The Menstrual Cycle

Ever-changing ovarian hormones result in release of an egg and ~4-weekly vaginal bleeding for almost half of women’s lives. Menstruation reflects a healthy environment (emotional/social/physical) and creates fertility and physical/emotional health. Regular cycles commonly adapt to physical/nutritional/psychosocial/illness stressors by maintaining cycle lengths/estrogen during modulated, reversible suppression of ovulation/progesterone—“silent ovulatory disturbances.” Chronic subclinical ovulatory disturbances pose current health problems (infertility, menorrhagia, endometriosis) plus current bone loss with later risk of osteoporosis, heart attack, and breast/endometrial cancer. Ovulatory disturbances are treatable with cyclic progesterone if recognized; they are rarely chronic when women feel valued and are treated equitably within a healthy society.