The Other Time of the Month

Your menstrual cycle can affect you in some surprising ways.

By Charlene  Laino
WebMD Feature

Reviewed By Brunilda  Nazario, MD

Yeah, yeah, we've all heard the jokes about "that time of the month," when our hormones are so out of whack that we might as well be on the all-Twinkie diet. The teasing might be funny (or not) but the misery is real: bloating, cramping, mood swings, and more.

But did you know that the rise and fall in hormones that drives our menstrual cycle affects just about every part of our body all month long? And the period around ovulation -- when estrogen levels zoom -- can really hit us in some unexpected ways.

We call it "the other time of the month."

"There's a connection to almost all the common ailments -- asthma, arthritis, migraine, diabetes, and some of the less common, like epilepsy," says Mary H.H. Ensom, PharmD, of Children's and Women's Health Centre of British Columbia in Vancouver. And that's not to mention the link to the common cold, canker sores, and sex drive.

Before we tell you how your body works in such mysterious ways, here's a quick primer on the hormone roller coaster.

The Female Hormone Roller Coaster

The average menstrual cycle takes about 28 days, with a range of 25-35 days considered as normal. The monthly cycle occurs in phases: the follicular phase, the ovulatory phase (ovulation) and the luteal phase.

Your cycle starts on the first day of your period; this also marks the beginning of the follicular phase. During this phase, estrogen levels start to rise as eggs start to grow, says Sandra Carson, MD, professor of obstetrics and gynecology at Baylor College of Medicine in Houston.

The ovulatory phase, or ovulation, occurs about day 14. One egg or follicle in your ovary emerges as the dominant one. It's ripe and ready to drop, and there's a surge and peak in estrogen.

The luteal phase begins right after ovulation. During the first part of this phase, estrogen levels briefly dip and then rise again and remain high, while progesterone kicks in, reaching its zenith. If you don't get pregnant and implantation of the fertilized egg doesn't happen, both hormones fall during this phase. The waning hormones result in menstrual bleeding and the start of a new cycle, she says.

In general, PMS symptoms occur during this phase, especially the latter half -- just before menstrual bleeding.

The Other Time of the Month

So what happens to your physical and mental well-being during "the other time of the month?" Just about anything!

After consulting with our experts, we've compiled the short list:

• You can get migraines. Everyone's heard of menstrual migraines, but did you know they can occur during 'the other time of the month' as well? "Many women report their headaches occur exclusively during menstruation itself and are symptom-free at other times during the cycle," Ensom says. "But some women have exacerbations during ovulation," due in part to peaking estrogen levels.
• Asthma, arthritis, and other common disorders may follow the same pattern, she says. Ensom advises women with ovulation migraines or asthma to keep a monthly journal, tracking signs and symptoms for at least three cycles. Once you've identified a pattern, you'll know when to anticipate attacks so you can avoid any [migraine] triggers, such as chocolate, she says.
• You may be prone to dental problems. A rise in estrogen and progesterone may exaggerate your gum's sensitivity to plaque and bacteria and may increase your risk for gum infections, or gingivitis. Your gums may get red and swollen and bleed a lot. Also, women who are prone to canker sores and cold sores may develop a pattern where the sores recur at the same time every cycle. What to do? As always follow good oral hygiene, brushing twice daily with fluoride toothpaste and flossing daily. Regular teeth cleanings are a must!
• Your sex drive increases. "Right before ovulation, there's also a change in male hormones and women tend to initiate sex more," Carson says. "Isn't that great? Right when your body is ready to get pregnant, you want more sex!"
• You can get pimples. Just prior to your period isn't the only zit zone: Women also tend to develop acne in the early part of the cycle and around ovulation, Carson says. Again, she blames those pesky male hormones.
• You're sharp. Studies have shown women do better on exams during their periods and at the time of ovulation, when estrogen is either very low or spiking, says Veronica Ravnikar, MD, a fertility specialist at St. Barnabas Medical Center in Livingston, N.J.
• You may be more prone to heart problems. For women with existing heart disease, which includes spasm of the vessels to the heart -- a condition called variant angina, worsening occurs during the time of lowest estrogen levels, a small Japanese study shows.
• You may be sluggish. A jolt of progesterone right after ovulation may cause sleepiness, Ravnikar says.

There's No Escape

Face it: Whatever the time of the month, you just can't escape those hormones. British researchers have found that women with breast cancer live longer when surgery is performed during the last two weeks of the menstrual cycle -- when estrogen levels are generally higher.