This work will help guide you through the Definition & Phases of mensural cycle °Explain The Premenstrual syndrome (PMS) °Aim for cycle tracking °How to calculate and track; -Regular Cycle & -Irregular Cycle °When to see a doctor ; During puberty During menstruation Outside menstruation °Conclusion /General Advice for all regarding the menstrual cycle

1. UNDERSTANDING YOUR MENSTRUAL
CYCLE & HOW TO CALCULATE IT

2. Understanding Your
Menstrual Cycle & How To
Calculate It
By Nnokwe Nzube Donald.
Final year medicine and surgery Student [EBSU]
Currently the Monitoring and Evaluation Officer for
Standing Committe on Health & Environment,
Federation of African Medical Students Association.
29th May 2020

3. Outline
• °Introduction / overview
• °Definition
• °Phases of mensural cycle
• °Premenstrual syndrome (PMS)
• °Aim for cycle tracking
• °How to calculate and track;
• -Regular Cycle &
• -Irregular Cycle
• °When to see a doctor ;
• During puberty
• During menstruation
• Outside menstruation
• °Conclusion /General Advice

4. Menstrual Cycle Overview:
Females are born with approximately 2 million immature eggs in
their ovaries. By the time they reach their first menstrual cycle they
have around 400,000 left.
Each monthly menstrual cycle, between 20-30 eggs are selected to
become a possible candidate for release. Usually, only one egg is
released per cycle.
The menstrual cycle starts on the first day of the menstrual period
and ends with the start of the following period.
It is made-up of four phases during which hormones change to
prepare women for pregnancy each month.
It is natural to experience some discomfort during the menstrual
cycle while other issues might require a visit to the doctor.

5. Definition
• • A menstrual cycle consists of natural changes that occur in a
woman’s body every month in preparation for pregnancy.
• • The cycle lasts an average of 28 days but may vary between
21 and 35 days. The first day of a cycle is the first day of a
menstrual period and the last day is that of the following
period.
• First menstrual period:
• The menstrual cycle often begins at puberty between the ages
of 8 and 15 (average age of 12). It usually starts two years after
breasts and pubic hair start to develop.

6. Phases of the menstrual cycle:
There are four phases:
• Phase 1: Menstruation
• Phase 2: Follicular phase
• Phase 3: Ovulation
• Phase 4: Luteal phase.

7. Phase 1 of your menstrual cycle
• - Menstruation:
• Menstruation is the elimination of the internal
lining of the uterine wall along with other
secretions from the body through the vagina.
• It usually lasts three to seven days but this could
change to more or less days from month to month
and depending on each woman

8. Phase 2 of your menstrual cycle
• - The follicular phase:
• The follicular phase starts on the first day of
menstruation and ends with ovulation. a follicle
(cyst) stimulating hormone produces 10 to 20
follicles in the ovary and each follicle houses an
immature egg. These follicles produce the hormone
estrogen, which in turn thickens the lining of the
endometrium(uterus) in preparation to receive a
fertilized egg.

9. Phase 3 of your menstrual cycle
• - Ovulation:
• Ovulation occurs 12 to 16 days before the following
menstrual period but not necessarily in the middle of
the cycle.
• The term “ovulation” indicates the formation of a
mature egg by one of the ovaries. The mature egg is
extracted from the follicle (cyst) and transported from
the ovary to the fallopian tube.
• If fertilization does not occur during this phase, the egg
continues to the uterus and dissolves within 6 to 24
hours.

10. Phase 4 of your menstrual cycle
• - The luteal phase:
• During this phase, the follicle from which the mature egg
burst out (now called the yellow body of the ovary or
corpus luteum) releases a large quantity of progesterone
and some estrogen. The two hormones help thicken the
lining of the endometrium of your uterus and maintains
its thickness.
• If fertilization does NOT occur, the yellow body degrades
and progesterone levels decrease, leaving the lining
unstable. The lining then falls away and a new menstrual
cycle period begins.

11. Premenstrual Syndrome (PMS)
They are Some psychological and physical changes
may occur during the luteal phase (the last phase of
your menstrual cycle, which welcomes and gives way
for a new cycle to start afresh.

12. These PMS INCLUDE :
*PHYSICAL changes:
o Breast tenderness and swelling
o Diarrhea or constipation
o Bloating and gas
o Cramps
o Headaches or backaches
o Fluid retention
o Fatigue and vertigo
o Inability to tolerate noise or bright lights
o Acne ( what we know as Pimple)

13. Cont'd
PSYCHOLOGICAL changes:
o Aggressive behavior and irritability
o Trouble sleeping (too much or too little)
o Changes in appetite
o Difficulty concentrating and remembering
o Stress and anxiety
o Mood swings
o Depression or sadness
o Reduced libido
These changes occur due to the sudden drop in progesterone and estrogen,
reason being that no fertilization occured, hence the yellow body providing these
hormones has degraded. However, they disappear a few days after menstruation
once hormones are back to their elevated levels.

