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On the Rag: A Guide to Menstruation

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Despite what you might think, your period doesn't just effect you when you're on the rag. In fact, your period is only one part of a complex hormonal, physiological and emotional cycle that circles every month, and on some level, affects you every single day. Understanding how your menstrual cycle works, and what it all means is a tool you can use to understand your sexuality, your body and your mind for the rest of your life.

Your menstrual cycle and your reproductive system have held people in awe (or perpetual duh, depending on how you look at it) for thousands of years. Follow us through a tour of how it all works, how to best manage it and find out what it means now and has meant to others in the past.

The Basics, Period.

Like much of your sexuality, your reproductive cycle starts in your brain, in a section called the hypothalamus. It produces and then releases some substances which travel down to the pituitary gland and stimulate it so that the pituitary releases two hormones: the follicle-stimulating hormones (FSH) and the luteinizing hormone (LH). These create changes in the ovaries that make an egg mature.

Eggs, or ovum -- what are fertilized by sperm and create a zygote (and if a pregnancy continues and is carried to term, eventually a kid), or which, when unfertilized, result in chemical signals to later bring on your menses, or period -- aren't created every month. They instead mature, one at a time (for most people -- some release more than one egg per cycle), and usually alternate in each ovary. That's why one month you can have a fairly mild period, but the next you can have painful cramps. The eggs in your body are held in your ovaries, and have been there since before you were born. You started with one to two million of them, and by the time you hit puberty, you have about three hundred to four hundred thousand of them left. These are the eggs that you have for the rest of your life, and when they're gone, they're gone.

When the FSH and LH stimulate an egg to maturity, the ovary that held it ruptures, and the egg is released into the fallopian tube. The little finger-like structures that appear to hold the ovary, the fimbriae, help to pull the egg into the tube. The wall of the fallopian tube then has a series of contractions that move the egg towards the uterus. At this time, another hormone, progesterone, is produced by the ovary, and this hormone is what prepares the lining of your uterus to nourish and house an egg, should it be fertilized by sperm. If the egg is fertilized, even more progesterone is released. If it is not, then the level of progesterone drops, and it is that drop that causes your period. That whole cycle takes on average, 28 days, and most people with menstrual cycles have cycles of anywhere from 23 to 35 days. From the time the egg is released until you get your period takes around 14 days.

It's Just a Phase

Let's look at this a different way: the menstrual or fertility cycle can be divided into three phases: the menstrual phase, the proliferative phase and the secretory, or luteal phase.

The Menstrual Phase Each of your monthly cycles starts on the first day of your period. You begin to bleed because the uterine lining that was prepared to nurture a fertilized egg is sloughed off because you did not get pregnant. In other words, the first day of a new cycle happens because a pregnancy did not in the last one. It is perfectly normal to have a menstrual phase that lasts anywhere from just a couple days to seven or more days, and both light and heavy flow, or a combination of the two, are both also normal.

How can I tell I'm in this phase? Because you're bleeding! In addition, when your flow decreases or stops, you'll notice that your vaginal secretions (you can see this on your underpants, or by putting a finger in your vagina and pulling a little from it's opening) is either hard to find at all (your vagina may be "dry") or is a little thick. It is not abnormal for it to have a brownish color during this phase, because even when your flow stops, the uterus can still be discarding some old flow.

The Proliferative Phase The proliferative phase brings about more of another hormone, estrogen, and that stimulates the lining of the uterus to ready itself to nurture a fertilized egg. It is during the proliferative phase that you get ready to and do typically ovulate: the egg is released from the ovary during this phase. This is around the time that most people are most fertile, by far: are most likely to become pregnant.


Can you be pregnant and still get your period? That's not likely, since the hormonal cycle we're describing here which causes a period does not continue with a pregnancy. However, some people have various kinds of vaginal bleeding during pregnancy, such as implantation bleeding, decidual bleeding, bleeding due to additional blood flow to the cervix and other reasons, most of which pose no harm or danger to mother or fetus. Some bleeding can be a problem or signal a problem, such as with miscarriage or an ectopic pregnancy. So, if you have had a pregnancy risk and you seem to get your period but the timing is a bit off, the bleeding seems different, or everything with your period is fine, but you're having other symptoms, you'll want to take a pregnancy test. For more on bleeding during pregnancy, see the Mayo Clinic's page or this pamphlet from the ACOG on the topic.

How can I tell I'm in this phase? You might or might not experience a little bit of cramping during ovulation. Your vaginal secretions will get a little thinner, and have a consistency that is like an egg white. This happens because it provides the best environment for sperm to reach the egg.

The Secretory Phase This follows right after ovulation, and is when the progesterone increases (and part of what that does is signal the body not to release any more eggs!).  It continues to increase and then hold still unless an egg was fertilized in this cycle; if it wasn't, progesterone will increase until you begin a menstrual period and then it'll drop as you begin your next cycle.

How can I tell I'm in this phase? Your vaginal secretions may be thick or chalky, and your vagina might feel more dry, just like in the menstrual phase. If you're someone who experiences PMS, it will usually start towards the end of this cycle.

