exasperate some of your symptoms.

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Lifestyle tips to help managing your cycle

While hormonal fluctuations are unavoidable, you can implement lifestyle adjustments to support your body through these changes. The internet is full of advice on “cycle syncing” by tailoring your diet, exercise and schedule to your cycle phases, though the scientific evidence on the efficacy of these practices remains limited.

According to Dr. Somasundaram, the evidence is mostly anecdotal. “There’s evidence that exercise can help manage menstruation, but it’s mixed and controversial,” she says. ” We don’t have great data and evidence-based medicine on it. And it’s hard to argue against anecdotal experience because it works for some people — it’s just that it doesn’t necessarily work for everyone.”

Her advice is to listen to your body. “If varying your exercise and diet during your menstrual cycle works for you, do it. If it’s too much work, don’t. There’s enough stuff we all have to do on a daily basis.”

Simple, consistent habits are often the most effective. Focusing on fundamentals like sleep and hydration are two lifestyle factors that can help support your body during hormonal shifts. 

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How birth control and menopause affect your hormones and cycle

For those on birth control, hormonal patterns are intentionally altered to prevent pregnancy. “Birth control pills trick your body into thinking you’re pregnant, which is why you can’t get pregnant,” explains Dr. Somasundaram. This is achieved by introducing synthetic versions of hormones like estrogen and progestin to flatten the normal hormonal surges needed to trigger ovulation. Without ovulation, the body doesn’t release an egg, and pregnancy cannot occur. 

For those that experience more severe PMS or PMDD, birth control pills can be a safe and valuable treatment for minimizing  symptoms like cramping or mood swings. Side effects are a common concern with using hormonal birth control, and Dr. Somasundaram emphasizes that healthcare providers need to listen. 

If you’re on birth control and experiencing unwanted side effects, don’t hesitate to speak up. “If you feel like the birth control pill your provider put you on makes you incredibly emotional, talk to them. There might be a better option for you,” she advises. The goal is to find a solution that works for your body and your life.

As you enter post-menopause, the hormonal landscape shifts dramatically. As natural estrogen and progesterone production decline, the body no longer follows the typical menstrual cycle. While birth control is no longer needed to prevent pregnancy during this stage, some post-menopausal individuals may use hormone replacement therapy (HRT) to manage symptoms like hot flashes or bone density loss. HRT introduces controlled doses of hormones to supplement what the body no longer produces. 

Understanding how birth control manipulates hormonal patterns offers valuable insight into its function and potential effects, allowing individuals to make informed decisions about their reproductive health.

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Recognizing hormonal imbalances and when to seek help

Hormones regulate numerous bodily functions, and disruptions in their balance can manifest through various symptoms. While some fluctuations are normal, persistent or severe changes warrant attention.

A primary indicator of potential hormonal imbalance in pre-menopausal individuals is irregular menstrual cycles. A typical cycle length ranges from 26 to 31 days. Cycles that are significantly shorter or longer, or periods that are frequently missed or unpredictable, suggest there could be an underlying issue. 

Beyond cycle irregularities, other symptoms may signal hormonal imbalances.

These can include: 

• Unexplained weight fluctuations
• Persistent fatigue
• Mood disturbances (such as increased anxiety or depression)
• Sleep disturbances
• Skin issues like acne
• Hair loss
• Changes in libido

If you experience any of these symptoms, especially when occurring in combination or persisting over time, it may be time to have a conversation with your OB-GYN or healthcare provider. 

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Listen to your body

Your hormonal cycle is a powerful force that affects your physical and emotional well-being. By understanding the rise and fall of estrogen and progesterone, you can better anticipate changes in your mood and energy. While lifestyle adjustments can help, the most important thing is to listen to your body and have open conversations with your healthcare provider.