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INFO POST! WOMEN'S HEALTH: Menstruation & You

10:46 am - 11/06/2011
DISCLAIMER: Info posts may contain triggering elements, so please be mindful of the topic and read at your own discretion. This post contains images but none that are sexually graphic (unless the cartoon uterus diagram is your thing idk).

SPECIFIC TRIGGER WARNINGS: depression, suicide

These posts are a "safe space" to ask questions you might otherwise be too shy to. Please do not reply to people with "Plz Google" or "educate yourself". Everyone should enter them with a learn and teach mindset (in that order). WITH THAT SAID, HOWEVER, please remain mindful of your questions and phrasing, be open-minded, learn, and know when to be quiet. If you are flippant with your ignorance, please anticipate that angered members will not hesitate to tell you about yourself.

Our favorite Aunt Flo comes for her monthly visit!

FEATURED ARTICLE: New Non-Hormonal Treatment for Heavy Periods

We have previously covered common causes of heavy menstrual periods–fibroids, polyps, & hormonal dysfunctional bleeding–as well as treatments. Von Willebrand disease (VWD) is the most frequent inherited bleeding disorder, effecting up to 1% of women. The condition results from a deficiency, dysfunction, or absence of a protein in the blood aptly named after its discoverer, von Willebrand factor (VWF). The most common symptom is heavy periods in 5–20% of these women.

A history of bleeding problems after medical or dental procedures, minor wounds, spontaneous or recurrent nosebleeds should raise the suspicion of a bleeding disorder. If so, then blood tests assessing the coagulation system should be obtained including VWF. Referral to a hematologist may assist in diagnosis and planning treatment strategies.

After diagnosis of VWD, the first choice of therapy for the management of heavy menstrual periods is birth control pills. The Mirena® IUD and endometrial ablation are also excellent options and can be obtained during an office visit. Desmopressin, is a synthetic version of the hormone vasopressin, which causes release of VWF stored in blood vessel walls and temporarily raises VWF for prophylactic use before minor procedures. It can be administered as a nasal spray. Treatments before major surgical procedures are beyond the scope of this newsletter.

A new medication, Tranexamic acid (Lysteda) was recently approved by the FDA as a non hormonal treatment for all women with heavy periods who decline the aforementioned interventions. It is contraindicated in women with history of blood clots in their legs or lungs. The medication is taken for 5 consecutive days beginning at onset of menstruation.

The World Health Organization estimates that 1 in 5 women will suffer with heavy menstrual bleeding at some point in their lives. As gynecologists we are often surprised how long afflicted women will endure heavy periods before seeking our help. Heavy periods are not a normal part of aging or occur after having babies. While hysterectomy (the removal of the uterus) is sometimes necessary, in the majority of cases there are many alternatives that are often successful.


Alright, let's get down to the nitty-gritty!

What happens during the menstrual cycle?

In the first half of the cycle, levels of estrogen (the "female hormone") start to rise and make the lining of the uterus (womb) grow and thicken. At the same time, an egg (ovum) in one of the ovaries starts to mature. At about day 14 of a typical 28-day cycle, the egg leaves the ovary. This is called ovulation.

After the egg has left the ovary it travels through the Fallopian tube to the uterus. Hormone levels rise and help prepare the uterine lining for pregnancy. A woman is most likely to get pregnant during the three days before ovulation or on the day of ovulation. Keep in mind, women with cycles that are shorter or longer than average may ovulate earlier or later than day 14.

If the egg is fertilized by a man's sperm cell and attaches to the uterine wall, the woman becomes pregnant. If the egg is not fertilized, it will break apart. If pregnancy does not occur, hormone levels drop, and the thickened lining of the uterus is shed during the menstrual period.

Read more here.

Women have been menstruating as long as we've been walking the earth. What the cave-women did during their menstrual cycle is obviously not documented, but basically back in the "olden days", as now, women have had 3 main options.

- Do nothing, and bleed freely.
- Insert something into the vagina to absorb the flow
- Insert something into the vagina to help direct the flow cleanly out of the vagina to an external catchment device.
- Place something against the vulva externally to catch the flow.

