Menstruation takes up five years of a woman's life. Well-chosen hygiene products will ensure that it will not be a time of discomfort
What is the best way to start a conversation about menstruation?
Start with mathematics. In the past, women started to menstruate at the age of 17 or 18, lived much shorter than modern women and gave birth to several or even up to a dozen children. Currently, the average woman has her first period at around the age of 12, and the average age of menopause is her 50th birthday. This means that she has her period for about 38 years. Children are also born less and less frequently than one hundred or two hundred years ago. And menstruation takes about one and a half thousand to two thousand days of life. That’s about five years.
Five years of living in pain, discomfort and embarrassment?
This may be caused by period poverty that too many women and girls still experience. The lack of appropriate hygiene products and money for them, the inability to maintain proper hygiene or reduce menstrual pain make menstruation a time when normal functioning is impossible. But it doesn’t have to be this way. Therefore, it is important to ensure that it is not a taboo subject and that problems are solved. So that menstruation is not a problem for any reason.
No more saying “this is women’s fate”, “we must suffer”?
Many of us have probably heard such words from our mum or grandma. But you really can deal with pain, heavy bleeding and PMS so that “this time” is not lost, or doesn’t lead to absences from school or work. The hygiene products that women have at their disposal also help with this.
Sanitary pads, tampons, menstrual cups. Various companies, sizes, types. How do you choose?
Taking into account your own needs, feelings, and anatomy. Different hygiene products will be needed by a person who spends their time quite statically compared to an athlete. For obvious reasons, a sanitary pad will not be a good solution for a swimmer. And a ballerina who is to perform on stage in a tight white outfit will need not only comfort, but also a unique feeling that she is properly secured. When choosing hygiene products, I would also suggest paying attention to the profusion of bleeding, often related to the day of the period, and adjusting the available products to the current needs. Anatomical conditions may be a limitation – there are women who cannot use tampons or menstrual cups because their structure would cause discomfort. Or when women suffer from pelvic pain syndromes, because there would be not only discomfort, but even suffering. There are also women who cannot use, for example, synthetic products because they cause an allergic reaction. For some women, those with very modest menstruation, tampons turn out to be a bad solution because their absorption is greater than required, and when applied, they can cause micro-injuries, irritation and pain. It is good to get to know the wider range of products, read pamphlets. A conversation with friends or a gynaecologist who can advise the best solution will also work. And, of course, trying the products out in practice. Because what is good for one woman may not suit another.
And can the composition of menstrual products have a negative impact on women’s health?
The vagina, thanks to the secretion of mucus and the constant exfoliation of the epithelium, naturally cleans itself of pathogens, secretions, and dead cells. Its surface is easily permeable. Some medications are intended for intravaginal use for a reason. From here, substances can easily enter the bloodstream, bypassing our treatment plant, i.e. the liver. There is a reason why we assume that harmful substances in menstrual products can also enter the blood through this route. The most controversial are tampons, which touch the delicate skin of the vagina with their entire surface. There have even been studies, e.g. in Sweden and France, which showed that undesirable substances contained in tampons may affect the endocrine or immune system, can damage the delicate epithelium, and irritation can increase the risk of sexually transmitted diseases.
There is no research that says the products are 100 percent safe. There are also no studies which would show that they are dangerous for women in case of long-term use. In order to determine the impact of the use of specific hygiene products on the reproductive system, comparative studies should be conducted over several decades in women who have decided on different solutions. It can be assumed that the negative impact of the use of menstrual products is no greater than the consumption of carbonated drinks or the use of plastic food packaging. Admittedly, a woman may use an average of 10,000 tampons in a lifetime, but how many products with artificial dyes will she eat throughout her life, how many gulps of polluted air will she take? I do not want to downplay this, but I am convinced that worrying about harmful substances in menstrual products should not keep us awake at night.
What about the toxic shock syndrome?
This is the body’s reaction to the toxins produced by staphylococci and streptococci. A dangerous complication, because it has a high mortality rate. Fortunately, it happens very rarely, affecting one person in a hundred thousand. It is associated with the use of tampons, because at the time when they were widely used in the 1980s, significantly more cases of this type were described in the literature in connection with the use of tampons. But it can also appear in puerperium, after gynaecological procedures or skin damage, or even after an insect bite. Most people are resistant to the effects of toxins or develop it with age. It is impossible to predict who will develop the syndrome, so it is worth paying attention to disturbing symptoms – sudden headache, abdominal pain, weakness, shortness of breath. It is also advisable, when using tampons, to choose those with the lowest possible absorbency and those made of natural rather than synthetic fibres, and to replace them regularly.
