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Hormone Health & Periods

Key Hormones in the Menstrual Cycle

Hormones are the body's chemical messengers, and they play essential roles in regulating the normal menstrual cycle.


The ovaries are under the influence of hormones that come from the pituitary gland in the brain. These two hormones play a key role:

  • Follicle -stimulating hormone (FSH)stimulates the ovaries to produce follicles, each of which contain an egg.

  • Luteinizing hormone (LH): works in conjunction with FSH to stimulate ovulation and support pregnancy. 


The ovarian hormones include: 

  • Estrogen: Rising estrogen encourages growth of the uterine lining to prepare the body for ovulation and potential pregnancy. There are estrogen receptors in most cells in the body and it is crucial for bone health, skin elasticity, and cardiovascular function.

  • Progesterone: This hormone prepares the uterus for pregnancy after ovulation by encouraging gland development in the uterine lining. It is also has important functions in the brain especially, supporting sleep. 

  • Testosterone: While often associated with men, testosterone is present in women at lower levels. It contributes to libido, energy levels, and muscle strength.

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Four Phases of The Menstrual Cycle

The menstrual cycle is typically divided into four phases, each characterized by specific hormonal changes and physiological events.

1. Menstruation (Days 1-5): The fist day of the period marks the start of the cycle, which is  the shedding of the uterine lining. Menstruation is triggered by a drop in the levels of estrogen and progesterone. 

2. Follicular Phase (Days 1-13): Overlapping with menstruation, is follicular phase that involves the growth of follicles in the ovaries under the influence of rising estrogen levels. The uterine lining begins to thicken.


3. Ovulation (Day 14): Around the midpoint of the cycle, a surge in luteinizing hormone (LH) triggers the release of an egg from the dominant follicle. This release of a mature egg is called ovulation. Estrogen levels peak, and testosterone also rises, enhancing libido and energy, motivation and creativity.

4. Luteal Phase (Days 15-28): After ovulation, the ruptured follicle forms the corpus luteum, which secretes progesterone. The egg that was released into the fallopian tubes may be fertilized if conditions for conception were good.

At the end of the luteal phase, progesterone and estrogen levels fall, leading to the shedding of the uterine lining, the period begins, marking the start of a new cycle.

A typical cycle lasts between 21-35 days, but can vary slightly from person to person.

Understanding these four phases and their hormonal changes can help you understand your body, your hormones, your menstrual cycle and potentially identify any issues or irregularities.

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Period And Menstrual Cycle Problems

For many people, hormones and periods affect their quality of life, feelings, sense of well being and health. Many women have regular, non-painful periods through most of their reproductive lives. However, difficulties with hormones, periods and reproductive health are common:

  • 80 percent of women experience painful periods at some point during their menstruating life

  • Endometriosis affects 11 percent of women.

  • Polycystic Ovary Syndrome occurs in 5-10 percent of women.

  • 11 percent of women of reproductive age experience infertility.

  • 40 percent of women seek medical attention for their menopausal symptoms.​​

  • 14 percent of women experience post-natal depression and many have difficulties adjusting to the changes of becoming a parent. 

  • More than 50 percent of exercising women in New Zealand are at risk of relative energy deficiency in Sports (RED-S)

At Ōtepoti Integrative Health we are passionate about supporting women with their hormones, periods and reproductive health because these conditions affect so much of the rest of your life.

Endometriosis | Mate kirikōpū

Endometriosis is a condition where tissue similar to the tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. The symptoms of endometriosis include:

  • period pain,

  • pain with sex,

  • pelvic pain,

  • heavy menstrual bleeding

  • bloating,

  • fluctuating bowel habit 

  • fatigue

  • low mood

  • reduced fertility. 

Endometriosis most commonly involves the ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial-like tissue may be found outside the pelvis in the abdomen. Many women use medications or have surgery to manage this condition. 

In New Zealand, clinicians are encouraged to make diagnosis of endometriosis early so that management of pain can be optimised and surgery minimised. People with endometriosis are at risk of developing chronic pelvic pain so early diagnosis and management are key to improving quality of life. Laparoscopy should not be used for diagnosis only and only is advised if surgery for treatment is to be carried out. 

Vaginal ultrasound is the most effective non-surgical method of diagnosis. With a skilled sonographer stage 2 to stage  4 can be identified. As many women with endometriosis also have pain sensitisation of adjacent tissues in the pelvis such as pelvic floor, bladder and bowel, a interdisciplinary approach to endometriosis is the most effective way to manage this condition. 

An integrative approach to endometriosis includes education, lifestyle changes such as an anti-inflammatory diet, exercise, supporting sleep and stress management, and evidence-based supplements as well as medications as needed. 

Polycystic Ovarian Syndrome (PCOS) | Huahua hua kūao

Polycystic ovary syndrome (PCOS) is a metabolic and hormonal condition that affects how the ovaries work, resulting in irregular or absent periods. It can also cause acne, facial and body hair growth, hair loss on the scalp, reduced fertility, issues with body image and depression.

The primary hormones involved with this condition includes insulin and testosterone. For many women their bodies have become less sensitive to insulin, meaning the body needs to increase it's production of insulin to keep the blood sugars balanced. 

The long-term impacts of PCOS are significant and can include:

  • difficulty conceiving/infertility

  • pregnancy complications such as preterm delivery

  • metabolic disturbances including diabetes and weight gain

  • increased risk of high blood pressure and heart disease

  • increased risk of endometrial cancer

  • depression, anxiety and body-image distress.

Our approach to PCOS includes a number of important features as advocated by international PCOS guidelines:

  1. Lowering androgen levels

  2. Providing progesterone to balance the unopposed estrogen

  3. Optimise insulin sensitivity

We offer a number of hormonal methods including body identical hormones, medications, supplements and lifestyle interventions to suit your preferences. 

Premenstrual Syndrome (PMS) &
Premenstrual Dysphoric Disorder (PMDD)

Premenstrual Syndrome (PMS) is a combination of physical, cognitive and mood symptoms that many women get after ovulation and before the start of their menstrual period. They can be mild to moderate and can vary with each cycle.


Symptoms of PMS can include:

  • breast tenderness,

  • fluid retention,

  • headaches

  • mood swings and

  • insomnia.

Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome (PMS) that affects 3-8% of menstruating women. Unlike PMS, the cognitive and mood symptoms in PMDD are more intense and can severely disrupt daily life.

These symptoms appear during the luteal phase of the menstrual cycle and subside once menstruation begins. They include:

  • extreme mood swings,

  • irritability,

  • depression, 

  • anxiety

  • and in severest cases recurring suicidality.


The causes of PMDD relate to withdrawal of neurosteroid hormones estrogen and allopregnanolone from the brain and these effects can be exaccerbated by chronic stress and trauma.


The impact of PMDD on women's health and mental wellness cannot be overstated, making effective management crucial.

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