Picture this: a normal menstrual cycle that arrives on time without significant symptoms. Sounds great, right? Unfortunately for many women this is not the reality. Painful and excessively symptomatic menstrual cycles are common but they are not normal and they are a sign that something is out of balance. The first step toward correcting these imbalances is learning how to identify and listen to the signs from the body.

In this article, we’ll talk about menstrual cycle phases, menstrual cycle hormones and how to have a healthy menstrual cycle using tools like diet, exercise and targeted supplementation.

woman in the kitchen cutting up vegetables

You have so much control over your menstrual cycle via food, lifestyle and supplementation.

What is the menstrual cycle?

The menstrual cycle is the natural, monthly hormonal rhythm that women of childbearing years experience. This distinct rise and fall of specific hormones across the cycle is what makes pregnancy possible. In addition to making pregnancy possible, this hormonal pattern has wide-reaching effects on many other aspects of health including mood regulation, metabolism, energy, digestion, and libido. (9)

Stages of the menstrual cycle

The menstrual cycle consists of four stages outlined below.

Menstruation

When the menstrual cycle starts, menstruation lasts anywhere between 3-7 days. At this time, both estrogen and progesterone are at their lowest, causing the uterine lining to shed and prepare for the next cycle. (19)

Follicular phase

During the follicular phase, estrogen steadily climbs over the course of this phase which helps to mature a follicle in the ovaries. Estrogen is a proliferative hormone meaning that it helps to build up the lining of the uterus to create a safe, nutrient-rich environment should conception occur. The peak in estrogen just prior to ovulation is what stimulates the follicle to release an egg during ovulation. This stage of the menstrual cycle lasts for about 14 days, so two weeks. (19)

Ovulation

When ovulation behind, an egg is released from an ovarian follicle making conception possible at this time. This stage is quite quick and only lasts one day. (19)

Luteal phase

After ovulation, the follicle that released the egg turns into the corpus luteum which produces large amounts of progesterone. In this phase, progesterone rises and peaks around day 21. Progesterone, just like the name sounds, is pro-gestation or supportive of a pregnancy. If conception occurs, progesterone stays high throughout the duration of pregnancy. If no conception, progesterone levels decline and this triggers the start of the next period and next round through the menstrual cycle. This lasts another 14 days. (19)

Note: there is some variation in the number of days each woman spends in each phase of the menstrual cycle. The typical/average cycle is what was described!

What is a healthy menstrual cycle?

A healthy menstrual cycle is one that occurs regularly and falls within 21-35 days. There should be only minor symptoms that occur during phases of hormonal changes. Your period should arrive without an entourage of PMS symptoms. Your period should last between 3-7 days and the bleeding, cramping, and mood changes should be mild. (2)

Abnormal menstrual cycles

You just learned in the previous section that a normal menstrual cycle is a coordinated dance of rising and falling hormones across the month. The hormones estrogen and progesterone have a major impact on the way we feel which means we will likely notice changes across the monthly cycle. Mild changes in mood, energy levels, libido, and even creativity are normal and expected.

Symptoms that get in the way of normal daily activities, however, are not normal and are a sign that underlying imbalances need to be supported. (17)

close up of woman sitting on bed holding her stomach in pain

Abnormal menstrual symptoms can get in the way of day to day living.

Abnormal menstrual cycle symptoms

  • Abnormally short or long periods (outside of the 3-7 day range)
  • Absent or irregular periods
  • Excessive cramping and pain that requires medication or missed workdays
  • Extreme mood changes before or during your period
  • Severe breast tenderness
  • Severe headaches or menstrual migraines
  • Significant digestive symptoms like diarrhea, constipation or vomiting
  • Spotting or bleeding between periods
  • Very heavy bleeding (17)

What causes the menstrual cycle to change dates?

Small changes in menstrual cycle length within +/- 4 days is normal. Anything outside of that or any change that causes you to fall outside of the 21 to 35-day cycle length range is not normal.

Stress and menstrual cycle changes

One of the biggest factors that can impact your cycle date is stress. When the female body experiences stress a central stress response system called the HPA axis is activated. (1) The HPA axis is a network that involves the hypothalamus, pituitary, and adrenal glands and is the connection between our central nervous system and our endocrine system. When activated, the HPA axis increases levels of two stress hormones cortisol and corticotropin-releasing hormone (CRH) that help the body manage the stress at hand. (1) Elevations of CRH and cortisol can suppress or delay ovulation, causing a change in cycle date. (20)(11)

If you’ve noticed a big change in your cycle date you would likely benefit from auditing your stress. It’s important to remember that stress has many different forms as well. Perceived stress, anticipatory stress, stress from chronic infection or inflammation, stress from too much exercise or too little food, and stress from traveling or circadian rhythm disruption are all part of the big picture here and can impact cycle date.

