Quickies: Periods and the Menstrual Cycle

A menstrual⁠ (menstrual: Having to do with menstruation.) period⁠ (period: The fluid – or flow – which contains blood, from the shedding of the uterine lining usually at the end of each menstrual cycle. Sometimes periods may be less fluid and more globby; this is the state that is often mistaken for blood clotting.) is the shedding of the lining of the uterus⁠ (uterus: An internal, muscular reproductive organ in the pelvis. During pregnancy, this is where a fetus will develop. The lining of a person’s uterus is also the thing that sheds every menstrual cycle in what we call a period.) . The shedding comes through the vagina⁠ (vagina: The internal passage leading from the opening of the vulva to the cervix of the uterus.) . To have a menstrual period⁠ (menstrual period: The shedding of the uterine lining as part of the menstrual cycle. This often appears as a bloody liquid, but sometimes is more solid, and is made of numerous components, of which blood is only one.) , someone first has to have a uterus and can’t be pregnant.

There are specific hormonal things that have to happen to create a menstrual period. The menstrual cycle is the term that describes the hormonal cycle. The cycle begins with a period and goes on, through different phases, until the next period. It takes 28 days on average. But many people have cycles that are shorter or longer.

The menstrual cycle has three phases:

1) Menstrual: The start of a menstrual period is first day of the cycle. Periods happen because the uterus sheds its lining. This lining was made in the last cycle in case an ovum⁠ (ovum: A reproductive cell, sometimes also called an egg. Ova (plural) are stored in the ovaries and released into the fallopian tubes during ovulation, and can then be fertilized by sperm cells which can result in pregnancy.) (egg) was fertilized. Periods usually last about three to seven days. The flow of a period is a combination of uterine tissue, cells from the lining of the vagina, bacteria, vaginal discharges, and blood. It varies in volume and color. Cramps are common during a period. Most people can manage them with analgesics like ibuprofen or naproxen, heat, rest and stretching.

2) Proliferative: The hormone estrogen⁠ (estrogen: A steroid hormone found in the bodies of all people, produced in the ovaries and the adrenal glands.It is involved in puberty, menstruation, pregnancy, mood, bone health, and other things across the body and lifespan .) increases during this phase. It tells the body to get the lining of the uterus ready in case it needs to support a fertilized egg. Ovulation is when an egg is released from the ovary so that it can possibly be fertilized. This usually happens during the proliferative phase. Vaginal discharge⁠ (discharge: In the context of sex and sexual health, any number of fluids which come from the genitals. Plenty of genital discharge is healthy, while some discharges can be symptoms of illness.) becomes thinner.

3) Secretory: During this phase, the hormone progesterone⁠ (progesterone: A steroid hormone in people's bodies, which is also included synthetically in hormonal birth control methods.) increases. It tells the body to stop releasing eggs during this cycle. Unless an egg was fertilized, progesterone will increase until a period starts. Then it’ll drop to a very low level. Vaginal secretions are thicker and pastier. The vagina feels drier than usual.

It usually takes a few years for a menstrual cycle⁠ (menstrual cycle: The whole of the phases of menstruation, which include, but are not limited to, the menstrual period.) to become “regular.” To be regular means the cycle is about the same number of days every cycle. People with regular cycles can still have changes in how long flow happens or how light or heavy it is. It’s common for people with regular periods to have what’s called a “standard deviation” — a common difference — of around five days with how long their menstrual cycle lasts each time. Not everyone has regular menstrual cycles. Most people have periods for around 40 years. Periods will change through those years. Changes are common and don’t always mean something is wrong.

Sometimes people skip periods. Periods can also come later than expected. This can happen because of pregnancy⁠ (pregnancy: The state of carrying a developing embryo or fetus within the uterus. Medically, someone is considered to be pregnant when an egg has been fertilized by sperm, cells divide, and the fertilized egg is implanted within the lining of the uterus.) . Late periods can happen for other reasons too. Illness, unmanaged stress, hormonal or body changes, eating disorders, exercise, and birth control⁠ (birth control: Any number of methods people use to intentionally prevent unwanted pregnancy, including the condom, the cervical barrier, the implant, the patch, the pill, the rhythm method, the ring, the shot, the IUD, spermicide and withdrawal.) can all affect a menstrual cycle. If someone doesn’t know why they missed a period, they should see a healthcare provider⁠ (healthcare provider: A qualified person to provide sound physical and/or mental healthcare, such as a doctor, nurse, clinician, counselor, medical assistant, midwife or other healthcare professional.) . People can experience painful periods, heavy flow, or other big symptoms. These symptoms can be difficult to manage. A healthcare provider can help with managing these symptoms.