There was at some point another option.... I've seen reference to women having a procedure done where their menstrual blood was sucked out of the body.... and here seems to be a DIY one. Sounds....err.... unpleasant......

Apparently ancient Egyptian women used papyrus and other such things to create early tampons, and that they would have used cloth pads of some form. Apparently Hippocrates documented that Roman women used wooden sticks wrapped with lint. So menstrual products of the past possibly ranged from animal skins, grasses & mosses, sea sponges, wool, ash, wood shavings, sheep skins, and pieces of cloth. Some women have even fashioned their own disposable pads from thin cloth stuffed with cotton wool.

There were also "catamenial sacks" of many types, that appear to be a pouch/collection pad suspended between the thighs that was used to collect the blood.

There seems to be evidence that even up until disposable pads became popular, that some women did nothing to collect menstrual blood, and instead let it flow. Either by simply not wearing anything and going about their day to day lives like that - or by being separated in a "Menstrual Hut" or other private place, where they simply sit there and bleed onto the ground. Some women today choose to "Free bleed" too. Others argue that women would have at least used something to collect it, because we're intelligent and resourceful enough to be able to find something and it would have been messy and inconvenient to have just let it flow (and not all women would have been able to go away and sit in a menstrual hut for the duration of their bleeding time). Why, surely at some point early on, someone discovered that the blood was coming from a crevice that could be plugged up with something to slow the flow, or that putting something against that area could catch that blood!..... Even if they had no idea what it was, where exactly it was coming from or why.

It's worth remembering that there were times in our history where bathing was considered to make you ill, so it is entirely possible that many women simply did just bleed into their clothes - as a perfectly normal and natural thing to do. I would imagine that it is only when society conventions required the collection and invisibility of menstrual blood that it became something embarrassing and taboo....and before then it was simply a matter of life. Remembering also that in a pre-industrial society sitting around was not as common as it is now, so a woman standing in a field without menstrual protection is going to have fewer soiled clothes than one sitting at a computer all day.... and I suppose in those days washing your legs is easier than getting blood stains off clothing/fabric. (Which makes you wonder if items like the Menstrual Apron were examples of products designed to protect clothing from being stained by blood, rather than being focused on providing affective catchment/containment for it). Plus it's also worth noting that with more physical labour, less nutrition, longer breast feeding and more children - women would have generally experienced less menstrual cycles than women today do.

It is impossible to give an accurate historical run down of what women have used over the ages, because not only is it unknown what women used in most cases, unlike clothing,menstrual protection was not something that was often documented. Also, due to the nature of it being somewhat "whatever you can find to soak up blood", and not a huge commercial industry as it is now, it can't be pinpointed to being representative of a particular time, region or country,unlike fashion or other historical things.

The topic of menstruation has almost always been taboo in an age where the majority of people can write, and such a mundane aspect of a woman's life was probably not important enough for people (particularly men) to document... it's not surprising there is little documentation of what women used. Think about it - in modern biographies and autobiographies do they mention the woman's menstrual gear of choice? no... (not unless there was something particularly different/interesting about it) it would be like documenting how you went to the toilet or blew your nose. Really only those of us who show an interest in the topic want to actually talk about it and know what was used.... How can women have known than hundreds of years later, we'd be curious :)

What We do know
(Or at least, what I know)

menstrual cup (Diva) storage bag

Since underwear as we know it (tight fitting bikini style briefs) is only a fairly recent invention too (Somewhere in the 1930s-1950s), most externally absorbing/collecting menstrual apparatus would have most likely been "belted" - held in place by use of some sort of arrangement that secured around the waist/hips/legs etc. of the wearer - as undergarments themselves were loose fitting and not able to hold the pads in place. Commercial disposable pads didn't come onto the scene until about 1888 or 1895. Early disposable pads were not stick on, as they are today - they were instead longer and were usually held in place at the front and back by a reusable menstrual "belt". Even after they were commercially available, they were too expensive for many women to afford. It also took women several years to be able to comfortably buy these products. One advertising company thought of a solution to the problem with tampons, and allowed women to place money into a box (so that the woman would not have to speak to the clerk to ask for them) and take a box from the counter themselves. Which doesn't sound all that revolutionary, but it was in those days. So it took several years for disposable products to become commonplace, even after they were available.

