For Lucrezia Bordi, reducing the cycle to menstruation gives an incomplete picture. It starts in the brain, through the hypothalamic-pituitary-ovarian axis: the hypothalamus secretes GnRH, the pituitary secretes FSH and LH, and the ovaries respond with oestrogens and progesterone, with positive feedback loops (the LH surge, ovulation) and negative ones (the luteal phase). Ovulation sits at the centre; menstruation is the consequence of a cycle that does not end in pregnancy.
The key hormones
Oestrogens play a part in follicular maturation, the endometrium, cervical mucus, energy, libido and bone health. Progesterone comes in after ovulation: it raises temperature, stabilises the endometrium, calms the nervous system and supports sleep. Testosterone contributes to energy, libido and the production of oestrogens via aromatase. Excess prolactin may hold back ovulation and lengthen cycles.
The four phases and their needs
Menstrual phase
The endometrium sheds, oestrogens and progesterone are at their lowest, and there is a local inflammatory process. Support: warm, simple, remineralising foods, sources of iron (paired with vitamin C for plant iron), ginger, small oily fish; in micronutrition, magnesium, zinc, omega 3, and iron where a deficiency is confirmed. Very long or very heavy periods, or disabling pain, are not the norm and warrant investigation.
Follicular phase
FSH stimulates follicular growth and estradiol rises. This is the most variable phase: a long one suggests delayed ovulation (stress, illness, travel, lack of sleep). Key point: signs of high oestrogen may come from insufficient clearance rather than from overproduction. Support runs through the liver, the gut, the microbiota and bowel transit, with the estrobolome (beta-glucuronidase) playing a role. Diet: cruciferous vegetables, fibre, ground linseed, good fats, protein, eggs, choline, prebiotics and probiotics; micronutrition: magnesium, zinc, vitamin D.
Ovulatory phase
Brief but telling: stretchy cervical mucus, the LH surge, a rise in basal temperature, sometimes mild ovarian pain, and increased energy and mental clarity. Very sensitive to stress and to under-eating. Support: an antioxidant diet, quality protein, complex carbohydrates, good fats, sufficient calorie intake; zinc, vitamin D, magnesium, omega 3 and DHA.
Luteal phase
Under progesterone dominance: the endometrium stabilises; if ovulation has not taken place, progesterone remains insufficient. Premenstrual syndrome sets in before the period (breast tenderness, bloating, food cravings, irritability). Support: B group vitamins, magnesium, calcium, omega 3, complete meals; chaste tree is sometimes useful where the luteal phase is fragile or prolactin is raised, and calls for caution (many contraindications).
PCOS: the priority areas
Three areas keep coming up: blood glucose and insulin, hyperandrogenism, and lifestyle (sleep, stress, suitable physical activity). Among the supplements mentioned, at clinical doses and always individualised: myo-inositol (insulin resistance and irregular ovulation profiles, sometimes combined with chiro-inositol), berberine (metabolic profiles), N-acetylcysteine (inflammatory profiles, oxidative stress) and saw palmetto (hyperandrogenic profiles: acne, oily skin, hirsutism). As a base: vitamin D, omega 3, magnesium.
Endometriosis: pain, inflammation and terrain
Often oestrogen-dependent but also highly inflammatory, endometriosis affects the immune, neurological and digestive systems. Disabling menstrual pain should never be treated as ordinary. Two profiles often coexist: high-oestrogen (heavy periods, marked PMS) and inflammatory (pain, fatigue, digestive disturbance). Areas of support: oestrogen regulation, support for the liver and the gut, bowel transit, modulation of inflammation, and support for progesterone sensitivity. A low-toxin diet, omega 3, magnesium, zinc, vitamin D, NAC, turmeric; PEA and yarrow are among the compounds mentioned. The copper coil may worsen symptoms in some patients.
Hormonal contraception and life after the pill
On the pill, the FSH-LH axis is put to rest and ovulation stops; the bleeds are withdrawal bleeds, not physiological periods. The pill can alter the digestive and hepatic axis, the microbiota and the thyroid axis, and can increase requirements for magnesium and B vitamins. On stopping, there are two challenges: restarting the cycle (post-pill amenorrhoea can last several months) and rebuilding stores. Support mentioned: vitamin B6, zinc, selenium, magnesium, work on the liver, a diet dense in micronutrients, and plants such as chaste tree, maca, milk thistle and nettle.
Putting this into practice with Simplycure
To support the cycle phase by phase and offer supplementation that is clear and individualised, Simplycure brings together on one platform the protocols and products of more than 300 brands. Create your practitioner account to compare and recommend in a few clicks.
