Tracking your Menstrual Cycles Demystified
by Dr. Sarah King ND
Upper Beach Health and Wellness
1937 Gerrard St E
Understanding your menstrual cycle involves more than just estimating your next
period. Knowing your body and tracking your menstrual cycles can provide insight into
your hormonal and reproductive health. You might be experiencing symptoms that we
usually label as “normal,” when we should be calling them “common.” These symptoms
could be signs of a hormonal imbalance, a nutrient deficiency, too little or too high
body-fat percentage, or a result of stress.
Menstrual Cycle Length
The length of a healthy menstrual cycle is in the range of 26–32 days. You can track
your cycle length either with your calendar or an app like “P Tracker,” counting your first
day of bleeding (first day of your period) as day 1, and continuing until the day before
your next period. When we assign a healthy cycle length, regularity is important. That
means that even if your cycle is 33 days long, outside of our healthy range, if your
cycles are consistent and are always within a very small range, say 32–34 days long,
that would still be considered healthy and regular. If, however, your cycles are always
a different length, for example, 23 days one month, 34 another, then 28 on month
three, and so forth, that would be more indicative of irregular hormonal fluctuations
or cycle irregularities. Consistency is key for hormonal health, but even more so for
Variations in cycle length have been linked to risk factors for cardiovascular disease,
breast cancer, and myocardial infarctions. The menstrual cycle can be broken down
into two distinct phases, the follicular phase and the luteal phase, both approximately 14
days long. Knowing which day ovulation occurs might not seem like an important task
for women who aren’t trying to conceive, but understanding where ovulation lies with
respect to your total cycle length can make a huge difference in investigating hormonal
The follicular phase is represented by days 1–14 of your cycle, or from day 1 of
menstruation until the day of ovulation. Conversely, the luteal phase occurs from the day
after ovulation until the day before your next menstrual bleeding day. In general, our
cycles tend to become shorter as we age, with perimenopause influencing the largest
variability in cycles. At this stage in a woman’s life, cycles may skip, producing a period
only every 2–3 months. For younger females, a longer cycle may be associated with a
higher BMI, recent use of oral contraceptives, and a later age of menarche. Marijuana
use in women has also been associated with longer follicular phases.
Shorter menstrual cycles and shorter follicular phases have been linked to heavy
caffeine intake and alcohol consumption. A short cycle in general may indicate a
shorter luteal phase. This can be determined by marking down the day of ovulation,
either with the use of ovulation-symptom tracking (see below) or LH test strips (also
known as ovulation prediction tests).
There are several factors that can affect and shorten the luteal phase, but often we see
hormonal abnormalities such as low progesterone, low estrogen, and consequently
impaired corpus luteum and endometrial function. Luteal-phase dysfunction or
shortening has been an associated cause of repetitive miscarriages, but the
consequences of abnormal hormone function go beyond fertility. Low progesterone
levels have also been linked to PMS symptoms including anxiety, sleep disruption,
water retention, decreased libido, and headaches or migraines.
Now that we understand the importance of cycle length and how the timing of ovulation
affects the length of each phase of the menstrual cycle, it’s important to recognize
when ovulation occurs. There are several ways to track ovulation, some more reliable
than others. Inexpensive, at-home ways to track ovulation consist of knowing your
body and recognizing the different types of vaginal and cervical discharge. Cervical
discharge may be apparent a few days before the date of ovulation, often appearing
1–5 days postmenstruation. Look for a clear, sticky, egg-white–like discharge. It may
appear “gooey” and can be tested by slowly plying it apart between two fingers (or with
bathroom tissue), looking for stretchiness. This type of discharge needs to be sticky
and stretchy in order to help facilitate retention of sperm for ovulation, and may still be
present one day (but usually no longer) postovulation.
Alternatively, many women use basal body temperature (BBT) tracking as a means
of identifying ovulation. Although not the most reliable method, it may serve as a
screening tool by looking at temperature trends throughout the cycle. In order to
properly track BBT, it’s important to take a temperature reading first thing upon waking,
but before getting out of bed. Many women find taking temperature under the arm in
the axilla to be sufficient, but oral temperature will also work, as long as the location
is consistent. BBT should be taken and recorded every day over the course of three
cycles. Because it is not the most reliable method, having readings over three months
helps to discern patterns in temperature.
Overall, BBT reaches a low point on the temperature curve before ovulation, then
displays a prominent rise, peaking postovulation. Although it may be difficult to identify
the exact day of ovulation, using BBT helps narrow it down to a range of approximately
two days around ovulation.
To date, one of the most reliable means of testing ovulation is via hormone testing.
This has been made easier for women with at-home ovulation predictor kits, also known
as urinary LH kits. These predictor kits are used to track the peak rise in LH levels, but
may be costly to continue use on a monthly basis.
Tracking Bleeding Patterns and Other Symptoms
Typically, bleeding during menses lasts 4–6 days. Again, you could experience
anywhere between 3 and 7 days of bleeding, but it’s more important to look for
consistencies from cycle to cycle. For most women, the first 2–3 days tend to be the
heaviest, with flow lightening for the remainder of menses.
Total flow over the course of a menstrual period should measure around 30–35 mL
of shed tissue. This equates to about two tablespoonsful. Heavy bleeding would be
characterized by at least double this amount. The easiest way to measure flow is by
using a menstrual cup which contains marked measurements, allowing you to keep
track of volume of flow each time you empty the cup. Alternatively, you may want to
track how often you need to change your pad or tampon. For example, needing to
change a saturated pad once an hour over the course of a day would be an indicator of
a heavy flow.
While tracking flow, take note of any clots, their size, and the overall colour of your
menstrual flow. The characteristics and volume of menstrual flow may lead your doctor
(ND or MD) to investigate bleeding disorders, current platelet count, as well as iron
storage. With any increase in lost blood, the risk of lowering iron levels also increases
and can result in chronic fatigue.
Lastly, cycle tracking provides a medium for tracking many other symptoms that can
be linked to hormonal fluctuations. Tracking mood swings, acne breakouts, headaches,
and/or migraines are all important in assessing the root cause of such symptoms.
Cycle tracking can be a powerful reproductive tool. We can use symptom tracking to
understand when we’re ovulating, when our periods are about to start, as well as if
something isn’t right. Cycle tracking can also be used as a way of understanding when
your fertile days are occurring. With a consistent and regular cycle, this tracking is used
in the Fertility Awareness Method (FAM) for either preventing or promoting pregnancy.
But apart from fertility tracking, knowing your cycle provides key information about
your hormonal health, and may help to discern whether other symptoms are linked to
Tracking can be done via smartphone or tablet app, or by chart/calendar tracking.
Monitor your cycles consistently, starting with cycle length, and try to observe when you
may be ovulating. Know your body, and pay attention to changes in vaginal and cervical
discharge. And most importantly, don’t hesitate to seek medical or naturopathic help to
try to understand your individual hormonal symptoms and fluctuations. Just because a
symptom is common, doesn’t necessarily mean it’s “normal.”