This list of Frequently Asked Questions (FAQs) about menstruation was compiled from ambassadors across all Pad Project cohorts. We asked ambassadors to think about their current questions regarding menstruation and questions they had previously. Responses came from people aged 12 to 45, and from North America, Europe, Asia, Africa, and Australia.
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What is menstruation?
What is menstruation?
Menstruation is the monthly shedding of the lining of one's uterus. The uterine lining (endometrium) thickens in preparation for potential pregnancy. When pregnancy does not occur, the body releases the lining and other fluids.
What are the phases of menstruation?
1. Menses Phase:
Duration: Approximately 3-7 days
Description: The beginning of the menstrual cycle. It is characterized by the shedding of the endometrial lining of the uterus, resulting in menstrual bleeding.
2. Follicular Phase:
Duration: Approximately 7-21 days
Description: This phase starts the day one's period arrives and ends at ovulation. The hormone estrogen levels rise, causing the lining of the uterus (endometrium) to grow. The follicle-stimulating hormone (FSH) stimulates the development of ovarian follicles. Towards the end of this cycle, one developing follicle will produce a mature egg (ovum).
3. Ovulation:
Duration: Approximately the 14th day of a 28-day cycle
Description: Ovulation is the release of a mature egg (ovum) from the ovary. A surge in the luteinizing hormone (LH) triggers the release of a mature egg (ovum).
4. Luteal Phase:
Duration: Approximately days 15-28
Description: After ovulation, the egg leaves the ovary, traveling through the fallopian tubes to the uterus. The progesterone hormone prepares the uterine lining for potential pregnancy, which occurs with the fertilization of the egg by sperm. If pregnancy does not occur, the uterine lining sheds during the period.
What is menopause?
Menopause is a natural biological process that marks the end of a menstruator’s reproductive years.
What: As the ovaries gradually produce fewer hormones, essential for regulating the menstrual cycle and supporting fertility, menopause is characterized by the cessation of menstruation and the end of the ability to conceive naturally
When: It typically occurs between the ages of 45-55, after not having a period for 12 consecutive months.
Potential Symptoms: hot flashes, night sweats, mood swings, vaginal dryness, and sleep disturbances.
What phases of the menstrual cycle are you most and least likely to get pregnant?
Pregnancy is most likely to occur during ovulation, which usually happens around the middle of the menstrual cycle (typically days 12-16 in a 28-day cycle). This is when an egg is released from the ovary and can be fertilized. Sperm can survive in the body for up to five days, so having unprotected sex in the days leading up to ovulation also carries a high chance of pregnancy.
Pregnancy is least likely to occur during menstruation (the period) and the early follicular phase (the time right after the period ends), as hormone levels are low and no egg has been released. However, it's still possible, especially for people with shorter cycles or irregular ovulation. Since cycle lengths vary, and ovulation timing can shift, using contraception is the most reliable way to prevent pregnancy.
It is important to remember, especially as a teenager, that menstrual cycles are often irregular. Therefore, ovulation isn't always on time, and pregnancy can occur throughout your cycle.
How do hormone fluctuations affect your cycle, especially as a teenager?
How do hormone fluctuations affect your cycle, especially as a teenager?
During teenage years, hormone fluctuations can significantly impact your menstrual cycle, often leading to irregular periods, missed periods, heavy bleeding, acne breakouts, and mood swings.
This occurs because the body is still establishing a stable hormonal balance during puberty, causing variations in estrogen and progesterone levels throughout the cycle; this is considered normal, especially in the first few years after starting menstruation.
How can you track your cycle?
How can you track your cycle?
Tracking your cycle can help you learn what a “typical” period is like for you, making it easier to spot trends that help you prepare for your next period. This information can also help you estimate the timing of your next cycle and identify significant changes/symptoms during your cycle that might be worth mentioning to a doctor.
How to track your period without an app:
1. Mark these days on either a paper calendar or a notebook, adding a note or key to indicate the days of your period. Once you’ve made note of your past periods and added them to a calendar, you’re ready to look at what a “typical” period looks like for you.
2. First, you’ll look at how many days your period usually lasts. Period length can vary from person to person and can last anywhere from 2-7 days, but most people have a pattern for how long it usually lasts for them (i.e., 3-4 days or 5-6 days). Based on past period lengths, note how long your periods last and write down this information.
3. Next, you’ll look at how long your menstrual cycle typically is by counting the days from the first day of a period to the day before the next period. Typically, cycles are between 26 and 32 days long, but vary from person to person. Based on the length of your past menstrual cycles, not how long your menstrual cycles usually are and write this information down next to your period length.
4. Keep in mind that the length of periods and the number of days between cycles can not only vary from person to person, but even from one menstrual cycle to the next (especially if someone experienced physical/emotional stress or a change in routine). Whether you use an app or a paper calendar, predicting future periods involves taking a best estimate, so it’s not always a perfect prediction for when a period will come.
