Each year on May 28th, we come together to celebrate Menstrual Hygiene Day, also known as Menstrual Health (MH) Day. This global celebration aims to raise awareness for Menstrual Health and draw attention to inequalities and barriers menstruating people face in an effort to promote health and equity around the world.
What is the holiday all about?
Menstrual Health Day celebrates the belief that:
Everyone should be able to access and afford whatever menstrual products they choose to use
Everyone is educated on menstruation
The stigma surrounding menstruating needs to end
Everyone has access to the necessary tools to menstruate safely, including access to water
What’s new on the topic?
Many groups, like the Terminology Action Group of the Global Menstrual Collective, are pushing to change the term “menstrual hygiene” to “menstrual health” permanently. Oftentimes people associate hygiene with something being dirty or needing to be fixed — which is NOT true for the menstrual cycle. In addition to bleeding, “menstrual health” also reminds us to take care of the rest of the physical, emotional, and social situations surrounding menstruation.
6 Myths and Facts
Everyone with a uterus experiences the same ‘time of the month’ — MYTH
While the average menstrual cycle lasts 28 days, there is a range of “normal” — for example, a menstrual cycle lasting up to 35 days can be considered normal.
Not all people experience regular cycles — some may have only a few days of bleeding, and some may experience bleeding for longer than a week.
Many factors may contribute to conditions such as amenorrhea (lack of menstrual period), oligomenorrhea (menstrual cycles that are less frequent than normal), or polymenorrhea (menstrual cycles occurring more frequently than normal). Many cycle irregularities can be regulated with the use of oral contraceptive pills.
If you have an abnormal cycle-check with your doctor to rule out any underlying medical conditions.
Symptoms and mood changes during the period are all in your head — MYTH
20-40% of menstruators have significant period-related symptoms, affecting more than 2.5 million people in the US.
Premenstrual Syndrome or PMS has been found to exist all over the world, in many different cultures and countries with similar frequencies.
While the exact mechanism is unknown, symptoms are thought to result from neurotransmitter fluctuations (like GABA and serotonin) caused by changes in circulating hormone levels (estrogen and progesterone).
And PMDD, or Premenstrual dysphoric disorder, is a real diagnosis given to women who experience more severe symptoms with their periods such as depression. There are even birth control pills approved specifically to treat symptoms of PMDD.
Irregular periods and other symptoms can often be treated with birth control pills or other hormonal treatments — FACT
Menstruators who benefit from a smaller amount of monthly blood loss (such as those with certain types of anemia) can use oral contraceptive pills (OCPs) to regulate menstrual bleeding.
OCP use has been shown to have a protective effect against certain cancers, such as ovarian and colorectal.
OCPs can reduce the incidence of ovarian cysts, and help decrease pain from conditions such as endometriosis and uterine fibroids.
Patients with irregular menstrual cycles may use OCPs to regulate bleeding.
You can get pregnant during your period — FACT (but it’s a very low chance)
For conception to occur, sperm must meet an egg that is released during ovulation. If no conception occurs, your body sheds your uterine lining that is needed to grow a fertilized egg in what we call your period. However, sperm can live inside a uterus for up to 5 days. So if you have a shorter menstrual cycle, you could ovulate sooner after your period and the sperm may still be alive to reach the egg. While unlikely, it is still possible.
This should not happen while using birth control pills, because you do not ovulate.
Bleeding with birth control is the same as a regular period — MYTH
Each month, the lining of your uterus thickens, to prepare to host a fertilized egg. If the lining of your uterus (the endometrium) does not become implanted with a fertilized egg, a drop in the hormone progesterone will cause the uterine lining to be shed, resulting in what we call a period.
When you take birth control pills, you don’t ovulate, so you never stimulate your uterus to grow a thick lining.
If you choose to take the placebo pills, you experience a withdrawal bleed. This uterine lining was never stimulated to grow, so for some people, it can be a shorter and lighter flow.
Stress and illness can affect your menstrual cycle — FACT
The hormonal regulation of your menstrual cycle is very complex, involving a part of your brain called the hypothalamus, which stimulates another gland in your brain, the pituitary. The pituitary gland stimulates your ovaries, which in turn release more hormones.
Interruptions anywhere along that chain can interrupt the normal flow of signaling required to create a period.
When you are under stress, your body produces higher levels of cortisol. This hormone can interfere with the normal hormone axis, telling your hypothalamus to stop stimulating the pituitary, which can even result in a stop in your period.
What are the key takeaways?
We need to prioritize menstrual health. For all people to have the opportunity to live their best lives, we need to promote health, and that includes menstrual health.Women’s health and in particular menstrual health is historically under-discussed and under-funded. We need to make this a priority locally and internationally with better access to materials and education.
Let’s talk about it. There is no shame in menstruating, and the more we talk about it the less stigma will exist. The best thing you can do is talk about it, ask questions, and help your fellow menstruators access the help they need. The more facts you know, the fewer myths you’ll fall for. There is nothing you can’t accomplish, even when you have your period.
Know your body better. The best way to take care of yourself is to know what is normal for your body. Tracking your symptoms each month, like your flow, your mood, and any other physical changes can help you and your provider identify any areas that could be improved. Together, you, your gynecologist, and Emme can work on addressing issues and period myths so you can benefit from a longer, fuller life.
Effects of sex steroids on brain beta-endorphin. Wardlaw SL, Thoron L, Frantz AG Brain Res. 1982;245(2):327.
Yonkers KA. Epidemiology and pathogenesis of premenstrual syndrome and premenstrual dysphoric disorder. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA.