How You Feel at Different Stages of the Menstrual Cycle

Medically reviewed on December 10, 2023 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• Stage One: Menses
• Stage Two: The Follicular Phase
• Stage Three: Ovulation
• Stage Four: The Luteal Phase
• Why Am I Feeling A Certain Way?
• Why Am I Feeling A Certain Way?
• Manage Your Menstrual Health With Everlywell

While men experience 24-hour hormone cycles, women and people assigned female at birth (AFAB) experience month-long hormone cycles due to the menstrual cycle.

The menstrual cycle is a recurring, physiological process that involves the release of an egg from the ovaries, the preparation of the uterus for a potential pregnancy, and the shedding of the uterine lining in the absence of conception.[1]

That said, the menstrual cycle consists of four stages, and how you feel at different stages of the menstrual cycle will vary.

Stage One: Menses

If sperm fertilizes an egg in the ovaries, pregnancy occurs. Accordingly, the uterus lining will be thick and its blood vessels will be enlarged to prepare to hold a growing fetus.[1]

If an egg is not fertilized, menstruation, also called menses or your period, will start. Your menstrual cycle begins with the first day of menstruation.[1]

At this point in the menstrual cycle, the thick uterine lining breaks down and bleeds, and both the lining and the egg shed and leave the body through the vagina.[1] This menstrual phase can last up to seven days; however, the duration can differ from person to person depending on the individual’s health status, current medications, and unique body composition.[2,3]

Some people may experience only spotting, while others can lose up to 80 mL of blood during menstrual bleeding. The average, however, is about 30 mL of blood loss during this stage. Typically, blood flow will start heavy and ease over time.[2]

It’s common for people on their period to experience symptoms that, collectively, can refer to a condition called premenstrual syndrome (PMS).[3] These symptoms can include:

• Bloating
• Breast tenderness
• Mood swings
• Irritability
• Skin blemishes
• Low sex drive
• Tiredness
• Headaches
• Cramping in the lower belly or lower back

Cramps occur as your uterus contracts, pushing the lining out of your body, and cramping is very common at this stage. But, the intensity can differ. Some people may only feel slight discomfort while others can experience intense, throbbing pain.[4]

Your estrogen levels will also decrease during menstruation. Estrogen is a sex hormone that plays a critical role in your sexual and reproductive health, helping to regulate your periods and prepare your body for pregnancy. When levels wane, oftentimes your energy levels do, too.[5]

To ease your emotional, mental, or physical discomfort, listen to your body. It may respond well to a warm bath, light exercise, or a triple-scoop of chocolate ice cream.

Stage Two: The Follicular Phase

The follicular phase overlaps with menstruation. Thus, this menstrual phase also begins on the first day of your period. Typically, this stage can last anywhere from 14 to 21 days.[6]

After your uterine lining completely sheds, your estrogen levels begin to rise again. This causes the uterine lining to thicken in preparation for a possible pregnancy.[5]

But estrogen doesn’t work alone. Follicle-stimulating hormone (FSH), which affects sexual development and fertility, stimulates the growth of follicles in the ovaries following your period. The ovaries are two small glands—one on each side of the uterus, that produce and store eggs.[7]

Although many follicles will grow, developing anywhere from 11 to 20 eggs, one dominant follicle emerges, and only this follicle’s egg will fully mature. The dominant follicle will also stimulate even more estrogen, preparing the uterus for eventual implantation. At the same time, elevated estrogen levels trigger a decrease in FSH, causing the remaining ovary follicles to reabsorb into the body.[7]

High estrogen levels also stimulate the production of luteinizing hormone (LH), which activates the subsequent luteal phase, in which the egg leaves the ovary.[7]

During the latter end of the follicular stage, it’s not uncommon to feel your energy levels rise, thanks to increased estrogen. Your skin may also clear and you may experience a higher sex drive and an improved mood.

