Menstrual cycle

Summary
The menstrual cycle is complex and controlled by many different glands and the
hormones that these glands produce.
The four phases of the menstrual cycle are menstruation, the follicular phase, ovulation
and the luteal phase.
Common menstrual problems include heavy or painful periods and premenstrual
syndrome (PMS).
Knowing when in the menstrual cycle a woman is most likely to conceive can increase the
chance of pregnancy.

The menstrual cycle is a natural process. It is a complex cycle controlled by female

hormones that cause regular bleeding (periods). The menstrual cycle has four
phases: menstruation, the follicular phase, ovulation and the luteal phase.
Some women may experience menstrual problems (e.g. heavy bleeding). Talk to your
GP (doctor)
(http://www.betterhealth.vic.gov.au/health/serviceprofiles/general-practitioner-services)
if you are worried about your period.
What is the menstrual cycle?
The menstrual cycle prepares your body for pregnancy. If you are not pregnant, your
hormones send a signal to your uterus to shed its lining. This becomes your period.
Once you start your period, the cycle starts again.
A menstrual cycle is measured from the first day of your period to the first day of
your next period. The average length of a menstrual cycle is 28 to 29 days, but every
woman’s cycle is different. For example, teenagers might have cycles that last 45
days, whereas women in their 20s to 30s might have cycles that last 21 to 38 days.
Your first period is called menarche. In Western countries, the average age for a first
period is 12 to 13, but it can start as early as nine and as late as 16.
Your last period is called menopause
(http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menopause)
. In Australia, the average age for women to reach menopause is 51 to 52. Some
women might reach menopause as late as 60.
Phases of the menstrual cycle
There are four main phases of the menstrual cycle.
1. Menstruation
Menstruation is commonly known as a period. When you menstruate, your uterus
lining sheds and flows out of your vagina. Your period contains blood
(http://www.betterhealth.vic.gov.au/conditionsandtreatments/blood-and-blood-vessels)
, mucus and some cells from the lining of your uterus. The average length of a period
is three to seven days.
Sanitary pads, tampons, period underwear or menstrual cups can be used to absorb
your period. Pads and tampons need to be changed regularly (preferably every three
to four hours) and menstrual cups should be changed every eight to 12 hours.
2. The follicular phase
The follicular phase starts on the first day of your period and lasts for 13 to 14 days,
ending in ovulation. The pituitary gland in the brain releases a hormone to stimulate
the production of follicles on the surface of an ovary. Usually, only one follicle will
mature into an egg. This can happen from day 10 of your cycle. During this phase,
your uterus lining also thickens in preparation for pregnancy.
3. Ovulation
Ovulation is when a mature egg is released from an ovary and moves along a
fallopian tube towards your uterus. This usually happens once each month, about
two weeks before your next period. Ovulation can last from 16 to 32 hours.
It is possible to get pregnant in the five days before ovulation and on the day of
ovulation, but it’s more likely in the three days leading up to and including ovulation.
Once the egg is released, it will survive up to 24 hours. If sperm reaches the egg
during this time, you may get pregnant.
4. The luteal phase
After ovulation, cells in the ovary (the corpus luteum), release progesterone and a
small amount of oestrogen. This causes the lining of the uterus to thicken in
preparation for pregnancy.
If a fertilised egg implants in the lining of the uterus, the corpus luteum continues to
produce progesterone, which maintains the thickened lining of the uterus.
If pregnancy does not occur, the corpus luteum dies, progesterone levels drop, the
uterus lining sheds and the period begins again.
Common menstrual problems
Some of the more common menstrual problems include:
premenstrual syndrome (PMS)
(http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/premenstrual-syndrome-pms)
– hormonal events before a period can trigger a range of side effects in women at risk,
including fluid retention, headaches, fatigue and irritability. Treatment options include
exercise and dietary changes
dysmenorrhoea
(http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menstruation-pain-
dysmenorrhoea)
– or painful periods. It is thought that the uterus is prompted by certain hormones to
squeeze harder than necessary to dislodge its lining. Treatment options include pain-
relieving medication and the oral contraceptive pill
heavy menstrual bleeding
(http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/heavy-periods)
(previously known as menorrhagia) – if left untreated, this can cause anaemia
(http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/anaemia)
. Treatment options include oral contraceptives
(http://www.betterhealth.vic.gov.au/health/healthyliving/contraception-choices)
and a hormonal intrauterine device (IUD)
(http://www.betterhealth.vic.gov.au/health/healthyliving/contraception-intrauterine-devices-iud)
to regulate the flow
amenorrhoea
(http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menstruation-amenorrhoea)
– or absence of menstrual periods. This is considered abnormal, except during pre-puberty
(http://www.betterhealth.vic.gov.au/health/healthyliving/puberty)
, pregnancy
(http://www.betterhealth.vic.gov.au/healthyliving/pregnancy)
, lactation
(http://www.betterhealth.vic.gov.au/health/serviceprofiles/Lactation-Consultant)
and postmenopause
(http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menopause)
. Possible causes include low or high body weight and excessive exercise.
When to see your doctor
Talk to your doctor if you are worried about your period.
For example, if:
your period patterns change
your periods are getting heavier (i.e. you need to change your pad or tampon more often
than every two hours)
your periods last more than eight days
your periods come less than 21 days apart
your periods come more than two to three months apart
your symptoms are so painful they affect your daily activities
you bleed between periods
you bleed after sexual intercourse.
More information
For more detailed information, related resources, articles and podcasts, visit Jean
Hailes for Women’s Health
(https://www.jeanhailes.org.au/health-a-z/periods/about-the-menstrual-cycle)
.
Where to get help
Your GP
(https://www.betterhealth.vic.gov.au/health/ServiceProfiles/General-practitioner-services)
Gynaecologist
(http://www.betterhealth.vic.gov.au/health/serviceprofiles/obstetrician-gynaecologist-service)
Jean Hailes for Women’s Health
(https://www.jeanhailes.org.au/)
Women’s health clinic
Sexual Health Victoria
(https://shvic.org.au/)
Tel. (03) 9257 0100
References
Understanding your menstrual cycle
(https://www.qld.gov.au/health/staying-healthy/men-women/women/menstruation)
, Queensland Health
The menstrual (period) cycle
(https://shvic.org.au/for-you/reproductive-and-sexual-health/menstrual-cycle)
, Sexual Health Victoria
Menstrual Cycle (periods)
(https://www.fpnsw.org.au/factsheets/individuals/periods/menstrual-cycle)
, Family Planning NSW

