TYPES OF MENSTRUAL CYCLES Period starts (aka menses) Follicular phase; FSH (follicle- stimulating hormone) and estrogen released, ovulation* begins Day 2-14 Day 1 Day 15-28 Luteal phase; progesterone** released, uterine lining matures *ovulation: the process of an ovum (egg) being released from the ovary; occurs 10-14 days before menses. **progesterone: a steroid hormone that tells the uterus to prepare for pregnancy Long = > 35 days Hormonal imbalance Ovaries with fewer eggs Approach of menopause Reduced fertility 4 May be a sign of: May be a sign of: Hormonal imbalance Lack of ovulation Other fertility issues Increased risk of miscarriage HEAVY BLEEDING Must change pad/tampon every 1 to 3 hours Your menstrual cycle provides valuable clues about your body’s reproductive health. Here are some red flags to look for. SIGNS TO WATCH FOR “Red flags” and early warning signs mentioned above Abnormal periods Heavy or prolonged bleeding Irregular menstrual cycle More than 3 months between periods Under 35 and trying for more than 1 year to get pregnant Age 35 to 39 and trying for 6 months or longer to get pregnant Age 40 or older and trying for 3 months to get pregnant If you are trying to conceive, consult with a fertility specialist if you’re experiencing any of these warning signs: Understand your menstrual cycle and understand your fertility. WHAT TO DO Sources 1 "Endometriosis." Womenshealth.gov. February 13, 2017. Accessed March 01, 2017. https://www.womenshealth.gov/a-z-topics/endometriosis. 2 "Polycystic ovary syndrome." Office on Women's Health. Accessed March 01, 2017. https://www.womenshealth.gov/publications/our-publications/fact-sheet/polycystic-ovary-syndrome.html#a. 3 "Infertility FAQs." Centers for Disease Control and Prevention. February 16, 2017. Accessed March 01, 2017. https://www.cdc.gov/reproductivehealth/infertility. 4 Wise, Lauren A., Ellen M. Mikkelsen, Kenneth J. Rothman, Anders H. Riis, Henrik Toft Sørensen, Krista F. Huybrechts, and Elizabeth E. Hatch. "A Prospective Cohort Study of Menstrual Characteristics and Time to Pregnancy." American Journal of Epidemiology. June 30, 2011. Accessed March 01, 2017. https://academic.oup.com/aje/article/174/6/701/88882/A-Prospective-Cohort-Study-of-Menstrual either short, long or inconsistent. 30% of women have an “irregular” cycle IS MY PERIOD NORMAL? Understanding Your Menstrual Cycle If You’re Trying to Conceive Normal = 21 to 35 days 30% of women are fertile only during the “normal” fertility window—between days 10 and 17 of the menstrual cycle. Only 15% of women have the “perfect” 28-day cycle. Give or take a few days, a normal cycle looks like this: WHAT’S NORMAL? 1 2 3 4 28 27 26 25 5 6 7 8 9 10 11 12 14 13 24 23 22 21 20 19 18 17 16 15 Short = < 21 days Hormonal imbalances Fibroids or polyps Endometriosis Bleeding disorders Could result in: Anemia Difficulty getting pregnant Increased risk of miscarriage More than 7 days PROLONGED BLEEDING Low BMI (body mass index) Get educated about what’s normal vs. abnormal. Knowledge can save you time and heartache if you’re struggling to conceive. Could result in: Iron-deficiency anemia Difficulty getting pregnant Increased risk of miscarriage Irregular ovulation Disruptions to the uterine lining Problems forming blood clots NEVER HAVING A PERIOD Ovulation isn’t happening Underdeveloped uterus or vagina Scar tissue inside the uterus Premature menopause Difficulty getting pregnant without intervention IRREGULAR CYCLE Could mean: Could mean: Could result in: Could mean: Could result in: Problems with ovulation Difficulty getting pregnant Increased risk of miscarriage Thyroid gland irregularities Elevated hormone levels, such as prolactin and androgens PCOS Diminished ovarian reserve Ovarian insufficiency Early signs of menopause Could mean: Fortunately, your menstrual cycle can tell you a lot about your fertility if you know what to look for. More than 95% of U.S. women start their periods by age 16. 70% of women have irregular menstrual cycles as menopause approaches. 11% or more of American women suffer from endometriosis. 1 10% of U.S. women are affected by PCOS (polycystic ovary syndrome). 2 12% of women have trouble getting or staying pregnant. 3 At least About 1.888.761.1967 http://www.ShadyGroveFertility.com/appointment