By Saheli Plus | August 19, 2024
When you think about women’s reproductive health, you tend to focus on the normal functioning of the reproductive system, sexual wellness, pregnancy, and childbirth. But there is a lot more to reproductive health than that.
For instance, women’s reproductive health also includes maintaining hormonal balance, which impacts various aspects of your daily life, including mood, energy levels, weight, and overall health and well-being. This is because reproductive hormones like oestrogen and progesterone are among the hormones that control and regulate daily bodily functions. For example, reproductive hormones also bring diuretic and anti-depressant properties. Therefore, you cannot lead a healthy life without achieving hormonal balance. On the flip side, failing to maintain the hormonal balance can lead to serious issues that affect women’s reproductive health, fertility, and overall wellness.
So, it is crucial to learn about reproductive health in detail and uncover every aspect for a better understanding. It helps you maintain reproductive health, identify health issues early, take appropriate measures, achieve overall wellness, and lead a healthy life.
This article is a comprehensive guide to women’s reproductive health. It covers the menstrual cycle, fertility, contraception, reproductive health issues, preventive care, and menopause. It also explores how Saheli enables women to make empowered health choices and achieve health empowerment and overall reproductive wellness.
The menstrual cycle is an integral part of a woman’s life. It starts during puberty, happens in four phases, and continues until menopause. It is also interrupted from pregnancy until after childbirth, sometimes after breastfeeding, depending on individual hormonal responses and breastfeeding practices.
The menstrual cycle is a complex interplay of hormones orchestrating a series of processes in the reproductive system to prepare the uterus for a potential pregnancy, trigger ovulation, and reset the uterus when pregnancy does not occur.
An ideal menstrual cycle spans 28 days, though it is normal for a woman to have menstrual cycles that range from 21 to 35 days.
The four phases of the menstrual cycle are:
The menstrual cycle starts with this phase. It lasts anywhere from three to seven days. During this phase, menstrual bleeding occurs as the uterine lining, also known as endometrium, formed during the previous cycle, is shed. The bleeding starts with light flow and progressively becomes heavier before gradually reducing and stopping.
The follicular phase starts simultaneously with the menstrual phase. It begins on the first day of menstruation and stops with ovulation. It can last from 11 to 27 days, varying significantly among women. During this phase, the follicle-stimulating hormone (FSH) stimulates the development of follicles in the ovaries.
One of these follicles will mature into an egg. Before the egg is released, the uterus prepares itself for a potential pregnancy by developing a uterine lining, which thickens due to the spike in the oestrogen levels. The increase in oestrogen simultaneously signals the brain to reduce FSH production. As a result, the multiple follicles in the ovaries stop developing, allowing just one dominant follicle to keep growing.
Ovulation happens when the ovary releases a mature egg into the fallopian tube. It is triggered by an increase in the luteinising hormone (LH). In an ideal menstrual cycle that spans 28 days, ovulation may occur on day 14. However, it may vary among individuals depending on their cycle length. It may vary even among different cycles, in case the individual has irregular menstrual cycles due to various factors, including stress, illness, and changes in routine.
The last phase of the menstrual cycle is the luteal phase, which starts after ovulation and lasts about 14 days in an ideal 28-day cycle.
During this phase, the follicle transforms into the corpus luteum, a transient, small endocrine gland. The corpus luteum produces progesterone, which maintains the thickened uterine lining and prepares it for implanting a fertilised egg. Without fertilisation, the corpus luteum breaks down, and the progesterone levels drop, triggering the onset of menstruation and starting a new cycle from the beginning.
The menstrual cycle is controlled by the female reproductive hormones, namely:
Oestrogen is a female reproductive hormone responsible for the development of female secondary sexual characteristics, such as breast development and the regulation of the menstrual cycle. It also supports bone health, cardiovascular function, and skin health. Oestrogen is primarily produced by the ovaries. It causes the thickening of the uterine wall and prepares the uterus for a potential pregnancy.
Progesterone maintains the endometrium/uterine lining and prepares it for implanting a fertilised egg. The hormone is mainly produced by the corpus luteum after ovulation. It decreases in level and triggers menstruation if fertilisation does not occur, thus maintaining the menstrual cycle. It also acts as a natural diuretic and anti-depressant, regulating mood and overall wellness.
