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PCOS Period! The facts about a normal menstrual cycle

Updated on August 15, 2009

What is a normal period?

PCOS, Period! PCOS and Your Menstrual Cycle

Typically, women with PCOS do not have normal menstrual cycles unless they are artificially induced by taking oral contraceptives. Because of hormonal changes caused by PCOS many women have irregular or non-existent periods. By learning about a normal menstrual cycle, you may be able to develop a deeper understanding of why women with PCOS do not menstruate.

First and foremost, let’s dispel the myth of the 28-day cycle. Most women experience menstrual cycles that range from anywhere from 22 to 32 days. The menstrual cycle is characterized by changing hormone levels which induce menstruation and ovulation. The goal of each menstrual cycle is to prepare the body for pregnancy. The menstrual cycle can be divided into two phases: the follicular phase and the luteal phase. Menstruation occurs right before the follicular phase, and ovulation occurs between the follicular and luteal phase

FSH stands for Follicle Stimulating Hormone. This is a hormone that stimulates the maturation of 15-20 eggs in each ovary. A follicle produces estrogen and surrounds each egg. Only 1 follicle becomes the largest and releases an egg.

The development of the follicle and release of an egg takes 2 weeks on average. Depending on how long it takes your body to reach the estrogen threshold this range can actually take from 8 to 30 days or more. This first half of the menstrual cycle, the follicular phase, is highly variable between women and even month to month within the same woman. Stress can affect the length of the follicular phase.

When the body reaches the estrogen threshold, those high levels of estrogen trigger ovulation.

When the egg bursts through the ovarian wall it enters into the fallopian tube where it slowly journeys towards the uterus and awaits fertilization by sperm.

The leftover follicle in the ovary releases progesterone and lives from 12 to 16 days. This duration stays relatively the same in any particular woman. Therefore, the second half of the menstrual cycle, the luteal phase (the time between ovulation and the next menstruation), tends to remain consistent in the same woman. The leftover follicle releases progesterone until it dies and menstruation occurs.

Progesterone causes the primary fertility signs to change. If pregnancy occurs, progesterone also performs a host of other actions. If pregnancy does not occur, estrogen and progesterone levels drop off and the growing endometrium, no longer needed to nourish and sustain a fertilized egg, is sloughed off in menstruation.

You can monitor these incredibly complex hormonal patterns throughout your menstrual cycle simply by paying attention to the 3 primary fertility signs: waking temperature, cervical fluid, and cervical position.

Waking body temperatures” A woman’s body temperature rises within a day or two after ovulation due to increased progesterone. Think of progesterone as the pregnancy hormone which turns up the heat in the oven to help you incubate the baby! Waking temperatures are measured right after you wake up, before engaging in any physical activity whatsoever. The temperature must be taken before any activity to get a true basal body temperature. It should be taken at the same time every day.

Cervical fluid refers to the changes that occur in cervical fluid throughout the menstrual cycle. The cervical fluid pattern starts off very dry right after menstruation, and then progresses to being sticky or pasty, then slightly rubbery, then creamy. This is when you would start to consider it as being fertile cervical fluid. However, the most fertile cervical fluid follows and resembles raw egg white. This egg white fertile cervical fluid is very slippery and stretchy. Sometimes it can be tinged with yellow or pink. These changes in cervical fluid are mediated by estrogen, and as estrogen drops off after ovulation you will notice a sudden drying of the cervical fluid.

Cervical position.” You may already have realized that your cervix changes position. Perhaps you have noticed that sometimes sexual intercourse in certain positions is painful, when other times that same position is not painful. This is because the position of the cervix (the lower part of the uterus, which extends into the vaginal canal) changes throughout the menstrual cycle. The cervix changes in order to facilitate pregnancy. During ovulation the cervix becomes high, soft, open and wet, in order to increase the likelihood that sperm will be able to pass through and reach the awaiting egg in the fallopian tube. During the rest of the cycle, the cervical position is lower, firm, closed, and dry.

