There’s a line in hormone expert Alisa Vitti’s first book, WomanCode, that perhaps says all we need to know about the lack of widespread, accurate information about women’s health and wellness. Vitti writes that after years of helping clients identify and overcome life-disrupting endocrine imbalances and issues, she had yet to meet a woman who could draw a chart of her own fluctuating hormones throughout a 28-day menstrual cycle. She concludes: “When you’re not properly taught this information, you simply can’t make informed decisions about what ails you when the problem is hormone-related.” For experts like Vitti, that’s simply unacceptable.
Vitti’s frustration with the state of women’s health is personal. When she was diagnosed with polycystic ovarian syndrome (PCOS) 15 years ago, she was told she’d require lifelong medications to manage the hormonal condition, which, in her case, caused weight gain and cystic acne among other severe symptoms. Vitti threw herself into developing a nutritional and lifestyle protocol to address her endocrine disruption and says she effectively healed herself of PCOS.
“Most of us don’t know enough about the hormonal patterns involved in our menstrual cycle,” she says. “Not knowing about how they work, how they affect major systems of your body, and how you need to care for them is absolutely holding you back from your best health.”
Dr. Alyssa Dweck believes that, despite the historic lack of education, resources, and candid conversation around menstruation, the landscape of women’s health is slowly starting to change. “I feel we’ve made great strides in this regard thanks in part to technology, new products for menstrual health, and media,” she says. “Menstrual apps are all the rage and allow women of all ages to really understand, track, and manage bleeding habits, PMS, and fertility/family planning.” But there’s still plenty of work to be done.
Today, Vitti’s company, FLO Living, offers programs to help women understand their endocrine systems and address imbalances through the holistic methods she used herself. Based on her research, she believes that there are specific, actionable steps women can take throughout the month to help them overcome issues ranging from PMS to endometriosis. The same theory applies to the impact the monthly hormonal changes can have on your skin. “Remember, you are not the same biochemically each week of the cycle, so your skincare and every other type of self-care needs to change along with your hormonal changes,” Vitti says.
The first step you can take to ensure your skin stays glowing regardless of your menstrual phase is to understand what your hormones are doing throughout the month, and what you can do about them.
The Menstrual Phase (days 1-7 of your cycle)
Welcome to your period. Ever wonder why your gynecologist always asks when the first day of your last cycle was? That’s because, in medical terms, day one is the day your period starts. Unless you’re pregnant, this is the time when your body sheds the lining of your uterus, which has been thickening throughout the month in preparation for possible conception. “The thickened uterine lining, which was prepared for pregnancy, is not needed if pregnancy does not occur,” Dweck says. “Estrogen and progesterone levels plummet during this time.” Estrogen and progesterone are hormones produced by your ovaries and each serves an important purpose: estrogen thickens the uterine lining in preparation for the possible implantation of a fertilized egg, influences how the body uses calcium, helps maintain healthy levels of cholesterol in the blood, and keeps the vagina healthy. Progesterone also helps prepare the uterine lining for potential pregnancy.
“In the few days leading up to your period and during your bleed, estrogen drops and your skin gets thinner, retains less moisture, and produces less collagen,” Vitti says, noting that some people may also experience extra sensitivity and inflammation during this phase. “This is the time of the month you may want to use soothing, hydrating masks to calm your skin, and you should absolutely avoid extractions.”
The Follicular Phase (days 1-14 of your cycle)
The follicular phase also starts on the first day of your period, but it lasts about a week longer than the menstrual phase. It represents the time between the start of your period and ovulation. At the start of the follicular phase, estrogen and progesterone levels are low, but midway through, hormone levels start to ramp back up. A part of the brain called the pituitary gland produces two hormones: follicle stimulating hormone (FSH) and luteinizing hormone (LH). “The ovaries are prompted to produce mature follicles, one of which will be ripe for ovulation,” Dweck says, explaining that the brain secretes FSH to cause this production. “This phase is usually 14 days with regular cycles and variable in duration for those with irregular cycles.”
During the second half of the follicular phase, Vitti says estrogen levels rise, which boosts collagen production and thickens the surface of the skin. While all these shifts and changes can feel chaotic, it’s important to keep in mind that hormonal fluctuations are a natural part of a healthy cycle. “Chemical exfoliators like lactic acid are best during this phase,” she says. “Aloe vera gel is a natural exfoliator that has anti-inflammatory properties, and it seals moisture into the skin.” If you’re a fan of facials, Vitti says the second half of the follicular phase is the time of the month to indulge in any necessary extractions.
The Ovulatory Phase (at or around day 14 of your cycle)
Ovulation is when your ovary releases a mature egg that travels down the fallopian tube toward the uterus — if it is fertilized, you become pregnant; if not, then you have your period. “The egg will be viable and ripe for ovulation for approximately three days,” Dweck says.
Vitti says estrogen and testosterone peak during ovulation. “If your endocrine system is functioning like it should, these spikes don’t cause a lot of problems,” she says. “But if something is off and your body isn’t properly eliminating excess hormones, the extra estrogen and testosterone can accumulate and cause acne.” Vitti says she recommends women use a gentle toner during this phase but says extractions aren’t a great idea since your skin may be on the sensitive side. “Try a clarifying mask instead,” she recommends.
The Luteal Phase (days 15-28 of your cycle)
“The luteal phase is the time from ovulation until menstruation if no pregnancy occurs,” Dweck says. “This phase is typically 14 days. The uterine lining becomes thick in preparation for pregnancy.” If pregnancy doesn’t occur, this is the time of the month when you may experience PMS symptoms like bloating, mood swings, food cravings, and more. According to Dweck, “Many women notice increased acne during the premenstrual week. Some women note hormone imbalances when ovulation doesn’t occur regularly — such as in those with PCOS. In those cases, testosterone levels tend to be elevated, which is one [cause] of acne.”
Vitti says because progesterone first increases and then sharply decreases during the luteal phase, any existing skin conditions may be exacerbated. “During this phase, try oil serums and masks with fruit acids,” she says. “These can help hydrate the skin and stimulate collagen production.” While using an oil serum during an acne-prone (and likely oilier) time of the month may sound counterintuitive, research has shown that in some cases, certain oils may actually be beneficial for managing acne.
Coming Full Circle
Regardless of which phase of your cycle you’re currently in, experts say the best tools to combat skin issues and other symptoms are education and preparation. “Get to know your cycle and plan accordingly with soaps, over-the-counter products, prescription medications, dermatology input, etc.,” Dweck says. “Getting into a regimen in which symptoms can be anticipated is the best routine.”
Knowing the phases of the generic menstrual cycle is important, but even more important is knowing your body’s own unique pattern of hormonal fluctuations. “Oftentimes, the menstrual cycle is a window into one's overall health,” Dweck says. “Irregular cycles, imbalanced hormones, and skin changes might be related or even cause and effect — get to the root of the problem and fix that first.”