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It used to be that even if someone got no other sex ed, they got a class on menstruation, usually around the time people their age tended to start menstruating. But it's become clear that a lot of people aren't getting even that anymore. As usual, we're pretty horrified by that, since we strongly feel that people are entitled to basic information about their own bodies, for crying out loud. So, if you haven't had any of this before, aren't sure if what you did have was right or current, or you have, but you just can't read enough about periods to satisfy your geeky little heart, we're here to give some of this information to you.
A period doesn't just effect a person when they're on it, or right before they're about to get it. A menstrual period is only one part of a complex hormonal, physiological and emotional cycle that circles around every month, and on some level, effects a person with that cycle happening in their body every single day: some ways we'll notice, and other ways we probably won't. But it certainly isn't something that people only experience when a period is happening, or something that people having periods only see. Periods and the whole of the menstrual cycle feel like things, physically and emotionally. For those of us who have periods, our experience with them, often every cycle, is more than having-period-am-bleeding, or not-having-period-are-not-bleeding.
(That last bit was a special note for all the terrified boyfriends we hear from who don't trust the wisdom or self-awareness of partners saying they know they are getting their periods soon: trust us, they really do know. And it's not about being psychic, it's just about all of this being something that can be felt, in a lot of ways, in the body, but not observed by someone outside that body.)
Some people get periods. Others don't. If a person never had a vagina and a uterus, or did once, but doesn't anymore (due to hysterectomy), they are not going to be having periods. If someone does have those body parts, they're usually going to be experiencing periods, and for around forty years. But some people with a uterus still don't have periods, don't always have them, or once did and don't anymore, whether that's due to certain medications, surgeries or health conditions, age (like before puberty and after menopause), or the use of certain methods of birth control that either supress or limit periods on their own, or can be used in that way intentionally. Some people who have periods are women, but not all: some people who have periods are transgender men, or people who identify their gender in some other way that isn't "woman."
Like much of sexuality, the menstrual cycle starts in the brain, in a section called the hypothalamus. It produces and releases some substances which travel down to the pituitary gland and stimulate it, so the pituitary then releases two hormones: follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These create changes in the ovaries that make an egg cell mature.
Eggs, or ovum -- what can be fertilized by sperm and potentially co-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 menses, or a period -- aren't created every month. The eggs in the body are all already in the ovaries: around one or two million of them are already there, just not matured, at birth. By the time a person reaches puberty, there's about three hundred to four hundred thousand left. These are the eggs available for the whole of a reproductive life, about five hundred of which will be released in a lifetime. When most of them are gone, it's over. Last call for healthy ovum that can result in a pregnancy is something else where there's a good deal of variation, but on average, menopause begins around the age of 50. Then no more eggs or periods.
So, ovum mature, one at a time (for most people -- some release more than one egg per cycle on occasion). When FSH and LH stimulate an egg to maturity, the ovary that held it then ruptures, and releases the egg into the adjoining fallopian tube. 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: this hormone is what prepares the lining of your uterus to nourish and house an egg, should it be fertilized by sperm and implant. 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 a period. That whole cycle takes 28 days on average; most people with menstrual cycles have cycles of anywhere from 23 to 35 days. From the time ovulation occurs until you have a period is usually around 14 days. (If you want to know more about how human reproduction does and doesn't happen, check out: Human Reproduction: A Seafarer's Guide.)
Menarche is the term for a very first period, which will usually happen a couple weeks after someone ovulates -- releases an egg from their fallopian tubes, and then usually has the ability to become pregnant -- for the first time. When people first start getting periods varies, but it most typically occurs in early puberty. On average right now, someone will usually be around 12 and 13 when they first get a period, but others may be a few years younger or older.
The menstrual or fertility cycle can be divided into three basic phases: the menstrual phase, the proliferative phase and the secretory, or luteal phase.
Each of the monthly(ish) cycle starts on the first day of a period. You begin to have flow mostly because the uterine lining that was prepared to nurture a fertilized egg is sloughed off because you didn't become pregnant. In other words, the first day of a new cycle, marked by a period, happens because a pregnancy did not in the last one.
Menstrual flow can vary greatly in volume, from light to heavy. On average, through the whole of a period there will only be 6-12 teaspoons of flow. Flow will not often start with a flood all at once, but more gradually, with light spotting, sometimes so light you don't even notice it. The color of flow can be red, light pink, brownish, and even blackish sometimes. People will often experience some cramping with periods due to the hormonal changes happening, uterine contractions and other factors; cramps can be anything from very mild to severe, from something that happens only when a period is starting to something happening throughout all of a period. From when flow first begins to when there isn't any more, periods usually last anywhere from around three to seven days. During that time, a person also may not have flow, or visible flow, the whole time. Sometimes a period can start one day, then the next day there's no flow, then the day after, it starts up again.
