What is the 7th day of the cycle? Phases of the menstrual cycle and the hormones that regulate them. Methods for its determination

Evgenia Nazimova, obstetrician-gynecologist highest category:

– The May issue contains a lot of material on infertility. Really, modern medicine has great technological capabilities to help childless couples. However, how much do we ourselves know about the natural physiological processes occurring in a woman’s body? After all, they are what are needed for pregnancy to occur.

Important
Pregnancy is not counted from the date of sexual intercourse after which it occurred. It is always counted from the moment of ovulation, therefore, regardless of other conditions, any methods for determining pregnancy can be used no earlier than 10 - 14 days after ovulation, even if sexual intercourse occurred at the very beginning of the menstrual cycle. And accordingly, any possible symptoms Pregnancies cannot appear before this moment. Everything else is your imagination.
If we are talking about the obstetric period of pregnancy, then we need to add two weeks to the date of conception (according to ovulation!). This will be the period that should coincide with the period determined by ultrasound. Because if ovulation occurs late, the ultrasound will always give you a shorter period than the date of menstruation. And this has nothing to do with a child’s developmental disorder.

Menstrual cycle

This is the period from the first day of one menstruation to the first day of the next. The normal duration of the menstrual cycle is a constant value for each specific woman with deviations from month to month within a maximum of three days. The average cycle length is 28 - 29 days. The maximum duration of a normal menstrual cycle is 23 - 35 days. Anything less or more is evidence of disturbances in a woman’s hormonal system.
We often hear from patients that menstrual cycle They have a regular period, menstruation comes “always on the same day of the month.” And you immediately understand that this patient does not particularly monitor her cycle, she simply notes that menstruation comes about once a month. Because each month has a different number of days and it is impossible to imagine that hormonal system I knew which month had how many days, and clearly adjusted my duration to these numbers. Of course, it is advisable to keep a calendar to mark the day your period begins. Then, if any questions arise, the doctor will simply be able to navigate the features of your cycle and get an impression of possible problems.
Normally, a healthy woman's menstrual cycle has two phases.
First phase in a normal cycle it can range from 7 to 21 days. During this period, the woman’s body prepares for possible pregnancy.
Newborn. Under the influence of follicle-stimulating hormone of the pituitary gland (FSH), the growth of follicles - vesicles with nutrient fluid containing the egg - begins in the ovaries. The membrane of growing follicles produces the main female sex hormone - estrogen. With the participation of FSH and LH (luteinizing hormone of the pituitary gland), one of the follicles reaches largest sizes and becomes dominant. It looks like a bubble with a diameter of about 30 mm.
The publication. Due to the peak release of LH into the blood, the membrane of the dominant follicle ruptures in an area devoid of blood vessels, and the egg is released into abdominal cavity– ovulation. At this point, some women experience slight pulling sensations lower abdomen. Very rarely there may be spotting bloody issues from the genital tract. In most cases, at this moment you can notice the flow from the vagina quite heavy discharge, similar to egg white. Don't be alarmed. This is not a disease, this is the norm!
Finding a partner. After the egg is released into the abdominal cavity, it is captured in the ampulla of the fallopian tube and very slowly begins to move along it. If at this moment sperm meets on her way, fertilization will occur and pregnancy will occur.

Planning the gender of the child
Determining ovulation can help in another important matter - planning the gender of the unborn child. This is perhaps the only scientifically based technique. It is known that the sex of the unborn child depends on the sperm. If the fertilizer of the egg contains a Y chromosome, you will have a boy; if it contains an X chromosome, then you will have a girl. It has been scientifically proven that sperm containing the Y chromosome are more active and fast, but less tenacious, than female sperm with the X chromosome. Therefore, if the fateful sexual intercourse occurs as close as possible to ovulation, Y-containing sperm will quickly reach the egg and fertilize it. But if there are still a few days before ovulation, then these fast sperm will most likely die before the desired moment, but the X-sperm will calmly reach their destination and will be able to wait for the egg.

