Throughout the first 27 years of my life I took very little notice of my cycles. As soon as it was time to try for a baby though, I realised just how important it is to firstly know about my cycle, and secondly to tick some important boxes in terms of "cycle health" for fertilty.
Cycles vary hugely and it's normal to have some cycle variation, but there are a few things that we need our cycle to have to increase our chances of a healthy pregnancy. Firstly, let's break down the cycle into the different important phases and how hormones contribute to each of these:
Follicular phase length (~10-16 days). This phase relies on a rise in GnRH (gonadotrophin releasing hormone), which stimulates the initial rise of lutenizing hormone (LH), and follicle stimulating hormone (FSH). The rise in these then stimulates the growth and development of follicles in the ovaries, which contributes to a rise in estrogen.
Regular ovulation (around mid-cycle). Ovulation relies on all of the above occurring with enough time for the follicle to develop and mature so that a healthy egg is released. This is why the follicular phase length is so important, as we need the follicle/ egg to have enough time to develop to be strong and mature for fertilization by sperm.
Luteal phase length (~10-16 days). This phase is one we talk and hear about alot. It's during this phase that the egg released during ovulation is fertilized, then implants into the uterus. It relies on healthy levels of progesterone and estrogen, and needs to ideally be no less than 10 days to give the fertilized egg enough time to implant. It is mainly progesterone that controls the length of this phase, which relies on a healthy corpus luteum (determined by egg health) along with other parameters that influence progesterone.
Menstrual bleed (period). This varies for everyone, but tracking the duration of your menstrual bleed, symptoms, and flow can be a helpful tool in tracking your cycles and identifying any abnormal changes. This phase is when the uterine lining is shed and the cycle begins again. This will only happen if the above process of hormone production occurs, which is why irregular or absent periods can be an indicator that there is something not right with hormone production in the body.
So what role does nutrition and lifestyle play in all of this?
Nutrient deficiencies will contribute to an imbalance in the above hormones, and can interfere with the process of conception. Lifestyle factors such as exercise and sleep are just as important and can be a huge determinant in your cycle length and duration of each phase.
Which nutrients and foods are most important?
Folate (Vitamin B9): Essential for healthy ovulation and early pregnancy as it contributes hugely to the health of the egg, then developing baby. Foods rich in folate include leafy greens, lentils, and fortified cereals.
Omega-3 Fatty Acids: A healthy egg will mean a healthier rise in estrogen and progesterone. Omega 3 contributes to this, as well as reducing inflammation to create a healthy environment for implantation. Omega 3 can be found in fatty fish (salmon, mackerel), flaxseeds, and walnuts.
Iron: Crucial for maintaining healthy blood flow during menstruation, as well as ensuring healthy thyroid function, prolactin levels, and regular ovulation. If your biochemistry indicates a deficiency then it's important to supplement to restore this to normal.
Antioxidants: These are mainly found in fruit and vegetables, and are very important for egg health. Antioxidants fight free radicals and prevent oxidative stress. A healthy egg will support estrogen and progesterone production.
Eating Enough Calories: Ensuring you consume enough calories is essential. Inadequate calorie intake can disrupt hormonal balance- specifically the very first step of your cycle; GnRH, LH, and FSH production.
Are there foods that will harm hormone production and cycle health?
AGEs (Advanced Glycation End Products): AGEs, found in processed and foods cooked at very high temperatures (barbecued and fried foods), can disrupt hormone balance by affecting insulin sensitivity and promoting inflammation, potentially leading to irregular menstrual cycles and insulin resistance, impacting hormones like insulin and cortisol. Choosing cooking methods like baking, boiling, steaming, and avoiding barbecued/ charcoaled foods can help with this.
BPA (Bisphenol A): BPA, a chemical found in plastics and food packaging, may interfere with estrogen receptors, potentially disrupting the menstrual cycle and hormone balance, particularly estrogen and progesterone and can contribute to anovulation. Using BPA-free plastics, heating food in glass or ceramic (not plastic) and avoiding using glad wrap or other plastics when possible will support this.
Alcohol: Excessive alcohol intake can disrupt hormone balance by affecting the liver's ability to metabolize hormones. It may lead to irregular menstrual cycles and altered levels of estrogen and progesterone and elevates cortisol which can interfere with the start of the cycle; GnRH production.
Caffeine: High caffeine consumption can disrupt hormone balance by stimulating the adrenal glands to release stress hormones, potentially leading to increased cortisol levels and menstrual irregularities, impacting cortisol and potentially other hormones like estrogen and progesterone. Limit your coffee intake to 1-2 instant coffees/ day or less than 200mg caffeine.
Sugar: A diet high in refined sugars can lead to insulin resistance, impacting insulin levels and potentially causing irregular menstrual cycles and hormonal imbalances.
Trans Fats: Trans fats from processed and fried foods can contribute to inflammation and insulin resistance, potentially disrupting hormone balance and leading to irregular menstrual cycles, affecting hormones like insulin and cortisol. Foods high in trans fats include packaged foods, commercial baked foods, fried foods, microwaveable convenience foods like frozen pizzas, and fast food.
What about lifestyle factors?
Cortisol: High stress levels elevate cortisol, which can interfere with our production of GnRH, which triggers the beginning of our entire cycle. It also impacts hugely on the production of progesterone and can cause shorter luteal phases and problems with implantation.
Sleep's Role:
Melatonin: Adequate sleep promotes melatonin production, aiding menstrual cycle regulation. Aim for 7-9 hours of quality sleep each night. Sleep will support your body to reduce cortisol levels and of course make you feel more energized and motivated to eat and exercise well.
Exercise:
Daily, moderate- low impact exercise can support a reduction in cortisol, and increase blood flow throughout your body. It also contributes to better quality sleep which as we know, is hugely important for our hormone health. High impact/ intensity exercise can cause hormone problems for some women, particularly if it causes elevations in cortisol or results in an inadequate energy intake vs output balance.
Healthy weight:
Both excessive and insufficient body fat can disturb hormonal balance and ovulation. High levels of body fat can cause estrogen to be too high which disrupts the beginning of the cycle, while not enough body fat can mean GnRH, LH, FSH, and estrogen do not rise enough to trigger follicle maturation and ovulation. Working with a dietitian can be a hugely helpful step in this.
Polycystic ovary syndrome (PCOS) can lead to estrogen imbalances. Weight management is crucial for women with PCOS.
How do I know if I need to start focusing on hormone balance?
Firstly it's important that you are tracking your cycle so that we can see what your cycle length, various phase length, and ovulation timing is looking like.
It's also important to make sure that you are tracking accurately and recording signs of ovulation such as cervical mucus, basal body temperature, or using ovulation predictor kits to pinpoint your actual ovulation day, rather than relying on estimates from apps.
If you have short or long follicular or luteal phases that fall outside of the normal range, then it would be a good idea to speak with your doctor to ask for further baseline testing of nutrients, thyroid function, and sex hormones. It would be a good idea at this point to seek support from a fertility dietitian, to pinpoint where in your cycle we need to be focusing on for improvement, and to develop a personalised hormone balance plan for you.
Hormone balance is often treated through medication as a first-line treatment plan, which can interfere with other processes and can cause other issues for some women. When possible, working on diet, supplement, and lifestyle factors is an important and necessary step to balancing your hormones for regular periods, ovulation, and a greater chance of conception.
I work with women 1:1 to create personalised step-by-step action plans to balance your hormones for healthy, regular cycles. If you would like science-backed support available to you from anywhere in the world, then now is the time to get in touch!
You can learn more about my fertility program here or book your free call and let's talk more about the best path forward for you.