How can I tell I'm in this phase? Because you're bleeding! Actually, you're not. Menstrual flow is not blood: it's a combination of uterine tissue (lining that grew but wasn't needed because a pregnancy did not occur, so it literally went south), cells from the lining of the vagina, bacteria, vaginal discharges and blood. Only around 35% of menstrual flow is blood. The idea menses is blood can result in people thinking or expecting menses to act like "regular" blood, and feeling confused when it doesn't. For instance, menstrual flow cannot coagulate (clot) like other blood, since it's missing the elements blood has in it to do so: when people think they are seeing clots in flow, what they're usually actually seeing are parts of uterine lining, or flow that got all globbed up with thick discharge, both of which are nothing to fret about). It can also freak some people out a lot more to think of it as being blood, so if that's you or someone you know, it might help to know that it's not.
When your flow decreases or stops, you'll notice that vaginal secretions (you can see this on your underpants, or by putting a finger in the vagina and pulling a little from it's opening) is either hard to find at all (the vagina may be "dry") or is a little thick. It is not abnormal for it to have a more brownish color during this phase, because even when your flow stops, the uterus can still have some old flow to work out.
The proliferative phase brings on more of another hormone, estrogen: that stimulates the lining of the uterus to ready itself to nurture a fertilized egg. During the proliferative phase the body gets ready to, and does typically, ovulate: the egg is released from the ovary during this phase, ready for action. This is around the time that most people are most fertile, by far: when everyone who becomes pregnant, ever, usually does.
How can I tell I'm in this phase? Vaginal secretions will get thinner, and typically have a consistency that's like uncooked egg whites. This happens because it provides the best environment for sperm to reach the egg. You may or may not experience a little bit of cramping during ovulation, called middleschmerz. Some people may sometimes also spot a little bit when ovulating. Some people feel their desire for sex increases around this time, others do not have that experience. Same goes with mood changes with this phase or any other: how we emotionally and psychologically experience these phases varies.
This follows right after ovulation. Progesterone increases (and part of what that does is signal the body not to release any more eggs), and continues to increase. Unless an egg was fertilized in this cycle, progesterone will increase until you begin a menstrual period and then it'll drop, pretty much to the floor, as you begin your next cycle.
How can I tell I'm in this phase? Vaginal secretions are usually thicker and pasty, and the vagina might feel more dry, just like in the menstrual phase. If you're someone who experiences PMS, it will usually start near the end of this cycle.
It's helpful to keep track of menstrual cycles each month, from the very start of them, especially if you're sexually active, and extra-especially if you're sexually active and inclined to freak out about possible pregnancies and forget the history of your cycles, including the way they will often differ sometimes. It can also help you figure out, over time and with your observations, what things seem to make you feel best with periods, and what only makes you feel worse.
If you keep a journal or a calendar, there's an easy way 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. Add notes as you'd like, like how much rest you did or didn't get, what you were eating, how bad or nonexistent cramps were, or what television series you learned makes you feel stabby or upset during a period. For more on charting, check this out.
Menstrual tracking apps for phones, tablets, or via websites are another way to do this. Just bear in mind that those claiming they can report when you're ovulating or most fertile almost always cannot do that accurately. If an app only asks you for period dates -- not for additional info like daily cervical mucus observations or basal temperatures, the things that give us much sounder information to predict ovulation with -- do yourself a favor and don't even look at it about anything fertility. For more on that, have a read here.
Cramps are common. There's the bad news: alas, they're not usually something wrong someone can fix and make go away forever. But the good news is that they can usually be taken care of very easily with an over-the-counter analgesic like ibuprofen, naproxen or acetaminophen. Cramps usually are also stronger in the first few years of a period, and tend to chill out some after that.
It's absolutely normal, and quite common for the menstrual cycle to take around five years to really get regular. For some people, or some people sometimes, irregularity can be a constant.
Regular does NOT mean cycles are the exact same number of days each time, nor that a period comes on the same date each month. In fact, a period coming on the same date each month, after a few months, is probably quite irregular, since months don't have the same number of days in them each time.