Why do periods sometimes come late/early, even if you've been tracking them regularly?
Why do periods sometimes come late/early, even if you've been tracking them regularly?
1. Puberty:
During puberty in women, reproductive hormones play a major role, and these hormones can sometimes cause periods to be irregular, coming either too early or too late. These irregularities are especially common during the first few years after the first period.
2. Intense Exercise
Intense exercise for medium-long periods of time can make periods irregular. Due to elevated levels of physical activity, certain hormones and proteins created in the body fluctuate, causing the timing of periods to fluctuate.
3. Weight Fluctuations
Obesity, being underweight, or having major weight fluctuations can all be causes of irregular periods. Studies show that people who are severely underweight or overweight are the most likely to experience inconsistent periods. Those who have drastic weight changes are also expected to have hormone fluctuations, leading to early, late, or entirely missed periods.
4. Stress
Experiencing high levels of stress and anxiety takes a toll on the body and can lead to varying concentrations of important hormones in your body. These hormones that control the menstrual cycle, when disturbed, can cause irregular periods.
5. Routine Change
Changes in routine or a typical state, such as working night shifts or changing time zones, can also lead to irregular periods. Doctors and scientists hypothesize it is connected to changing circadian rhythms. Body systems are connected, so one disruption can cause another.
6. Medication
Certain medications (i.e., anticoagulants/blood thinners) can lead to irregular periods. With blood thinners, periods may be longer and heavier because the blood is more liquid. Depending on the medication, menstrual cycle regularity can be affected.
7. Birth Control
Birth control medication is a hormone regulator that can disrupt certain hormones, causing changes in menstrual cycle phase timing and longevity.
8. Related Health Issues
Sometimes irregular periods can be a sign of other preexisting health conditions such as PCOS, endometriosis, thyroid disease, or diabetes.
What is menstrual hygiene and how can you practice it?
Menstrual hygiene refers to the practices and conditions needed to ensure safe and hygienic management of menstruation.
Healthy habits:
1. Wash your hands before and after using the restroom and/or changing menstrual products
2. Trapped moisture and heat allow germs and bacteria to grow. To prevent this, change menstrual products frequently as directed, use the lowest absorbency products (if using pads or tampons), and wear lightweight, breathable clothing.
3. Wash the outside of your vagina (vulva) daily with only water. The vagina is a self-cleaning organ, so don’t use chemicals or scented products that can change the natural pH.
4. Use unscented products. Scents can irritate the skin and change vaginal pH.
What can you do to manage period pain and cramps effectively and safely?
1. Apply Heat Therapy
Use a heating pad or warm water bottle to relax uterine muscles and reduce cramping. Heat improves blood flow, helping ease pain and tension. A warm bath can also provide similar relief.
2. Stay Hydrated
Drinking plenty of water helps reduce bloating, which can exacerbate cramps. Warm or hot water is especially effective as it boosts circulation and relaxes muscles.
3. Eat Magnesium-Rich Foods
Magnesium helps relax muscles and reduce cramping. Magnesium-rich foods include bananas, spinach, almonds, and dark chocolate.
4. Take Omega-3 Fatty Acids
Omega-3 fatty acids have anti-inflammatory properties, which can help lower prostaglandin levels and ease cramps. Foods rich in omega-3 fatty acids include salmon, walnuts, and flaxseeds.
5. Avoid Caffeine and Sugary Foods
Caffeine and sugar can increase bloating and irritability. Opt for herbal teas like chamomile or peppermint, which can soothe the digestive system and reduce cramps.
6. Use Over-the-Counter Pain Relief Cautiously
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can block prostaglandins, offering quick relief. However, they should be used sparingly and as directed.
7. Ensure Adequate Sleep
Poor sleep can worsen period symptoms. Consistent sleep schedules support hormonal balance and help the body recover, reducing pain intensity.
8. Incorporate Gentle Exercises
Light activities (i.e., yoga, walking, and stretching) release endorphins, which are natural painkillers. Regular exercise also improves overall circulation, reducing menstrual discomfort over time.
What is endometriosis?
Endometriosis is a disorder characterized by the ectopic growth of lesions on the outside of the uterus and throughout the peritoneal cavity.