The luteinising hormone, produced by the pituitary gland, triggers ovulation around the middle of a menstrual cycle. When the luteinising hormone level increases, the fully mature follicle that developed in the ovary during the follicular phase releases an egg. The hormone also stimulates the corpus luteum to produce progesterone.
FSH stimulates the ovaries to produce follicles, and the hormone is vital for ovarian follicles to grow and mature. When its level drops, only one follicle keeps developing and matures into a mature egg. FSH is produced by the pituitary gland, just like the luteinising hormone.
These hormones control the entire menstrual cycle. By maintaining these hormonal levels and achieving good hormonal balance, you can ensure reproductive health and consistent periods. In contrast, failing to maintain the levels of these hormones can cause health issues and irregular periods.
A typical menstrual cycle of a healthy woman is between 21 and 35 days long and varies among women. When the length of a woman’s menstrual cycle is consistently the same or within a range of 2-3 days of each other, the individual will have a regular menstrual cycle. Regular periods indicate reproductive wellness and a good hormonal balance.
When a woman’s menstrual cycles are shorter or longer than the normal range or when a woman misses periods, they are called irregular periods. Variations in the length of menstrual cycles usually coincide with heavy or light menstrual bleeding. If the menstrual bleeding occurs outside the normal range of 2-7 days, it is also considered a menstrual irregularity.
Irregular periods may be caused by underlying health conditions. It is indispensable to consult a doctor to determine the cause of irregular periods and receive appropriate preventive care. You must also monitor your reproductive health and have a good understanding of how menstrual health affects your life.
Menstrual health and good hormonal balance can impact women's physical, emotional, and social well-being.
When there is hormonal balance, and when the reproductive system is functioning correctly, a woman will have regular periods. In contrast, irregular cycles come with menstrual disorders that indicate underlying health issues, such as:
1. Polycystic Ovary Syndrome (PCOS), a hormonal disorder that causes enlarged ovaries with small cysts
2. Thyroid disorders such as hypothyroidism or hyperthyroidism
3. Endometriosis, a condition where tissue similar to the lining inside the uterus grows outside it.
4. Uterine fibroids, which are non-cancerous growths inside the uterus.
5. Premature Ovarian Insufficiency (POI) that causes ovaries to stop functioning normally before the age of 40.
6. Pelvic Inflammatory Disease (PID), an inflammation of the female reproductive organs.
7. Eating disorders like anorexia and bulimia.
8. Stress high enough to disrupt the hormonal balance and affect the menstrual cycle.
9. Diabetes caused by insulin resistance.
10. Obesity that disrupts hormonal balance.
11. Hyperprolactinemia, which causes an increase in prolactin in the blood.
12. Chronic Conditions like celiac disease and inflammatory bowel disease.
These conditions may affect fertility, women’s health, and quality of life. So, medical attention is a must. Prolonged menstrual irregularities can have lasting effects on overall health and reproductive wellness. Conditions like PCOS can increase the risk of cardiovascular diseases. Heavy bleeding in the long term can cause iron deficiency and anaemia, leading to chronic fatigue, weakness, and dizziness.
The menstrual cycle involves changes in various hormone levels, which influence the mood and emotional state of women. So, it leads to premenstrual syndrome (PMS), which can cause symptoms such as:
Understanding and managing these symptoms is crucial for maintaining emotional well-being.
While emotional health, anxiety, depression, and irritability can affect work relations and productivity, pain and heavy bleeding can force women to take leave from work and reduce participation in social activities and interactions.
However, the most significant impact of menstrual health is on fertility, reproductive wellness and the ability to conceive.
Good menstrual health, regular periods, and good hormonal balance are directly linked to fertility, reproductive wellness, and the ability to conceive. They are essential to create a conducive environment for ovulation and successful conception. Menstrual health impacts fertility in the following ways.
The day of ovulation, the days preceding it, and the day after ovulation are crucial for conception. So, anticipating and predicting the ovulation date is a must to achieve pregnancy. Good menstrual health and regular periods lead to consistent ovulation during every cycle. So, it is easier for someone enjoying good menstrual health to predict the ovulation day and increase the chances of becoming pregnant. Irregular periods make it harder to predict the fertile window.
