Menstruation 101
A guide for everyone, whether you menstruate or not
by Rachael Deng, #FTPCA Marketing
It’s no secret that menstrual health—and education about menstrual health—is extremely important. Menstrual hygiene management (MHM), which concerns management of hygiene related to the menstrual process, is a key focus area for the World Health Organization (WHO) and UNICEF. These two organizations emphasize that good MHM enables women and adolescent girls to “understand the basic facts linked to the menstrual cycle and how to manage it with dignity and without discomfort or fear”.
Apart from ensuring that menstruators are able to manage their periods with proper hygiene, WHO and the United Nations are working to improve menstrual health and hygiene (MHH), which was approved as one of UNICEF’s five core priorities for adolescent girls in its Gender Action Plan (2018–2021). MHH concerns how large-scale systemic factors connect menstruation to issues such as health, equity, empowerment, rights, and education. UNESCO summarizes these systemic factors as:
“… accurate and timely knowledge, available, safe, and affordable materials, informed and comfortable professionals, referral and access to health services, sanitation and washing facilities, positive social norms, safe and hygienic disposal and advocacy and policy”.
In alignment with the WHO and UN, both #FreeThePeriodCA and PERIOD share a strong belief in the essential nature of MHM and MHH. Furthermore, we strive to educate everyone, regardless of age or sex, about menstruation and its impact on daily life. Why is this so important?
Why Periods are an Issue for EVERYBODY
In 2015, the Huffington Post UK reported on a campaign called #JustATampon, created for International Tampon Alert Day. The article included a video in which men were quizzed about the use of period products. With obvious discomfort, most participants struggled to even remove a tampon from its applicator. Similar experiments have been conducted by BBC, As/Is, and many more groups, most of which demonstrate men’s highly lacking knowledge of periods and their biases or misconceptions.
To some, it may seem irrelevant that non-menstruators don’t know much about menstruation; after all, they don’t have to deal with a period personally. However, the situation is much more complex: when the majority of an entire group ignores or misunderstands something as common as having a period, small biases and gaps in knowledge can easily turn into widespread stigma. When a significant number of policymakers and people in power are non-menstruators, we then see a rise of poorly-informed legislature and societal norms which institutionalize gender inequality and inadequate MHH. To get the full picture, Blood + Milk’s piece on including men in menstruation education is a must-read.
When menstruators are barred from access to quality menstrual hygiene and health management systems, they often have to skip work or school, or be under the stress of fearing stigma. In this way, many womxn are unfairly prevented from maximizing their potential as contributors to society and the economy. Thus, everyone is affected—if around half of the population cannot reach their full potential, then all of society inevitably loses productivity.
With the goal to educate as many people as possible in mind, let’s delve into the diverse world of period products.
Menstrual Products: The Traditional
Broadly speaking, menstrual products fall into two categories: external and internal protection. The most common forms of external protection are pads and pantyliners, both of which absorb menstrual flow after it leaves the body. On the other hand, internal protection such as tampons catch and absorb flow before it leaves the body, since these products are inserted into the vagina. Traditional products can be either disposable or reusable.
Pads
External or internal? External
Pads are worn in the underwear to absorb menstrual flow. Disposable sanitary pads are adhesive on one side to better stay in place, and generally have sticky “wings” on either side to further secure the pad. Typically made with a blend of plastic, rayon, and cotton in a layered design, pads are designed in a variety of sizes and absorbancies. Users should dispose of a sanitary pad after a maximum of 8 hours to prevent infections, and ideally every 3–4 hours to stop odor formation from bacteria.
Less popular in the U.S. but used widely in other parts of the world are reusable pads, which are usually held in place by snaps in the underwear. They are made from a variety of natural or synthetic materials such as cloth, and can be washed, dried and re-used for around one year. However, many cloth pads can actually be used for several years, which is great for sustainability!
Pantyliners
External or internal? External
Disposable pantyliners are quite similar to disposable pads, but are often thinner and narrower, thus being less bulky and detectable to the wearer. They also generally do not come with wings due to this reason. Pantyliners are best used for light menstrual flow, menstrual discharge, or daily vaginal discharge to prevent underwear staining. Nevertheless, they must still be changed frequently to minimize risks of infection or irritation.
Reusable cloth pantyliners are also available, and secured to underwear with snaps. Both disposable and reusable pantyliners come in a variety of sizes, materials, colors, and absorbencies.
Cloths
External or internal? External
Cloths can be worn in underwear or tied to the waist to absorb menstrual flow. Typically, menstrual cloths are made from fabrics such as cotton, and can be newly purchased or repurposed from clothing and other materials. For many low-income or under-resourced populations, cloth is the most accessible form of period product because fabric is cheap and available in most areas, and the cloth can be reused so repeat purchases are unnecessary. Generally, it is agreed that cloths should not be reused for longer than 1 year.