Starts from the moment of ovulation second phase.
For any length of the menstrual cycle, this phase accounts for 14 days (+ – 2 days). During this period, at the site of release of the egg in the ovary, under the influence of LH, it matures corpus luteum, which produces the second female sex hormone progesterone and, to a lesser extent, estrogen. Progesterone can cause phenomena in a woman such as increased appetite, drowsiness, and weight gain due to fluid retention in the body. Body temperature sometimes rises to 37 degrees C.
The corpus luteum has a special mission: in the event of pregnancy, it is called upon to ensure its safety at first. If the egg is not fertilized, there is nothing to develop, the level of hormones drops sharply and menstruation begins. That's it, finish. At this point, one menstrual cycle ends and the next one begins, exactly the same.
Now let's look at two important issues, which I think most women are interested in.
First: How to avoid getting pregnant when you don't want to?
Second: how to get pregnant when pregnancy is desired?

Cold - hot

Let's start with the simpler one, the first one. From the characteristics of a woman’s menstrual cycle, it is clear that for conception it is necessary that an egg and a sperm meet in the fallopian tube. The egg enters the tube only after ovulation. According to various sources, its lifespan is no more than three days.
It would seem that everything is clear. Determine the time of ovulation, add 3 days, and during this period abstain from sexual intercourse or use additional contraception. And no unplanned pregnancies. But, unfortunately, not everything is so simple. Firstly, sperm that enter a woman’s reproductive tract before ovulation are not in a hurry to commit suicide because they did not meet an egg there. Most of them prefer to calmly wait for ovulation to occur and the egg to appear. According to various sources, the lifespan of sperm in a woman’s genital tract can be up to 7 - 10 days! This means that at least another 7, or even 10 days before ovulation become dangerous from the point of view of pregnancy.
Well, okay, you can endure 10 - 13 days. If you are sure that the rest of the days are safe. But there is little hope for this either. Because all our calculations are valid only for the case when we know exactly the day of ovulation. How can you recognize this day? There are several ways:
1. Determination of ovulation by measuring basal temperature. The principle of the method is simple: after ovulation, a corpus luteum is formed in the ovary, which produces a large number of progesterone. And progesterone, as mentioned above, has the ability to slightly increase body temperature. Therefore, by recording the moment the temperature rises, we can confirm the fact of ovulation.
What to do: basal temperature is measured with a regular thermometer inserted into the anus for 5 - 7 minutes strictly in the morning, without getting out of bed. We are interested in body temperature not associated with food intake, physical activity and the like. Therefore, if you get up in the morning and then remember about your temperature, then measuring it is already useless, it will not be informative. Measure your temperature every day at approximately the same time, preferably between 7 and 9 am.
We do not measure temperature during menstruation. Usually, during a normal menstrual cycle, before ovulation the temperature is low 36.3 - 36.6 degrees C, and immediately after ovulation it increases by at least 0.4 degrees and becomes more than 37 degrees. This temperature normally lasts almost until menstruation. This method is able not only to determine the presence and time of ovulation, but also to assess the usefulness of the entire menstrual cycle as a whole. But often even healthy women basal temperature charts are not ideal, so often only a specialist can understand them.
2. Ultrasound monitoring of ovulation. When conducting an ultrasound examination, especially with a transvaginal sensor, the process of maturation of follicles in the ovaries is clearly visible, which means it is possible to track ovulation. To carry out such monitoring, it is usually necessary to conduct a series of ultrasound examinations during one menstrual cycle.
The first is always done immediately after menstruation (on the 5th - 7th day of the cycle). During this ultrasound, the initial state of the uterus and ovaries is assessed, the absence of obvious pathology on the part of these organs - tumors, cysts, polyps. If everything is in order, the doctor invites you for the next examination, usually on the 10th - 12th day (depending on average duration your normal cycle), when a dominant follicle should already appear in one of the ovaries.
Further studies are carried out at a time determined by the doctor depending on the current ultrasound picture. Normally, the doctor will see how the dominant follicle grows to the size of the ovulatory one, then ovulation occurs (rupture of this follicle), in parallel with these processes, characteristic changes in the uterus will appear. In the absence of ovulation, ultrasound monitoring quite clearly determines at what stage the failure occurs. This is important when we're talking about about infertility.
3. Ovulation tests. The simplest and available method. They are sold in pharmacies and are made on the principle of pregnancy tests. Only it is not the level of hCG that is determined, but the level of LH in the urine, which increases significantly during ovulation. The instructions describe in detail how and when to carry out these tests.
Of course, in some situations, a combination of two or more of these methods is possible to increase the accuracy of ovulation determination. If you determine that ovulation is occurring in the first cycle, you will need to test three menstrual cycles in a row to see if ovulation occurs on the same day in each. If it turns out that at the same time, you can use this knowledge to develop an individual calendar for your dangerous and non-threatening dangerous days. If ovulation is not recorded in the first cycle under study, do not be alarmed. Even a completely healthy woman can periodically have non-ovulatory cycles. Just continue your research for another 2 - 3 months.
But in any case, it is necessary to take into account that even with a very clear menstrual cycle with stable ovulation failures associated with illness, travel, and overwork are possible. The deadlines may shift, and quite significantly. Accordingly, you can get pregnant on those days that you considered safe.

