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No doubt about it, menstrual periods tend to get a bad rap. Between the mess, the inconvenience, and the expense of menstrual products, it’s no wonder so many women wonder if they really need <\/em>to have a period each month. In fact, CNBC News recently reported<\/a> on the formation of The Tampon Tax Back Coalition, which promises to compensate consumers for the state sales tax many pay on their tampons and other period care products. Frustratingly, the sales tax is added to all \u201cnonessential\u201d items, whereas \u201cessential\u201d items like food and medicines are tax-exempt. Here at Natural Womanhood, we\u2019ve always known that regular periods are essential <\/em>for women\u2019s health. In our Reasons Women Need Periods (RWNP) series, we\u2019ve explored how the menstrual cycle helps the female body in a host of ways<\/a>, from brain health to bone health to immune health. In this latest installment of RWNP, we explain how the menstrual cycle quite literally prepares the body for a healthy future pregnancy. <\/p>\n\n\n\n

Pregnancy is an inflammatory event\u2026 <\/span><\/h2>\n\n\n\n

After an embryo implants in the lining of a woman\u2019s uterus, a biological chain reaction takes place. Her uterine arteries become highly dilated blood vessels to supply blood to the trophoblast, which is the outer layer of the blastocyst (one of the very earliest stages of human development). The placenta develops from the trophoblast, and the rapidly growing embryo derives his or her oxygen, hydration, nutrition, and waste management from the placenta via the umbilical cord. <\/p>\n\n\n\n

If all of that sounds a bit… invasive, that\u2019s because it is! In fact, as a 2009 article from the American Journal of Obstetrics and Gynecology<\/em> notes, human beings are one of a few species where \u201cplacenta formation entails deep trophoblast invasion of maternal tissues and its vasculature\u201d [1]. This deep infiltration of the mother\u2019s tissues by a genetically distinct entity (i.e., the baby and the placenta) means that during implantation and pregnancy, the mom\u2019s uterine cells undergo some temporary damage due to inflammation. As it happens, menstruation is also<\/em> an inflammatory event [2]. <\/p>\n\n\n\n

\u2026 and menstruation is, too<\/span><\/h2>\n\n\n\n

Because of the deep infiltration of maternal tissues required for proper implantation of an embryo, endometrial decidualization, or the changes that happen in the endometrium<\/a> to allow the growing embryo to implant, plays a major role in future pregnancy health. Notably, endometrial decidualization occurs during the second half of each menstrual cycle, even if pregnancy doesn\u2019t occur<\/em>. <\/p>\n\n\n\n

A major way we might encourage a future healthy pregnancy, then, is to regularly allow a woman\u2019s body to undergo the process of endometrial decidualization, and then shed its lining during her period. Menstruation helps protect the cells of the uterus from hyperinflammation (too much inflammation) and oxidative stress associated with pregnancy<\/a> [1]. This is because the uterus gets a sort of \u201cpractice run\u201d with menstruation.  <\/p>\n\n\n\n

In a 2020 article from the International Journal of Molecular Scientists<\/em>, the authors thus conclude that \u201cthe primary driver of pregnancy health is the quality of the soil, not the seed\u201d [3]. (In this metaphor, the soil is the endometrium, and the seed is the embryo.) Far from an \u201cevolutionary coincidence,\u201d then, menstruation appears to be crucial for what one might call “cultivating the soil” for the health of future pregnancies [1]. <\/p>\n\n\n\n

Healthy, regular inflammation via menstruation may be protective against preeclampsia<\/span><\/h2>\n\n\n\n

Notably, in a case-control study of infertile women who became pregnant after receiving treatment, those with a history of endometriosis-related infertility were less likely to develop preeclampsia<\/a> [4]. This was the opposite<\/em> of what the researchers expected. Could prior inflammatory events in a woman\u2019s body precondition her to handle pregnancy-related inflammation\u202fwithout<\/em>\u202fprogressing to preeclampsia? The authors of the aforementioned\u202fAmerican Journal of Obstetrics and Gynecology\u202f<\/em>article note that endometriosis might be a malfunctioning of the body\u2019s normal inclination to precondition the body for pregnancy [1]).   <\/p>\n\n\n\n

Interestingly, previous research<\/a> correlated preeclampsia with a lack of regular menstruation [5]. In a 2023 article for FACTS about Fertility<\/a>, medical student Kathy Fatovic developed a theory behind why that might be the case.<\/p>\n\n\n\n

As Fatovic wrote<\/a>, preeclampsia is more severe in younger women (under twenty years old) than it is in older women. One possible explanation might be that younger women have, on average, obviously not experienced as many regular menstrual cycles as older women have. Thus, younger women’s bodies have not been as preconditioned to handle inflammatory events as the bodies of older women have. <\/p>\n\n\n\n

Is preeclampsia an autoimmune problem?<\/h3>\n\n\n\n

Fatovic notes that the exact causes of preeclampsia are unknown, though increasingly researchers suspect an autoimmune component. Abnormal development of the placenta (which, like the embryo, is genetically distinct from the mother and deeply infiltrates the maternal tissues and vasculature) almost certainly plays a role.\u202f<\/em>Consequently, low-level inflammation via repeated, regular menstruation may help prepare a woman\u2019s body to react to pregnancy-associated inflammation.\u202f  <\/p>\n\n\n\n

Certainly, more research is needed, especially given that endometriosis generally decreases a woman\u2019s chances of conceiving. Perhaps in the subset of women with endo who do<\/em> go on to conceive, prior inflammation serves to decrease the body\u2019s response to pregnancy-related inflammation.  <\/p>\n\n\n\n