Nurses in the first world war created the first disposable pads by taking bandages and forming those into a pad they could throw away. The early pad companies were actually companies making bandages, and moved into pad making.



Premenstrual syndrome (PMS) refers to a wide range of physical or emotional symptoms that typically occur about 5 to 11 days before a woman starts her monthly menstrual cycle. The symptoms usually stop when menstruation begins, or shortly thereafter.

Causes, incidence, and risk factors

The exact cause of PMS has not been identified. Changes in brain hormone levels may play a role, but this has not been proven. Women with premenstrual syndrome may also respond differently to these hormones.

PMS may be related to social, cultural, biological, and psychological factors.

The condition is estimated to affect up to 75% of women during their childbearing years.

It occurs more often in women:

Between their late 20s and early 40s

Who have at least one child

With a personal or family history of major depression

With a history of postpartum depression or an affective mood disorder

The symptoms typically get worse in a woman's late 30s and 40s as she approaches the transition to menopause.

As many as 50% - 60% of women with severe PMS have a psychiatric disorder (premenstrual dysphoric disorder).


PMS refers to a set of physical, behavioral, or emotional symptoms that tend to:

Start during the second half of the menstrual cycle (14 days or more after the first day of your last menstrual period)

Go away 4 - 7 days after a menstrual period ends (during the first half of the menstrual cycle)

It is important to keep a daily diary or log to record the type of symptoms you have, how severe they are, and how long they last. You should keep this "symptom diary" for at least 3 months. It will help your doctor make an accurate PMS diagnosis and recommend appropriate treatment.

The most common physical symptoms include:

Abdominal fullness, feeling gaseous

Bloating of the abdomen

Breast tenderness


Constipation or diarrhea

Food cravings


Less tolerance for noises and lights

Other symptoms include:


Difficulty concentrating


Feelings of sadness or hopelessness (See also: Premenstrual dysphoric disorder)

Feelings of tension, anxiety, or edginess


Irritable, hostile, or aggressive behavior, with outbursts of anger toward self or others

Loss of sex drive (may be increased in some women)

Mood swings

Poor judgment

Poor self-image, feelings of guilt, or increased fears

Sleep problems (sleeping too much or too little)

Slow, sluggish, lethargic movement

Signs and Tests

There are no physical examination findings or lab tests specific to the diagnosis of PMS. To rule out other potential causes of symptoms, it is important to have a:

Complete medical history

Physical examination (including pelvic exam)

Psychiatric evaluation (in some cases)

A symptom calendar can help women identify the most troublesome symptoms and confirm the diagnosis of PMS.


A healthy lifestyle is the first step to managing PMS. For many women with mild symptoms, lifestyle approaches are enough to control symptoms.

Drink plenty of fluids (water or juice, not soft drinks or other beverages with caffeine) to help reduce bloating, fluid retention, and other symptoms.

Eat frequent, small meals. Leave no more than 3 hours between snacks, and avoid overeating.

Your health care provider may recommend that you take nutritional supplements. Vitamin B6, calcium, and magnesium are commonly used. Tryptophan, which is found in dairy products, may also be helpful.

Your doctor may recommend that you eat a low-salt diet and avoid simple sugars, caffeine, and alcohol.

Get regular aerobic exercise throughout the month to help reduce the severity of PMS symptoms.

Try changing your nighttime sleep habits before taking drugs for insomnia. (See also: Sleeping difficulty)

Aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed if you have significant pain, including headache, backache, menstrual cramping, and breast tenderness.

Birth control pills may decrease or increase PMS symptoms.

In severe cases, antidepressants may be helpful.

The first options are usually antidepressants known as selective serotonin-reuptake inhibitors (SSRIs).