Sod's Law

Now the second question: How to determine the days most favorable for conception? Everything is the same here, only exactly the opposite. Determine the day of ovulation. Sexual intercourse later than 2 - 3 days after ovulation is of little effectiveness, since sperm need time to penetrate the fallopian tubes. This usually takes them several hours. By this point, the egg will most likely die. Therefore, from this point of view, sexual intercourse is most effective directly on the day of ovulation, as well as 3 to 4 days before it. As you can see, no one has repealed the law of meanness, and if you do not want to get pregnant, then you will have as many as 10 - 13 dangerous days, and if you dream of a child, then the most favorable for conception is a maximum of 5 - 6 days during the menstrual cycle.
However, if we are talking about infertility, we must not forget that for pregnancy to occur, ovulation alone is not enough and many important things must coincide. Therefore, if you determine that you are ovulating, but pregnancy still does not occur, then a more detailed examination is required. What we already talked about in the last issue of the magazine.

The menstrual cycle consists of several phases. Gynecologists divide the phases of the menstrual cycle by day as follows:

• menstrual phase: from 3 to 6 days;
• second phase - follicular: about 14 days;
• ovulation phase: about 3 days;
• luteal phase: 14-16 days.

Menstrual phase

The beginning of the menstrual cycle should be considered the first day of the onset of menstruation. This physiological process occurs due to rejection of the endometrium of the uterus. Every woman may have bloody discharge different character: from heavy bleeding before smearing. When the endometrium of the uterus is shed, the body prepares to produce a new egg. Each menstrual cycle is a preparation of the female body for fertilization and pregnancy.

The first phase of the cycle is accompanied by painful sensations lower abdomen, weakness, drowsiness and irritability. These days it is better to refrain from physical activity and, if your life schedule allows, rest more and be in a calm environment.

Painful sensations can be reduced with the following drugs: Tamipul, Spazmalgon, No-shpa, Paracetamol. It should be noted that all medications should be taken only after the recommendation of a doctor.

In healthy women, these symptoms appear in a mild form. Often the reason painful menstruation can be:

1. Heredity. If your mother or grandmother suffered from pain before menstruation, that is, Great chance these manifestations in subsequent generations.
2. Pathology of the uterus: bending, curvature or underdevelopment of the organ. In this case pain syndrome will accompany menstruation even in women who have given birth.
3. Tension in the pelvis due to contraction of the uterine muscles.
4. Squeezing nerve endings due to an enlarged uterus.
5. Increased sensitivity of the body to ongoing physiological processes.
6. An increase in prostaglandin hormones, which affect the genitals and thereby cause pain.
7. Stagnation of blood in the pelvis and tissue swelling.
8. Intrauterine device. It can cause intense contraction of the muscles of the uterus, resulting in pain.

However, very often painful periods are associated with inflammatory processes in the pelvic organs. To make sure that these manifestations are absent, you need to be examined by a doctor and, if necessary, undergo a course of treatment.

During menstruation, a healthy woman loses about 10 ml of blood. To avoid anemia, these days you should eat more fruits and vegetables containing iron, and also take a complex of vitamins. This applies primarily to teenage girls, whose bodies are not yet fully formed.

Useful for women during this period Fresh air And calm environment. Family members should not forget that during menstruation complex events occur in a woman’s body. hormonal changes, because of which she perceives everything very acutely, can be irritable and unbalanced. That's why the best medicine these days, a woman will receive support and understanding from her family.

Follicular phase and ovulation

Second phase monthly cycle lasts about 2 weeks after the end of bleeding. However, stress and wrong image lives can be affected normal duration this phase.