14. AIM FOR CYCLE TRACKING
*The aim to track the cycle is to :
-Know when your next period is likely to start.
-Know your safe period when you won't get pregnant.
-Know your most fertile period when you can get pregnant.
-Be able to detect any abnormal changes.
-Finally to be incharge of your body.
We can achieve this via :
-Using a menstrual cycle bead.
-Using Some Mobile app (which i will share a link later at the end of this
session).
-Manually Calculating it with aid of a calendar

15. Calculation for a "REGULAR"
CYCLE.
Assuming a woman has a 28-day cycle, her time of ovulation will
be around day 14 of her cycle* .
_If your period is regular and the length is the same every
month,_ then you can *CALCULATE OVULATION by Counting
back 14 days from the END of the cycle.
For example :
if your cycle is *32-days* long then *ovulation* will occur
around *day 18,*
or
if your cycle is *28 days* long then *ovulation* will occur
around *day 14.*

16. How is this so? *LETS
CALCULATE!!!* 🤔
Remember we said, the cycle length is between 21 days
to 35 days.
So for a *32 days, Regular cycle whose ovulation period
will be on 18th day of cycle* . This is how we will
calculate it.
32 minus 14 = 18th day of ovulation
*For a 30days regular cycle*
30 minus 14 = 16th day of ovulation
*For a 28 days regular cycle*
28 minus 14 = 14th day of ovulation

17. • As you can see... *14 is a constant number* _because_ it
will take approximately 14days after ovulation has
occurred for your next cycle to start again with a
menstruation.
• So i believe we all know our cycle length, you can use this
simple method to calculate your ovulation day privately.
• *REMINDER* :
• 2 days before your ovulation and 2 days after your
ovulation which is your most fertile period,
• A period when, if unprotected sexual intercourse occurs,
the chances of getting pregnant is very high.
• Thus 6 days out of your menstrual cycle is the only time
conception (pregnancy) is possible.

18. For an IRREGULAR CYCLE
If your cycle is IRREGULAR and changes length each month it is much harder to
calculate ovulation.
But dont be alarmed! 🤗
You may still notice some changes during your ovulation.
They include :
*The cervical mucus will change from being sparse, cloudy and dense to thin, clear and
slippery.( _often described as having the appearance of raw egg white_ ).
This mucus is sperm friendly and allows the sperm to swim freely and last in this
environment.
*Some women may also experience slight pain during ovulation and may also notice
some abdominal bloating.
*They may also experience breast tenderness.
*A little increase in basal body temperature
*A Fern pattern on a slide smeared with the cervical mucus. (Lab based)

19. However, some women may NOT notice any of the
above.
Yet, still nothing is impossible! 👍
HOME OVULATION KITS are good predictors of
ovulation and are available in pharmacies and large
supermarkets. 🤗
They can help to accurately determine the time a
woman is most likely to become pregnant.
They are a *SIMPLE URINE TEST* and they detect the
amount of LH or Luteinising Hormone present, which is
needed for the release of an egg.
This will peak in the urine 24-36 hours prior to the egg
being released.

20. When To See A Doctor
See a doctor if any of the following problems occurs
DURING PUBERTY :
- If the menstrual cycle begins before the age of 8
- If a girl is 15 years old but hasn’t started her cycle
- If the cycle doesn’t start within three years of breast
development
- If the menstrual cycle remains irregular after the first
three years

21. See a doctor if the following problems occur DURING MENSTRUATION:
o If the symptoms are severe to the point of hindering daily activities
o If painkillers don’t help relieve menstrual pains
o If large and abnormal clots are discharged with the blood
o If cramps are felt outside the usual times (before and during
menstruation)
o If menstruation continues for over 8 days
o If you need to change sanitary napkins every one or two hours
o If you experience symptoms of iron deficiency anemia (including:
dizziness, weakness, fatigue, chest pain, difficulty breathing)
o If you experience changes in menstruation (unusually heavy periods)

22. See a doctor if the following problems occur
OUTSIDE MENSTRUATION:
o Bleeding after intercourse (more than once)
o Bleeding outside menstrual period
o Bleeding after menopause

23. Conclusion / General advice:
• • Try to eat healthy foods with lots of fruit and vegetables.
• • Consume less caffeine as it causes stress.
• • Eat foods rich in calcium as calcium alleviates PMS symptoms.
• • Use painkillers such as Ibuprofen to alleviate the pain from cramps. • It is best
to monitor and record menstruation dates and the accompanying symptoms to
help diagnose problems when they arise.
• • Change sanitary napkins every three or four hours to prevent Toxic Shock
Syndrome.
• • Stop smoking.
• • Place warm compresses on your stomach.
• • Go for a light walk to reduce psychological stress.
• • Consult a doctor before using any contraceptive method.

24. • Cheers....
• Thanks for Reading.
• See you next Time
• Contact info :
• Twitter :@donaldzubby
• LinkedIn : linkedin.com/in/zugen