Physiological Changes Associated with the Menstrual Cycle

Abstract

The cyclic hormonal changes that regulate the menstrual cycle are a significant biological influence on the female body, one with both physical and emotional ramifications. Menstruation is governed by tightly orchestrated changes in the levels of ovarian estrogen and progesterone, which produce varying responses in diverse tissues and organs. The skin, the largest organ in the body, is replete with estrogen receptors (in both dermis and epidermis) and to a lesser extent, progesterone receptors. Cyclically fluctuating levels of estrogen and progesterone influence numerous characteristics of the epidermis, including skin surface lipid secretion and sebum production, skin thickness, fat deposition, skin hydration, and barrier function. Dermal collagen content, which contributes to skin elasticity and resistance to wrinkling, is also influenced. Interestingly, estrogen levels also influence skin pigmentation and UV susceptibility, as well as resident microflora. In addition, changing hormone levels across the menstrual cycle produce measurable variations in immune function and disease susceptibility. An understanding of the profound influence that fluctuating estrogen and progesterone levels have on the biological responses of the premenopausal adult woman is critical to optimizing the efficacy of medical therapies in this population.

Impact of Aging on Steroid Hormone Biosynthesis and Secretion

“…In brief, plasma levels of estradiol begin to rise around the mid-point of the follicular or proliferative phase, increasing almost linearly for the last few days, and reach a maximum level 1 day before ovulation (i.e., LH and FSH peaks) [226,227]. Thereafter, estradiol levels decline rapidly, rise slightly during the middle of the luteal or secretory phase and, subsequently, decline rapidly reaching a basal level shortly before the initiation of menstruation and the next cycle [226,211].…”

“…Thereafter, estradiol levels decline rapidly, rise slightly during the middle of the luteal or secretory phase and, subsequently, decline rapidly reaching a basal level shortly before the initiation of menstruation and the next cycle [226,211]. The plasma levels of progesterone remain low in menstrual phase and follicular phase, but rise steadily following ovulation reaching maximum levels around the middle of the luteal phase and decline rapidly afterwards reaching a baseline shortly before the onset of the menses [226,227]. In contrast to these fairly predictable changes in estradiol, progesterone and gonadotropin levels throughout the menstrual cycle during the fertility period, such changes become highly erratic with variable relationships between sex steroids, LH and FSH, the occurrence of ovulation, and initiation of menstruation in response to the aging-induced menopausal transition (MT) and postmenopausal period [228][229][230][231].…”

Expert opinion and review article: The timing of comedone extraction in the treatment of premenstrual acne – a proposed therapeutic approach

“…Women are more susceptible to acne because of higher levels of androgens during the follicular phase of their menstrual cycle [68]. Skin physiology changes during the menstrual cycle: the sebum production increases following the release of oestrogen after ovulation [46], resulting in a higher level of skin lipids and subsequent increase in skin microflora [69,70].…”

Anatomic and Hormonal Changes in the Female Reproductive Tract Immune Environment during the Life Cycle: Implications for HIV/STI Prevention Research

“…Every month, the cyclic fluctuation of sex hormones prepares the uterus for the potential implantation of a fertilized ovum and induces the shedding of the endometrium if implantation does not occur. 8 The menstrual cycle, divided into the follicular phase (also known as the proliferative phase) and luteal phase (also known as secretory phase), is followed by menstrual bleeding. 9 During the follicular phase, estradiol levels progressively rise until lutenizing hormone secretion from the pituitary gland induces ovulation, and if no fertilization occurs, these levels sharply drop.…”