During this period, the ovaries produce a hormone that stimulates the development of follicles, FSH. IN dominant follicle subsequently the egg matures.

The follicular phase is characterized by the release of the hormone estrogen, which promotes renewal of the uterine wall. This hormone affects the biological environment in the cervix, making it insensitive to sperm. Nature has decreed that during this period the female body prepares for fertilization, and premature entry of sperm is undesirable.

Estrogen is considered the main beauty hormone. Skin, hair and nails become strong and beautiful. During this period, all kinds of cosmetic procedures are appropriate.

On day 14, the body releases the luteinizing hormone LH, while the production of the hormone FSH decreases. The LH hormone has a beneficial effect on the mucus in the cervix, making it receptive to sperm. Under the influence of this hormone, the maturation of the egg ends and it is released from the follicle.

This process is called ovulation, which lasts from 2 to 4 days. Exactly this favorable time for conception. Many girls who want to get pregnant calculate these days on the calendar.

The mature egg moves along fallopian tubes, where he awaits a meeting with sperm within 2 days. Sperm can live for about 5 days, so if sexual intercourse occurs shortly before ovulation, there will be a high probability of fertilization of the egg.

In this phase, girls' appetite increases, which threatens speed dial weight. This is due to the body’s accumulation of necessary nutrients in case of a possible pregnancy. At this time it is better to increase your consumption fermented milk products and plant foods.

The likelihood of conception is possible as early as the 9th day of the cycle. There is even a certain theory of conceiving a child of the desired sex. If parents dream of a girl, then sexual intercourse should be performed before ovulation, since the X chromosome, which determines the female sex, is more viable. And if the desired sex of the child is male, then he should be conceived on the days of ovulation - on days 12-14 of the cycle.

Ancient eastern teachings say that before ovulation, a woman accumulates energy, and after ovulation, it is redistributed. Conserving energy allows a woman to achieve harmony and peace of mind.

During ovulation, women develop a special smell that attracts men. She shines with beauty, health, and her sexuality these days is at the highest level.

Luteal phase of the menstrual cycle

After the egg is released, the empty follicle, or corpus luteum, begins to produce the hormone progesterone. It prepares the endometrium of the uterine cavity for the implantation of a fertilized egg. At this time, the production of the hormone LH ends and cervical mucus dries out.

The luteal phase lasts from 14 to 16 days. The female body is preparing for the implantation of an embryo. This process occurs within 6-12 days after fertilization. As soon as this happens, the production of the hormone human chorionic gonadotropin begins. It supports, which produces progesterone throughout pregnancy, which ensures normal bearing of the child.

Modern pregnancy tests are sensitive precisely to human chorionic gonadotropin, which is called the pregnancy hormone.

If fertilization does not occur, the corpus luteum and egg die, and progesterone production stops. The endometrium of the uterus also begins to deteriorate.

From the 20th day of the cycle, the concentration of luteinizing hormone decreases and the corpus luteum begins to reverse development in the ovary. It is believed that from this day on the probability of becoming pregnant becomes minimal.

At the end of the luteal phase upper layer the uterus begins to tear away and subsequently comes out of it with menstrual flow. This is the beginning of a new cycle.

In the final phase of the menstrual cycle, metabolism slows down. A week before the onset of menstruation, work intensifies sebaceous glands skin. Girls begin to develop skin rashes. These days it is advisable to refrain from physical activity, as connective tissues become more vulnerable.

PMS - premenstrual syndrome- affects not only appearance, but also on mental state women. As a result of a change in hormone levels, a woman becomes vulnerable and vulnerable; she needs the support and understanding of her family.

The mammary glands increase in size, daytime sleepiness, anxiety or apathy appear. Gynecologists these days recommend such “medicines” as sex and chocolate. However, some women experience decreased libido during PMS, so chocolate remains, which promotes the production of the happiness hormone.

The duration of the menstrual cycle is individual for each woman.

Therefore, the duration of the monthly phases may vary for each woman.

Cycles lasting from 21 to 32 days are considered normal.

Every month reproductive system a woman undergoes certain changes that leave an imprint on both her physiological and psychological state. They are necessary so that the female body can prepare for conception - and then for pregnancy. Such changes are regular and are called the menstrual cycle - which, in turn, consists of several phases.