Menstrual flow will stain and can go through clothes. There are a few options for managing menstrual flow.

Pads: Pads are worn inside underwear and absorb flow. People change them when they’re getting full or when they want to. Pads often the best choice for someone new to periods, for heavy flow, or during sleep. There are disposable pads and washable pads, and both can be found online or at in-person stores.  Washable pads can be worn many times. They are better for the environment, can be more comfortable, and cost less long-term. They can be washed and dried, just like underwear.

Insertables: These are inserted into the vagina to catch or absorb flow. They’re good for swimming, sports, or for people who don’t like pads. People can usually get them at in-person stores or online. Tampons are usually easier to find at in-person stores than cups or sponges.

• Tampons: These are the most common insertable. Tampons are safe to use when the directions are followed. One risk with tampons is Toxic Shock Syndrome (TSS). TSS is rare, but serious. It can cause severe medical problems. People using tampons should change them often, only during the day, and use 100% cotton tampons, without bleaches or synthetic materials.

• Sea sponges: These are small natural, recyclable, reusable sponges. People can wet them, squeeze the water out⁠ (out: Short for ‘out of the closet’. When someone’s LGBTQ+ identity is known to other people.) , and slide them into the vagina. They should be changed often. People can reuse them by squeezing out the flow then boiling and drying them. They are a good option for people who want an insertable but don’t like tampons or menstrual cups or have a hard time using them.

• Menstrual cups: These are flexible silicone, latex, thermoplastic elastomer, or rubber cups that are inserted into the vagina and catch flow. They can be reused for many years and can be worn for up to 12 hours at a time. They cost less long-term than tampons or sponges.

It’s best to avoid scented pads or tampons. They can irritate the vagina or vulva⁠ (vulva: The name for the external genitals of people assigned female at birth. The vulva includes the mons, external clitoris, inner and outer labia, fourchette and perineum.) .

Everyone feels differently about periods, depending on things like culture, family, and gender⁠ (gender: Characteristics that are seen or presented as distinguishing between male and female in a society. Gender may or may not include assigned or chosen: social roles, feelings, behaviors and/or presentation or appearance.) . You should know that there’s nothing gross, bad or wrong about periods. They’re just something bodies do, like breathing, eating or peeing.

Want to find out more about periods and the menstrual cycle?

• Here's the article this one is a summary of: On the Rag: A Guide to Menstruation, by Heather Corinna
• For advice on how to deal with cramps: Stamp Out Cramps (Without the Pill)
• To learn why a period might be late: M.I.A or, Dude, Where's My Period
• To learn about endometriosis, one cause of severe pain with periods: Endometriosis-Why You Shouldn't Ignore Severe Period Pains
• To learn how to chart periods to use in natural family planning or for other reasons: Get With the Flow: All About FAM

Some good outside resources on periods and related topics are:

• Kindara (Period Tracker)
• Cycle Savvy
• Period Information from AMAZE
• How to make your own menstrual pads at Fuzbaby
• Yoga poses to help with cramps at Yoga Journal
• Period: A Girl’s Guide to Menstruation by JoAnn Loulan and Bonnie Worthen
• Own Your Period: A Fact-Filled Guide to Period Positivity by Chella Quint
• Wait, What? A Comic Book Guide to Relationships, Bodies, and Growing Up by Heather Corinna and Isabella Rotman.

Teachers, caregivers, therapists, peer educators and other sex⁠ (sex: Different things people choose to do to actively express or enact sexuality and sexual feelings; often this involves genitals, but not always. ) and relationships education providers: you're welcome to use the PDF handout version of this article for free, in any of the work you do, so long as it is provided to learners at no cost, you print it exactly as it is provided, and give attribution!