Ovulation: The Star of the Show
Often, we associate the week that we’re bleeding as the main event of our period, when in reality the main event should really be ovulation. Ovulation is often tied in with conversations around fertility and trying to conceive (or avoid it), but in this week’s blog I want to shed light on why ovulation is healthy and necessary for women beyond it’s implications in pregnancy.
Having a full, natural menstrual cycle is a biomarker of health and a vital sign. There is so much information that can be gathered on the state of your health based on just your period alone! But when hormone are off balance, our cycles can be associated with debilitating cramping, nights spent crying and lashing out at your loved ones for reasons you don’t know, and a week straight of aggravating bleeding, I understand why having a full cycle is not exactly sought after.
When you combine the promise of near erasing theses symptoms along with an almost guaranteed promise of pregnancy prevention, the pill seems like an attractive option.
Before we dive in deeper, I want to make it clear that I think I am not against hormonal contraceptives. They have their time and place and can be a very important method of pregnancy prevention for many women who need it. What I am an advocate for is increasing our knowledge on how the pill can impact our health and to provide alternatives for those that don’t want to be on it, but still want to find balance in their cycles.
What happens with hormones during the menstrual cycle?
On day one of a cycle: we feel very depleted as all of our hormones are “bottomed out”
FSH slowly begins to rise as a response to low estrogen, which stimulates an increase in estrogen levels as a follicle is getting ready to be released
Once estrogen hits it’s peak, it sends a signal to our brain to release a surge in LH, which moves us into ovulation as the matured follicle is released
Once that follicle ruptures, it forms the corpus luteum which produces progesterone. This is all happening during our luteal phase
If fertilization has not occurred, then hormone levels drop and our menstrual flow begins and we start the cycle over again!
What happens with hormones while on hormonal contraception?
When women are on a hormonal contraceptive, they do not cycle. Ethinyl estradiol and progestin fit into the same receptors as our natural estrogen and progesterone, so in short this stops our body from making it’s own.
A steady flow of synthetic estradiol and progestin prevents the dips and peaks of estrogen and progesterone, along with suppression of FSH & LH which leads to a lack of ovulation
Some women may take 3 weeks of hormones and 1 week placebo, and this lack of hormones during that week results in a withdrawal bleed
As you can see, there’s a big difference in what’s happening over the course of a month during a natural cycle vs. being on the pill! When you are on the pill, you do not ovulate and therefore miss the benefits of ovulation. As a note: the pill is not 100% effective and sometimes ovulation may happen leading to unwanted pregnancies.
Why Should I Care About Ovulation?
The health of your cycle each month reflects your emotional, mental, and physical environment that past ~90 days. This is why there is push to view it as a 5th vital sign. Your brain would not signal to the body to release eggs if it did not feel we could provide a safe, healthy environment to raise a baby . This is why many women under high levels of stress, excessive exercise, or suffering from an ED will experience amenorrhea.
Aside from this, there are critical health concerns that arise when we no longer have the protective effects of natural estrogen and progesterone flowing through our bodies at a delicate balance:
As explained by Jennifer Block in her novel, Everything Below the Waist, progesterone and estradiol collaborate on overall wellness. This perfect ratio maintains bone mass, clears arteries of plaque, and regulates blood insulin. Even the mitochondria of our cells (the famous powerhouse getting its moment of fame!) require estrogen to function properly
Our bone health is tied in with our hormones! Progesterone increases the amount of osteoblast cells we have (the cells from which bone arises) whereas estrogen maintains that bone. Studies have found that synthetic progestin actually has the reverse effect-being associated with a 10-20% increase in fracture risk . Premenopausal women with a diagnosis of osteoporosis are found to benefit from increasing progesterone levels alongside therapy
Emotional and mental health is threatened without ovulation. One 2016 study out of Denmark with one million women found a significant correlation between hormonal contraception and treatment for depression….most frighteningly with an 80% increase in teenagers
Overall, we can analyze the symptoms associated with the different phases of our cycle to get a better understanding of our health
What can cause anovulatory cycles?
Malnutrition
Eating disorders
Over exercising
Stress
PCOS
High prolactin
The pill
So now to further understand why ovulation is beneficial, let’s look into the major hormone produced after ovulation: progesterone.
Why Progesterone is our Friend:
As we discussed earlier, after ovulation we see a big spike in progesterone levels during our luteal phase. Progesterone has many wonderful benefits for our health, and we need a decent amount of it to counter the effects of estrogen in order to minimize PMS.
Some benefits of progesterone include:
Increases bone formation by stimulating osteoblast cells
Reduces inflammation
Supports immune response
Regulates control of hormone levels by mediating the HPA Axis
Assists in digestion and lowering levels of anxiety
Protects the uterine lining
How Can I Support Ovulation & Naturally Increase Progesterone?
Decrease stress through meditation and mindfulness practices
Opt for exercises like barre, yoga, and pilates over high intensity workouts like HIIT
Supports stress & HPA axis with adaptogenic and nervine herbs
Nourish yourself with healthy fats such as nuts, avocado, and salmon
Snack on dark chocolate and pumpkin seeds for zinc and magnesium
Increase protein intake with meals to support blood sugar
Prioritize sleep and get sunlight upon waking
Vitex can be used under a doctor’s discretion to increase progesterone, but use with caution in PCOS as it can make the condition worse for some if LH is elevated
When making any form of decision around contraception, working with a naturopathic doctor can be very empowering. If the pill doesn’t work for you and you are looking for other alternatives to support your hormonal health, there are many things that can be done!
If you’re interested in exploring your hormonal health in depth, click here to book a discovery call with me.