Remember, you can learn volumes about your body by paying attention to the subtle changes happening on a monthly basis. If you are a woman with PCOS who has irregular periods you may have learned that during the follicular phase, your body due to increased insulin levels and hormonal imbalance, your body is not releasing the egg from the follicle. Therefore, you are not ovulating. This non ovulatory cycle is responsible for infertility, ovarian cysts, and increased chances or further hormone imbalance. You can benefit from connecting with other women who have PCOS, and by consulting your doctor about options to restore your menstrual cycle.


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      Never loose hope :D 5 years ago

      I was told I had PCOS few months later I was pregnant now have a gourgous girl whose 23 months now. And now in pregnant again and wasn't even planned or tried. I feel really blessed as I know people with PCOS who have been trying. When I was told few yrs back I have PCOS the doc advice was to have sex every other day as with PCOS it's hard to know& calculate when the ovulation date is. My advice is never loose hope but start having sex regularly and take folic acid when trying. Also where I'm on a bit of a large side, I would also recommend loosing weight. Because I started eating healthy and meal replacements shakes for a month and everyone noticed I lost weight, then I came on my period and normally would last two/three weeks but this time only 1 week like normal non PCOS patients, then few days ago did a test because it's been nearly two months since I last come on and found out in pregnant. If that fails, go to the Doc as I was advised that they now have new medication. good luck everyone x

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      Trying to conceive 5 years ago

      My hubby and I are trying and have been for two years feb I got my period and start of mach only for a few hours and then on the 30th of march I got a proper period lasted me 5 days a so a heavy flow, is it possiable to fall pregagnat now and how long after the flow should I wait till I try for a baby?? Please reply desperate for info thanks

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      Erin 5 years ago

      I had irregular periods so went to get checked out and was diagnosed with PCOS, although I also had a scan which did not revealany cysts. However what the scan didn't pick up was that I was pregnant, only by about 6 weeks though. I am now a mother to a 9 month old son :)

      I thought I would have problems conceiving so bought a thermometer to check my waking temp, but I also decided to try the 28 day cycle and have sex on the 14th day before my cycle should begin (if based on 28 days of course) and it must have worked. I hadn't been prescribed any medication as my fiancé was due to go for a test until I found out. I was 7 weeks later before I even thought about testing and was expecting a BFN like every other test i'd done before.

      Also, my sister is now pregnant with her 6th child after having numerous cysts removed, and having a coil (which must have fallen out) so ladies please don't lose hope, it can happen and it will happen.

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      sunem 5 years ago

      ours is love marriage. we waited for our parents'permission for five years and we got married last june. i have regular periods and i am 30 years old. i am of correct weight and do not have any facial hair.i was trying to conceive but could not. so my husband and myself both went for checking up our bodies. my husband was normal and i was detected with PCOS.i am still not able to accept this. i am yearning to have a kid like my dear husband. but this has come as a shock to me. is it possible to get pregnant with pcos. the doctor has given metformin

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      Jeni 6 years ago

      You should go and see a doctor. Coz I myself was diagnosed with PCOS though I am having regular period.. So irregular period is not really the basis of all. Better for you to be check. Good luck!

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      virgo.luv 6 years ago

      Good info. I was recently searching for way to remove facial hair and came across info regarding about PCOS and realized i have some of the symptons, but the only one i did have is that i always have a normal period. It comes like clock work everymonth, but what i want to know if i should still go to the doctor to get checked out.

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      isjung 7 years ago from Montreal, Quebec

      i'm always wary of taking too many meds because I hate all the side effects. I posted a bit about herbal remedies on my hub here: Hopefully some people will find it useful!

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      cquest 7 years ago

      If you have any problems conceiving, take a look at Insulite's PCOS website. They have doctors available for free consultations. Great women who really listen to your particular situation. Good Luck!

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      emeraldkell 7 years ago

      Great hub. Thanks for writing it. I'm a woman with PCOS who just started having regular periods without pills, etc. My hubby and I are trying to conceive. The imformation you provided helps. Thanks for writing.

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      kitsch2000 8 years ago

      As usual, great info. I love insulin hub.

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      Madelinefancher 8 years ago

      Thanks for the information!