For most people, a period that happens at exactly the same day of every cycle, with exactly the same flow, number of days and side effects is uncommon, especially over all the years people who get periods will be getting them, and all the changes of life and bodies that tend to happen during that long time. So, if your period is not exactly the same for months or years on end, no need to worry: that's actually more common, rather than less. A regular period just means your cycles are around the same number of days each time, with room to give or take a couple or a few days earlier or later. (A late period, for the record, is generally considered so only once it is five days later than the latest it is expected. For more on late periods, see here.)
You might even find you skip a period sometimes, or have a way shorter or longer cycle seemingly out of nowhere. Periods and fertility cycles can vary a lot or be very different sometimes because the reproductive system is pretty sensitive: all the various changes in our lives -- rest, activity, how and what we eat, stress, health changes, how our bodies can change after pregnancies, even a move from one place to the next -- can impact cycles and periods. Just remember that regardless of how often you get your period, from the first time you get it, you're able to become pregnant, even if you then go months without flow.
It is also possible, if you're missing periods, that it's due to diet or exercise. If you aren't eating enough (a certain amount of body fat is necessary for ovulation and menstruation), are overexercising, or super-inactive, on the flip side, it can throw your system out of whack, and you may begin to miss periods, get irregular or experience more cramps and other not-fun stuff, like depression, that can happen with or around periods pretty much everyone wants to limit. Take care of yourself. Be sure to eat enough for the energy you expend, get enough rest, and eat a well-balanced diet. If you know or think you may have an eating disorder, please check in and ask for help from a healthcare provider so you can get well again and safeguard your long-term health: missing periods or being unable to become pregnant is really the least of the hardship EDs can put on your body and mind.
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 a lot by using sound birth control and STI protection, or by not engaging in any kind of sex that you don't feel safe and secure enough about. And if you were part of something that could have posed a risk of pregnancy, when you can take a pregnancy test, you'll really need to suck it up and do that. Putting that off and driving yourself bananas with Dr. Google and his cohorts instead is not a happymaking alternative.
There are some home, herbal and vitamin remedies for helping your cycles and any discomfort you may experience. Vitamins E and K, which are usually in a regular daily multivitamin, help with regularity, and can help slow a very heavy flow. You can also make an herbal tea of red raspberry leaf, strawberry leaf, peppermint and ginger (it's tasty, too) to help with cramps and to help balance cycles. Yoga can be a big help with cramps and blarghy feelings: here are some basic poses you can try. Alternative medicine -- like acupuncture, especially acupuncture -- can also be a big help, especially if you prefer those methods, or standard medical approaches just are not helping. Hormonal methods of birth control, or one type of IUD, are other alternatives that can help. For more on ways to help with cramps without using those methods, if you prefer or do not have access to them, you can read up here.
However, if you find that you consistently experience any of the following:
... then your best bet is to check in with a healthcare provider. It's most common during the first few years of having periods to have irregular periods, heavier or lighter periods than you might later, and heavier cramps. But ongoing or severe problems with menstruation can sometimes be due to other health issues or conditions -- like eating disorders, thyroid disorders, endometriosis or PCOS, for example -- which need treatment, and that treatment can also often make your periods less of a pain in the uterus. Your period truly should not be utter misery or feel like it takes over your whole life. A doctor can also fill you in on options you can't access without prescription that may better help with your menstrual issues.
And by all means, if your period is making you suffer in any way, don't feel like it's too minor or not okay to talk to a doctor about. Healthcare providers see periods as a health issue: it's not about shame or symbolism or sex for them, just like a pap smear or IUD insertion isn't. There's no benefit to being in pain or big emotional distress when either can be alleviated.
You've got some choices when it comes to how you deal with menstrual flow. When I first started my period, there were these old pads that attached to bizarre belts with clips and all number of confusing elements. It was like getting suited up for getting launched into space. Except I didn't get to go to space. I only got cramps and a period. Talk about a bummer.
You don't have to use those. Yay! And you have quite a few choices, any of which are valid and yours to make based on your own needs and preferences. You can choose between disposable pads, washable pads, tampons, sponges or menstrual cups. Read below to find out what might be best for you. Disposable menstrual products create an unbelieveable amount of waste on our planet, so I would encourage you to at least consider the waste you may create with your choice and see what you can't do to reduce that. It also often happens that what's better for our ecosystem is also better for our bodies.
