Human Females Menstruate to Eliminate Unviable Fetuses

From a female perspective, pregnancy is always a huge investment. Even more so if her species has a hemochorial placenta. Once that placenta is in place, she not only loses full control of her own hormones, she also risks hemorrhage when it comes out. So it makes sense that females want to screen embryos very, very carefully. Going through pregnancy with a weak, inviable or even sub-par fetus isn't worth it.

That's where the endometrium comes in. You've probably read about how the endometrium is this snuggly, welcoming environment just waiting to enfold the delicate young embryo in its nurturing embrace. In fact, it's quite the reverse. Researchers, bless their curious little hearts, have tried to implant embryos all over the bodies of mice. The single most difficult place for them to grow was – the endometrium.

Far from offering a nurturing embrace, the endometrium is a lethal testing-ground which only the toughest embryos survive. The longer the female can delay that placenta reaching her bloodstream, the longer she has to decide if she wants to dispose of this embryo without significant cost. The embryo, in contrast, wants to implant its placenta as quickly as possible, both to obtain access to its mother's rich blood, and to increase her stake in its survival. For this reason, the endometrium got thicker and tougher – and the fetal placenta got correspondingly more aggressive.

But this development posed a further problem: what to do when the embryo died or was stuck half-alive in the uterus? The blood supply to the endometrial surface must be restricted, or the embryo would simply attach the placenta there. But restricting the blood supply makes the tissue weakly responsive to hormonal signals from the mother – and potentially more responsive to signals from nearby embryos, who naturally would like to persuade the endometrium to be more friendly. In addition, this makes it vulnerable to infection, especially when it already contains dead and dying tissues.

The solution, for higher primates, was to slough off the whole superficial endometrium – dying embryos and all – after every ovulation that didn't result in a healthy pregnancy. It's not exactly brilliant, but it works, and most importantly, it's easily achieved by making some alterations to a chemical pathway normally used by the fetus during pregnancy. In other words, it's just the kind of effect natural selection is renowned for: odd, hackish solutions that work to solve proximate problems. It's not quite as bad as it seems, because in nature, women would experience periods quite rarely – probably no more than a few tens of times in their lives between lactational amenorrhea and pregnancies.