This article was reviewed by Dr. Connie Olson MD 2021/08.
Questions about your period that you are too afraid to ask
Let's get one thing out of the way:
The belief in many cultures, that menstruation (or menstrual blood specifically) is dirty and unhygienic, is utter cretinism. Especially nowadays, since we have developed many different methods and products to deal with our menstrual cycle! Recent years have brought a spike in research on menstrual cycles and women's health in general since women have become more aware of the effects of birth control, food, and overall lifestyle on their bodies. There is more than one way for you to make it as comfortable as possible.
We know you have things you’ve just gotta know but would never dare to ask. Here’s an assortment of the most important (and embarrassing!) menstruation questions, answered.First and foremost:
What happens during the menstrual cycle?
Answering this question can help you with many other questions that you might have down the road! It is alarming how long women have been expected to just take severe pain, irregular periods, premenstrual syndrome (PMS), and other emotional and physical symptoms as "normal". It is not.
That doesn't mean these symptoms are not fixable. In fact, they are preventable even. The first step is to understand the cycle itself and what hormones do.
Here are the facts:
- The average menstrual cycle lasts 28 days.
- The first period usually occurs between the ages of 11 and 15.
- The cycle starts at the first bleeding day of the menstruation (a couple of days give and take are normal).
- The last menstrual period happens when women reach menopause in their late 40s to their mid-50s. The average age nowadays is 51.
- Menstrual cycles are controlled by glands and the hormones they produce.
- Important Menstrual Cycle Hormones are:
- Estrogen: female sex hormone that is responsible for growing the lining of the uterus and maturing the egg before ovulation. Estrogen levels peak during the follicular phase (the first half of the cycle).
- Progesterone: also called the relaxing hormone as it balances the effects of Estrogen. it is produced after ovulation during the Luteal Phase (second half of the cycle). In the case of pregnancy, it helps to maintain the uterine lining. If no pregnancy occurs, the Progesterone level falls again and the shedding of the lining of the uterus begins, thus: menstruation.
- Testosterone: While males have much higher levels of testosterone (ten times as high as females), it still is important to the female cycle. Its levels rise a bit during ovulation and experience a slight but steady rise before menstruation. Why are the levels higher during ovulation? It raises sex drive and helps to maintain strength in your body.
There are two other hormones important to the menstrual cycle:
- Follicle Stimulating Hormone (FSH): This hormone stimulates the ovarian follicles to mature.
- Luteinizing Hormone (LH): this hormone is released during ovulation and helps the ovaries to release the egg.
By the way, men do have a hormone cycle as well. But it's a 24-hour cycle and is almost entirely governed by the ebbs and flows of their Testosterone levels. In addition to that, a man's hormone levels are not at all as predictable as a woman's. Testerone usually peaks in the morning and ebbs in the evening BUT also rises when watching an action movie, drinking coffee or alcohol, or simply seeing an attractive person, making for a surge in energy, competitiveness, and temperament. This means mood swings are a daily occurrence for men, whereas women tend to have a steady mood level - sometimes it's just a particularly (but predictable) bad one.
Why am I tired during my period?
As you were able to see in the diagram above, the menstrual cycle is governed by hormones. The fall of the hormone Estrogen leads to a decline in energy. This occurs during ovulation and then again when the menstrual period begins.
Heavier menstrual flow also takes a lot of energy and can lead to fatigue even during normal menstruation. Unfortunately, this is considered normal.
All in all, you can factor in two phases of slight fatigue during your monthly hormonal cycle. However, if you experience extreme fatigue and struggle to execute routine activities, you should talk to your doctor about the symptoms. It could point to other issues like an underactive thyroid or anaemia.
I missed my period. Am I pregnant?
Whoa – huge question! If you have missed one period and think you might be pregnant, don’t panic (or celebrate) immediately. It’s a reasonable thing to think, but periods can also be missed because of infection, nutritional changes, travel, and stress. If you take a pregnancy test and it comes out negative, you’d be wise to see your doctor just to make sure nothing is wrong. If your periods tend to not be similar/regular, medical attention might be in order. Reasons for irregular periods can also be low body weight, extreme sport, and even your diet in general. Have your doctor take a look either way!
Is the pill bad for your body?
Most birth control pills contain Estrogen and Progesterone to prevent ovulation. Remember the diagram? Estrogen and Progesterone need to fall to allow for ovulation and the menstrual period to start. The pill keeps those levels steady thus preventing a natural menstrual cycle. Any sperm that enters will have a hard time finding an egg. However, there is still a slight chance of getting pregnant if you and your partner do not use a condom!
You take breaks from taking the pill to initiate the shedding of the uterine lining, and the menstruation begins. Some pills prevent even that. Those pills are taken every day without breaks.
