Let's Talk About: Menstruation
I want to talk to you about menstruation. Getting your period. Surfing the crimson wave. Having a visit from Aunt Flow. Shark Week. It is also one of the most defining and uniting characteristics of the female body. Periods are the worst. I’ve never met a female who didn’t kind of hate (or really hate) getting her period. It’s something we can pretty much all agree on. For some it is an absolutely debilitating condition that renders them unable to function for days at a time each month. It also unites us, there are few instances in this life where women will come together to help each other more swiftly than when a woman finds herself tampon-less in a public restroom and needs to ask for help from a stranger. We should all be believers in tampon karma.
Unfortunately, from the time that we hit puberty and get our first period (“Menarche”) until the time that we hit menopause, it’s a simple fact of life. Now, there are plenty of women who don’t get periods, either for anatomical reasons, hormonal reasons, or because they’re on a form of birth control that prevents menstruation. And not everyone who menstruates identifies as a woman. However for most females this cycle is one we’re all too familiar with. So why is it that people refuse to talk about it? If women spend close to ¼ of their time from puberty to menopause bleeding from their vaginas then WHY do we not hear more about it? Why do so many people who don’t menstruate (usually men) seem to be under the impression that menstruation is something we make up or something we can control?
Because our education system has deeply let people down when it comes to the female body.
Let me break it down for you.
For the sake of argument we’re going to use the 28 day cycle. Most females do not have a 28 day cycle, and lots of people have cycles that vary in length. If you have a uterus it’s important to get to know your own cycle, that way you’ll know if something unusual is going on.
Day 1- The first day of your period is day 1 of your cycle. This also when you start counting for how pregnant a person is, even though getting your period is one of the sure fire ways to determine that one is not pregnant. The menstrual flow is the shedding of the thick lining of the uterus (endometrium), which forms each month in preparation for implantation of a fertilized egg. It’s worth mentioning for anyone who has not menstruated, during this week we females basically expel an organ from our bodies then spend the rest of the month making a new one. This is the beginning of what we sometimes affectionately refer to as “Shark Week”.
Day 2-5- Menstruation continues. Women make peace with the void. Men flee in terror.
Day 7- The bleeding has stopped. Follicles begin to form on the ovaries, these are fluid filled pockets that each contain an egg.
Day 7-14- The lining of the uterus begins to thicken once more. The egg in the follicle begins to ripen.
Day 14- Ovulation occurs. The follicle bursts open, sending the egg into the fallopian tubes. Some females can feel ovulation occur, with a sharp pain on one side or the other that slowly fades. Over the next few days the egg will travel down the fallopian tube and, if intercourse with an unprotected penis has occurred, may meet a sperm and combine. If there is no sperm, the egg simply travels down the tube. The time frame between ovulation and the start of the next menstrual cycle is called the “Luteal phase”
Day 25- If the egg meets sperm hormones will be released that tell the uterine lining to continue to thicken. If not hormone levels begin to drop. This is the cause of PMS symptoms. Hormone levels drop until…
Day 28/ Day 1: The first day of your period… again.
Of course, like everything else when it comes to human sexuality, there’s a lot more to it than just that.
The human body is a complicated dance between various chemical and electrical signals that control everything from physical actions to mood to body cycles. The system of pumps and factories for the chemical signals in the body is called the endocrine system. I do not have the knowledge or time to really get into the nitty gritty of the endocrine system. If you are interested, and a you are a giant nerd about human anatomy like I am, I recommend reading up on it. It’s fascinating. For the sake of this post what you need to know is that the endocrine system is involved in the entire body and different hormones control many different things. There is also overlap and interplay between them. We’re basically all great big bags of hormone soup all the time.
The hormones directly involved in the regulation of the menstrual cycle are:
Estrogen is often thought of as the most female of all hormones. Unique to women right? Wrong. Both males and females have estrogen in their bodies. In females it is produced primarily by the ovaries, in males and females it is produced by the adrenal glands as well as by fat tissue. Estrogen kicks off puberty in females, starting the menstrual cycle as well as the development of secondary sex characteristics such as breasts and the growth of pubic and underarm hair. Estrogen serves many functions, such as controlling cholesterol and protecting bones, but specifically it is Estrogen’s job to build the thick fluffy endometrial layer and get everything ready for implantation of a fertilized egg.
