You may have observed various changes that your body undergoes each month during the menstrual cycle. Common experiences include cramps, bloating, breast sensitivity, and fluctuations in mood. These symptoms, in addition to vaginal bleeding, typically persist for three to five days. Nevertheless, the conclusion of bleeding does not signify the absence of further bodily changes for the remainder of the month. The menstrual cycle extends beyond the end of menstruation, continuing until the onset of the next period. The follicular phase encompasses the initial half of your menstrual cycle. Continue reading to learn more about this particular phase.

What is the follicular phase?

In general, a menstrual cycle typically lasts between 21 and 35 days. Research published in StatPearls in 2022 indicates that the average duration of this cycle is 28 days. The follicular phase, recognized as the second phase of the menstrual cycle, commences with menstruation. There is some overlap with the initial stage, known as the menstrual phase. Menstruation occurs during both phases; however, in the menstrual phase, an egg from the preceding cycle remains unfertilized.

In the follicular phase, the ovarian follicles undergo growth and maturation, driven by the action of follicle-stimulating hormone (FSH), explains Dr. Shobha Gupta, a gynaecologist and expert in in vitro fertilization. This hormone, which is secreted by the pituitary gland located in the brain, plays a crucial role in regulating sexual development and fertility in both women and men. "During the follicular phase, the body prepares for the release of an egg, while estrogen levels increase, leading to the thickening of the uterine lining in anticipation of a possible pregnancy," the expert adds.

How do you feel during the follicular phase?

Some of the follicular phase symptoms are:

• Higher energy levels: As estrogen rises, metabolism and stamina improve, making you feel more energetic.
• Better mood: "Increased serotonin levels help to uplift mood, reducing irritability and anxiety," says the expert. A 2023 study, published in Brain Sciences, showed that women had a significant increase in positive (friendly, and cheerful) and a drop in negative (anxious, depressed, and fatigued) dimensions of mood during the follicular phase.
• Increased libido: Higher estrogen may boost sex drive, especially as ovulation approaches.
• Glowing skin: "Estrogen can help to promote collagen production," says the expert. This can lead to clearer, more radiant skin.
• Mild menstrual cramps: Some may experience mild menstrual cramps and fatigue at the beginning of this phase of the menstrual cycle due to bleeding.

Long follicular phase

The average follicular phase usually lasts for approximately 16 days. It can also range from 11 to 27 days, according to research published in the Journal Of Women's Health in 2010.

A longer follicular phase can be caused by:

• Polycystic Ovary Syndrome: PCOS is a common health condition that causes hormonal imbalances. "This can lead to delayed or absent ovulation, which can lengthen this phase," says Dr Gupta.
• Thyroid disorders: An underactive (hypothyroidism) or overactive (hyperthyroidism) thyroid can disrupt follicle-stimulating hormone and estrogen levels, affecting the length of this phase of the menstrual cycle.
• Stress and lifestyle factors: Chronic stress, poor diet, excessive exercise or lack of sleep can all alter your hormone production, and delay your ovulation.
• Poor ovarian reserve: If your ovaries are not responding well to FSH, it may take longer for a follicle to mature, prolonging this phase.

A slightly longer follicular phase may not be a problem if ovulation occurs. "However, if the phase is too long, it can indicate poor egg development or inconsistent ovulation, reducing your chances of getting pregnant," says the expert.

Short follicular phase

A short phase, usually less than 10 days, means that the egg may not have enough time to mature properly. "This can affect the egg quality and negatively affect chances of pregnancy," says the expert.

Here are some reasons why this phase is short:

• Ageing (diminished ovarian reserve): As you grow older, the FSH levels increase to stimulate egg development faster. This can shorten the length of this phase.
• Hormonal imbalances (low estrogen, high FSH): Low estrogen can speed up follicular development, leading to premature ovulation and lower egg quality.
• Certain medical conditions: Ovarian dysfunction or past surgeries can affect your ovarian function, leading to irregular or shorter cycles.

When to see a doctor?

When it comes to your menstrual cycle, you should consult a doctor if you experience:

• Persistent anovulation (not ovulating regularly)
• Severe menstrual pain
• If the cycles are frequently longer than 35 days
• Difficulties in conceiving after 6 to 12 months of trying.
• If the follicular phase is consistently less than 10 days, which may be a sign of ovarian insufficiency.
• Signs of hormonal imbalances like hair loss, acne or excessive weight changes.

Understanding your menstrual cycle, especially the follicular phase, is important to maintain your reproductive health and overall well-being. A balanced follicular phase ensures proper egg development and prepares your body for pregnancy. If you have plans of getting pregnant, make sure this phase is not too long or short.

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