Tampons
External or internal? Internal
Tampons are absorbent cylindrical materials that are inserted into the vaginal canal, either with or without an applicator, to absorb menstrual flow. They expand with moisture to avoid leakage, and come in different sizes and materials. Removal is aided by a removal string. It is recommended that tampons are removed within 4–8 hours to avoid bacterial infections; in rare situations, such infections could develop into toxic shock syndrome (TSS). The U.S. Food & Drug Administration (FDA), which regulates tampons as medical devices, has additional information if you want to learn more.
Many menstruators use tampons since they are compact and secure inside the body, so people feel it less and can play sports more easily. While popular in countries such as the U.S., tampons are often unavailable in low-income countries. Even when accessible, many cultures inaccurately perceive tampons as inaccurately associated with tearing the hymen, a sign of lost virginity. Luckily, tampons have not been proven to cause endometriosis or tear the hymen.
Menstrual Products: More Options
Alternative options to pads, liners, and tampons are growing in popularity as menstruators seek products that better fit their lifestyles, bodies, and priorities. Whether someone is looking for a more sustainable choice or curious about trying a new innovation, there’s bound to be a fitting product.
Period Panties
External or internal? External
Period panties, popularized by the brand Thinx, can be worn during menstruation in place of normal panties, with or without a tampon. They are designed with an absorbent, layered crotch that can absorb several tampons’ worth of menstrual flow. The fabric is also tailored to minimize staining, leaking, and odors. Although the upfront costs are high—those who commit must invest in multiple pairs at $20–40 per pair, or prepare to do daily laundry while on their period—period panties are environmentally-friendly as they are reusable and waste-reducing. They can be worn for longer durations without risk of toxic shock syndrome, and some even claim to have less cramping.
Menstrual Cups
External or internal? Internal
Reusable menstrual cups, such as the DivaCup® and OrganiCup, are rising in popularity as a sustainable alternative to tampons. These bell-shaped devices are inserted into the vagina to create a seal; the cup can then collect menstrual flow to be emptied during removal. Menstrual cups are usually made of medical-grade silicone, rubber, or other non-absorbent and flexible materials that enable the cup to be comfortably inserted. They tend to come in at least two sizes, and different shapes are becoming more common. Depending on the size of the cup, it can hold the equivalent of three to six tampons’ worth of blood. Cups need to be emptied and washed every 6–12 hours; after each menstrual cycle, they must be boiled for 5–10 minutes.
Perhaps one of the greatest advantages of menstrual cups is that with proper care and washing, they can be used for up to 10 years. This makes them highly cost effective, and especially optimal during times such as the COVID-19 pandemic, when many people are stockpiling supplies and disposable menstrual products may be in low stock.
Also, due to the materials they are made from, cups do not dry out the vagina’s natural moisture as a tampon would. As an added benefit, many users say their cramps are more manageable when using a cup. Menstrual cups are not linked to TSS because they only collect blood and do not absorb it. They may not be suitable for people with heavy menstrual flow, but are generally easy to incorporate into one’s lifestyle.
Menstrual Disc
External or internal? Internal
One of the newest popular innovations on the period product market is the menstrual disc, popularized by The Flex Company’s FLEX™ Disc as well as Softdisc™. Commonly compared to a menstrual cup, the disc is also inserted into the vagina to collect menstrual flow instead of absorbing it. However, menstrual discs are designed for one-time use, in contrast to the reusable cup. The biggest advantage to menstrual discs is not shared by any other product: they can be left in during intercourse, enabling a mess-free experience for both partners even during menstruation. Additionally, because the disc sits at the base of the cervix and not inside the vaginal canal, it is least prone to slippage and thus optimal for people with an active lifestyle. The only downside is that they are not the most environmentally friendly and are relatively expensive.
Sea Sponge Tampons
External or internal? Internal
Sea sponge tampons are a natural alternative to synthetic tampons, and come in different sizes to absorb varying amounts of blood. Prior to insertion, sea sponges must be dampened and squeezed; they then expand with moisture to absorb menstrual flow. They should be rinsed out about every 3 hours and thoroughly cleaned at the end of each menstrual cycle. Although they are a completely natural, non-synthetic product, sea sponges still carry the same risks of toxic shock syndrome as normal tampons. One sea sponge lasts up to 6 months.
More Resources
- Planned Parenthood: “How do I use tampons, pads, period underwear, and menstrual cups?”
- UNICEF: Guide to Menstrual Hygiene Materials
- MADE SAFE: Tips for a Healthier Period & Planet
Ultimately, the menstrual product(s) one chooses to use comes down to personal preference. As innovation continues in the period product space, we will hopefully have an even more expansive variety to choose from. Moreover, companies are inventing high-tech tools to track and manage periods in novel ways.
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