Progesterone is another major player in the menstrual cycle. It controls when menstruation actually occurs. So estrogen is signaling the endometrial layer to grow grow grow, when ovulation occurs a new, temporary gland is formed from the sack that expelled the egg called the “Corpus Luteum”. This produces progesterone, which tells the lining to get ready to be implanted. It also prevents the uterine contractions from occurring, so that the lining isn’t shed and prevents further ovulation. If implantation does not happen the corpus luteum breaks down and progesterone drops and menstruation occurs.
Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) also play roles in ovulation. FSH makes the follicle grow and mature and then LH causes it to rupture and let loose the egg. Both hormones are produced by the Pituitary gland in the brain.
Testosterone is often thought of as the most male of all hormones, but of course females have it too. It has a lot of functions in the body, but often sees a spike around ovulation. This is thought to coincide with an increase in sexual desire and energy during ovulation (Which then encourages the female to go out and have sex and get pregnant).
Some people have different levels of different hormones, and the interplay with these hormones and the rest of their bodies varies wildly, which can cause a variety of symptoms. This is why everyone’s menstrual cycle is a little different and why everyone has different reactions to their menstrual cycle. Everyone has different secondary symptoms that go along with getting their periods. Some females get PMS that makes them tired, headachey, bloated, hungry, exhausted and/or unable to sleep. Some people have sore breasts, muscle aches, migraines, or acne breakouts. Changes in mood such as depression and anxiety are very common. In people who struggle with mental health issues the menstrual cycle can bring a whole host of different problems to the table. Not to mention the painful cramping, and all the blood.
If your periods are extremely painful, unmanageable, or debilitating please go see a doctor. The pain is real, but it shouldn’t stop you from living your life, if it does please go get treatment. And if your doctor doesn’t believe you, or tries to brush off your problems, find a new doctor.
If you are a person who hasn’t had a period, it’s important to remember that it can be an extremely difficult time for people who do get a period. Showing some kindness and understanding can go a long way. Also remember that we can’t control our periods, they come when they come.
Luckily for those of us who do menstruate there is a whole world of options out there for us to explore in terms of managing the large quantity of blood that we have to deal with on a monthly basis.
Most people reading this are familiar with the basics of pads and tampons.
There are other options out there, if you have a monthly blood flow to manage and are unsatisfied with pads and tampons I recommend trying reusable pads, the Soft cup (disposable menstrual cup, I buy them at CVS) or a reusable menstrual cup (Diva Cup and Luna Cup are two popular brands). I’ve heard a lot of people who try them really love them. Though I've never tried a reusable menstrual cup, I do really like the disposable menstrual cup for occasional wear. They're just too expensive for every day protection in my book but I do really like them. If you're not happy with your current method of period management try something new!
One last note before we finish up for this week. Can I give a giant WHAT THE FUCK to the tampon tax? In many states (40 to be exact) necessary medical supplies are exempt from sales tax, in those same states menstrual products (pads, tampons etc..) are not exempt. Why? Because for some reason people seem to think that feminine hygiene products aren’t necessary. And while it may be true that one can survive without them, one certainly can not function in society without them.
In fact there are places in the world where women don’t have access to sanitary napkins or tampons and often can’t go to school or function simply because they have no means of absorbing the blood from their periods. Many homeless women in American cities have no access to feminine hygiene products.
So let’s all get on the same page here.
Menstruation is real and a fact of life for most female bodied people.
Menstruation can be extremely painful.
Feminine hygiene products are absolutely necessary for menstruating people to be able to function.
Next week we’ll be talking about Sexual Health and the Aging process!
Stay safe out there
-Erin
For more reading on the menstrual cycle and female hormonal stuff I reccomend "Taking Charge of Your Fertility" by Toni Weshler.
Websites I visited for specific information about hormones:
http://womeninbalance.org/about-hormone-imbalance/
http://www.hormone.org/diseases-and-conditions/womens-health/what-is-estrogen
http://www.hormone.org/hormones-and-health/what-do-hormones-do/progesterone