The Importance of Knowing Your Body: Why Your Reproductive Health Matters
By Jessica Joseph, RN, BSN, MHA
The views and opinions expressed are those of the authors and should not be considered medical advice. Always consult your doctor, or a mental health professional, for the most appropriate treatment.
An alarming number of women are unaware of the basics of their reproductive health, including their anatomy, hormones, and phases of their cycle, such as ovulation. Unfortunately, this prevalence is due to the lack of education available on women’s health starting at an early age, particularly about their reproductive system or similar health topics.
Knowing the fundamentals of your reproductive health is essential for several reasons when it comes to your health needs, primarily because reproductive health is linked to your overall well-being, and if there are components that are not quite aligned, it can be a sign of an underlying medical issue. Most women are unaware of any problems until it is time to conceive. As a result, they are at an increased risk of facing hurdles (such as infertility) that could have been addressed when they were younger to prevent delays or interventions in their timeline to grow their family.
The Basics: Female Reproductive Anatomy
Female reproductive anatomy consists of:
- Two ovaries (which are roughly the size of almonds)
- Two fallopian tubes
- Uterus (which is pear-shaped and the size of your fist)
- Cervix (which is the opening to the uterus)
- Vagina (which opens into your vulva, the external part of your reproductive tract)
Your uterus has a lining that thickens with the rise of two hormones, estrogen and progesterone. If you are not pregnant, this lining will shed, known as menstruation (or your period). Every month, your ovaries are supposed to produce a dominant follicle containing an egg. If you have regular cycles and hormonal balance, you will ovulate an egg once a month. If this egg is unfertilized, it will shed with your monthly period.
Menstruation
If you’re wondering about the status of your reproductive health, even if you’re not trying to get pregnant, your period may provide critical insights.
Your menstrual cycle is impacted by hormones that determine when you will get your period and when you will ovulate. Your period is induced when your progesterone levels drop, and your prostaglandins (hormone-like substances) rise, which causes the inner lining of your uterus to shed, making you bleed. With regular cycles, the first day of your period should occur every 21 to 35 days. If your cycle length is longer or shorter, this is considered an irregular cycle.
Factors that also impact your menstrual cycle are underlying conditions or medications. Abnormally heavy bleeding or mid-cycle bleeding may be a sign of an underlying health problem such as fibroids, polyps, endometriosis, polycystic ovary syndrome (PCOS), or cancer. A healthcare professional should always evaluate painful periods, pelvic cramping, and irregular bleeding.
It’s important to note that medications, such as birth control pills, may regulate your period but may also mask hidden conditions. Women who take birth control for medical reasons, such as painful periods or PCOS, might be masking an underlying condition that could cause fertility issues in the future. It is important to treat not just the symptoms of period irregularities and pelvic pain, but also the condition that might be causing it.
Reproductive Hormones
The four critical hormones influencing your reproductive health are follicle-stimulating hormone (FSH), estrogen, luteinizing hormone (LH), and progesterone. These four hormones are responsible for menstruation, ovulation, pregnancy, and menopause.
FSH is responsible for follicle maturation, which allows a dominant egg-containing follicle to develop. It peaks with LH before ovulation and is low during pregnancy. Abnormal levels of FSH may be due to conditions such as anorexia, PCOS, and certain cancers. During perimenopause and menopause, FSH levels are typically high. This means estrogen is usually low, and ovulation and your period are suppressed.
Estrogen rises at the start of your fertile window, which is a five-to-six-day window in your cycle when you are the most fertile (which means not using contraceptive methods while having intercourse during this time has a higher chance of resulting in pregnancy). Estrogen also regulates other important components of your overall health, including bone development and cardiovascular functions. It also regulates mood. Some women suffer from a condition called “estrogen dominance,” meaning they have high levels of estrogen in their bodies. This condition is usually correlated with other disorders, including endometriosis, PCOS, and obesity. Women with an estrogen-dominant condition may struggle to conceive when the time comes.
