The menstrual cycle
How the cycle works, and what it does to energy, mood, sleep, appetite and workouts. Plus PMS, and how to track a cycle.
- 1How the cycle worksA cycle is counted from the first day of one period to the first day of the next. In each cycle the body builds up the uterine lining, releases an egg, and sheds the lining if there's no pregnancy.
- 2The hormones, step by stepEstrogen rises in the first half of the cycle and builds the uterine lining. A surge of LH triggers ovulation. Progesterone rises after ovulation. When estrogen and progesterone both drop, a period starts.
- 3What the cycle does to the bodyCramps come from prostaglandins, chemicals that make the uterus contract. Headaches, bloating, breast tenderness, skin changes, discharge and body temperature each have their own cause, and some aren't fully understood yet.
- 4Why mood, appetite and sleep shiftMood changes before a period follow hormone shifts, and PMS and PMDD are real medical conditions. On average, people eat about 168 more calories a day after ovulation. Sleep changes are small.
- 5What's normal, and when to get helpRegular cycles last 21 to 35 days, and periods last up to 7 days. Tracking shows a person's own pattern. See a doctor if periods stop, the cycle or bleeding changes a lot, or bleeding is very heavy.
- 6Should training follow the cycle phase?Reviews haven't found one best phase to train in. Dr. Stacy Sims, who promoted phase-based training, now recommends training by how ready the body feels, lifting consistently all month and fueling every day.
- 7Fuel, data and moving through symptomsEating enough every day matters in every phase, and a missing period can be a sign of underfueling. One watch reading can't tell a sleep effect from a cycle effect. Regular exercise eases period pain.
- QuizA short quiz on this section. Try again for new questions.
Where can I learn more?
- Cleveland Clinic: Uterus
- NHS: Periods and fertility in the menstrual cycle
- Cleveland Clinic: Menstrual cycle
- Cleveland Clinic: Ovulation
- Physiology, Menstrual Cycle, StatPearls 2024
- Cleveland Clinic: Luteal phase
- Wikipedia: Cervix (cites anatomy textbooks)
- Cleveland Clinic: Cervix
- NHS: The stages of labour and birth
- The composition of menstrual fluid, its applications, and recent advances to understand the endometrial environment, F S Reviews 2024
- The potential of menstrual blood-derived stem cells in differentiation to epidermal lineage: a preliminary report, 2016
- Ultrasound image attributes of human ovarian dominant follicles during natural and oral contraceptive cycles, Reprod Biol Endocrinol 2005
- Office on Women's Health: Your menstrual cycle
- Menstrual-associated gastrointestinal symptoms and their impact on IBS diagnosis in adolescents, 2026
- Progesterone signaling in cardio-renal physiology and pathophysiology, 2026
- An overview of the impact of the menstrual cycle on nutrient metabolism: an integrative perspective, 2026
- ACOG: Dysmenorrhea (painful periods)
- Cleveland Clinic: Dysmenorrhea
- Menstrual migraine: a distinct disorder needing greater recognition, Lancet Neurology 2021
- Do gastrointestinal symptoms vary with the menstrual cycle? BJOG 1998
- Clue: Period bloating 101
- Mastalgia, StatPearls 2025
- Natural Cycles: Why do my breasts hurt before my period?
- Ubie Health: Breast tenderness after ovulation
- Medical News Today: Sore nipples and ovulation
- Flo: Sensitive nipples after ovulation
- Physiological differences in sebum composition in regularly menstruating healthy women, J Dermatol 2025
- Flo: Acne before your period
- Healthline: Period acne
- Schweiger Dermatology: Period acne tips
- 28 Health: Hormonal breakouts
- Temperature regulation in women: effects of the menstrual cycle, Temperature 2020
- NHS: Vaginal discharge
- Clue: Cervical fluid vs. arousal fluid vs. vaginal discharge
- Endogenous mediators in regulating primary dysmenorrhea, Front Cell Dev Biol 2026
- Clinical characteristics of pure menstrual migraine and menstrually-related migraine, BMC Neurol 2026
- NHS: Bloating
- NHS: Breast pain
- Hormonal acne therapies in pediatrics, Curr Opin Pediatr 2026
- Towards understanding the biology of premenstrual dysphoric disorder, Neurosci Biobehav Rev 2023
- ACOG: Premenstrual syndrome
- Premenstrual dysphoric disorder: epidemiology and treatment, Curr Psychiatry Rep 2015
- Sex hormones, appetite and eating behaviour in women, Maturitas 2012
- The effect of the menstrual cycle on energy intake: a systematic review and meta-analysis, Nutr Rev 2025
- Circadian rhythms, sleep, and the menstrual cycle, Sleep Med 2007
- NHS: PMS (premenstrual syndrome)
- ACOG: Abnormal uterine bleeding
- ACOG: Using the menstrual cycle as a vital sign (for teens)
- High frequency of luteal phase deficiency and anovulation in recreational women runners, J Clin Endocrinol Metab 1998
- Dr. Stacy Sims: The evolution of menstrual cycle training (October 2025)
- NHS: Bacterial vaginosis
- NHS: Vaginal thrush
- NHS: Trichomoniasis
- The effects of menstrual cycle phase on exercise performance in eumenorrheic women: a systematic review and meta-analysis, Sports Med 2020
- Current evidence shows no influence of women's menstrual cycle phase on acute strength performance or adaptations to resistance exercise training, Front Sports Act Living 2023
- Menstrual cycle phase does not influence muscle protein synthesis or whole-body myofibrillar proteolysis in response to resistance exercise, J Physiol 2025
- Effects of follicular and luteal phase-based menstrual cycle resistance training on muscle strength and mass, Sports Med 2022
- Understanding the female athlete: molecular mechanisms underpinning menstrual phase differences in exercise metabolism, Eur J Appl Physiol 2023
- Dr. Stacy Sims: Nail a PR at every phase of your menstrual cycle (October 2024)
- Dr. Stacy Sims: Cutting through the confusion of cycle-sync style training (October 2024)
- Bidirectional interactions between the menstrual cycle, exercise training, and macronutrient intake in women: a review, Nutrients 2021
- 2023 International Olympic Committee consensus statement on relative energy deficiency in sport (REDs), Br J Sports Med 2023
- Stanford Human Performance Alliance: Four key nutrition strategies for women in sport (2026)
- Stanford Human Performance Alliance: A wearable device tracked over 42,000 menstrual cycles (2026)
- Cleveland Clinic: Cycle syncing for fitness and nutrition
- Comparative effectiveness of exercise interventions for primary dysmenorrhea: a systematic review and network meta-analysis, BMC Womens Health 2024
- Aerobic exercise to alleviate primary dysmenorrhea in adolescents and young women, Acta Obstet Gynecol Scand 2025