Cognitive behavioral therapy may be an alternative to antidepressants.

Light therapy may decrease the need for antidepressant medications.

Patients who have severe anxiety are sometimes given anti-anxiety drugs.

Diuretics may help women with severe fluid retention, which causes bloating, breast tenderness, and weight gain.

Bromocriptine, danazol, and tamoxifen are drugs that are occasionally used for relieving breast pain.


Menstrual Disorders
Amenorrhea: Absent periods
Dysmenorrhea: Extremely painful periods
Hypermenorrhea: Extremely heavy or long periods (one guideline is soaking a sanitary napkin or tampon every hour or so, or menstruating for longer than 7 days)
Hypomenorrhea: Short or extremely light periods (aka a "scanty period")
Menometrorrhagia: prolonged or excessive uterine bleeding that occurs irregularly and more frequently than normal
Menorrhagia: Heavy menstruation flow at regular cycle intervals and duration ; and another article
Metrorrhagia: Breakthrough bleeding between periods (aka "spotting); normal in many women
Oligomenorrhea: Infrequent periods; secondary article
Polymenorrhea: Too-frequent periods (defined as more frequently than every 21 days)

Dysfunctional Uterine Bleeding: is a hormonally caused bleeding abnormality. Dysfunctional uterine bleeding typically occurs in premenopausal women who do not ovulate normally (i.e. are anovulatory). All these bleeding abnormalities need medical attention; they may indicate hormone imbalances, uterine fibroids, or other problems.
-Thanks, Wikipedia for the brief descriptions!

Pre-Menstrual Dysmorphic Disorder aka YEARS SUFFERING IN SILENCE

While most women have some premenstrual discomfort, far fewer have the severe and disruptive symptoms that make up PMDD. Far fewer doesn't mean rare since PMDD is present in about 5% of menstruating women. How can you tell if you suffer PMDD? The first step is to take our brief screener. While a screener cannot replace diagnosis by a qualified clinician, it can help you identify the presence of symptoms. If the screener suggests you are experiencing symptoms of PMDD, we strongly encourage you to seek help. We can probably give you a better idea if you have PMDD if you continue on in this section. To make a diagnosis for sure however, requires evaluation by a trained clinician.

Over the years, many treatments have been used for premenstrual symptoms, for premenstrual syndrome (PMS), and most recently for premenstrual dysphoric disorder (PMDD). Until recently, few of these treatments were evaluated in carefully designed research studies and even fewer were shown to be effective. There are now four prescription drugs that have been approved by the U.S. Food and Drug Administration (FDA) for treating the condition. These FDA-approved medications are fluoxetine (Sarafem), paroxetine controlled-release (Paxil CR), and sertraline (Zoloft), together with drospirenone/ethinyl estradiol oral contraceptive (YAZ). Nonetheless, many treatments of less well established value remain in widespread use and some women find them to be quite satisfactory. Unfortunately, promise of "cures," often costly, are sometimes made for treatments that have not been subjected to well-designed confirmatory research. When we discuss treatments for PMDD here, we'll base our comments on the best available research data, the opinions of experienced clinicians, and a generous sprinkling of common sense.

There are 3 broad approaches to treating PMDD. While most experts recommend a combination of all 3, there have been no scientific studies to determine if combination treatment is really the best approach. It is likely that the best approach or combination of approaches will vary from woman to woman based on things like symptom severity and which symptoms are most troublesome.

1. Medications - including antidepressants, antianxiety drugs, analgesics, hormones and diuretics.
2. Psychobehavioral - including exercise and psychotherapies (cognitive-behavioral, coping skills training, relaxation).
3. Nutritional - including diet modification, vitamins, minerals and herbal preparations.

Please click the Source

Helpful links and resources.
Available Medications for PMDD
Marijuana strains for PMS relief

Self-Help and Coping With Depression
Depression Online Support Group
How to Help a Loved One
Managing Monthly Depression
Mental Health Help

Uterine Fibroids aka MORE SILENT SUFFERING

Uterine fibroids are noncancerous growths of the uterus that often appear during your childbearing years. Also called fibromyomas, leiomyomas or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer.

