There’s a missing map in menstrual health awareness. Ovarian signals shape health across a lifetime, not just during the reproductive years.

Why ‘Reproductive Aging’ Clouded the Story

Decades ago when I was at school, there was no mention of menopause. No explanation of how ovaries age. What we were given instead was a story of reproduction: periods begin, cycles repeat, fertility rises and falls, and one day reproduction ends. That was the whole script. Not only was menstrual health missed out entirely, they also missed out the word aging, and simply told us the menstrual cycles were about reproducing, or not - particularly during sex ed classes. There was no mention of ovarian aging nor the role they play in terms of whole mind-body health.

Even if they had said ‘reproductive aging’, it’s not the same as ovarian aging. Reproduction is only one part of what the ovaries do. Their signals shape the brain, bones, immune system, metabolism, skin, and mood across the entire lifespan. When we reduce the story to reproduction, we erase the bigger picture of health.

A Timeline We Were Never Shown

The Menstrual Health Timeline ‘typically’ stretches across decades. Each stage tells us something important:

• Puberty: Ovarian aging begins with the very first cycles. Follicles are already on their timeline journey, setting the tempo for the years ahead.
  

• Menstruating Years: Cycles ‘regularly’ repeat, but they should not be seen as background noise. They are a vital sign of systemic health.
  

• Perimenopause: Most often feels sudden, but in fact the rhythm shift has been happening for a while — when ovarian signals change and sensitivity intensifies.
  

• Postmenopause: Not a complete stop, but another stage of ovarian rhythm, still influencing every operating system of the body, for many years.

This is the map we should all have been given. It places reproduction in context, but does not reduce ovarian health to reproduction alone.

Research shows there’s a Tipping Point of Ovarian Aging (TPOA) around age 37.5, when the ovarian follicle pool falls to about 25,000. From here, ovarian aging begins to accelerate, setting the stage for the transitions that follow. Yet this marker is never taught. The regular explanation jumps straight to perimenopause, when in fact there is a prequel shift in the internal ovarian rhythm that is not reaching the headlines. Frontiers in Endocrinology: Aging conundrum: A perspective for ovarian aging - (Wu et al 2022)

Why the Map Matters

Without the map, confusion takes over. A client feels different but has no framework to explain it. A trainer sees recovery slow but doesn’t link it to ovarian rhythms. A coach hears rising anxiety without knowing it’s part of transition.

This isn’t about re-writing biology — it’s about the lens we were given. When menstrual health is taught only as reproductive ageing, everyone misses the bigger story.

The timeline corrects that. It shows that menstrual health is not fertility on a countdown, but ovarian signals across a lifetime. And once you see it that way, the conversations you have with clients will never be the same.

Because the menstrual health timeline is not just a missing map. It’s the foundation of a new way to practice. And the professionals who learn to use it will be the ones to change the story for good.

What the Research Says

• The SWAN study shows menopause ‘day’ is not sudden but the outcome of decades of follicle depletion and hormone shifts, with different estradiol trajectories across the transition (Tepper et al., 2012).

• Mechanisms of Ovarian Aging (Wang et al 2023)

Course Insight: The Menstrual Health Timeline

The menstrual health timeline reframes ovarian aging beyond reproduction. Understanding how each stage shapes health helps professionals support clients with clarity and confidence.

We teach this in Level 1: An Introduction to Ovarian Aging, where you’ll learn how to use the timeline in practice.

[ → Discover Menstrual Health Informed Training ]