What happens during menstruation (a period) and does it hurt? What products should I use during my period?

The development of a menstrual cycle is part of puberty for people with vaginas. This cycle prepares a person’s body for pregnancy each month; if no pregnancy occurs during that cycle then hormones signal the body to end the cycle. When the cycle ends, blood and other nutrients that have lined the uterus are released from the vaginal opening. This is called a period.

For each menstrual cycle (which lasts about 28 days but can vary widely), an egg (ovum) matures and is released from one of a person’s two ovaries. The egg travels from the ovary, through a uterine tube (each ovary has a uterine tube) toward a person’s uterus. As the egg travels, it sends hormonal signals to the body, telling it to develop a thick lining of blood and tissue inside the uterus. The job of this lining is to help the egg attach to her uterus, should it meet up with a sperm and become fertilized. If this happens, the fertilized egg latches onto the thick lining of tissue and blood, and a pregnancy begins.

While a cycle can last about 28 days, each person’s cycle is different. A person’s period can come anywhere from every 21 days to every 34 days. When a person first starts getting their period, it might skip a month or a person’s period may start earlier or later than they thought it would come. This is a normal part of growing into an adult. Eventually, a person’s menstrual cycle will stabilize, and it will be easier to know when to expect a period.

At the end of the menstrual cycle, when a person has their menstrual flow or period, the uterus contracts to help push the blood and tissue from the body. These contractions can cause menstrual cramps. They can be uncomfortable, but they don’t happen for everyone. Cramps can be eased by taking over-the-counter medications, like acetaminophen or ibuprofen, which are available in drugstores and supermarkets. Stretching, sitting in a warm bath or using a heating pad on the abdomen or lower back can also help ease menstrual cramps. Exercise and eating healthy, especially before the period starts, can also help. It’s uncommon for cramps to be so bad that a person has to spend the day in bed, but if that were to happen, a person could visit a doctor to find out what’s going on.

Premenstrual Syndrome (PMS)

Some people feel cranky, tired, moody, bloated, achy and irritable the week before their period begins. This is called premenstrual syndrome (PMS). This happens because hormone changes in the body can affect all sorts of things, including mood, water retention and the sleep cycle. Some people have little to no PMS. Others have a tough time functioning when it happens. If your PMS is very bad, talk to your health care provider about how you can manage it.

Sanitary Pads and Tampons

The most common menstrual products are sanitary pads or tampons, which are both available in drugstores and supermarkets.

• Pads come in a lot of different shapes and sizes—maxi pads for heavy days, thin pads for light ones, pads for overnight and pads that are longer. They have sticky stuff (adhesive) on one side so they stick to your underwear. The other side is an absorbent material, sometimes covered by a thin mesh to help keep your skin dry.
• Tampons also come in various sizes—like regular or super—and are designed for different flows. They’re inserted into the vagina and can be a good choice if you’re going swimming, have a longer period of time where you can’t use a bathroom or just don’t want to wear a pad.

Tampons must be changed every four to six hours to prevent the possibility of an illness called toxic shock syndrome (TSS). Wearing tampons (especially wearing the super absorbent kind when your flow is normal) for a long time can trap bacteria inside your vagina and can cause TSS. TSS symptoms include fever, nausea, vomiting, severe diarrhea, headache, dizziness, sore throat and a rash or peeling skin on your hands and feet. It is rare and can be treated with antibiotics if caught early enough.

Menstrual Cups and Sponges

Menstrual cups are inserted deep into the vagina and cover the cervix (the bottom end of the uterus) or sit in the lower vagina. Menstrual blood collects in the cup, which can be worn up to 12 hours. When the cup needs to be changed, it’s removed, washed and reinserted or replaced with a new one. Menstrual cups are sold under a variety of brand names, including Instead, the Diva Cup or The Keeper.

Menstrual sponges or sea sponge tampons are made of natural sea sponge and are also inserted deep into the vagina, covering the cervix. Because they’re sponges, they’re very absorbent and can be changed less often than a tampon or pad. They can even be rinsed out and re-inserted.

Menstrual cups and sponges are much less commonly used than other methods and may take a little practice, just like any other method that’s new to someone. Menstrual cups and sponges are also considered more environmentally friendly because they can be reused so there’s no waste.

Menstrual Underwear

Menstrual underwear is absorbent underwear that a person can wear during their period. The underwear is made with layers of material that absorb menstrual blood and prevent leaks. Some styles can absorb up to two tampons-worth of menstrual flow.

Scented Menstrual Products and Douching

It’s a good idea to avoid scented menstrual products because they can irritate the vulva and the vagina and just aren’t necessary. It’s also good to avoid douching, vaginal powders and sprays (both during your period and afterward) because they can also irritate the vulva and vagina. A period and natural vaginal fluids are perfect vaginal cleansers!