It's a great idea to keep track of your menstrual cycles each month, from the very start of them, especially if you are sexually active. If you keep a journal or a calendar, there is an easy system to do this. The first day of your period, just make a little red dot on your calendar. Continue the dots until you are no longer bleeding. After that, pay attention to your vaginal secretions, or discharge. When I chart, I note a "D" when my mucus is dry or thick, and an "O" when it seems thinner, a sign of being fertile. Charting your cycles will help you to best understand them, and help you be more alert when you may have any problems, and when the best time is for you to avoid sex altogether, birth control or not. Later in your life, when you want to conceive, or have a child, knowing your cycles will help you to do so most easily.

The Rag, When it's a Drag

It is absolutely normal, and quite common for the menstrual cycle to take up to as much as five years to really get regular. You might find that you go a few months without a period sometimes, or have shorter cycles, bleeding every three weeks instead of every four. Just remember that regardless of how often you get your period, from the first time you get it, you're able to get pregnant, even if you go months without bleeding.

It is also possible, if you're missing periods, that it is due to diet or exercise. If you aren't eating enough, or are overexercising (more than four hours a day, or running over ten miles a day), it throws your system out of whack, and you may begin to miss periods. Take care of yourself. Be sure to eat enough calories for the calories you burn, get enough rest, and eat a well-balanced diet. The impact of stress and how you deal with it can also make you miss a period, including stressing out about a possible pregnancy. If you're sexually active, you can reduce that stress by using sound birth control and STD protection, and just don't have sex at all while you're ovulating.

Menstrual flow (how much blood there is) can vary greatly, from light to heavy. Cramps are also normal, and can be taken care of very nicely with some ibuprofen. I remember when there wasn't any ibuprofen yet, and boy, did having cramps stink! In fact, the name of this section of the site comes from the pink slip of paper I used to be able to get to get out of gym because I had my period and horrible cramps, with nothing decent to abate them.

There are some good herbal and vitamin remedies for helping your cycles and the discomfort you may experience. Vitamins E and K, which are usually in a regular daily multivitamin help with regularity, and to slow a very heavy flow. You can also make an herbal tea of red raspberry leaf, strawberry leaf, peppermint and ginger (and it tastes nice, too) to help with cramps and to balance your cycles. If it tastes gross to you, add some honey. Go to your local health food store, and they can help you find what you need. Alternative medicine -- like acupuncture -- can also be a big help, especially if standard medical approaches don't seem to have much to offer.


Flow with It: Pads, Tampons and Even Better Solutions

You have a lot of choices when it comes to how you absorb menstrual flow. When I first started my period, there were still old pads that attached to these heinous belts with clips and all number of confusing elements. It was like getting suited up for Space Camp.

Thankfully, things have improved. You can basically choose between commercial pads, natural/reusable pads, tampons, sponges or cups. Read below to find out what might be best for you. Bear in mind, too, to consider the waste you create with your choice. It often happens that what is best for our bodies is also best for our ecosystem. If you can use a method that creates minimal waste, you're doing the whole world a favor.

Disposable Pads: Pads are often a best choice when you're first starting your period, if you have a heavy flow, and at night when you're sleeping. Most have an adhesive backing (sticky) that you pull paper away from and attach to your underwear. If you're going to use pads, make sure you do not get any that are scented, or have any added perfumes, as these can cause vaginal infections. Organic cotton is the best thing you can do for your body, if you're going to use disposable pads. No one is going to smell your period unless you aren't changing your pad often enough. Some people complain though that pads make them feel like they're wearing a diaper. In that case, you may try using smaller pads and changing them more often.

Disposable Pads we Recommend: Natracare or Seventh Generation, and other brands which offer pads that are 100% cotton, preferably unbleached.

Reusable Pads: When using pads, these really are a better choice: for the environment, for your body, and over time, for your pocketbook, as well. They're made out of a cotton liner, wrapped in fabric, and you just wash and dry them for reuse. Some brands have a "filler" you can remove as well. Some have snaps on little wings that you just snap around your underwear, and other attach like a pair of underwear , with a little g-string.

Great Reusable Pads: Lunapads are the best thing since sliced bread. And yes, we're playing favorites.

Tampons: Tampons are good for when you're swimming, if you're active, if you have a special occasion, or if you just don't like pads. They are best for lighter flows, since the larger, more absorbent tampons can cause problems as I'll explain in a moment. Again, be sure to buy the kind without any fragrance or perfumes, and to really get to know your body, try the kind without the applicator. It is possible if you have a resilient or fairly intact corona/hymen that it might be more difficult for you to use tampons, and in that event, you should ask a parent for some help. To insert a tampon, it's easiest if you sit on the toilet or squat. If you're using one without an applicator, press your finger into the bottom of it where the string is, and push the tampon up deeply into your vaginal canal. You do not have to worry about losing it in there, as there is not an endless canal in which it goes. If you're using a tampon with an applicator, you press the curved top of the applicator into your vagina, and then push the bottom of the applicator up, until it releases the tampon.

