In TCM (Traditional Chinese Medicine), the female life is divided into cycles, with one cycle occurring every seven years. This is termed “TianGui”. Menstruation occurs at the age of 14 with the appearance of Tiangui. At the age of 49, the TianGui declines, and her ability to menstruate and give birth will cease. Hence, the period between the age of 14 to 49 is the reproductive period.
During the reproductive period, menstruation occurs every 28-35 days and will last for 3-7 days. The follicular phase begins on the first day of menstrual bleeding. The luteal phase begins after ovulation. It lasts about 14 days.
Monthly Renovation of the baby’s room
The monthly menstrual cycle is like running a regular renovation project at home, except that the renovation is for the baby’s room only. During the follicle phase, the gonads and related organs will get the best environment ready (baby’s room) for a new baby (implantation of an egg). When an egg did not move into the new room, the body will tear down all the decorations so they won’t be going moldy. When an egg moves in, the body will constantly adjust the decoration to ensure it continues to fulfill the needs of the developing fetus. The baby needs will become the top priority in keeping the system nourished.
Coordinating the Renovation of the Baby’s Room
The baby’s room renovation project follows the menstrual cycle:
- Follicle phase – Planning and getting the basics ready to create a comfortable environment (estrogens elevated continuously) for the potential arrival of a baby
- Ovulation phase – Room is ready (estrogens peaked) and potential baby will do a site visit to check out if it is ready for him or her
- Luteal phase – Room is continually upgraded and stabilized to support the baby’s growth as and when needed. In case no baby turns up, stabilizer used will gradually retreat (progesterone secretion will decline) until when the next renovation is due (menses start).
On average, it is 14 days from ovulation to luteal phase, whereas the follicle phase can vary, hence the length of the menstrual cycle varies mostly due to the varied duration of the follicle phase.
Apart from the mentioned estrogens and progesterone, many different organs álso participate in this monthly renovation project:
- Overall Project Director – Hypothalamus is responsible for detecting hormonal levels from different glands and in the circulation and is responsible for setting up sub-contracts for the renovation (i.e., issue instructions for the listening glands and organs)
- Sub-Contractor – Pituitary Gland is responsible for sending signals to the related organs/glands for the execution of the hormone biosynthesis.
- Gonads and Related Organs – Ovary is responsible for the biosynthesis of estrogens, progesterone and testosterone in addition to the fertilization of eggs. The uterus is responsible for supplying nutrition to the ovary in carrying out the biosynthesis.
Signals of Remodeling
Estrogens is like layers of wall paints/wallpaper that create a warm and comfortable feeling for the room (the baby’s room), Progesterone is like the “glue” that holds the wallpaper together except that this “glue” has to be continuously supplied otherwise the wallpaper cannot be held in its position. When conception ends up not happening, estrogens and progesterone synthesis will decline, and without the glue (progesterone), the wallpaper (estrogens) will start shredding as menses.
Menstruation <> Presence of Ovulation
Progesterone is synthesized and secreted upon ovulation. In other words, progesterone production will be minimal without ovulation. Without progesterone (the glue), shredding of wallpaper (menses) in the baby’s room will happen as well. The major difference is that when there hasn’t been much progesterone right from the beginning, shredding (menses) will be even more, and that’s often the case of excessive menstrual bleeding. Hence, menstruation can be a sequel of ovulation without conception, but menstruation does not necessarily mean that there is ovulation!
With or without conception, the baby room of females is a very sacred and special space that is instrumental to the balance of the endocrine system. It deserves the best protection and nutrition to ensure the monthly renovation project goes smoothly (healthily)!
Estrogens not only for the Baby’s Room
Estrogens is a group of hormones that have body-wide implications. They do not only act on the gonads, but they also act on multiple organs and tissues (see Table 1). During the reproductive period of a female, 90% of the estrogens are produced in the ovary. The estrogen produced will also circulate to other needed parts of the body, so will the small amount of estrogen produced by the adrenal glands. The remaining 10% of estrogen are synthesized (aromatized) in the peripheral organs/tissues, and these estrogens will be used locally and cannot be found in the circulation system.
Protect Your Health, Protect Your Baby Room
Outside of pregnancy, the ovary and the uterus don’t normally get much attention. This may be the reason there are increasing rates of hysterectomy for women aged over 40 (40% of women aged 45 to 54 have had one hysterectomy!). Hysterectomy is seen as panacea for a multitude of women’s health issues. Unfortunately, it is not! Uterus supplies the nutrition to the ovary and Ovary is responsible for the bulk majority of the biosynthesis of estrogen, which is shown to have body-wide health implications. When the uterus and/or ovary is removed (oophorectomy or hysterectomy), the body starts to enter menopause (termed “surgical induced menopause” with declining hormones. The other glands, organs and peripheral tissues will have to shift to synthesis of the hormones in a relatively short period, and you can see how stressful the body will be. And even then, the production may not be sufficient to support all the estrogen functions, and body functions will start to deteriorate soon.
Every single organ or tissue exists in our body for a good reason! The next time that you are recommended for an operation on the ovary or uterus, it is always good to do more research, discuss more with your physician before rushing for a decision that has life-long implications.
- Surgical Menopause, Australian Menopause Society, January 2017
- Li R, Cui J, Shen Y. Brain sex matters: estrogen in cognition and Alzheimer’s disease. Mol Cell Endocrinol. 2014;389(1-2):13–21. doi:10.1016/j.mce.2013.12.018
- Mauvais-Jarvis F, Clegg DJ, Hevener AL. The role of estrogens in control of energy balance and glucose homeostasis. Endocr Rev. 2013;34(3):309–338. doi:10.1210/er.2012-1055
- Thornton MJ. The biological actions of estrogens on skin. Exp Dermatol 2002: 11: 487–502. C Blackwell Munksgaard, 2002
- Palmisano BT, Zhu L, Stafford JM. Role of Estrogens in the Regulation of Liver Lipid Metabolism. Adv Exp Med Biol. 2017;1043:227–256. doi:10.1007/978-3-319-70178-3_12
- Surgeries in Hospital-Owned Outpatient Facilities, 2012, Lauren M. Wier, M.P.H., Claudia A. Steiner, M.D., M.P.H., and Pamela L. Owens, Ph.D.