LH rises around mid-cycle, which triggers the process of ovulation. The rise is the result of the balance between FSH and an increase in estrogen. Women with irregular cycles may not ovulate regularly. Usually this means their LH levels are typically high throughout their cycle, or very low. Instead of having a single LH rise or peak, they might peak multiple times, or run at a high or low level throughout their cycle.
Progesterone typically rises after ovulation. It is a critical hormone for pregnancy support, as it thickens the uterine lining, which assists an embryo to implant into the uterus. It is secreted from multiple structures, including the corpus luteum, which is the former follicle that releases the egg and remains in the ovary. Once the placenta develops during pregnancy, it takes over progesterone production. If not pregnant, progesterone levels will drop, which induces a period. Progesterone is known to help PMS, and is sometimes given synthetically to treat abnormal uterine bleeding.
Reproductive Mental Health
Mental health impacts your reproductive health based on hormonal shifts, family-building obstacles, and traumatic events. In addition to these factors, the societal and cultural expectations surrounding reproductive health can also contribute to the impact on mental well-being. Seeking support from healthcare professionals and engaging in open conversations about reproductive health can play a crucial role in promoting overall mental wellness. Reproductive conditions and circumstances that affect mental health include:
- Premenstrual Syndrome (PMS): PMS refers to a range of physical and emotional symptoms that occur in the days leading up to menstruation. These symptoms can include mood swings, irritability, bloating, and fatigue.
- Premenstrual Dysphoric Disorder (PMDD): PMDD is a severe form of PMS that can significantly impact a woman’s emotional well-being. It is characterized by intense mood swings, severe irritability, depression, and anxiety.
- Infertility: Dealing with infertility can be emotionally challenging and can lead to feelings of sadness, frustration, and anxiety. The pressure to conceive and the uncertainty surrounding fertility treatments can also take a toll on mental health.
- Miscarriage (Emotional Health): Experiencing a miscarriage can be a traumatic event for both women and their partners. The grief and emotional distress following a miscarriage can contribute to feelings of sadness, guilt, and anxiety.
- Sexual Trauma (Abuse): Sexual trauma, such as abuse or assault, can have long-lasting effects on mental health. It can lead to symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, and difficulties with intimacy.
It is crucial to address these mental health concerns and seek appropriate treatment based on the specific condition and symptoms. Seeking support from healthcare professionals, therapists, fertility coaches and support groups can help individuals navigate these challenges and promote overall well-being.
Physical Activity & Reproductive Health
Physical activity can immensely influence reproductive health. Exercising can ensure a healthy body weight and fat ratio. Women with higher ratios of adipose tissue (also known as fat) tend to have higher levels of estrogen. Having consistently high estrogen levels can be detrimental to overall health and pose health risks, including a predisposition to breast cancer. Conversely, exercising too much can cause dysregulated hormones, and women who do so may have a condition called amenorrhea, which means they do not get their periods. When it comes to physical activity, moderation is key. Always talk to your healthcare provider about which type of and how much exercise is right for you.
Sexual Health
Sexual health encompasses many aspects of your life, including having healthy relationships with a partner of your choice, remaining free from sexually transmitted infections, and the ability to plan or prevent pregnancies. Your reproductive health is optimized with regular visits to your OB/GYN. They can help identify any causes for concerns by routine STI (sexually transmitted infection) screening and pap smears. They can also review which option of birth control is right for you, whether that is natural family planning, contraceptive use such as condoms, or hormonal options such as birth control pills. Ultimately, the option is a personal one based on preference and lifestyle.
If and when the time is right, an OB/GYN can also refer you to a fertility specialist (reproductive endocrinologist or RE), a doctor who specializes in diagnosing and treating fertility challenges. The CDC currently recommends seeking the help of a fertility specialist if you are under 35 and have been trying to conceive for over a year (or if you are over 35 and have been trying to conceive for over 6 months).
