Menstrual cycle - 40 years in a circle
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Fluctuating cycle
It takes almost 40 years from the first menstrual bleeding to menopause. Every month the female body prepares itself in case of pregnancy. On average, the cycle lasts 28 days. However, the female body is not a machine, and both 21 and 35 days are normal. For most women, the cycle will fluctuate within these limits over the years.
The female cycle is controlled by hormones. The most important sex hormones are estrogen and progesterone (luteal hormone). The latter is the most important representative of the progestins. Estrogens are mainly produced in the ovary, progesterone mainly in the corpus luteum and placenta. Two hormones of the pituitary gland (pituitary gland) also play an important role: FSH (follicle-stimulating hormone) and LH (luteinizing hormone).
Up and down the hormones
»Proliferation or build-up phase: Under the influence of the FSH hormone, several follicles in the ovary begin to mature. As a rule, a follicle soon asserts itself and is the only one that continues to grow. The maturing follicle produces more and more estrogen. The female hormone ensures that the lining of the uterus grows.
»Ovulation: Once the estrogen has reached a certain concentration in the blood, the pituitary gland secretes more LH. The sudden, steep LH surge triggers ovulation.
The mature egg can now be fertilized for around 24 hours.
»Secretion or corpus luteum phase: After ovulation, the empty follicle remains in the ovary. This so-called corpus luteum changes the production of hormones and releases more progesterone. This messenger substance prepares the uterus for a fertilized egg cell: nutrients are stored in the mucous membrane. At the same time, the levels of estrogen in the body drop.
If the egg is not fertilized, the corpus luteum will atrophy within the next ten to eleven days; he also no longer produces progesterone. This withdrawal of hormones causes the uterine lining to be poorly supplied with blood and in some cases dies.
»Menstruation: The excess tissue from the uterus is shed during menstrual bleeding.
The first day of the menstrual period is already the first day of the new cycle: Follicles mature again and the uterine lining rebuilds under the influence of rising estrogen levels. The purpose of menstruation is therefore to shed the old uterine lining and make room for a new mucous membrane that will enable pregnancy again in the next cycle.
Mimicked cycle
Hormonal contraceptives switch off the natural cycle. Because the body receives the sex hormones from the outside, it stops the production of its own messenger substances. The ovaries are "paralyzed", egg cells and uterine lining no longer mature.
The inventors of the estrogen-containing pill tried to mimic the natural rhythm in the female body. Theoretically, one could also choose another cycle course such as 30 or 40 days. From a medical standpoint, there is no compelling reason to imitate the natural cycle. Rather, social and cultural aspects seem to play a role. Regular menstruation is often understood as an expression of physical well-being and normalcy.
Estrogens - 21 + 7 days
Usually women using the pill use a simple scheme: they imitate a natural menstrual cycle by taking the pill for 21 days and then taking 7 hormone-free days. As a result, the blood concentration of the supplied hormones drops rapidly and what is known as hormone withdrawal bleeding occurs. This is not a natural bleeding, as the structure of the mucous membrane is influenced by the pill intake and the rejection of these cell layers is artificially triggered.
Progestins - 28 days
Progestin-based contraceptives (new minipill, minipill, contraceptive stick, three-month injection) reduce the activity of the uterine lining. Since no estrogen is supplied (as with the combined pill), the cyclical build-up of the mucous membrane does not occur. The bleeding becomes less frequent and weaker, in some women the bleeding even stops completely.
New mini pills and mini pills are taken continuously without a break. Especially at the beginning of the hormone intake, the uterine lining is repeatedly rejected. In contrast to the hormone withdrawal bleeding with the estrogen-containing pills, this is not a cyclically predictable bleeding, but occurs irregularly with varying strength.
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