The change in hormone levels orchestrates how the reproductive system prepares for pregnancy. So, good hormonal balance and menstrual health are crucial for conception. Hormonal imbalances can cause conditions like lack of ovulation, also known as anovulation, or inadequate preparation of the uterine lining to support pregnancy due to luteal phase defects.
Conditions that affect menstrual health can also impact fertility. PCOS causes irregular ovulation or lack of ovulation. Endometriosis can cause inflammation and scarring, creating a hostile environment for egg fertilisation and implantation. Hypothyroidism and hyperthyroidism can cause irregular periods and ovulatory dysfunction, making it challenging to conceive and have a healthy pregnancy.
Preventive care is crucial for maintaining menstrual health and reproductive wellness. You can opt for the following preventive care measures for early detection and treatment of underlying reproductive health issues.
Visit your gynaecologist at least once a year to monitor menstrual health. During these checks, the doctor usually assesses the overall health of the reproductive organs, including the uterus, ovaries, and cervix, through a pelvic exam. The gynaecologist physically checks for any abnormalities, such as masses or cysts, that could indicate conditions like ovarian cysts or uterine fibroids.
Regular follow-up appointments ensure that any detected abnormalities are closely monitored and managed. This proactive approach helps prevent minor issues from developing into serious health problems.
A Pap smear test is conducted to detect cervical cancer or precancerous changes in the cervical cells. Women aged 21-29 should take this test once every three years. Women aged 30-65 should take it once in five years, combined with HPV (Human papillomavirus) testing, which helps identify high-risk strains of HPV that could lead to cervical cancer.
Hormone levels of the four reproductive hormones, namely oestrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH), should be measured through blood tests to diagnose conditions like PCOS and thyroid disorders. Further, thyroid functions must be assessed through thyroid function tests (TSH, T3, T4).
Pelvic and transvaginal ultrasound tests must be conducted regularly to diagnose conditions such as ovarian cysts, uterine fibroids, endometrial abnormalities, adenomyosis, and other structural problems.
During an endometrial biopsy, a small sample of the uterine lining is taken and analysed. This test helps diagnose abnormal uterine bleeding and endometrial hyperplasia or cancer.
Women lose bone density with age and are prone to osteoporosis, especially when they suffer from conditions like early menopause and PCOS that affect oestrogen levels. Women who carry those risks should take a DEXA scan (Dual-Energy X-ray Absorptiometry) to measure bone density and detect osteoporosis early to take preventive measures on time to protect bone health.
Hormonal imbalance also leads to insulin resistance, type 2 diabetes, and increased cardiovascular risks. So, women with hormonal imbalances should regularly monitor their blood glucose levels and lipid profile to identify these health risks early and treat them.
It is indispensable to take regular breast exams and mammograms for early detection of breast cancer, especially if you have a family history or other risk factors. You can also take regular gynaecological exams and ultrasound to diagnose ovarian cancer as part of a preventive strategy. Those with a genetic predisposition for breast or ovarian cancer should get genetic testing for BRCA1 and BRCA2 mutations.
With these health screenings and regular check-ups, women can manage their reproductive health and ensure fertility. When they have good reproductive wellness and fertility, they can conceive and have children by identifying the fertile window.
The specific time period in a menstrual cycle, during which women can most likely conceive, is called the fertile window. Engaging in intercourse during the fertile window maximises the chances of pregnancy.
The length of the menstrual cycle of a woman with regular periods is between 21 to 35 days. Ovulation, which determines the fertile window, occurs during the middle of the cycle. You can determine the fertile window by tracking the average cycle span and predicting the ovulation day of every menstrual cycle. This process is called fertility tracking.
Fertility tracking helps women:
Fertility tracking can be achieved using fertility awareness methods that involve tracking the menstrual cycle and observing and recording various physiological indicators and symptoms.
This method involves identifying a consistent menstrual cycle length between 26 and 32 days and predicting ovulation. However, it is unsuitable for women with cycle spans that do not fall within that range.
The thickness of cervical mucous varies during the various phases of the menstrual cycle due to hormonal changes. When it is relatively clearer, stretchy, more abundant, and reaches the consistency of egg whites, it indicates impending ovulation.
