During the menstrual cycle, the concentrations of female sex hormones, estrogen, and progesterone, oscillate. Because of this change in concentration, depending on the cycle stage, skin composition, pain perception, thermoregulation, brain size change, and dietary and caloric needs change. The menstrual cycle also affects the immune system, affecting allergies and autoimmune diseases, and drug metabolism.
The menstrual cycle is regulated by progesterone, estradiol, follicle stimulating and luteinizing hormones that interact with each other. It usually lasts for 28 days and starts with the beginning of menstruation, so the first period day is also the first day of the menstrual cycle. Menstruation lasts from 4 to 6 days. The follicular or proliferative phase lasts from the 7th to the 14th day. Ovulation is the culmination of the follicular phase. The follicular phase is followed by the luteal or secretory phase which includes day 15 to day 28. Throughout menstruation and in the early follicular phase, estrogen and progesterone levels are low, estrogen levels begin to rise a week before ovulation occurs and reach a maximum the day before ovulation. During ovulation, progesterone is produced in increased amounts and grows rapidly during the luteal phase. As the luteal phase progresses, estrogen levels rise again and a second concentration maximum of estrogen is reached 5 to 7 days after ovulation. Then the concentrations start to drop again so the concentrations of both progesterone and estrogen are low at the end of the luteal phase. Shortly before the onset of menstrual bleeding, hormone concentrations return to baseline, and this marks the beginning of a new cycle.
Effect on the skin
The skin is full of estrogen receptors, it contains, to a lesser extent, progesterone and androgen receptors, so it is not surprising that depending on the concentration of these hormones in the body, the composition of the skin changes.
Effect on lipid content
The integrity of skin as a barrier largely depends on lipid content. Skin cells are covered with lipids that protect the skin from water loss. It has been found that the degree of lipid coverage on skin cells and the size of these cells depends on estrogen. Comparing the skin of women of reproductive age, who have more estrogen, and postmenopausal women, it was observed that skin cells in fertile women are significantly larger and completely covered by lipids. The analysis showed that the secretion of lipids on the surface of skin cells is greatest from the 16th to the 20th day of the menstrual cycle.
Impact on sebum production
Androgenic hormones are known to be the main stimulators of sebum production in humans. On the other hand, estrogens in high concentrations prevent the production of sebum, so the production of sebum in women is directly related to the menstrual cycle. When the level of estrogen in a woman’s body is at high concentrations, sebum production is at its lowest. At a time when estrogen levels are low, for example just before and during menstrual bleeding, sebum production is higher, so the skin is prone to acne.
Impact on dermatological diseases
Although the oscillation of hormones during the menstrual cycle affects various diseases and conditions (worsening of asthma, epilepsy, migraine, glaucoma during the luteal phase), dermatological diseases seem to be most affected by this change in hormone levels. Conditions such as acne vulgaris, rosacea, psoriasis, urticaria, atopic eczema and other dermatitis have been shown to worsen during the luteal or premenstrual phase, primarily the week before bleeding.
Does the intensity of pain change during the menstrual cycle?
Sex hormones are thought to play a role in regulating pain. Animal studies have shown that estradiol and progesterone have both pronociceptive (pain-causing) and antinociceptive (pain-preventing) effects, suggesting that the effect of these hormones on pain is complex and probably depends on hormone interactions and degrees of oscillation. Studies in humans have shown that pain is strongest when estrogen levels are lowest or when they drop rapidly. For example, the most common and strongest intensity of headaches has been reported during menstruation, while the rarest headaches occur in the middle of the luteal phase when estrogen and progesterone levels are high. During pregnancy, when estrogen and progesterone levels rise dramatically, a significant reduction in the incidence of migraines has been observed in women who were prone to them. In the postpartum period, when estrogen levels fall, studies have noted an increased incidence of migraines. These changes in the sensation and intensity of pain have not been observed in completely healthy women, but only in those who are prone to headaches, migraines, or abdominal pain.
Menstrual cycle and nutrition
At different stages of the cycle, energy needs differ. Researchers noticed a significant reduction in body weight before ovulation, and increased calorie intake and increased consumption of protein, carbohydrates, and lipids during the luteal phase of the cycle. These data confirmed the theory that progesterone promotes hunger, while estrogen reduces hunger. During the luteal phase, a woman’s body prepares for pregnancy, so the energy needs are higher. Research showed a decrease in plasma amino acid and lipid levels during the luteal phase which correlates with progesterone stimulation of protein biosynthesis required for uterine endometrial thickening. Vitamin B levels also change during the cycle, vitamin B-6 supplementation during PMS has shown a positive effect on stress, anxiety and depression that occur during this premenstrual period. Vitamin D decreases in the luteal and periovulatory phase, which is associated with the formation of follicles before ovulation and progesterone synthesis during the luteal phase. Glutathione is also low during the luteal phase, so it is recommended to consume vegetables rich in vitamin B-6 to boost glutathione metabolism.
From the data above, it is established that the diet during the luteal phase should contain sources rich in proteins, omega-3, and omega-6 fatty acids, the already mentioned vegetables are rich in vitamin B-6 and increase sun exposure due to vitamin D status. Sufficient amounts of antioxidants should be ingested throughout the whole cycle through fruits and vegetables.
The menstrual cycle affects every aspect of a woman’s life, both physiological functions and psychological state. It is therefore not surprising that more and more women are trying to align their diet patterns with the menstrual cycle (cycle syncing). In any case, healthy eating guidelines should be followed and, depending on the phase of the cycle, the intake of certain foods should be adjusted, such as higher needs for carbohydrates, proteins, and lipids during the luteal phase. The knowledge of the changes that occur in a woman’s body through the menstrual cycle and applying adequate measures to prevent unwanted symptoms could greatly change women’s quality of life.
Translated by Patricia Štriga
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