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 a sticky backing to attach them to your underwear. If you're going to use disposable pads, try to avoid any that are scented, as these irritate the vagina and can make its healthy bacterial balance go wonky. No one is likely to smell your period unless you aren't changing your pad often enough, and even if they do, whatever: it's a period, and like all of our bodies and many of their processes, it can have a smell. Your crotch smelling like pine trees or roses is certainly going to smell more bizarre than your body smelling like a body. Some people complain 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. You can find disposable pads at nearly any pharmacy, superstore or grocery.
Washable 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 cotton, 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.
Some people have concerns that somehow washable pads are less sanitary than disposable pads, tampons or other options. They're not, just like it's not unsanitary to use washable underwear, rather than underwear you would only wear once, then throw away. So long as you wash your pads just like you do your clothes (and it is also just fine to wash them with anything else), and, just as you would with tampons or pads, don't leave dirty pads laying around everywhere, it's all good.
You can get washable pads online, at dedicated companies like Lunapads (who also sell underpants with a pad sewn right in that are utterly genius), or independent sellers at a place like Etsy. You can also find them at some health food stores, and sometimes at feminist bookstores or sex toy shops. If you're handy with a sewing machine, or know someone who is, you can make them yourself, and find patterns to do so online.
Tampons: Tampons and other insertables 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. 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. 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 the 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 the vagina, and then push the bottom of the applicator up, until it releases the tampon. Some people find a little lube on the end of a tampon makes inserting it easier or more comfortable.
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 is how often you want to do so), especially the commercial brands that contain rayon fibers or bleaches, pose a risk of Toxic Shock Syndrome (TSS). TSS is rare, but still serious: it 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, without bleaches, when possible.
You can find tampons at nearly any pharmacy, superstore or grocery.
Sea Sponges: You can use small sea sponges (you can usually find them in the cosmetics section of health food stores) instead of tampons. They're recyclable, natural, and all you do is moisten one lightly and insert it inside the vagina. To change them, you just gently grab an edge, pull it out, boil it before reuse, and put in a fresh one as need be. You can't reuse these forever, though, they're really only good for a handful of uses before they get smelly and start to fall apart a bit, like most kinds of sponges, so they are kind of between a disposable and a reusable method. This is a good alternative if you feel "poked" by tampons, find putting in cups is making you want to hurl them out the window, or are looking for an alternative to disposables that reduces waste.
Menstrual Cups: The Divacup, Mooncup, Keeper, Lunette (and other brands) and the Instead/Softcup are also choices if you want something insertable that is also reusable and which is not a tampon. Because cups contain flow -- rather than pulling flow and all vaginal fluids into something absorbent like tampons do, which also can cause some serious vaginal dryness -- they can help limit extra cramping. They usually come in two sizes, for those using them who have gone through a pregnancy, and those who have not. Most cups are reuasable, over years: if you want the most cost-efficient way to manage your period, a reusable cup is probably it.
These aren't usually as easy to insert as tampons or sponges, but many folks find are something they can learn to do easily with a little practice, and enjoy them because they do not have to worry about the possibility of TSS (toxic shock syndrome) as they do with tampons. To insert a cup, you simply squeeze its sides and slide it into the 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. For more help with using cups, have a read here. When you remove a cup, you just dump out the flow inside, wash it up, and it's all ready to use again.
The Divacup, Keeper, Lunette and other cups like them, which you will probably only buy once every handful of years, tend to typically be a better bet than Insteads/Softcups, which are only meant for one-time use. Those other cups are just engineered in a much smarter way, tend to leak less, and again, they're reusable, so you'll save big bucks and do the planet a favor if you invest in a long-term cup, rather than disposables. A diaphragm can also do double-duty as a menstrual cup.
You can find cups online (there are a bunch of brands now, so just do a search for "menstrual cup" unless you already know the brand you want to try) and at natural food stores.
Many people feel embarrassed when they first get periods; some never stop feeling ashamed.
Much of that shame comes from the fact that still today, and through much of history, someone getting a period isn't treated very well (or is, but is held at arm's length), and women, specifically, the people most often having periods, were and are not treated well, period. A lot of that attitude is based on dusty notions that people with breasts and vulvas are "dirty," (and menses is then seen as clear evidence of such) or in fear. 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.
Not feeling comfortable with periods can also be about more individual feelings or life experiences, like not feeling so excited or comfortable going through puberty, having a gender identity that is or feels in conflict to periods, or general anxiety or fear about body functions. It can be a trigger for some people who have had vaginal injuries, especially those due to assault. Discomfort can even come from something that was intended well, like having family or others around you just get TOO excited and involved about your period when you wish everyone would STFU and let it be private.