In women who have symptoms, the most common symptoms of uterine fibroids include:

Heavy menstrual bleeding
Prolonged menstrual periods — seven days or more of menstrual bleeding
Pelvic pressure or pain
Frequent urination
Difficulty emptying your bladder
Backache or leg pains

When to see a doctor
See your doctor if you have:

Pelvic pain that doesn't go away
Overly heavy or painful periods
Spotting or bleeding between periods
Pain with intercourse
Difficulty emptying your bladder
Difficulty moving your bowels

Doctors don't know the cause of uterine fibroids, but research and clinical experience point to these factors:

Genetic alterations. Many fibroids contain alterations in genes that are different from those in normal uterine muscle cells.

Hormones. Estrogen and progesterone, two hormones that stimulate development of the uterine lining during each menstrual cycle in preparation for pregnancy, appear to promote the growth of fibroids. Fibroids contain more estrogen and progesterone receptors than do normal uterine muscle cells.

Other chemicals. Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth.

Read more at the source.

A fact sheet on UF brought to you by womenshealth.gov.

Who gets uterine fibroids?

Uterine fibroids are extremely common. In fact, many women have uterine fibroids at some point in life. Uterine fibroids in most women are usually too small to cause any problems, or even be noticed.

No one knows what causes uterine fibroids, but their growth seems to depend on estrogen, the female hormone. Uterine fibroids don’t develop until after puberty, and usually after age 30. Uterine fibroids shrink or disappear after menopause, when estrogen levels fall.

African-American women tend to get uterine fibroids two to three times as often as white women, and also tend to have more symptoms from uterine fibroids.

Other factors may influence development of uterine fibroids:

- Pregnancy: Women who have had children are less likely to get fibroids
- Early menstruation: Women whose first period was before age 10 are more likely to have uterine fibroids
- Women taking birth control pills are less likely to develop significant uterine fibroids
- Family history: Women whose mothers and sisters have uterine fibroids are more likely to have them, too.


All uterine fibroids are similar in their makeup: all are made of abnormal uterus muscle cells growing in a tight bundle or mass.

Uterine fibroids are sometimes classified by where they grow in the uterus:

- Myometrial (intramural) fibroids are in the muscular wall of the uterus.
- Submucosal fibroids grow just under the interior surface of the uterus, and may protrude into the uterus.
- Subserosal fibroids grow on the outside wall of the uterus.
- Pedunculated fibroids usually grow outside of the uterus, attached to the uterus by a base or stalk.

Uterine fibroids can range in size, from microscopic to several inches across and weighing tens of pounds.


Moderate and large-sized uterine fibroids are often felt by a doctor during a manual pelvic examination. Imaging tests are often done to confirm the presence of uterine fibroids.


Treatment and Drug Options for Uterine Fibroids

Uterine Fibroids and You

Uterine fibroids affect somewhere around 1 in 4 women in the United States. Many are immediately directed down the hysterectomy path by their gynecologists. They are never told that there are choices and decisions to be made. They are told "this is your only choice."

Some women, unhappy with the "hysterectomy indicated" option, choose to simply ignore their doctor and their physical problems until their bodies force them to "do something." Then, they begin a treacherous walk down the road to researching their options and determining whether or not there is a more palatable solution that they can comfortably and safely choose.

Sometimes they simply find themselves "giving up" and "giving in" to the hysterectomy option.

The variety of physical conditions and stages that women who are diagnosed with uterine fibroids experience are numerous. No two women develop uterine fibroids in the same manner, at the same pace, or with the exact same combination of resulting symptoms.

Although millions of women in the United States are walking around with uterine fibroids, we are all different. As a result, we all react to the diagnosis differently and, based on the information provided to us by our physicians, we make the best decisions that we possibly can.

uterinefibroids.com recommended by thepuddingcook

PAP Testing 101
PAP/HPV test via Planned Parenthood
*please share any other additional women's health care links so that members in other locations can find accessible care for themselves or loved ones
**also please don't be afraid of the exam; it only lasts 6 minutes and YOU CAN REQUEST THAT YOUR DOCTOR OR NURSE IS A WOMAN; THE FACILITY IS NOT ALLOWED TO DENY YOU THAT.