Let's take a closer look at how they pass, how long they last, and what signs indicate the onset of each phase.

The first phase of the menstrual cycle is called menstruation

What should you know about menstruation?

Its duration is approximately 3-7 days.

It is characterized by the following symptoms:

1. Bloody vaginal discharge.
2. Breast augmentation.
3. Pain in the abdomen.
4. Irritability.
5. Pain in the lumbar region.
6. Changeability of mood.
7. Nausea and sometimes vomiting.
8. Headache.

Not all of the above signs will necessarily accompany “critical” days. For many girls, they pass quietly, and the only thing that indicates menstruation is the presence of uterine bleeding.

The cause of painful and heavy periods, nausea, chills, headaches may be increased level in the blood of prostaglandins in this phase. These chemical substances produced by the tissue of the uterus and cause its contraction.

The menstrual cycle begins from the day on which the spotting began from the genitals. During it, the old endometrium is rejected.

Uterine bleeding indicates that pregnancy did not occur in the previous cycle.

At the same time, the ovaries begin to develop follicles. This is the name given to bubbles filled with liquid. Each of them contains one egg. Under the influence of follicle-stimulating hormone, they begin to mature.

How thick should the uterine mucosa be during menstruation?

What happens during the second, follicular (proliferative) phase of the cycle?

After the end of menstruation, the female body begins to prepare for possible conception baby. All processes occurring during this period are caused by follicle-stimulating hormone - which, in turn, is produced by the pituitary gland.

Thus, FSH has a huge impact on the level of estrogen in the blood. Starting from the 1st day of menstruation, it rapidly grows upward. Thanks to this, the endometrium, which has grown in the new cycle, is saturated with blood and various nutrients. This is necessary so that in case successful conception the fertilized egg was able to receive in the uterus everything it needed for further growth and development.

Immediately after the end of menstruation, one follicle “overtakes” its comrades in its development, as a result of which the latter stop growing and return to previous state. The “winning” vial of liquid continues to grow the egg.

Size of liquid bubble in diameter

About a woman’s well-being during this period

During the second phase the girl:

1. Efficiency increases.
2. Your mood improves.
3. Sexual desire increases.

Endometrial thickness in the proliferative phase

Third, ovulatory phase of the cycle

The ovulatory phase, unlike the others, lasts very little - approximately 24-36 hours. It is during this phase that women have a chance to get pregnant.

The level of the hormone estrogen in the third phase is at its highest high level. During ovulation, the level of luteinizing hormone in the blood increases, but the concentration of follicle-stimulating hormone decreases.

What happens to the mature egg during this phase?

First, it destroys the wall of the follicle - and, with the help of epithelial villi, begins to move into the fallopian tube.

Then, if she meets a sperm, she is fertilized.

Otherwise, the egg dies just a day after leaving the ovary, after which it dissolves in the uterine mucosa.

In addition, you can determine the presence or absence of ovulation using home tests.

The beginning of the ovulatory phase can also be detected on ultrasound examination , during which the doctor will have to find out what the size of the ovaries and cervix is, and in what condition they are now.

Endometrial thickness in ovulatory phase must be within 1-1.3 cm.

The fourth phase of the menstrual cycle is the corpus luteum phase, or luteal phase.

Its duration is fourteen days.

After the egg leaves the vial of liquid, a yellow body begins to grow at the site of its rupture. It produces estrogens, androgens, and the “pregnancy hormone” progesterone.

If the corpus luteum produces progesterone in small quantities, then fertilization of the egg may for a long time not happen.

So that a woman can become pregnant and then give birth to a child in due date, doctors may prescribe her to take special hormonal drugs.

What other function does progesterone perform?

Thanks to it, the endometrium softens, becomes loose, and increases in thickness. This is necessary in order to ovum was able to infiltrate it.

Whether pregnancy has occurred or not can only be determined at the end of the luteal phase. Menstruation, if conception has occurred, will not begin. Basal temperature will remain at 37.3.

You can use home test , which can be bought at any pharmacy, or by donating blood at the clinic to check the hCG level.

Nausea, dizziness and other signs of conception that have occurred appear much later.

Signs and symptoms of the luteal phase

If the egg was not fertilized by a sperm, then in the first days of the luteal phase the girl will feel great. A “pregnant” woman will feel the same way.