Stage Three: Ovulation

During ovulation, your ovary releases the mature egg, which travels down the fallopian tube and awaits fertilization. Both FSH and LH trigger this process.[8]

At the end of the follicular stage and during ovulation, women and people AFAB are their most fertile.[8]

During ovulation, you may experience the following [9]:

• Light spotting
• Slight cramping
• Pain on one side of the pelvis
• Breast tenderness
• Abdominal bloating
• Increased sex drive
• Mood changes
• Appetite changes
• Heightened sense of smell, taste, and/or vision

You may also notice a difference in your vaginal discharge. During ovulation, it can look like egg whites and may be sticky. Your body temperature may also decrease.[9]

Stage Four: The Luteal Phase

Technically, ovulation occurs during the luteal phase. As the egg moves into the fallopian tube, your body will also produce progesterone, a sex hormone, to prepare the uterine lining for pregnancy, thicken cervical mucus to prevent bacteria growth, and reduce contractions in the uterus, allowing for easier implantation of the egg within the uterine walls.[10] Learn more about this sex hormone in our post: Does progesterone make you tired?

If sperm does reach the egg and fertilizes it, the egg will then continue down the fallopian tubes and attach itself to the thick uterine lining. The lining provides nutrients to the egg, allowing for its eventual development into the fetus and placenta.[8]

When pregnant, your body needs to keep the uterine lining, meaning you won’t have a period.[8]

However, if the egg is not fertilized within 12 to 24 hours after ovulation, the egg dies, the body reabsorbs it, and you will get your period.[8]

During the luteal stage (following ovulation), your body temperature increases and your cervical mucus becomes thick and dry, like glue. You may also experience symptoms that are similar to those experienced during PMS, such as [11]:

• Mood changes
• Breast tenderness
• Bloating
• Breaking out
• Appetite changes

Why Am I Feeling A Certain Way?

Hormone levels are largely to blame for the physical, emotional, and mental changes you may experience during your menstrual cycle. Certain menstrual conditions or disorders, however, may also impact the severity of your period and overall wellness throughout your cycle.[12] These include:

• Polycystic ovary syndrome (PCOS) – Characterized by a hormone imbalance, PCOS may lengthen the luteal phase, meaning your period may come about 18 days after ovulation. More specifically, the ovaries produce high levels of androgens (like testosterone). This can cause an irregular menstrual cycle, missed periods, and inconsistent ovulation. People with PCOS may also experience abnormal hair growth on the face, arms, chest, and abdomen; acne on the back, chest, and face; and hyperpigmentation and/or skin tags. They also have a higher chance of having ovarian cysts (which can be painful) and being obese or infertile.[13]
• Dysmenorrhea – This type of menstrual disorder causes severe and painful cramps during menstruation. It’s believed that a chemical imbalance causes abnormal uterine cramping or endometriosis, another type of menstrual disorder that causes significant pain. In addition to cramping and extreme physical discomfort, people with dysmenorrhea can experience nausea, vomiting, diarrhea, fatigue, weakness, fainting, and headaches.[14]
• Endometriosis – Endometrial tissue makes up the uterine lining. For people with endometriosis, the lining forms outside of the uterus, often impacting the fallopian tubes, pelvic cavity, ovaries, uterosacral ligaments, and/or outside of the uterus. In rare cases, the tissue may also grow on or around the bladder, cervix, intestines, rectum, stomach, or vagina. Since endometrial tissue grown outside of the uterus is not regularly shed, this condition can cause inflammation, scarring, and painful cysts. People with endometriosis can experience painful cramping and pain after sex as well as diarrhea, constipation, fatigue, painful urination, spotting between periods, and/or heavy and irregular periods.[15]
• Menorrhagia – This condition is characterized by long or heavy periods, often due to an imbalance of estrogen and progesterone levels. People with menorrhagia will typically need to change their tampon or pad every one to two hours and can bleed longer than seven days. This can also manifest as abdominal pain and via symptoms caused by anemia, such as fatigue, weakness, and shortness of breath.[16]
• Amenorrhea – Amenorrhea is the absence of menstrual periods altogether (that’s not caused by pregnancy, breastfeeding, or menopause). People with amenorrhea will likely experience hot flashes, vaginal dryness, headaches, vision changes, acne, excessive hair growth, and nipple leakage. There are a variety of reasons why someone might develop amenorrhea, such as poor nutrition, extreme exercise, birth control, uterine surgery, and certain medications. Hormone levels, genetics, and an underdeveloped reproductive system may also be to blame. In the latter case, people can also experience pelvic pain.[17]
• Oligomenorrhea – People with oligomenorrhea will experience infrequent periods, often going longer than 35 days in between menstrual bleeding, due to a hormonal imbalance. Symptoms of oligomenorrhea include acne, headaches, hot flashes, abdominal pain, impaired vision, excess body hair, and vaginal discharge.[18]