I have read product leaflets and have always wondered why more absorbent tampons are more dangerous.
They are not. But the less absorbent ones need to be replaced more often. Together with them, we remove toxins that can cause an undesirable reaction.
Can we all use menstrual cups? And how do we choose the safest one?
Most often I hear questions about whether it can be used by women who have not given birth and girls who have not had intercourse. There are no contraindications. Sometimes, however, as with tampons, women are reluctant to applying them or feel discomfort. Let me tell you that there are many offers on the market, from the cheaper ones, for about PLN 40, to the more expensive ones – for PLN 150. They differ slightly in shape, size and capacity. They are stiffer or more flexible. It is worth trying to choose something for yourself. If the cup fits well, it does not cause any discomfort.
But a woman using it may feel eco-friendly.
It is estimated that a woman produces 130 kilograms of postmenstrual garbage in a lifetime. Considering how many of us are in the world, this is quite a burden. One cup can serve us even for ten years. To avoid infection, remember to wash your hands also before, not just after application. It is convenient because once worn, it can be replaced even every eight hours, depending on the needs of a given woman.
What do you think about the latest convenience – menstrual underwear?
This is a solution similar to reusable sanitary pads. It will not suit ladies who do not accept their washing and drying, the sight of blood. Menstrual underwear is an environmentally-friendly and convenient idea. Such underwear is sewn a bit like cycling shorts – with an absorbent sponge-like filling, most often made of natural fibres. Menstrual underwear is changed four times a day, so you need to take into account that you need to have conditions to change and an adequate supply. This type of protection is comfortable – the absorbent insert will remain in place also during physical activity – it allows you to avoid shifting or rolling up as in the case of sanitary pads.
Maintaining hygiene during menstruation is a matter of great importance for women. For some, menstruation is even associated with cleansing the body, i.e. getting rid of something dirty.
It is quite the opposite! The menstrual cycle is a natural process that gives a woman the opportunity to get pregnant and stay healthy. It’s physiology and beauty, not a reason to be embarrassed. Of course, hygiene is especially important during your period. Adequate hygiene products help a lot in this. And I wanted – with all conviction – to encourage women not to overdo it with this care of hygiene. We tend to mask the smell at all costs. The smell of a woman and her body changes depending on age, health, what we eat and what medications we take. Knowing our bodies and their smells, we can notice disturbing symptoms in time. The metallic smell of menstrual blood – the smell of haemoglobin and iron – is not unpleasant. And despite the fears of women, while maintaining proper hygiene, it is imperceptible to other people.
Proper, meaning?
Water or water with a mild cleaning agent is enough. Many women use irrigation to feel fresh. But it is neither healthy nor good, because we get rid of the physiological secretions and we can disrupt the beneficial microflora of the intimate areas. There are perfumed pads and tampons on the market, but I don’t recommend them. They contain additional chemical ingredients that can irritate. The same applies to perfumed wet wipes, also those intended for babies. I urge my patients to use such products only in an emergency. It is worth making friends with your body and not trying to interfere too much.
And what hygiene products would you recommend to young girls who have just started menstruating?
They can use various types of sanitary pads as well as tampons, menstrual cups or menstrual underwear. The easiest to use are pads or underwear. They also have an important advantage – they allow a teenager to get to know their body, see which days are marked with more or less profuse bleeding. For the youngest users of tampons, the ones with an applicator are a good solution – they are easier to use. It seems to me that the first period is the time for an important and good conversation with a girl. About how to take care of herself, about changes in the body. But also – about setting limits, about listening to her needs. About physiology, but also about respect and sympathy for your body. It’s good to show from the very beginning that this is not a taboo subject. This conversation may be conducted by their mother, an older sister, or another close person. But it is also worth offering the teenager a visit to a specialist, because it’s easier to pose some questions to a gynaecologist or midwife. This is the time to tell a young woman that menstruation is nothing to be ashamed of, but a reason to feel pride. “You are menstruating, it means you are healthy. It’s natural and beautiful. Everything is fine with you!” We should keep this in mind also in adulthood.
Agnieszka Urazińska talks to Hanna Szweda, MD
Ilustration: Marta Frej
- Hanna Szweda, MD - gynaecologist, academic lecturer at the Faculty of Medicine and Health Sciences, A. Frycz Modrzewski Krakow University
Text published at wysokieobcasy.pl on 13 February 2021