The only sign that can indicate to her that conception has occurred is the appearance of a few drops of blood on her underwear - 7-10 days after intimacy.

If pregnancy does not occur, then a few days before menstruation the woman’s condition may change. She may have PMS syndrome , which is often associated with a woman’s irritability and anxiety. Her mammary glands may swell and she may experience minor abdominal pain.

How thick should the endometrium be during the luteal phase?

The woman’s body is a mystery of nature; it can be studied endlessly.

Great impact on well-being and emotional background affects the menstrual cycle. It is the duty of every woman to know about it and be able to feel her body.

• Show all

  1. What is the menstrual cycle?

  The menstrual cycle is usually called a period of time, the beginning of which is considered, and the end is the day before the appearance of the next menstrual flow.

  This process is repeated in all healthy women every month, with the exception of pregnant and breastfeeding women.

  Every month nature prepares a woman for a potential pregnancy and does everything to ensure that the fetus is in a comfortable and favorable conditions, in which you can grow and develop harmoniously.

  When a girl is born, there are about 2 million eggs in her ovaries, but by the time of puberty there are no more than 400 thousand of them. During 1 cycle, as a rule, 1 egg is consumed.

  It is impossible to imagine a regular menstrual cycle without the participation of brain structures and hormones.

  Sequence of events occurring during normal cycle, is due to the close relationship between the work of the hypothalamus, the anterior pituitary gland, ovaries and endometrium.

  On average, its duration is 28 days. But a cycle that lasts from 21 to 35 days is also considered normal.

  If the cycle does not fit into these time periods, this is not the norm. In this case, you should contact a gynecologist and undergo comprehensive examination under his leadership.

  

  Figure 1 - Scheme of the phases of the menstrual cycle

  2. Cycle phases

  The menstrual cycle consists of several phases. The phases of changes in the ovaries and endometrium differ (see diagram in Figure 1 and table). Each of them has its own characteristics and characteristics.

  	Endometrial phase	Peculiarities	Signs
  Ovulation (1-2 days)	---
  Luteal (14 days +/- 2)	Secretory

  Table 1 - Phases of the menstrual cycle

  2.1. Follicular

  The very first phase of the menstrual cycle is called follicular. It begins on the 1st day of menstruation, and its end occurs on the day when ovulation occurs.

  During menstruation, the surface layer of the uterine mucosa is shed and bleeding begins.

  On days 1-3 of the cycle, the uterus looks like wound surface, is great these days. By day 5, the thickness of the endometrium begins to increase.

  During the first phase, follicles mature in the ovaries under the influence of FSH (follicle-stimulating hormone).

  Initially, there may be several of them, but only one will complete the maturation process, becoming dominant (main).

  During this period there is active growth(proliferation) of the endometrium in the uterus under the influence high concentration estrogens (mainly estradiol).

  Thus, the follicular phase correlates in time with menstruation and the endometrial proliferation phase, that is, it covers days 1-14.

  2.2. Ovulation

  It begins after a sharp surge of LH (luteinizing hormone). After the dominant follicle bursts, an egg is released and begins its movement along the fallopian tube.

  If at this moment the egg and sperm meet, an embryo is formed and the woman can become pregnant.

  If this meeting does not occur, the egg will die in about a day. Ovulation can be calculated and determined by the signs listed below:

  1. 1 A woman begins to experience strong sexual desire.
  2. 2 Basal temperature rises.
  3. 3, they become mucous, viscous, but remain light and are accompanied by other symptoms.
  4. 4 Moderate pain may occur in the lower back, nagging pain.

  2.3. Luteal

  The second phase is characterized by the formation and growth of the corpus luteum at the site of the ruptured follicle. On average it lasts 12-16 days. The corpus luteum prepares the body for pregnancy and produces progesterone.

  The maximum concentration of progesterone is observed 6-8 days after the formation of the corpus luteum (approximately day 22 of the cycle).

  During this period, the endometrium thickens even more, only due to the formation of secretion by the uterine glands and an increase in cell size (the third phase of secretion). Its thickness at the end of the luteal phase can reach 12-14 mm.

  If conception does not occur, then the level of hormones (estrogens, progesterone, FSH, LH) gradually begins to decrease. Their minimum triggers the onset of menstruation, and a new cycle begins.

