From puberty until the menopause women have a period each month if an embryo has not implanted. There are many reasons for periods not appearing in normal women, the commonest of which by far is pregnancy, but others include an emotional shock, physical or mental
ill-health, a change of time zones, a woman’s fear that she might be pregnant and all kinds of stress.
Periods can vary greatly in their duration and in the heaviness of the blood loss. Normal periods can last for anything from two to eight days and the amount of blood loss is usually between five and six tablespoons. It seems a lot more because blood spreads over surfaces easily. If you ever have bleeding between your periods, see your doctor.
One of the earliest practical considerations is sanitary protection. Sanitary towels or tampons have to be used to absorb the menstrual blood. Sanitary towels are pads of highly absorbent material — often paper. Today’s slimmer pads are unobstrusive even under tight clothes and many come with a waterproof backing film to prevent leaking.
Tampons are more convenient and comfortable for many girls and women. These are small plugs of absorbent material about the size of a finger that are inserted into the vagina where they expand and absorb the menstrual flow. If a girl is a virgin she may find it difficult to push the tampon into her vagina at first but most hymens already have a large enough hole to make it fairly easy. On first inserting a tampon the girl may actually break or stretch the hymen and this can cause some soreness for a day or two. It may be helpful to use a mirror at first. For the first few times a tampon is used it can help to smear its tip with KY jelly or something similar. Follow the instructions on the packet as these vary according to the type of tampon you are using. The most helpful thing of all when putting a tampon in the first few times is to relax. It cannot get lost inside. It is relatively easy though to forget that it is there, especially when the period ends and there is no leakage. All tampons have a string attacked to their base which, when pulled, brings them out of the vagina. Tampons very rarely get stuck but if they do don’t worry. Just ask your mother to help you or go to your doctor.
Whether a tampon or a sanitary towel is used it should be changed several times a day and more often if the flow is heavy. Lots of girls and women put a stick-on ‘pant-liner’ inside their pants to mop up the inevitable occasional leak.
Many girls and women wonder about sex and their periods, but even though many cultures have a taboo on sex with menstruating women there is no reason to avoid intercourse. Of course, some women or their partners use periods to avoid having sex for a quarter or more of the month. An orgasm can help to reduce some of the symptoms of premenstrual tension and the cramping pains some women have in the first couple of days of their period. Research has proved that many women are most interested in sex around the time of a period and actually during it, and again at around ovulation (in the middle of the month), so clearly there is no reason to believe that nature meant sex to be a no-go area because of a period.
Although there is an ancient Jewish notion that menstruating women are unclean, no medical evidence has ever been found to support this, though some doctors persist in talking about menstrual ‘toxps’, the existence of which has never been proved. In spite of the advertising world’s suggestions, and many women’s suspicions, that menstruating women smell and that men are likely to find them unattractive, this is not true if reasonable rules of hygiene are observed.
Having periods affects women in many different ways. Some are completely unchanged physically and mentally and others are tired, grumpy, irritable, have a lot of lower abdominal pain and back pain, and feel bloated. Considerable research shows that women are more likely to be ill, to be admitted to hospital, to have acute medical and psychiatric illnesses, to crash the car, to hit their children, to be off work, and a host of other things, around the onset of their period. Men (including male doctors) for years thought that these problems were in the mind but research has now proved that the signs and symptoms are indeed very real. Explaining all these premenstrual troubles to children can be a problem and should be done in a way that does not make them think of menstruation as an illness. Girls raised to think in this way often end up with intolerable premenstrual symptoms themselves because they expect to be ill when they have a period.
Obviously having periods can be messy and some women consider them a misery and call periods ‘the curse’. Today’s Western woman will have 400—500 periods in a lifetime, but her ancient ancestors would only have had about thirty cycles, partly because of a later onset of periods and an earlier menopause and partly because most of the others would have been suppressed by having many pregnancies and breastfeeding on a prolonged basis.
Endometriosis is worth a mention here because it is found by chance during laparoscopic examination in up to 5 per cent of women whereas the condition is said to be present in up to half of subfertile ones. Endometrial cells (cells that normally form the lining of the uterus — the endometrium) are found outside the uterus in this condition, especially in the ovaries, bowels and behind the vagina. Such cells escape from the open, outer ends of the fallopian tubes during mensturation and are usually mopped up by the body’s defences. Defects in these defences possibly prevent the cells being scavenged and so endometriosis results. Women between 30 and 45 are most vulnerable and whilst many have no symptoms others suffer from heavy periods, abdominal and back pains, painful periods, and painful intercourse. Surgery, or a male-type hormone called Danazol, which induces a temporary false menopause, can be used to relieve the condition. Any blockage of the cervix which may encourage menstrual blood to flow along the tubes must also be cleared.