Common symptoms:
1. Pelvic pain: Often associated with menstrual periods, but can occur at other times.
2. Heavy menstrual bleeding: Sometimes with blood clots.
3. Pain during intercourse: Often felt deep inside.
4. Painful bowel movements or urination, especially during menstruation.
5. Infertility: Difficulty getting pregnant is sometimes the first sign. The lesions can grow around the reproductive organs, causing adhesions and causing the organs to adhere to each other, causing major infertility issues (30 to 50 percent of people with endometriosis are infertile)
6. Other symptoms: Fatigue, diarrhea, constipation, bloating, and nausea, particularly during menstrual periods.
Diagnosis:
1. Medical history review: Discussing symptoms and menstrual cycles with a healthcare provider.
Diagnosis:
1. Medical history review: Discussing symptoms and menstrual cycles with a healthcare provider.
2. Pelvic exam: Checking for cysts or scars behind the uterus.
2. Pelvic exam: Checking for cysts or scars behind the uterus.
3. Imaging tests: Ultrasound or MRI to visualize endometrial implants.
3. Imaging tests: Ultrasound or MRI to visualize endometrial implants.
4. Laparoscopy: A minimally invasive surgical procedure where a camera is inserted into the pelvic cavity to identify and sometimes treat endometrial tissue.
4. Laparoscopy: A minimally invasive surgical procedure where a camera is inserted into the pelvic cavity to identify and sometimes treat endometrial tissue.
Treatment Options (depends on the severity of symptoms and the potential desire for pregnancy):
1. Pain medication: Over-the-counter pain relievers like ibuprofen or prescribed medications.
Treatment Options (depends on the severity of symptoms and the potential desire for pregnancy):
1. Pain medication: Over-the-counter pain relievers like ibuprofen or prescribed medications.
2. Hormonal therapies: Birth control pills, GnRH agonists, or progestin therapy to reduce or eliminate menstruation.
2. Hormonal therapies: Birth control pills, GnRH agonists, or progestin therapy to reduce or eliminate menstruation.
3. Surgical treatment: Laparoscopy to remove endometrial tissue, cysts, and adhesions. In severe cases, a hysterectomy might be considered.
3. Surgical treatment: Laparoscopy to remove endometrial tissue, cysts, and adhesions. In severe cases, a hysterectomy might be considered.
4. Lifestyle changes: Diet and exercise adjustments, stress management techniques, and alternative therapies like acupuncture.
4. Lifestyle changes: Diet and exercise adjustments, stress management techniques, and alternative therapies like acupuncture.
What is TSS (toxic shock syndrome)?
Toxic Shock Syndrome (TSS) is a rare but serious condition caused by toxins produced by certain strains of bacteria, most commonly Staphylococcus aureus (staph) and Streptococcus pyogenes (strep). These toxins can enter the bloodstream and cause severe symptoms. TSS can affect anyone, but it's often associated with tampon use. It's crucial to seek medical attention immediately if you suspect TSS, as it can progress rapidly and lead to serious complications like organ failure.
Symptoms:
1. High fever
2. Low blood pressure
3. Vomiting or diarrhea
4. A rash resembling a sunburn, especially on the palms and soles of the feet
5. Confusion
6. Muscle aches
7. Redness of the eyes, mouth, and throat
Using tampons safely is key to preventing Toxic Shock Syndrome (TSS).
Tips for using tampons:
1. Choose the right absorbency: Use the lowest absorbency tampon needed for your flow. Higher absorbency tampons can increase the risk of TSS1.
2. Change regularly: Change your tampon every 4-8 hours, even if it's not full. Leaving a tampon in for too long can create an environment for bacteria to grow.
3. Wash your hands: Always wash your hands before and after inserting a tampon to reduce the risk of introducing bacteria.
4. Alternate with pads: Consider using pads at night or when your flow is light to give your body a break from tampons.
5. Follow instructions: Read and follow the instructions on the tampon packaging carefully.
6. Be aware of symptoms: Know the symptoms of TSS and seek medical attention immediately if you experience them.
What is PMS (premenstrual syndrome)?
Premenstrual syndrome (PMS) is a group of physical and emotional symptoms that start one to two weeks before a menstruator’s period. Most menstruators have at least some symptoms that can range from mild to severe, which generally disappear within four days after the start of the menstrual period.
Potential Signs and Symptoms:
1. Behavioral signs can include tension or anxiety, depressed mood, crying spells, mood swings and irritability or anger, social withdrawal, poor concentration, appetite changes and food cravings, trouble falling asleep (insomnia).
2. Physical signs can include joint or muscle pain, headache, fatigue, weight gain related to fluid retention, abdominal bloating, breast tenderness, acne flare-ups, constipation or diarrhea, and alcohol intolerance.
What is PMDD (premenstrual dysphoric disorder)?
Premenstrual dysphoric disorder is a more severe form of PMS. Symptoms are severe, and people have trouble functioning at work, at home, and in relationships. Hormone changes cause serotonin deficiency, affecting mood (i.e., depressed mood, increased anxiety, self-critical thoughts, etc.) and physical symptoms (i.e., breast swelling, body aches, weight gain, bloating, etc.). Like PMS, it lasts a week before menstruation and ends a few days after your period starts.
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