What happens during the menstrual cycle?

The menstrual cycle is necessary for reproduction. It typically is divided into the menstruation, follicular, and luteal phases. The length of each of these three phases can vary from woman to woman and from cycle to cycle.

The average complete menstrual cycle is about 28 days. During the follicular phase, estrogen gradually increases, and the lining of the uterus thickens. Follicles in the ovaries develop, each containing an ovum, or egg, waiting to be fertilized.

After several days of development, one or two follicles continue to develop, while the others shrink and die. About mid-cycle, a hormone called luteinizing hormone surges, signaling the beginning of the luteal phase. Increasing levels of luteinizing hormone cause the dominant follicle to release its egg.

This is termed ovulation. After the egg is released, it lives for 24 hours or less if it is not fertilized. Once released, the rest of the follicle begins to produce the hormone progesterone.

This hormone prepares the uterine lining for potential implantation to establish a pregnancy if the egg is fertilized. If implantation doesn't occur within 2 weeks, estrogen and progesterone levels drop. This causes the uterus to shed its lining, resulting in menstrual bleeding.

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