Diet and menstrual cycle changes

Major changes to your diet can impact your cycle both in terms of cycle length and regularity and in the severity of menstrual symptoms. Dieting or the restriction of calories or macronutrients is a potential source of stress on the body if your intake falls below the body’s baseline needs. (7) Like we’ve already discussed, high-stress levels can delay or suppress ovulation leading to cycle changes.

A diet that is lacking in important nutrients can affect the menstrual cycle. Your body manufactures hormones out of a combination of both macronutrients and micronutrients. Macronutrients include carbohydrates, proteins, and fats which are the calorie-containing portion of foods. Micronutrients include non-caloric nutrients like vitamins, minerals, and anti-oxidants. A diet that falls short in either category can potentially disrupt a healthy menstrual cycle. For example, we know that a prolonged deficit in total calorie intake can cause disruption or even the absence of a menstrual cycle. (21) Vitamin D deficiency is related to menstrual cycle abnormalities as well. (14)

A diet that includes inflammatory, processed foods can affect the menstrual cycle. The Standard American Diet is one that is laden with highly processed, calorie-dense yet nutrient-deficient foods available at high convenience. Unfortunately, many of these ingredients like high fructose corn syrup, chemical additives, and processed oils can cause inflammation in the body. There is a direct association between inflammatory levels and the severity of menstrual symptoms like cramps and mood swings. (7)

Exercise and menstrual cycle changes

We know that exercise can factor into the menstrual cycle equation as it shows up as a condition called the female athlete triad across multiple sports and competitive levels. The female athlete triad is a combination of low energy availability, menstrual irregularities, and low bone density. (10) This condition occurs when energy availability dips too low as a result of high training volume and/or under fueling. While there are many hormonal benefits to exercises that can help maintain a healthy menstrual cycle, (5) it is important to always look at total exercise volume and ensure that total calorie intake and recovery measures are sufficient to match it.

Integrative protocol for healthy menstrual cycles

A combination of diet and supplements can help support overall health and may minimize symptoms associated with the menstrual cycle.

Healthy menstrual cycle diet

A diet that supports a healthy menstrual cycle is one that provides adequate total calories, balanced macronutrients, and plenty of micronutrients. Accomplishing these three things ensures that dietary stress on the body is at a minimum and the body has the raw materials it needs to manufacture hormones. (8)

Opting for a variety of real foods, whenever possible, helps fill potential micronutrient gaps. Building meals to contain a source of protein, healthy fat, and carbohydrate together can help make sure blood sugar stays balanced and macronutrient needs are met. (6)

close up of a vegetable/plant-based bowl of food

A healthy diet can significantly reduce common PMS symptoms.

Healthy menstrual cycle supporting foods

  • Quality animal proteins like grass-fed beef and organic poultry
  • Anti-inflammatory fats like olive oil and avocados
  • Fibrous carbohydrates like berries, potatoes, and oats
  • Cruciferous vegetables like kale, cabbage, and brussels sprouts
  • Highly pigmented fruits and vegetables like beets, carrots, and oranges
  • Anti-inflammatory spices like ginger and turmeric (15)(13)(18)

Supplements for a healthy menstrual cycle

There are several important vitamins for a healthy menstrual cycle.

Vitamin C for menstrual cycle support

Vitamin C benefits the menstrual cycle as an anti-oxidant and also as a way to improve iron absorption from food or other supplements. Supplementation with vitamin C can help shorten periods that are too long and reduce blood flow to a normal level. (3)

Vitamin B6 for menstrual cycle support

Vitamin B6 has been shown to help improve mood during the premenstrual period as it plays a role in serotonin production. (12)

Vitamin D for menstrual cycle support

Low levels of Vitamin D have been linked to fertility issues and menstrual cycle irregularities. (9)

Magnesium for menstrual cycle support

This mineral has wide-ranging benefits for the menstrual cycle that include reducing menstrual cramps, helping with stress management, supporting a positive mood, and preventing menstrual migraines. (16)

Probiotics for menstrual cycle support

Keeping the gut microbiome happy and healthy can help support a healthy menstrual cycle by reducing inflammation and improving the removal of excess estrogens from the body. (4)

Fish oil for menstrual cycle support

By providing omega 3 fatty acids, a fish oil supplement can help prevent period cramps and other PMS symptoms by modulating inflammation. In fact, it was shown to outperform ibuprofen in managing period pain. (22)

Natural tips for healthy menstrual cycles

  • Eat a well-balanced diet built from real foods
  • Include a variety of fruits, vegetables, proteins and healthy fats daily
  • Incorporate an exercise regimen that provides the benefits of exercise without overly taxing your system
  • Manage stress daily
  • Focus on adequate intakes or targeted supplementation with menstrual cycle nutrients like Vitamin C, B6, magnesium, probiotics, and fish oil

The bottom line

The menstrual cycle is a complex, multi-phase hormonal process that occurs in women of childbearing age. There are many diet, lifestyle, and supplement changes that can support a healthy, symptom-less menstrual cycle.