Any pill can have side effects on your body. These include:
- irregular periods (more common with the mini-pill)
- nausea, headaches, dizziness
- tender breasts
- mood swings
- blood clots due to increased blood pressure (very rare)
But side effects can also be good:
- less cramping
- lighter periods
- improves acne
- levels emotions
In the end, birth control pills mess with your natural hormone cycle, and you have to decide whether you want that or not. Talk to your doctor about it, and ask them about alternatives as well. There's always a way!
Is it safe to have unprotected sex during my period?
If you don’t want to get pregnant, the answer is NO - your period is not automatically a “safe” time to have sex. Cycles can and do vary. If you happen to ovulate a little early, you can get pregnant, even during your period. For example, let’s say you have unprotected sex on day 4, then you ovulate on day 6. There is a small, but still significant, chance the spermes could reach an egg because sperm can stay alive for up to five days in your reproductive tract.
What happens when your period suddenly stops?
If you are referring to your period not starting after another month, that could mean that you are pregnant. A test might be in order. But there are other factors that can disrupt your normal menstrual cycle. Significant weight loss or excessive exercise for example. Either way, call your doctor if you can't make out a reason or your period stays away for another month!
You should watch out for Polycystic ovary syndrome (PCOS) as well. Small cysts, elevated Testosterone levels, acne, and hair growth can be a sign to look out for.
What causes abnormal bleeding?
Sometimes abnormal bleeding, meaning bleeding in between periods can occur in the first three months of using hormonal contraceptives such as the pill, an implant, or a patch.
If this keeps on happening after a few months, seek medical attention.
Keep in mind that this can also happen if you've been on the pill for a while. Think, have you had diarrhea, or have you been sick (throwing up)? That can prevent the pill from working, and disrupts your cycle which sometimes leads to bleeding between periods.
Have I miscarried without knowing?
Unfortunately, it’s entirely possible for someone fertile and sexually active to get pregnant without realizing it. So yes, periods might actually be miscarriages in some cases, especially if for someone who is usually very regular but who menstruated at an unexpected time. If you’re concerned about this, familiarize yourself with the symptoms of a miscarriage and definitely contact your doctor if you think you might be experiencing one.
Why do I poop more during menstruation?
You probably find you need to “go” a lot more when you’re on your period. Why is this? Substances called prostaglandins, which cause your smooth muscle to relax as you’re getting ready to shed your uterine lining, increase during your period. They aid your body in eliminating excess poop to clear the way for a baby’s potential emergence into the birth canal. The more prostaglandins you produce, the more often and urgently you will need to poop. Like you’d expect, fewer prostaglandins could cause constipation.
Important: If you notice that your poop is slimy during menstruation, this could mean something serious is going on with your period or with your gut. Be sure to let your doctor know.
Can orgasms ease the pain from cramps?
Yes…yes…YES! Orgasms do help relieve cramps! The production of a hormone called oxytocin increases during The Big O. Made in the brain’s hypothalamus region, this other “Big O” is considered to be nature’s answer to pain pills. Oxytocin has also been dubbed the "cuddling hormone" because it just makes one feel closer to their partner. So, treating yourself to some extra affection during menstrual periods could make them less painful and more enjoyable. Don't have a partner? Did you know, hugging a plushie triggers the same effect in your body? Try it!
Also, prostaglandins (mentioned above) can offer some welcome cramp relief, because your body experiences an involuntary muscle spasm when you orgasm. This inspires your uterus’s muscular layer to slough off the endometrial lining, giving you a temporary but blissful reprieve from period pain.
How worried should I actually be about Toxic Shock Syndrome (TSS)?
The stories you’ve heard about people needing to be hospitalized after going to bed with a forgotten tampon inside aren’t just urban myths. TSS is a real, potentially fatal infection. Happily, though, it occurs a lot less often since public warnings first started being issued decades ago. In fact, for those who remove high-absorption tampons and don’t leave them in overnight, incidences have grown shockingly low: about 1 to 3 per 100,000 tampon users yearly.
IMPORTANT FYI: Although it’s pretty unlikely you’ll ever get TSS, here are the symptoms:
- High fever
- Low blood pressure
- Low energy
ACT IMMEDIATELY if you experience these because they can progress extremely quickly to stupor, coma, and multiple organ failure. If you even think you might have TSS, get medical attention without delay.
Why do I want more sex during my period?
It could have to do with the production of the primary sex hormone, estradiol, and progesterone, which helps regulate your menstrual cycle and peaks toward the beginning of menstruation.
When you’re menstruating, your estrogen level is at its lowest, but you have high “T” – testosterone. This hormone is strongly linked to sex drive in females, who get an extra shot of T during ovulation (aka “mid-cycle”). Basically, it’s just your mom nagging - Mother Nature, that is - giving you a heads up that it’s a great time to make a baby.
How do I deal with the mess of period sex?
Vaginal intercourse during menstruation is maybe not the tidiest of experiences. In fact, it can be downright icky for a fastidiously clean person. If it grosses you out but you still want to try, tools you can try to make it less of a mess include a diaphragm, a cervical cap, or a flexible catchment like the Softcup, which surrounds your cervix up inside of you, out of the way of the action.
