Your Period: On and Off the Pill

So what does a healthy, “normal” period look and feel like? Let’s dive into a quick (and very simplified) lesson on Menstruation 101.

First off, there’s a huge variance of what a healthy period looks like, so “normal” isn’t really a thing. (Like most everything health-related, your period is very unique to you.) However, a typical menstrual cycle lasts an average of 28 days, but can range from 26 to 36 days.

Your cycle is divided into three phases.

The first half of your cycle (days 1 to 13 of a 28-day cycle) is called the follicular phase, and day one is the first day of your period. Although both major female sex hormones estrogen and progesterone drop at the beginning of your cycle, which is what triggers the lining of your uterus to shed (your period), the follicular phase is primarily dominated by estrogen.

This phase is called the follicular phase because Follicle Stimulating Hormone (FSH) kicks into action when estrogen and progesterone drop to stimulate the growth of follicles in your ovaries, which prepare an egg to be released.

Once that follicle and egg are mature, usually around day 14 of a 28-day cycle, ovulation occurs, thanks to another hormone called luteinizing hormone (LH), which stimulates the ovaries to release that egg from the follicle.

After peaking just before ovulation, estrogen levels drop, and the luteal phase ensues, which is dominated by progesterone. The luteal phase lasts from day 15 to 28 of a typical cycle.

Note: This is a very simplified explanation of a typical period. For the purposes of this course, I won’t go into detail about what happens to your cycle when you get pregnant—that’s a whole other course!

So, there you have it. A typical period! Fascinating, right? But maybe you’re wondering what happens to your period when you’re on the pill?? I’m glad you asked.

If a natural menstrual cycle is like a monthly performance of Swan Lake by the Bolshoi ballet, a cycle on the pill is more like tiny tots first ballet recital. (It’s kind of hormonal mayhem.)

Dear reader, I want to make one thing very clear: if you are on the pill or were on the pill at any point in the past (I was too), this is not to make you feel guilty or ashamed for your choices. It is simply to educate and inform you, so you can make better informed decision from this point on. Because knowledge is power! Woo!

So, the pill.

There are two main types of pills- combination, which is the most common and most effective form of birth control pill, and progestin (synthetic progesterone) only. Remember how a natural cycle sees several well-orchestrated peaks of estrogen, progesterone, LH, and FSH throughout the cycle?

The birth control pill provides a steady dose of synthetic estrogen and progesterone (or just progestin) throughout the entire month, minus the week of sugar pills when you get your “period”, which is really just a withdrawal bleed (because you never actually ovulated). Ovulation is suppressed because with this unnaturally high level of daily hormones, the pituitary gland is signaled to hold off on releasing FSH and LH.

Why is this an issue? Because with the heightened levels of (synthetic) hormones every day, the brain thinks there is absolutely no need for more hormones to be released, so it stops sending the signal that would result in your endocrine glands producing more.

This means brain hormone production is ceased, natural hormone rhythm flatlines, and of course, no ovulation—which is the point of contraceptive pills; so you don’t end up pregnant. But as you can now see, there is so much more going on in your body when you’re on the pill than just keeping you from having a baby. And if you’re on the pill for non-contraceptive reasons like many of us, the pill is likely doing way more harm than good.