  This process is influenced by stress, bad habits And past illnesses.

  3. Causes of menstrual irregularities

  What causes the cycle to break?	Conditions and diseases
  	Hyperprolactinemia
  	Cushing's disease
  	Thyroid pathologies
  Decreased endometrial quality
  Effect on the ovaries
  Impact on multiple links

  4. What should you pay attention to?

  Women should be attentive to their bodies. The ability to feel the changes occurring in it, to hear its signals, will help you avoid many difficult situations.

  What is not the norm, and what warning signs should you pay attention to?

  1. 1 If more than once every 21 days, or less than once every 35 days, you should consult a doctor.
  2. 2 Heavy bleeding, when 1 pad or 1 tampon is not enough for 2 hours.
  3. 3 Bleeding also occurs.
  4. 4 Menstruation lasts more than 7 days.
  5. 5 During menstruation or during ovulation, symptoms arise that interfere with full work, study and daily activities.
  6. 6 are pronounced and reduce the quality of life.

  5. Why do you need a period diary?

  Now there is no need to start a special notebook for this. You can install an app on your phone and enter data regularly. Such a diary is needed to know the average time of one cycle.

  

  What does the menstrual calendar look like?

  If its duration changes sharply, the diary will help to find out the nature of the violations.

  The diary will also help determine the date of expected ovulation. This is especially important for those who have problems conceiving.

  Electronic applications offer to enter the start and end date of your period each month. Based on this data, they will automatically calculate the cycle length, ovulation time, unfavorable days for planning a child and the start time of the next menstruation.

  Some applications are not limited to this data; they can record how you feel on certain days (amount of blood released, symptoms, changes).

  All this data, if necessary, will make the doctor’s work easier and help identify the causes of violations.

  Phase of the ovarian cycle and its duration	Endometrial phase	Peculiarities	Signs
  Follicular (average 14 days, range from 7 to 22 days)	Menstrual + proliferative	FSH stimulates the formation of follicles. An increase in estrogen concentration from days 3-5, the growth of a renewed endometrium.	It begins at the same time as menstruation. Bloody discharge appears. In the first days, the woman feels bad, she is bothered by pain in the lower abdomen, lower back tension, and her mood is low. After the end of menstruation, the discharge is moderate or scanty, the skin condition gradually normalizes.
  Ovulation (1-2 days)	---	A sharp surge in LH stimulates the release of the egg from the follicle. Movement of the egg through the fallopian tube.	Increased sexual desire, moderate pain in the lumbar region, lower abdomen. Quantity light discharge increases, they become mucous, viscous or liquid. The skin under the influence of estrogen is clean, smooth, and radiant. Increase in basal temperature.
  Luteal (14 days +/- 2)	Secretory	The follicle transforms into the corpus luteum, and progesterone production begins. Its peak concentration occurs 6-8 days after the formation of the corpus luteum.	In the middle of the phase, against the background of hormonal changes, some people experience premenstrual syndrome. Its symptoms include swelling of the mammary glands, decreased mood, tearfulness or aggression, increased appetite, nagging pain in the lower abdomen, weight gain, swelling, headaches, less often constipation, flatulence.

  What causes the cycle to break?	Conditions and diseases
  Anovulation (no normal ovulation)	PCOS (polycystic ovary syndrome), ovarian failure
  	Hypothalamic syndrome, tumors and other diseases of the pituitary gland
  	Excessive training and exercise
  	Disorders eating behavior, anorexia nervosa, bulimia
  	Hyperprolactinemia
  	Cushing's disease
  	Thyroid pathologies
  Decreased endometrial quality	Cancer, endometrial hyperplasia, endometritis, polyps, endometriosis (adenomyosis)
  Effect on the ovaries	Cysts, tumors, adnexitis, cancer
  Changes in the levels of hormone regulators	Incorrect reception and selection oral contraceptives, intrauterine systems, early menopause, taking tamoxifen, progesterone drugs
  Impact on multiple links	Inflammatory diseases of the cervix and vagina, including STDs (chlamydia, genital herpes, trichomoniasis, gonorrhea)
  	Reception medicines(for example, anticoagulants)
  	Are common somatic diseases: kidneys, liver, adrenal glands, diabetes, inflammatory diseases intestines, hemophilia and other diseases of the blood coagulation system, oncology, etc.