Or if you don’t want to mess with anything invasive to curb your menstrual flow, just do what you’ve probably already been doing: lay dark towels over your sheets and wash them by themselves afterward. Or have sex in the shower. Win-Win.
Why am I moody during my period? Is it PMS, and what is that, anyway?
PMS is a blanket term for a number of different, but related period symptoms. If you’ve ever been overcome by sadness, anxiety, despair, anger, heightened emotional sensitivity, and mood swings, bloating, breast tenderness, headaches, severe pain, and low energy before and during menstruation (but not all at once, we hope!), you KNOW what we’re talkin’ ‘bout!
Moodiness is more common during the luteal phase (i.e., the time between ovulation and bleeding) when you have more progesterone sloshing around in you. While this state of emotional overdrive is annoying and unwelcome, it’s also normal. The hormone fest that’s going on in your body during your period can affect neurotransmitters in your brain, which tends to trigger more emotional PMS symptoms. Then testosterone rises on top of that and triggers areas in your brain that make you more competitive, irritatable, and prone to anger.
Vitamin and mineral deficiencies might also occur during your menstrual cycle. These can make you feel kind of off, so be sure to pay attention to what you eat so you can feel your best (or at least not any worse).
These foods help you prevent and fight PMS:
- Fruits and vegetables: You need nutrients and plenty of that! Iron, Vitamin B from green leafy foods!
- Calcium and Vitamin D: Yogurts, Salmon, Low-Fat Cheese!
- Go nuts!: walnuts, almonds, pine nuts, you name them! Get your omega-3 fatty acids.
- Complex Carbs: you need to get your cravings under control? Try sweet potatoes, lentils, and oats.
- Limit Alcohol and Caffeine: less is more before your period. It helps you sleep and that in turn helps with PMS.
If changing your diet does not work, please seek out a doctor!
I don’t know which product I should use - help!
The bad news is that your period is just something you will have to deal with every month. But the good news is, there are more products to help you slay it than ever before in recorded history (no hiding out in a tent until it passes anymore). If you don’t know everything that might be available, check these out:
- Reusable pads can help you cut both waste and expense. You need to buy them less frequently, and for the Greta Thunberg-likeminded, you won’t have to feel guilty, because you didn’t generate the planet-destroying plastic waste of traditional pads. Plus, users generally say they’re more comfortable than traditional pads - nontoxic, too.
- Menstrual cups...aka the punchline to, “What really sucks and fits inside your vagina?” (Thanks, we’ll be performing here all week!) Believe it or not, this newer and very popular choice has actually been around since the 1930s (although not in its current form, obvs!). Flexible and discreet, a menstrual cup is a device that stays stuck inside you by means of suction and that can catch your blood for up to 12 hours.
- Period panties. These are exactly what they sound like - underwear designed to catch your monthly flow. The verdict from many triers is, these things are all-around awesome and really do work.
- Traditional products like tampons and standard pads are still around everywhere, although they’re not as popular anymore thanks to the newer choices. If you go this route, be sure to opt for the most eco-friendly varieties possible (like tampons with paper applicators, not plastic).
Heavy menstrual flow! Is it anything to worry about?
If you’ve ever held your breath and silently panicked when you felt what seemed like a huge surge of blood gushing out on a heavy flow day, you might wonder how your menstruation compares to “normal.” Here’s an answer:
The average woman loses eight to 14 teaspoons of blood over the span of her period, or roughly 2 1/2 teaspoons a day. Two to four regular absorbency tampons or two to three super absorbency tampons can catch this.
This is only an average, so you’ll need to observe what your own body tends to do over time. A light flow day for you could be a heavy one for someone else or the other way around.
IMPORTANT: If your flow ever changes dramatically from normal (either heavier or lighter), see a doctor. This change, along with symptoms of lightheadedness, dizziness, lethargy, or excruciating cramps with severe blood loss, could signal something concerning like a hormone imbalance, fibroids, cysts, or something harder to pinpoint, like endometriosis.
That said, such symptoms could also be nothing to worry about. Your body goes through all sorts of hormonal rises and dips in life. How much menstrual blood you lose can change around menopause, after a pregnancy, or simply as a part of getting older. Don’t try to Google and guess, though - get it checked out by a doctor.
Something’s not right this month - what should I do?
If something seems weird or wrong about your period like there’s abnormal spotting or clotting, it feels too long, or you didn’t get it at all - whatever might be bothering you - never hesitate to tell your doctor. Call and make an appointment ASAP.
If you do know what you normally experience but it changes significantly, pay attention to what your body is telling you and let your doctor know.
Hopefully, you learned some things in this article that you needed to know about your period but were afraid to ask! If you need more information, ask an adult you trust, or best of all, your doctor. You might feel embarrassed, but trust us, your doc has seen it ALL and then some. Above all, take care of YOU!