Our Bodies, Ourselves by Boston Women's Health Book Collective Read Free Book Online

experience very irregular spotting, those symptoms may indicate a gynecological problem.
    The menstrual cycle also provides important information about a woman’s overall health. Just as blood pressure and heart and respiratory rates are described as “vital signs” key to the diagnosis of potentially serious health conditions, recognizing menstrual patterns may also provide information that leads to the early identification of possible health concerns. Marked changes in menstrual cycles may signal problems with the blood’s ability to clot, significant weight change, emotional stress, thyroid disease, autoimmune conditions, hormonal imbalance, diabetes, Cushing’s disease, primary ovarian insufficiency (POI), late-onset congenital adrenal hyperplasia (CAH), or even cancer. Menstrual changes can also indicate pregnancy or perimenopause (the years leading up to the final menstrual period). Throughout our reproductive years, when we have medical concerns, the evaluation of the menstrual cycle should be included along with an assessment of our other vital signs.
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Menstrual Fluid
    The fluid that flows from the vagina during the menstrual period includes much of the uterine lining that has built up during that cycle. In addition to blood (sometimes clotted) and endometrial cells, menstrual fluid contains cervical fluid and vaginal secretions. This mixed content is not obvious, since the blood colors the fluid red or brown. A usual discharge for a menstrual period is about two to five tablespoons, though it often looks like more.
What to Do with the Menstrual Flow
    Across time and cultures, women have used and continue to use a variety of products for catching menstrual flow. The choice often comes down to comfort, availability, convenience, and price. You might find the perfect match right away, or you might try different options, looking for more comfort or a better fit.
    TAMPONS AND PADS
    Many women use commercial tampons or pads (also called sanitary napkins) to catch menstrual blood. These are the products most easily available. Whether you use a product worn outside your body (such as a pad) or a product worn inside your body (such as a tampon) is a personal choice.
    COMMON QUESTIONS ABOUT TAMPONS
    Will a tampon get lost inside me? No, absolutely not. The vagina is a closed space, and the opening of the cervix is far too small for the tampon to get inside. It is true, though, that a tampon can be forgotten and may slip into a vaginal fold, becoming difficult to find and remove. This can result in a strong odor and brown discharge after a few days. If you have trouble finding the string, you can squat down and reach the tampon with your fingers. For afunny and informative video about this, see “The Lost Tampon” at docgurley.com.
    Will tampons make me sick? No. You may have heard that tampons cause toxic shock syndrome (TSS). TSS is a serious but rare condition caused by bacteria. Keeping tampons in longer than eight hours can increase the risk of TSS. If used according to the directions on the package and changed regularly, though, tampons are safe.
    If I use a tampon, does that affect my virginity? No again. Virginity generally refers to whether or not someone has had sexual intercourse, not to menstruation or tampons. Tampon use may be one of the factors that play a role in the disintegration of your hymen, but whether you have a visible hymen says nothing about whether you have had sex. For more information on hymens and virginity and “Virginity.”
    MORE OPTIONS
    For many reasons, including comfort, environmental concerns such as a preference for reusable products, and worries about chemical residues, many of us use modified or alternative products to collect menstrual blood. These include all-cotton (sometimes organic) chlorine-free tampons, chlorine-free disposable pads, washable cloth pads, and devices that collect rather than absorb the menstrual fluid. All-cotton and