Managing Menstruation - Know your options (Booklet)

Publication date: 2022

KNOW YOUR OPTIONS Contents Menstrual bleeding management Pain Management Contraception & Menstruation Period Tracking Additional Information Menstrual bleeding management There are several product types for managing menstrual bleeding. • Disposable pad • Reusable pad • Cloth • Tampon • Menstrual cup • Period panty All product types are safe if used, washed, and dried appropriately. Do not use for longer than suggested in package instructions. Depending on which option(s) you choose, you may also need water, soap, underwear, and containers for washing and storing. For all product types, quality may vary and thus affect your experience with the product. If you are unsatisfied with your initial experience with a specific product type, another brand, style, or size might work better for you. If pain or rash occurs, switch to a different brand or type of product. Reusable products may be more expensive initially, but become more affordable over time. Some people like that reusable products result in less waste. Some types of products are new and may not yet be available in your area. Ask for them! A single-use pad designed to absorb blood. It is placed in your underwear and usually held in place by a sticky adhesive. Comes in different shapes and sizes for heavier or lighter bleeding. Pros: Easy to use, effective even when exercising, does not require washing Cons: Not reusable, can be costly over time How to dispose: Dispose in a trash bin. Do not put in toilet Can safely wear for: About six to eight hours or according to package instructions Availability: Widely available in shops Disposable Pad    A sewn cloth pad designed to absorb blood. It is placed in your underwear and usually held in place by snaps. Comes in different sizes, shapes, and materials. Cloth pads can be purchased or self-sewn. Comfort, absorbency, and ease of use vary. Pros: Reusable, less likely to leak or move out of place than cloth, becomes more affordable with continued use Cons: Has to be washed and dried after each use How to wash: Wash with soap and water, then hang or lay in sun until fully dry . Can safely wear for: Up to six hours at a time or according to package instructions Availability: Usually available locally Reusable Pad    Pieces of fabric, folded into layers and placed in underwear or tied around the waist, to absorb blood. Pros: Affordable, can be reused several times if properly cleaned Cons: Has to be washed and dried after each use, can be hard to keep in place How to wash: Wash with soap and water, then hang or lay in sun until fully dry Can safely wear for: About 2-4 hours at a time Availability: Everywhere. Cloth can be purchased new or repurposed Cloth    A single-use cotton or rayon plug inserted into the vagina to absorb blood, with a string that stays outside of the body to help with removal. Comes in different sizes for heavier or lighter bleeding. Pros: Effective even when exercising, does not require washing Cons: Not reusable, can be costly over time, can take a few attempts to get comfortable inserting and removing How to dispose: Dispose in a trash bin. Do not put in toilet Can safely wear for: Up to eight hours Availability: Available mostly in urban shops Tampon    A bell-shaped silicone device inserted into the vagina to collect blood. Comes in different sizes, shapes, and degrees of firmness that can affect personal comfort. Pros: Reusable for up to ten years, becomes affordable with continued use , effective even when exercising Cons: Expensive initially, can take a few cycles to get used to, has to be washed and disinfected How to wash: Wash with soap and water in- between use. After your period is over, boil it in water for 10 minutes to disinfect Can safely wear for: Up to twelve hours at a time or according to package instructions Availability: As a newer product it may be hard to find Menstrual Cup    A special type of underwear designed to absorb blood. Comes in different sizes, styles, and materials. Pros: Reusable, becomes affordable with continued use Cons: Expensive initially, has to be washed and dried after each use How to wash: Wash with soap and water, then hang or lay in sun until fully dry Can safely wear for: Up to six hours at a time or according to package instructions Availability: As a newer product it may be hard to find Period Panty    Pain Management You may experience abdominal pain, cramping, headaches, and/or other changes in your body in the days before or during your menstrual bleeding. Take ibuprofen or naproxen, which work better than paracetamol or acetaminophen Apply heat, such as a hot water bottle Rest or lie down Light exercise, yoga, or stretching Self-care options include If menstrual pain makes it hard for you to engage in day-to-day activities, talk with a doctor, nurse, or other health care provider. They may have other ways to help you manage the pain, such as hormonal contraceptives. They may also be able to determine if you have a more serious condition, such as endometriosis or uterine fibroids. Contraception & Menstruation If you use hormonal contraception or a copper IUD, you may experience changes in your menstruation. These changes are normal. They may affect