What happens during the menstrual cycle phases?

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Your menstrual cycle is driven by your hormones. Hormones are biochemical substances that are produced in one area of your body and carried in your bloodstream to send signals that trigger responses in another part of your body. The hormones that control your fertility signals are produced in the following areas:

• hypothalamus (in your brain)
  
• anterior pituitary gland (also in your brain, located behind and attached to the hypothalamus)
  
• ovaries
  
• adrenal glands (located on top of your kidneys).
  

A series of hormonal steps trigger the events of your menstrual cycle:

1. At the beginning of your menstrual cycle, the hypothalamus produces GnRH (gonadotropin-releasing hormone). The GnRH pulses through your bloodstream from the hypothalamus to the pituitary gland in spurts every 60-90 minutes from menstruation until ovulation. The GnRH signals the anterior pituitary gland to secrete FSH (Follicle Stimulating Hormone) and later LH (Luteinizing Hormone). This is what is happening when you have your period and in the days before ovulation.
   
   
2. The Follicle Stimulating Hormone (FSH), as its name suggests, stimulates the development and maturation of follicles in the ovaries. One of these follicles will become dominant and contains the ovum that will be released at ovulation. The developing follicles begin to produce estrogen. 
   
   
3. The estrogen released by the developing follicles, and later by the dominant follicle, causes the lining of the uterus, the endometrium, to grow and thicken in preparation of implantation of a fertilized ovum. 
   
   
4. By about the seventh day of your cycle on average (but this can vary widely) the dominant follicle takes over. The eggs within the other follicles lose their nourishment and die as do the follicular cells. 
   
   
5. The dominant follicle produces a sharp rise in estrogen. (You can recognize this stage of your cycle by closely monitoring your cervical fluid). Estrogen is at its peak one to two days prior to ovulation. 
   
   
6. This estrogen surge signals the release of LH (Luteinizing Hormone). This is the hormone that is measured by ovulation predictor kits (OPKs). LH travels through the bloodstream to the ovary where it causes the ovary to release enzymes that make a hole in the sac of the dominant follicle. This causes the dominant follicle to rupture and release the ovum into the fallopian tube where it can be fertilized. This is ovulation. The LH surge is necessary for ovulation to occur. The LH surge (the highest concentration of LH) occurs 12-24 hours prior to ovulation but LH begins to rise about 36 hours before ovulation. 
   
   
7. Estrogen drops dramatically after ovulation. 
   
   
8. The dominant follicle, transformed by LH, becomes the corpus luteum after ovulation. This phase of your cycle after ovulation is called the luteal phase since hormone production is governed by the corpus luteum. The corpus luteum continues to produce a small amount estrogen, but now also produces progesterone. Progesterone is the hormone that dominates this phase of your cycle. Like estrogen, progesterone is needed to develop the endometrium so that a fertilized egg can implant and be nourished should fertilization occur. Your BBT (Basal Body Temperature) rises as a result of progesterone production. 
   
   
9. If an egg is fertilized and implantation of the fertilized egg occurs, the corpus luteum's life is extended. In conception cycles, the corpus luteum keeps on producing progesterone and some estrogen and the development of the endometrium continues. The pregnancy hormone, hCG begins to be produced when the fertilized egg implants, at around 7-10 days past ovulation. As the pregnancy progresses, hormone production is taken over by the placenta. 
   
   
10. If there is no pregnancy, the corpus luteum dies, progesterone levels fall, and a new cycle begins. 
    
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