This page has been produced in consultation with and approved by:

(https://www2.health.vic.gov.au/)
(http://www.jeanhailes.org.au/)

View all reproductive system - female

(http://www.betterhealth.vic.gov.au/conditionsandtreatments/reproductive-system-female)

Content disclaimer
Content on this website is provided for information purposes only. Information about a therapy, service, product
or treatment does not in any way endorse or support such therapy, service, product or treatment and is not
intended to replace advice from your doctor or other registered health professional. The information and
materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects
of the therapy, product or treatment described on the website. All users are urged to always seek advice from a
registered health care professional for diagnosis and answers to their medical questions and to ascertain
whether the particular therapy, service, product or treatment described on the website is suitable in their
circumstances. The State of Victoria and the Department of Health shall not bear any liability for reliance by any
user on the materials contained on this website.
Reviewed on: 06-09-2022

The Victorian Government acknowledges Aboriginal and Torres Strait Islander people as the Traditional
Custodians of the land and acknowledges and pays respect to their Elders, past and present.

The Department of Health celebrates, values and includes people of all backgrounds, genders, sexualities,
cultures, bodies and abilities.
Privacy statement: https://www.betterhealth.vic.gov.au/about/privacy
Copyright notice: https://www.betterhealth.vic.gov.au/about/terms-of-use
Disclaimer notice: https://www.betterhealth.vic.gov.au/about/terms-of-use

This web site is managed and authorised by the Department of Health, State Government of Victoria, Australia ©
Copyright State of Victoria 2021.