World Menstrual Hygiene Day 2020: Everything You Need To Know About Your Menstrual Cycle And Fertility

World Menstrual Hygiene Day is observed on May 28. This day is meant to raise awareness about menstrual hygiene and reduce the taboo around menstruation. Menstruation is a physiological process which is directly related to and responsible for the ability to bear children. The time from the first day of a woman's period to the day before the next period is the menstrual cycle. This cycle of approximately 26-30 days involves a lot of changes that occur in a woman's body in preparation for a pregnancy.

The main reproductive organs in a female are the uterus and two ovaries. The female hormones oestrogen and progesterone rise and fall with the cycle to orchestrate the maturation and release of an egg from the ovary around mid-cycle, which is then implanted in the uterus if it is fertilised by the sperm. Else, the thick lining of the uterus is shed at the end of the cycle in the form of periods. The cycle goes through a series of hormonal changes from day one of the cycle to the 14 day when an egg is released from the ovary and the uterus prepares for pregnancy. Fertility is known to depend on the menstrual cycle.

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Menstrual cycle and fertility: How the former determines the latter

The menstrual cycle is divided into two phases: the follicular or the first half phase and the luteal phase or the second half. Follicular phase begins on day 1 of the cycle, during which time the hormone oestrogen stimulates the ovaries for growth of eggs, and ends with the ovulation or release of one egg. Luteal phase begins with ovulation during which time progesterone prepares and thickens the lining of the uterus in case of a pregnancy and ends as shedding of this lining or menses in the absence of fertilization.

The length of the follicular phase may vary while that of luteal phase is around 14 days. While the length of the menstrual cycle varies from one woman to another, it usually lasts 28±7 days.

Each menstrual cycle has a fertile window. This is the period during which women can conceive. In a standard cycle, the fertile window begins 5 days before ovulation and ends on the day of ovulation. While it is difficult to precisely tell when ovulation occurs, most women usually ovulate around 10 to 16 days prior to the next period. The fertile window also varies from cycle to cycle.

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The length of your menstrual cycle says a lot. It may serve as a potential indicator of hormonal imbalances and whether ovulation is occurring in a regular manner. A normal length cycle points to regular ovulation while a short or long menstrual cycle suggests that ovulation is either not occurring or occurring irregularly. The fertility rate of women with long or irregular cycles is also decreased.

A shorty cycle usually lasts for less than 21 days
Photo Credit: iStock

A short cycle, usually less than 21 days, may indicate that ovaries have fewer eggs and may point to imminent menopause. It may also suggest that ovulation is not occurring as it should. If further tests confirm the same, conception may be difficult. A longer cycle (>35 days) also suggests that ovulation is not occurring or is not occurring in a regular manner, thus making conception difficult. Bleeding for a longer period, say more than 7 days, may also suggest that ovulation is not occurring in a regular manner.

Menstrual cycle characteristics therefore appear to have a key link with the fertility potential. Normal menstrual cycle has a robust link with ovulation and fertility potential. If you are in the reproductive age group and wish to conceive but you have irregular menstrual cycles, you must consult a specialist.

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Irregular or no ovulation decreases the odds of conception without medical intervention. A woman less than 35 years of age with normal cycles who has been unable to conceive after a year of trying should consult a specialist. A woman over 35 with a normal menstrual cycle who has been trying for 6 months and has had no success should also seek a specialist's advice. Normal menstruation indicates regular ovulation, but there may be other reasons for not being able to conceive. As for irregular cycles, we know that ovulation does not occur in a regular manner in such cycles and medical attention is thus required.

(Dr Veena Aggarwal, MD IJCP Group of Publications, Medical Advisor Medtalks.in. She practices in her own clinic in South Delhi)

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