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Having a period is something all women have to go through, but none of us talk much about – unless we’re asking for a tampon or complaining of cramps. We even avoid saying we’re on our period because you know, Aunt Flow is visiting, it’s that time of the month, it’s moon time, or you have girl flu instead! But seeing as we have a period every month (that’s an average of 400 in our lifetime!), you might as well know how you should look after yourself during what the grown-ups call menstruation. It’s not embarrassing, and you shouldn’t feel ashamed, you should know your options and how to deal with your period because it couldn’t be more normal! So, we spoke to New York’s leading dermatologist (and author of the amazing new book, Beyond Beautiful), Dr. Doris Day, to get the down low on how you should be dealing with your period…

Tampons or pads: Is it just a preference thing, is one more hygienic than the other?

There are many excellent options to keep you comfortable during your period, (aka menstrual cycle). What you choose to use is mostly about preference, but the most important thing is choosing an option that supports your flow. Your period is usually heavier at the start, for 1-2 days and then after a day or so gets lighter and can last for another 3-4 days, for a total of about 5-7 days. The main thing to be aware of is that there is a greater risk with wearing tampons and leaving it in for too long, which can cause toxic shock syndrome – more on that later.

The Dos and Don’ts of wearing pads:

via Giphy

Do choose a pad that matches your flow: You may be tempted to leave a heavy pad on all day if you have a lighter flow, but this can lead to irritation of the skin from both the fabric of the pad and from the friction of the pad against the skin.

Don’t choose fragranced pads: Fragrances can be a source of allergy and skin irritation. A regular flow does not have an odor different from the smell of your body in general, and it is much better to change the pad than to try to conceal the odor of one left in too long.

Do change it often: Even if your flow is light and your pad doesn’t seem to need changing, you should still change it every four hours. This is because bacteria can grow in the blood once outside your body, which can cause an odor.

Do’s and don’ts of using tampons:

via Giphy

Do pay attention to the material: Choose tampons that are made from cotton or rayon fibers rather than polyester foam.

Don’t be rough: Be gentle when putting them in and taking them out to avoid creating breaks in the skin along the way. Tampons with an applicator will make insertion easier and more comfortable, (especially if you’re a first time user).

Do change it often: You should change your tampon every four to eight hours, or even more often if you’re heavy.

Do use a tampon to match your flow: To avoid leaking, you should use a superabsorbent tampon when your flow is heavier and change it often. Similarly, you should avoid using a superabsorbent tampon on a lighter day since there is less blood flow and the tampon can dry out the vagina. This can irritate and cause tiny breaks in the skin as you pull it out and put a new one in, and those breaks may be a point of entry for poison from the bacteria into the bloodstream that can lead to toxic shock syndrome.

The other alternative: Menstrual Cups

menstrual cup

Source: Mooncup

Menstrual cups are a relatively new sanitary solution; the cup-shaped devices have a stem to help insert and remove them. They are usually made of flexible silicone and create a seal against the vaginal wall just below the cervix. They collect the fluid rather than absorbing it. For some it is a good option because it can be washed and reused for 3-5 years, making it very economical and eco-friendly, but if left in for too long it can pose a risk for infection as with tampons, especially if it scrapes too hard against the vaginal wall on the way in or out, creating breaks in the skin as portal of entry for the bacteria and the poison it creates. Menstrual cups can be a little more difficult to use and get used to, but they’re also a much more cost-effective solution in the long-run.

Toxic shock syndrome:

What Toxic Shock is: A tampon, when saturated with blood, becomes a great environment for growing bacteria, especially Staphylococcus aureus. This is a bacteria commonly found and harmlessly present in the vagina. For reasons that are still unclear, under certain conditions the bacteria can rapidly grow and release poisons which, if they get into the bloodstream can cause toxic shock syndrome (TSS), which can be fatal. It seems to be related to the superabsorbent tampons, especially ones made of polyester foam, and especially when they were left in for many hours, i.e., more 30 hours at a time.

How Toxic Shock happens: Having overgrowth of bacteria alone will not cause toxic shock syndrome, the poison also needs to get into the bloodstream. This can be due to breaks in the skin, which can occur from various causes including the simple act of pushing a tampon into place, especially if the area is dry.

The symptoms of Toxic Shock Syndrome include: Headache, fatigue, a red rash on most of your body that can look like a sunburn, vomiting, low blood pressure, or low urine production. This can occur within two days of infection. Fortunately, it is rare, but it can be fatal if not treated and those who get it are more prone to getting it again and should avoid using tampons, sponges or diaphragms.

Any other methods you could use?

There are IUD’s, hormonal contraceptives and other options that can limit how often you get your period and can also make the flow lighter. These are considered safe and effective, and your doctor can help select the best option for you. Getting your period is now optional, you don’t need to have it every month if you don’t want to, and if you’re not planning pregnancy, you can choose options to safely reduce the number of periods you get a year. If your periods are irregular or overly heavy, it is important to see your doctor to determine if you have a hormonal imbalance. This can be treated, and you will feel so much better!

Now you know exactly what you should be using on your period, here’s how to have a chill af period and keep any cramps under control.

The Bigger Issue!

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There are millions of young girls and women around the world who don’t have access to menstrual sanitary care. Most of us are fortunate enough not to experience this, but imagine if you didn’t have your usual stash, what would you do? Not only are there women who aren’t able to find the necessary sanitary solutions during this time, but many girls have no idea what their period is, or are made to feel ashamed about it. There are some amazing charities around the globe that work to provide sanitary care to women that can’t afford or don’t have access to pads, while others also teach girls about menstruation and work on de-stigmatization in communities where the subject is taboo. If you would like to contribute, either with a donation or fund-raising event, please check out these charities:

Binti: Binti currently works in India, Africa, the UK and the US, sharing three core aspects of their menstrual dignity mission: Access (providing sanitary products), education about menstruation and what to expect, and de-stigmatization. Find out more at here.

Days for Girls: Days for Girls provides washable menstrual hygiene solutions, health education, and social enterprises to help them reach the last mile in their own communities. They work in over 110 countries around the globe. Find out more about here.

#HappyPeriod: #HappyPeriod provides menstrual products to anyone with a period that has low-income, is homeless, or living in poverty, across the US. Find out more at here.