how you choose to manage your menstruation. The changes may also help you manage your bleeding and/or pain. Changes due to contraception can include: • Lighter or less bleeding • Less frequent and/or shorter bleeding • Paused or no bleeding while using the method • Spotting or bleeding when you do not expect it • Heavier bleeding • Less cramping and pain Different contraceptive methods can cause different changes. And everyone is different; it is hard to predict what changes you will experience when using a specific contraceptive method. Your menstruation will return to its normal pattern and your fertility (ability to get pregnant) will return after you stop using the contraceptive method. To learn about the contraceptive methods that might be right for you, contact a doctor, nurse, or other health care provider. Period Tracking Some people find it helpful to keep track of their menstruation on a calendar or phone app. This enables them to better estimate when their next period may start. The time from the first day of one period to the first day of the next period is usually between 21-35 days. Bleeding generally lasts 3-7 days. During puberty and perimenopause, periods are often irregular. Some contraceptive methods also cause irregular periods. What is menstruation? Pregnancy occurs when a fertilized egg implants in the lining of the uterus (womb). During each menstrual cycle, the lining of the uterus thickens in anticipation of this happening. When pregnancy does not occur, the lining of the uterus releases in the form of blood flowing from the uterus out of the vagina. This is menstruation. Additional Information This tool provides information on self-care options to manage menstruation. It promotes greater awareness of all options, including options for managing bleeding and pain. It also has information on how contraception can affect menstruation and how it is managed. It provides evidence-based and unbiased information that supports users to make fully-informed choices that best meet their needs and preferences. This tool seeks to reach a broad audience of anyone who menstruates, including adolescents as well as older menstruators. It could also be used by healthcare providers and educators as a counseling or teaching tool. It can find a home in health care facilities, schools and universities, points of sale such as pharmacies and drug stores, community centers, workplaces, public bathrooms, and various other settings. It is available open-source as a single-page poster, a two-page poster, and as a booklet. Please visit https://bit.ly/mnh-options to download and for more information. References: Armour, M., Smith, C. A., Steel, K. A., & Macmillan, F. (2019). The effectiveness of self-care and lifestyle interventions in primary dysmenorrhea: a systematic review and meta-analysis. BMC complementary and alternative medicine, 19(1), 1-16. Marjoribanks, J., Proctor, M., Farquhar, C., Sangkomkamhang, U. S., & Derks, R. S. (2003). Nonsteroidal anti‐inflammatory drugs for primary dysmenorrhoea. Cochrane database of systematic reviews, (4). Rademacher, K. H., Sergison, J., Glish, L., Maldonado, L. Y., Mackenzie, A., Nanda, G., & Yacobson, I. (2018). Menstrual bleeding changes are NORMAL: proposed counseling tool to address common reasons for non-use and discontinuation of contraception. Global Health: Science and Practice, 6(3), 603-610. UNICEF. Guide to Menstrual Hygiene Materials. May 2019. Wilson, L. C., Rademacher, K. H., Rosenbaum, J., Callahan, R. L., Nanda, G., Fry, S., & Mackenzie, A. C. (2021). Seeking synergies: understanding the evidence that links menstrual health and sexual and reproductive health and rights. Sexual and Reproductive Health Matters, 29(1), 1882791. https://bit.ly/mnh-options Acknowledgements: Developed by: Lucy Wilson, Rising Outcomes, with Lillian Rountree, FHI 360 and Columbia University Input and review provided by: Emily Hoppes (FHI 360), Jennifer Amadi (Knit Together Initiative), Ina Jurga (WASH United), Valentine Adolphe, Linda Njeru (Yz-Me International, Ltd.), Kate Rademacher (FHI 360), Nancy Muller (Independent consultant), Natacha Mugeni (Kasha), Halima Lila (Hope Centre for Children, Girls and Women in Tanzania), Jennifer Gassner (MSI Reproductive Choices), Helen Pankhurst (CARE), Marni Sommer (Columbia University), Tanya Mahajan (Pad Project), Neville Okwaro (Kenya Ministry of Health WASH Hub), Elisabeth Zambelis (MHM Solutions), Aditi Krishna (Iris Group International), Michal Avni (Iris Group International), and Odette Hekster (Population Services International - Europe), Sarah Harlan (Johns Hopkins Center for Communication Programs- JHCCP), Tykia Murray (JHCCP), Brittany Goetsch (JHCCP), Haley Millet (Days for Girls International), Sara Stratton (Palladium Group), and Radha Paudel (Radha Paudel Foundation, Global South Coalition for Dignified Menstruation). Formatting and graphic design provided by Reproductive Health Supplies Coalition (RHSC)―the world’s largest network of reproductive health organizations. Spanish translation provided by RHSC; French translation provided by Valentine Adolphe. For more information or to provide feedback, please contact Lucy Wilson lucy.wilson@gmail.com. mailto:lucy.wilson%40gmail.com?subject=

View the publication