Does this image make you flinch? Why it's time to rethink our attitude to periods
It's time to break the period taboo - we need greater information, education and action to tackle ignorance around menstrual cycles and access to feminine hygiene products, writes Chrissie Russell
Forget coy whispers about 'Aunt Flo' being in town, cryptic references to 'TOM'. The (crimson) tide is finally turning and we're ready to talk frankly about periods.
Given the fact that billions of women around the world have them, you'd think that menstruation would be as normal a topic of conversation as breathing but alas that simply hasn't been the case.
"Periods are a taboo subject," says Deputy Catherine Martin TD, chair of Oireachtas Women's Parliamentary Caucus. "Women feel ashamed about them. They hide their tampons in their sleeves when they go to the bathroom and it shouldn't be this way."
Earlier this year the Caucus tabled a motion calling on the Government to provide free sanitary products for women. "The next step rests with the Government," says Deputy Martin.
"They hold the purse strings when it comes to budget allocation... but that doesn't mean the Caucus will just sit back and hope it happens. I've already written to Minister for Health Simon Harris to adopt our motion in Budget 2020 and will continue to make that call over the month."
She's one of many women in Ireland leading the charge to put menstrual issues to the front and centre of debate. Women like Claire Hunt, manager of Homeless Period Ireland, working tirelessly to get sanitary products to homeless and low-income women.
Others are creating support and dialogue around menstrual issues, such as Dubliner Lisa de Jong, who works as a period coach and womb yoga practitioner; 'wellness warrior' Catherine O'Keeffe, a perimenopause coach, and Aisling Grimley, who runs menopause website My Second Spring and is currently organising Ireland's first menopause conference in October.
What is clear is that there's a very real need for greater information, education and action to tackle ignorance around menstrual cycles and access to feminine hygiene products. A survey last year by Plan International Ireland, the humanitarian organisation that advances children's rights and equality for girls, found that 61pc of Irish girls feel embarrassed by their period.
Half felt school hadn't provided helpful information on periods. Further statistics reveal huge gaps in education: 43pc didn't know what to do when their period started, one in 12 believed you can't get pregnant during your period, while one in 13 reckoned you could lose your virginity by using tampons.
To prepare girls better, parents and caregivers need to not put off having 'the period talk', because it might be needed sooner than they realise.
"The age of first periods has been getting earlier so it is normal for periods to start at age 10 or 11 or can be even earlier," reveals Shirley McQuade, medical director at the Dublin Well Woman Centre. "Cycles can take several years to become regular, however, with most girls having regular cycles by the age of 16."
"A first period is individual and there are no hard and fast rules," adds Dr Mary Short, director of women's health at the Irish College of General Practitioners (ICGP). "Cramping might occur, bleeding may be erratic or light." Some will experience pre-menstrual syndrome.
"This occurs in the second half of the cycle after the egg has been released and is thought to be a sensitivity to the body's natural progesterone," explains Dr Short. "It can be debilitating with symptoms of weeping, fatigue, sugar cravings, fluid retention and significant irritability."
It's also no cause for concern if you don't have a 'normal' 28-day cycle. "In fact, a normal cycle can last anything from 23 to 35 days long with intercycle variation of two to three days also normal," says Shirley. Most women will miss at least one period because ovulation hasn't happened that cycle, something that could be down to stress - moving house, moving job or bereavement.
But when might your period be a sign that something is wrong?
The main symptom to watch for is heavy bleeding. "Periods are considered to be heavier than normal if there are clots or flooding," explains Shirley. "Passing clots or having gushes of blood [flooding] or having to change tampons or pads during the night are all signs that bleeding is more than normal."
A one-off heavy bleed can happen if ovulation hasn't happened that cycle - and this is nothing to worry about - but if there's a pattern of heavy bleeding it might be due to a physical cause such as uterine fibromyomas (fibroids), a non specific hormonal change, conditions like polycystic ovary syndrome (PCOS), endometriosis or occasionally a thyroid problem. In some cases it could be a sign of pregnancy complications or even a sign of some cancers.
"Heavy periods are also the most common cause of anaemia in premenopausal women so it is important to get checked out," says Shirley. "If there is no obvious cause for the bleeding, it still needs to be managed.
This might be with contraceptive pills, progesterone tablets or an intrauterine device that releases progesterone. There are also non-hormonal tablets that can control very heavy bleeding as a temporary measure."
If you're regularly experiencing heavy bleeding or notice any changes to your period, the important thing is to get it checked out by your GP.
But it's also a fact that your period will change throughout your lifetime. "Women in their 20s and 30s generally have regular periods that last for four or five days and are not particularly heavy or painful," says Shirley. "As women get older, periods tend to become heavier. Women who have had children also experience heavier bleeding."
She continues: "Women in their 40s often notice their period cycle starts to become shorter. This is an indication of changing ovarian hormone levels and is a perimenopausal effect."
Perimenopause is the time of hormone change that happens in advance of menopause. "Women still have a period but it may become more sporadic, or they may have longer or shorter cycles," explains Aisling Grimley from My Second Spring.
"In addition, you might have other symptoms like irritability, mood swings, insomnia, fatigue, dryness, hot flushes, acne, night sweats, joint stiffness, hair loss, the list goes on... I think many women only expect to have menopausal symptoms after their periods stop, but that's not the case."
While the average age for natural menopause in Ireland is 51, perimenopausal symptoms can take place up to 10 years in advance of natural menopause. Women who stop having periods earlier than 45 should consider taking HRT as they are at higher risk of osteoporosis and heart disease.
Unfortunately, as with many other aspects of anything period related, it's something that's not often talked about. "Women very often don't speak to anyone about their symptoms, especially psychological symptoms of menopause like anxiety and brain fog," says Aisling. "They frequently think they are going mad or getting early onset dementia.
Many GPs are not familiar with symptoms of perimenopause and don't provide women with the help they need. It's a time of life that can be very challenging and women should get help if symptoms are debilitating."
Women spend an estimated €8,100 on sanitary products in their lifetime with the average woman using over 11,000 disposable, one-time-use menstrual products. That's a lot of money and waste. Here are some products on the market that are friendlier on the purse and the planet.
⬤ Menstrual cups: Silicone menstrual cups (also known as moon cups after the popular brand) that fit securely inside the vagina and collect menstrual fluid which you then empty and reuse.
⬤ Eco-friendly tampons and pads: Some companies (like Natracare) have developed plastic-free, organic, vegan-friendly versions of traditional sanitary products
⬤ Period pants: Companies like ModiBodi produce breathable, stain-proof, leak-proof underwear that absorb menstruation blood, then simply get thrown in the wash like regular pants.
⬤ Re-usuable pads: A little more expensive than standard pads but cheaper in the long run. You just rinse in cool water, machine wash and dry, then use again.
Health & Living