Something serious you need to be aware of with tampons is that it is critically important you change them often. Tampons not changed often (every few hours), and especially commercial brands that contain rayon fibers and bleaches (and all of them do) can pose a risk of Toxic Shock Syndrome (TSS). TSS can cause severe medical problems such as hair loss, shock, kidney failure, heart and lung disease, and in as many as 15% of cases, death. To safeguard, make sure you only use tampons during the day (use a pad at night), change them often and buy 100% cotton tampons (again, in your health food store) when possible.

Good Tampons (Cotton Only): Organic Essentials, Natracare and Seventh Generation.

Sea Sponges: For many years I used small sponges (you can get them in the cosmetics section of your health food store or at a bath store) instead of tampons. They're recyclable, natural, and all you do is insert one inside the vagina, then to change them, pull it out, clean it before reuse, and put in a fresh one as need be. This is a good alternative if you feel "poked" by tampons, or are looking for an alternative that creates less waste. Lunapads carries them.

Menstrual Cups: The Divacup, Keeper and Instead (which you can get at drug stores) are another fantastic choice if you want something insertable. These are not as easy to insert as tampons or sponges, but many folks find they work very well, and enjoy them because they do not have to worry about the possibility of TSS as they do with tampons. To insert a cup, you simply squeeze its sides and slide it into your vagina. If it is placed right, you shouldn't feel it at all. It may be helpful to use a little lubricant (like KY Jelly) to insert it.

The Divacup and the Keeper are a typically better bet than Instead -- they're just engineered in a much smarter way -- and they're also reusable, and can be used for years, so you'll save big bucks on menstrual products, and do the planet a favor, if you invest in a long-term cup, rather than a disposable. As an extra bonus, because they contain flow -- rather than absorb flow and vaginal fluids like tampons -- they can help with cramping.


Meaning and Menses: Where We're at With it All

Many people are embarrassed when they first get periods (also called, "menarche"). Much of that shame simply comes from the fact that in our modern-day culture, and in a lot of history, someone getting a period isn't treated very well (or is, but is held at arm's length), and women, specifically, were not treated well, period. A lot of that attitude is based on very old notions that people with breasts and vulvas are "dirty," (and menses can be seen as further evidence of such) and mainly in fear because before people really understood menstruation, blood of any sort meant that something was wrong with someone. That someone could have any kind of bleeding for days and not get ill or die was a great source of fear simply because no one understood WHY that could happen. On some level, this is often the case with much of sexuality, and many people still have a hard time talking about it, but the best remedy for that is just to try and keep talking, listening and learning.

However, in many cultures and traditions, and still today, menarche -- the time at which someone first begins their period -- and menstruation are both also seen as reasons for joy and celebration. Basically, your period and your menstrual cycle are a symbol of what a lot of people think of as the miracle of possible birth and of human reproduction.


Want even more on all things period? Check out: Eight Myths About Washable Menstrual Pads Dispelled, That First Period Talk, I, Being Born Woman and Suppressed, Stamp Out Cramps! and a whole batch of advice and information on periods by clicking here.

In some parts of Africa, when someone gets their first period, they can stay home from school, spending the day with relatives who celebrate and explain cycles, and later friends and family host a big party. In parts of Asia, a feast is served. Many cultures hold great celebrations and rituals like this, and some cultures, like many Native American cultures, consider menstruation to be a time of great personal power, a time for meditating and reflecting. Aboriginal men in Australia even sometimes cut their penises to copy and mimic menstruation. (We don't endorse menstrual celebrations that end with the loss of anyone's appendages ourselves, though.)

At the same time, many cultures still carry on traditions based in taboo and superstition that a woman may spoil things, or are having periods as a result of punishment from God. However, again, bear in mind that many of those fears and taboos are based in ignorance, but have become matters of tradition and religion. Had people known thousands of years ago what we know today, their outlook may have been far different.

Another interesting fact is the correlation between the menstrual cycle and the cycle of the moon. The moon's cycle is the same number of days as the average menstrual cycle, and even the word "menses" is related to the original word for month, and our months used to be determined not by a number of days, but by each cycle of the moon. As noted at the Red Spot (http://onewoman.com/redspot/), "experiments have shown that people with irregular menstrual cycles have become more regular by sleeping with a soft light on in their rooms (to stand in for the light of a full moon) during the fourteenth, fifteenth and sixteenth days of their cycle, the days they would ideally be ovulating. After a few months, their cycles regulate. This is called the Dewan effect, and it seems to show a connection between light and the menstrual cycle."

All in all, finding peace and joy in your cycles -- or at least a working, factual acceptance -- can make you really feel like you and your body are working together, and it will make all of this stuff a lot less mysterious. Create your own rituals. On the first day of your period, find some way to celebrate it, or just to take care of yourself. You can use it for reflection or meditation, or even just give yourself a quiet day of your own. If you're not the quiet type, have a party! Write something, or create. Some artists have even created art with their menses (don't you say "eeew"), and in ancient times, the time of menses was seen as a good time for prophecy, or dreaming. or just go on with your regular day or week if that's what feels best to you. Just go with the flow.

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