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  1. Boudarene, M., Legross, JJ., Timsit-Berthier, M. (2002). [Study of the stress response: role of anxiety, cortisol and DHEAs]. Encephale, 28(2), 139-46.
  2. Creinin, M. D., Keverline, S., & Meyn, L. A. (2004). How regular is regular? An analysis of menstrual cycle regularity. Contraception, 70(4), 289–292.
  3. Deeny J. (1940). Vitamin C and the Menstrual Function. The Ulster medical journal, 9(2), 117–124.
  4. De Vrese, M. (2009). Health Benefits of Probiotics and Prebiotics in Women. Menopause Int., 15(1): 35-40.
  5. Ennour-Idrissi, K., Maunsell, E., & Diorio, C. (2015). Effect of physical activity on sex hormones in women: a systematic review and meta-analysis of randomized controlled trials. Breast cancer research: BCR, 17(1), 139.
  6. Gaby, A. (2013). A Review of the Fundamentals of Diet. Global Advances in Health and Medicine, 2(1), 58–63.
  7. Gold, E. B., Wells, C., & Rasor, M. O. (2016). The Association of Inflammation with Premenstrual Symptoms. Journal of women’s health (2002), 25(9), 865–874.
  8. Gorczyca, A. M., Sjaarda, L. A., Mitchell, E. M., Perkins, N. J., Schliep, K. C., Wactawski-Wende, J., & Mumford, S. L. (2015). Changes in macronutrient, micronutrient, and food group intakes throughout the menstrual cycle in healthy, premenopausal women. European Journal of Nutrition, 55(3), 1181–1188.
  9. Hawkins, S. M., & Matzuk, M. M. (2008). The menstrual cycle. Annals of the New York Academy of Sciences, 1135(1), 10–18.
  10. Javed, A., Tebben, P., Ficsher, P., Lteif, A. (2013). Female Athlete Triad and Its Components: Toward Improved Screening and Management. Mayo Clinic Proceedings, 88(9), 996-1009.
  11. Kalantaridou, S. N., Makrigiannakis, A., Zoumakis, E., & Chrousos, G. P. (2004). Stress and the female reproductive system. Journal of Reproductive Immunology, 62(1), 61–68.
  12. Kashanian M, Mazinani R, Jalalmanesh S. (2007). Pyridoxine (vitamin B6) therapy for premenstrual syndrome. Int J Gynaecol Obstet. 2007;96:43–44.
  13. Khayat, S., Fanaei, H., Kheirkhah, M., Moghadam, Z. B., Kasaeian, A., & Javadimehr, M. (2015). Curcumin attenuates severity of premenstrual syndrome symptoms: A randomized, double-blind, placebo-controlled trial. Complementary Therapies in Medicine, 23(3), 318–324.
  14. Łagowska K. (2018). The Relationship between Vitamin D Status and the Menstrual Cycle in Young Women: A Preliminary Study. Nutrients, 10(11), 1729.
  15. Najafi, N., Khalkhali, H., Moghaddam Tabrizi, F., & Zarrin, R. (2018). Major dietary patterns in relation to menstrual pain: a nested case control study. BMC Women’s Health, 18(1).
  16. Parazzini, F., Di Martino, M., Pellegrino, P. (2017). Magnesium in the gynecological practice: a literature review. Magnesium Research, 30(1): 1-7
  17. Rafique, N., & Al-Sheikh, M. (2018). Prevalence of menstrual problems and their association with psychological stress in young female students studying health sciences. Saudi Medical Journal, 39(1), 67–73.
  18. Salama, A., Amine, E., Salem, H. E., & Abd El Fattah, N. (2015). Anti-inflammatory dietary combo in overweight and obese women with polycystic ovary syndrome. North American Journal of Medical Sciences, 7(7), 310–316.
  19. Thiyagarajan, D., Basit, H., & Jeanmonod, R. (2019). Physiology, menstrual cycle. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK500020/
  20. Vitoratos, N., Papatheodorou, D. C., Kalantaridou, S. N., & Mastorakos, G. (2006). “Reproductive” Corticotropin‐Releasing Hormone. Annals of the New York Academy of Sciences, 1092(1), 310–318.
  21. Williams, N. I., Leidy, H. J., Hill, B. R., Lieberman, J. L., Legro, R. S., & De Souza, M. J. (2015). Magnitude of daily energy deficit predicts frequency but not severity of menstrual disturbances associated with exercise and caloric restriction. American journal of physiology. Endocrinology and metabolism, 308(1), E29–E39.
  22. Zafari, M., Behmanesh, F., & Agha Mohammadi, A. (2011). Comparison of the effect of fish oil and ibuprofen on treatment of severe pain in primary dysmenorrhea. Caspian Journal of internal medicine, 2(3), 279–282.