*shopping links are provided at the bottom!

Reusable Products
Cloth Pads

Improve your health by reducing your exposure to harmful chemicals. Disposable pads contain a myriad of chemicals and additives which serve to increase their absorbancy and keep them looking white and bright but these chemicals don't do you any good at all.

Your genital tissue is highly sensitive, and these chemicals are easily absorbed into your body, causing irritation and discomfort in the process. We already live in increasingly polluted environments, so it makes sense to reduce your exposure to chemicals in any way you can.

Increased comfort - Because Pleasure Puss cloth menstrual pads are made from natural cotton fabrics, they are cool and comfortable to wear. Unlike plastic used in disposable pads, cotton allows your skin to breathe, reducing the likelihood of fungal infections.

Natural cotton is also unlikely to cause any irritation to your sensitive skin. And lets face it - that part of your body is one of the most sensitive parts of your whole person - so be nice to it.

In addition, Pleasure Puss Menstrual Pads don't have any sticky bits on them to get stuck to your skin, your pubic hair or your underwear - No ouch here.
More on why to use cloth pads

Menstrual Cups

- It's economical!
- It reduces waste!
- It limits expoure to chemicals!
- It is effective!

Learn more!

How to Use

FAQ (Diva Cup)
Even more FAQ brought to you by Glad Rags!

Sea Sponges

Sea Pearls are completely natural reusable sea sponge tampons containing no Dioxin or synthetic fibers. Sustainably harvested and reusable for three to six months or more, Sea Pearls are easy to use, economical, and earth friendly. Rest assured, we are NOT using sponges harvested from the Gulf of Mexico!

Sea Pearls are extremely comfortable, soft, and textured much like the vaginal wall. They can be custom trimmed to fit your unique form, so you won't even notice they are there! Sponges are naturally very absorbent, and can also be used during sex. Some women choose to use them for contraception with a spermicide of their choice.


Disposable Products

Disposable Menstrual Cup

Sanitary Napkins

The History of Sanitary Napkins


The History of Tampons

The ancient Egyptians invented the first disposable tampons made from softened papyrus. The ancient Greeks invented tampons made from lint wrapped around a small piece of wood, recorded in writing by Hippocrates in the fifth century B.C. Other materials used for the first tampons have included: wool, paper, vegetable fibers, sponges, grass, and later cotton.

In 1929, the modern tampon (with applicator) was first invented and patented by Doctor Earle Haas who wanted to invent a tampon that could be effectively mass produced. Earle Haas filed for his first tampon patent on November 19, 1931. His patent description was for a "catamenial device," derived from the Greek word for monthly. He later trademarked Tampax as the brandname for his tampon product.

Gertrude Tendrich founded the Tampax company for the mass production of tampons after buying the patent and trademark rights from Earle Haas.

In 1929, the modern tampon (with applicator) was first invented and patented by Doctor Earle Haas who wanted to invent a tampon that could be effectively mass produced. Earle Haas filed for his first tampon patent on November 19, 1931. His patent description was for a "catamenial device," derived from the Greek word for monthly. He later trademarked Tampax as the brandname for his tampon product.

Gertrude Tendrich founded the Tampax company for the mass production of tampons after buying the patent and trademark rights from Earle Haas.">Source</a>

Additional Links
MGH Center for Women's Mental Health
Museum of Menstruation & Women's Health
Premenstrual Syndrome aka PMS

Where to buy...
Glad Rags
Moon Cup
Party In My Pants
Period Products
Soft Cups
*any additional international shopping sources would be welcome!

Dicussion time!
___closetome 7th-Nov-2011 09:45 am (UTC)
I've ruined many pairs of panties because of evil day 3 (or 4) eventually I caught on...
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