Sexual Anatomy, Reproduction, and the Menstrual Cycle

What Do We Do with Our Menstrual Flow?

Menstrual Periods

Women’s menstrual cycles vary widely. Counting from the first day of one period to the first day of the next, most cycles last between twenty-three and thirty-six days. For teens the variation can be even broader, from twenty-one to forty-five days. Often we think of periods as occurring once per month (in fact, the word “menstruation” is from the Latin word mensis, for “month”). While some women have periods that do occur exactly every month, other women have cycles that are longer or shorter. Some women have consistently regular cycles (bleeding every twenty-eight or thirty-five days, for instance), while other women’s cycles vary in length from one cycle to the next. Hormonal contraceptives or breastfeeding may alter the length of our cycles or even stop them altogether. After we have been pregnant—whether we have an abortion, a miscarriage, or give birth—our cycles may change.

Most women’s periods last between two and eight days, with four to six days being the average. The flow stops and starts, though this is not always noticeable.

Menstrual Fluid

The fluid that flows from the vagina during the menstrual period includes much of the uterine lining that has built up during that cycle. In addition to blood (sometimes clotted) and endometrial cells, menstrual fluid contains cervical fluid and vaginal secretions. This mixed content is not obvious, since the blood colors the fluid red or brown. A usual discharge for a menstrual period is about two to five tablespoons, though it often looks like more. 

What to Do with the Menstrual Flow

Across time and cultures, women have used and continue to use a variety of products for catching menstrual flow. The choice often comes down to comfort, availability, convenience, and price. You might find the perfect match right away, or you might try different options, looking for more comfort or a better fit.

TAMPONS AND PADS

Many women use commercial tampons or pads (also called sanitary napkins) to catch menstrual blood. These are the products most easily available. Whether you use a product worn outside your body (such as a pad) or a product worn inside your body (such as a tampon) is a personal choice.

Common Questions About Tampons

Will a tampon get lost inside me? No, absolutely not. The vagina is a closed space, and the opening of the cervix is far too small for the tampon to get inside. It is true, though, that a tampon can be forgotten and may slip into a vaginal fold, becoming difficult to find and remove. This can result in a strong odor and brown discharge after a few days. If you have trouble finding the string, you can squat down and reach the tampon with your fingers. For a funny and informative video about this, see “The Lost Tampon” at docgurley.com.

Will tampons make me sick? No. You may have heard that tampons cause toxic shock syndrome (TSS). TSS is a serious but rare condition caused by bacteria. Keeping tampons in longer than eight hours can increase the risk of TSS. If used according to the directions on the package and changed regularly, though, tampons are safe.

If I use a tampon, does that affect my virginity? No again. Virginity generally refers to whether or not someone has had sexual intercourse, not to menstruation or tampons. Tampon use may be one of the factors that play a role in the disintegration of your hymen, but whether you have a visible hymen says nothing about whether you have had sex. For more information on hymens and virginity, see p. 7 and “Virginity,” p. 141.

MORE OPTIONS

For many reasons, including comfort, environmental concerns such as a preference for reusable products, and worries about chemical residues, many of us use modified or alternative products to collect menstrual blood. These include all-cotton (sometimes organic) chlorine-free tampons, chlorine-free disposable pads, washable cloth pads, and devices that collect rather than absorb the menstrual fluid. All-cotton and all-organic cotton, chlorine-free tampons are often sold in health food stores and online, and increasingly at some drug and grocery stores. Also, you can make your own cloth pads. There are make-your-own sites online, showing very economical alternatives.

Some women use natural sea sponges that work like tampons. These are also available in health food stores and online. They are reusable and relatively inexpensive. Unfortunately, many pollutants are dumped into oceans and it’s possible that sponges may absorb some of these pollutants and cause problems. Therefore, some users boil a sponge for five to ten minutes before using it for the first time and between uses. Doing so, however, shrinks and toughens the sponge and reduces its lifetime.

Some women prefer products that collect rather than absorb the menstrual fluid. The Keeper, the DivaCup, and the Mooncup are three examples of menstrual cups—elongated cups made of rubber or medical-grade silicone that are held in place by suction in the vagina. They can be worn during swimming and other physical activities but not during intercourse or other insertive sex. Some women use a diaphragm or a cervical cap in the same way as a cup. A disposable device called Instead is worn in the upper vagina to collect menstrual flow. The rim softens in response to body temperature and creates a seal to protect against leakage and slipping. (For more information on these products, see www.youngwomenshealth.org/alternative_menstrual.html.)