Hormonal changes around ovulation increase the basal body temperature by 0.5°F. Recording the temperature every morning before getting out of bed reveals ovulation patterns.
Combining these fertility awareness methods enhances the accuracy in predicting ovulation and helps you determine the fertile window more precisely.
Tracking menstrual health and determining the fertile window is crucial for both conception and contraception. Using this knowledge, you can plan for or avoid a pregnancy.
By tracking the menstrual cycle and predicting the day of ovulation using a fertility awareness method, you can determine the fertile window and pinpoint your most fertile days. Having intercourse during this time increases the chances of conception. So, a woman with a better understanding of her menstrual health, reproductive wellness and fertility will find it relatively easier to plan her pregnancy.
In contrast, the most fertile days can be identified and couples can avoid intercourse during those days to prevent pregnancy. It can be considered a natural family planning method. However, since the chances of pregnancy still exist outside the fertile window, it is advisable to complement this natural contraception method with a reliable contraceptive as a backup measure.
So, understanding the menstrual cycle and tracking fertility and reproductive health empowers women to make informed decisions about contraception and choose a safe and effective contraceptive like Saheli.
Saheli is the world’s only non-steroidal oral contraceptive pill that is completely free from all the side effects. DCGI has approved it and Saheli Plus has been included in the National Family Welfare Programme of India since 1995. Trusted by millions of women in India for planning family and child spacing, it is a safe and highly affordable choice for most women.
With its proven effectiveness, it complements natural contraception by acting as a backup to prevent unwanted pregnancies. It is also a convenient choice for women, as it has a unique weekly-once dosage pattern, in stark contrast to hormonal pills that come with a daily dosage.
In addition to offering effective contraception, Saheli also offers numerous reproductive health benefits.
With these benefits, Saheli not only helps women maintain good reproductive health and achieve effective contraception but also enables women to make empowered health choices and plan their families according to their convenience.
When women choose hormonal Oral Contraceptive Pills (OCPs), they have to consider their short-term and long-term side effects. Short-term side effects include nausea, weight gain, hair fall, acne, and mood swings. Long-term side effects of progestin-only pills include blood clots, high blood pressure, increased cardiovascular risks, etc.
However, Saheli is different. It is the world’s first non-steroidal OCP, and it has no side effects. Further, it has a much shorter list of contra-indications and can be consumed by most women, including breastfeeding mothers. As a result, when they choose Saheli, women:
Saheli enables women to exercise control over their fertility and make informed decisions about their reproductive health, which helps them attain health empowerment and financial independence. With Saheli, women can:
So, Saheli enables women to make empowered health choices, contributes to their health empowerment, and primarily helps achieve contraception as long as they menstruate.
When a woman stops having her menstrual cycle consecutively for 12 months, she has reached Menopause, which marks the end of her menstrual cycle.
The three stages leading up to menopause and beyond are:
1. Perimenopause, a phase that leads up to menopause over several years, during which the ovaries gradually reduce oestrogen production, impacting the menstrual cycle, and stop releasing eggs.
2. Menopause, which occurs when a woman has not menstruated for 12 consecutive months.
3. Post-menopause, which is a phase beyond menopause, where women lose reproductive hormones and have various symptoms and increased health risks.
Menopause symptoms include:
You can manage menopause symptoms with a healthy, balanced diet rich in whole grains, lean proteins, fruits and vegetables, daily exercise, good sleep, yoga, meditation, and breathing exercises, constant hydration, vaginal lubricants and moisturisers, nutritional supplements, and regular medical check-ups.
The objective of learning about women’s reproductive health, menstrual cycle, fertility, contraception, and menopause is to understand your menstrual health and reproductive wellness. A thorough understanding of these topics helps you take control of your reproductive rights, attain health empowerment, take preventive care, and identify health issues and risks early to address them and lead a healthy life.
An ideal menstrual cycle spans 28 days, though it is normal for a woman to have menstrual cycles that range from 21 to 35 days.
The signs of a healthy period are:
Safe days to avoid pregnancy are typically include:
However, this method is not 100% reliable and varies per individual. Use additional contraception for better protection.
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