Aside from these menstrual conditions, other factors, such as getting off birth control, may impact your menstrual cycle and symptoms.

Manage Your Menstrual Health With Everlywell

Throughout your menstrual cycle, it’s common to experience a variety of symptoms that can impact how you feel day to day. Certain menstrual disorders can further impact your physical and emotional health.

If you’re having difficulty identifying your symptoms or are experiencing uncomfortable or unusual ailments, consult with an Everlywell provider via an online women’s health appointment. Through a private virtual visit, you can discuss your symptoms and receive a care plan to treat or ease your discomfort.

Sign up for a virtual care visit today.

Related Content

What Causes Early Periods?

Does Progesterone Make You Tired?

PID and Pregnancy: What's the Connection?

References

1. Professional CCM. Menstrual cycle. Cleveland Clinic. URL. Accessed Nov 18, 2023.
2. Thiyagarajan DK. Physiology, menstrual cycle. StatPearls - NCBI Bookshelf. Published October 24, 2022. URL. Accessed Nov 18, 2023.
3. Website N. Periods. nhs.uk. Published April 14, 2023. URL. Accessed Nov 18, 2023.
4. PMS symptoms | How to relieve Premenstrual Syndrome Symptoms. Planned Parenthood. URL. Accessed Nov 18, 2023.
5. Professional CCM. Estrogen. Cleveland Clinic. URL. Accessed Nov 18, 2023.
6. Professional CCM. Follicular phase. Cleveland Clinic. URL. Accessed Nov 18, 2023.
7. Professional CCM. Follicle-Stimulating Hormone (FSH). Cleveland Clinic. URL. Accessed Nov 18, 2023.
8. Professional CCM. Ovulation. Cleveland Clinic. URL. Accessed Nov 18, 2023.
9. American Pregnancy Association. Ovulation symptoms – Am I ovulating? American Pregnancy Association. Published December 29, 2022. URL. Accessed Nov 18, 2023.
10. Cable JK. Physiology, progesterone. StatPearls - NCBI Bookshelf. Published May 1, 2023. URL. Accessed Nov 18, 2023.
11. Professional CCM. Luteal phase. Cleveland Clinic. URL. Accessed Nov 18, 2023.
12. Odongo E, Byamugisha J, Ajeani J, Mukisa J. Prevalence and effects of menstrual disorders on quality of life of female undergraduate students in Makerere University College of health sciences, a cross sectional survey. BMC Women’s Health. 2023;23(1). doi:10.1186/s12905-023-02290-7 URL. Accessed Nov 18, 2023.
13. Professional CCM. Polycystic ovary Syndrome (PCOS). Cleveland Clinic. URL. Accessed Nov 18, 2023.
14. Dysmenorrhea. Johns Hopkins Medicine. Published May 13, 2019. URL. Accessed Nov 18, 2023.
15. Endometriosis. Johns Hopkins Medicine. URL. Accessed Nov 18, 2023.
16. Menorrhagia. Johns Hopkins Medicine. Published November 19, 2019. URL. Accessed Nov 18, 2023.
17. Professional CCM. Amenorrhea. Cleveland Clinic. URL. Accessed Nov 18, 2023.
18. Professional CCM. Oligomenorrhea. Cleveland Clinic. URL. Accessed Nov 18, 2023.

Jordan Stachel, M.S., RDN, CPT works with a wide variety of individuals, ranging in age from children to the elderly, with an assortment of concerns and clinical conditions. She helps individuals optimize overall health and/or manage disease states using personalized medical nutrition therapy techniques.