What Is a Menstrual Cycle and What’s Happening to My Hormones?! By District PT – Your Neighborhood Pelvic Health Expert in Capitol Hill, DC

“I’m feeling really hormonal right now!” — sound familiar?

Here’s the surprising truth: the menstrual phase (your period) is actually when your main reproductive hormones are at their lowest levels. In fact, hormones surge much higher later in the month during the follicular, ovulation, and luteal phases.

Understanding your cycle can help you decode mood changes, energy dips, GI symptoms (like “period poops” or constipation), and even iron levels. Here’s a clear, PT-friendly breakdown.

The Menstrual Cycle: More Than Just a Period

Your period is only the beginning of the menstrual cycle. A full cycle has several distinct phases:

• Menstruation Phase — bleeding, low estrogen & progesterone

• Early Follicular Phase — follicle-stimulating hormone (FSH) wakes up ovarian follicles

• Late Follicular Phase — estrogen rises, uterine lining rebuilding

• Ovulation — luteinizing hormone (LH) surges, releasing a mature egg

• Luteal Phase — the empty follicle becomes the corpus luteum, pumping out progesterone to prepare the uterus

What Your Hormones Are Really Doing

• FSH & Estrogen (Follicular Phase): FSH helps follicles mature, while estrogen builds the uterine lining and can increase energy and focus.

• LH Surge (Ovulation): Triggers egg release — often when libido and energy peak.

• Progesterone (Luteal Phase): Progesterone = “pro-gestation,” calming but can slow GI motility. This is why constipation is common after ovulation.

• Prostaglandins (Menstruation): These compounds help the uterus shed its lining but can also stimulate the bowels — cue the “period poos.”

Menstrual Health, Energy, and Iron

Typical periods cause about 1 mg of iron loss monthly.

But with heavy menstrual bleeding (HMB), iron loss may be 5–6× higher. Symptoms like fatigue, low focus, and mood dips could signal iron deficiency — worth checking with your healthcare provider.

Why This Matters for Pelvic & Whole-Body Health

Knowing your cycle helps you:

• Track patterns — energy, bowel changes, cramping

• Plan self-care — hydration, nutrition, movement

• Prepare your workouts — including pelvic floor and strength training when energy is often higher in the follicular phase

• Recognize red flags — heavy bleeding, severe pain, or persistent GI changes

• It’s the “Fifth Vital Sign”- The American College of Obstetricians and Gynecologists (ACOG) consider the menstrual cycle should be seen as a vital sign for it’s easily observable marker of underlying health

At District PT, we often talk about how menstrual cycle awareness can support pelvic floor therapy, postpartum recovery, and return to fitness. If you’re experiencing period pain, heaviness, or new bladder/bowel symptoms, you don’t have to “just live with it.” Pelvic health physical therapy can help you understand your body’s natural hormone shifts, improve core and pelvic stability, and manage discomfort.

Stay tuned for our next blog on practical cycle-syncing strategies to be your own menstrual detective. And if you’re curious about how your menstrual health connects to your pelvic floor or postpartum recovery, our Capitol Hill clinic and mobile visits offer one-on-one, personalized care.

👉 Book a visit at District Physical Therapy — your neighborhood PT for pregnancy, postpartum, and pelvic health.