In many cultures and traditions, and still today, menarche -- the time at which someone first begins their period -- and menstruation are also sometimes seen as reasons for joy and celebration, or as a coming of age moment. The menstrual cycle illustrates or symbolizes what a lot of people think of as the miracle of possible birth and of human reproduction, so some of those folks think it's pretty special. Menarche has also often been seen as something that shows someone is "becoming a woman," though that obviously may not be how everyone feels about it or their own experience of womanhood, especially if they're a woman who doesn't have periods, a uterus or a vagina in the first place, or they're a guy who also happens to have a uterus. For some people, a yay-periods-such-a-big-deal view may feel empowering and awesome, while it may actually feel depressing, insulting or be discriminatory for others.
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. (Alas, in a lot of Africa, many people with periods wind up missing school they don't want to, because they lack supplies to manage flow with. If you'd like to find out more about that and how to help, check out what the fine folks at Lunapads are doing.) In parts of Asia, a feast is often served. Many cultures hold celebrations and rituals like this, and some cultures, like Native American cultures, consider menstruation to be a time of great personal power, a time for meditating and reflecting. Aboriginal men in Australia even have sometimes cut their penises to copy and mimic menstruation. (We personally suggest menstrual celebrations where everyone gets to leave with all appendages unharmed.)
At the same time, many cultures -- including in the Western World -- still carry on traditions based in taboo and superstition that a woman (generally identified as such by vaginas and periods with folks thinking this way) may spoil things, or are having periods as a punishment from God. There are also plenty of widespread taboos about all or some body fluids, period, and about anything to do with genitals, especially vaginas. (For examples, should you need them, see some supremely embarrassing and woefully recent examples from United States politics of this kind of baloney here or a more general overview of these attitudes here.) Again, many of those fears and taboos are based in ignorance, but have unfortunately been codified in cultural tradition and religions. Had people known thousands of years ago what we know today, their outlook may have been far different. Had people known or cared even a hundred years or so ago about both the realities of menstruation and the health and, you know, equal rights, of people menstruating, a lot of not-so-wonderful, or just plain bizarre, ways people have marketed, created, sold or endorsed menstrual products sure would have been different, too.
Some people have outdated ideas about periods they're willingly choosing not to correct -- it's not that they don't know what's real, it's that they like the lies or what they feel they do for them better -- and update sucks, but that's not about menstruation being the bad guy. That's mostly about sexism sucking, which it always does. If this was just about fluids and hygiene, the same taboos and bad attitudes would be found in the way people treat and address semen or saliva. They're not. Mostly because: sexism.
Undoubtedly, there have also been plenty of people and cultures who addressed periods with neither raucous joy nor shameyscorn, whose cultural approach is or was likely best summed up with, "Periods, whatever." But "whatever" is not the stuff of history or anthropology books.
You get to be wherever you'd like on this spectrum, too.
Everyone's experiences of, and feelings about, menstruation vary; even just one person within their lifetime may find they don't always feel the same way about it. It's not only right to think super-positively about it, or necessarily wrong to just think it's an asshole you have to put up with, like someone who rides the bus with you you don't like, and barely tolerate until you get to your stop. You get to feel how you feel about it, however that is. As with anything else, there's no right or wrong ways to feel about your own life and body.
But since it's going to likely be a part of your life for at least a couple decades, you probably want to figure out how to think about it and manage it -- both in terms of flow-items that you like best and in how you think about it and treat yourself with it -- in some way that really works for you, and doesn't make it a drag or more of one.
Developing some kind of acceptance of your period -- and for one person, that may be outright celebration, for another, a grudging tolerance -- generally works a whole lot better for people than going to the bad place when it comes to periods. Better individually, and certainly better culturally. Even if you're not super-stoked about yours, sporadically or pretty much always, thinking of any part or process of your body (or of someone else's) as the enemy or a punishment tends to make anything that might be uncomfortable in any way ten times more so.
You can create your own menstruation rituals. Or not. Or your ritual can just be taking a little extra care of yourself during and around your period. Or not. Maybe what you want to do instead is run swearing and bleeding and sweating into a mosh pit and get badass-punk bruises to brag about later. (Which I can certainly appreciate the appeal of, as it's pretty much the way I managed and revered my menstrual angst through all of high school.)
Whatever works for you. Good, bad or whatever, this is a temporary relationship: after thirty or forty years, it's done. So, if you're into it, relish, celebrate and enjoy it while you can. If you're not, well...figure you've got all the time you need to plan a truly epic post-period breakup party.
Illustrations: Copyright 2014, Isabella Rotman