The past decade has seen conversations about menstrual wellness go mainstream. The rise of ‘expert influencers’ has made opened up access to crucial information on social media platforms, and it’s unfiltered. Menstrual cup insertions and feeling unusually horny during menses is breakfast talk among menstruating people. This shift is as timely as important – more people want to be educated about menstrual wellness in ways that weren’t accessible before. This is especially true when discussing topics that might make some people shy and reserved. Well, we got experts to answer them for you; let’s meet them.
Dr Anjali Kumar, a driving force of Maitri, a digital platform dedicated to conversations about gynaecology, sexual health, pregnancy and holistic health.Also joining the feature is Dr Riddhima Shetty is a Mumbai-based Obstetrician-Gynecologist who, with her lively and approachable content on Instagram, is taking the stress out of discussing menstrual wellness.
1. Why Do I Have Brown Discharge During Periods?
Brown coloured blood is old blood; fresh blood is usually bright red in colour. Sometimes, the blood takes time to come out of the uterus and exit your body if the flow is scanty. That is why it oxidises (reacts with oxygen) and changes colour in time, becoming brown. It’s normal for a woman to have brown discharge before and immediately after the periods.
When the fresh blood typically comes out of the vagina, it does not get time to stay inside the acidic environment of the vagina and get oxidised. So it looks red. But at the beginning of the period and towards the end, that discharge is significantly less. It stays in the vagina for a longer time. It gets oxidised, and it looks brown.
Having said that, sometimes, the brown discharge could be a sign of a hormonal imbalance, maybe a polycystic ovary. It could be a sign of some cervical infections, cervicitis, cervical polyps, ectopic pregnancies, signs of a miscarriage, or some kind of infection like bacterial vaginosis or STDs. So in case the brown discharge is persisting throughout the cycle or associated with some sort of pain, fever, foul-smelling discharge, you must speak to your doctor.
2. Why Are Period Poops So Annoying?
It’s perfectly normal to have loose or frequent stools during your periods. Prostaglandins, a hormone, makes the uterus contract to expel the blood. The same prostaglandin acts on the intestines also. This causes nausea, diarrhoea, and an increased frequency of pooping. Frequent and loose stools are nothing to worry about. Prostaglandins also make that the food you eat pass through your colon faster. It also sometimes interferes with the electrolytes secretions as well.
People who have a lot of anxiety-related symptoms, depression or maybe a lot of PMS symptoms tend to experience diarrhoea more. Make sure to keep yourself well hydrated, avoid spicy foods, caffeine, sugary foods, and make sure to work on your stress levels.
3. Why Is There So Much Taboo Around Menstrual Cups?
Dr Anjali shed light on the systematic avoidance of menstrual cups, “Firstly, I feel that menstrual cups are not really part of the mainstream advertising the way the sanitary pads are. It is also not part of the big companies ads about the menstrual hygiene product. Maybe there’s some kind of economics at play. Obviously, buying a pack of sanitary pads every month is more profitable than a menstrual cup which may last for years. Secondly, I think the menstrual cups are not pushed as the sanitary pads are pushed at the government level. Also, I feel the role of the doctors and medical staff is also crucial. Many are not aware of the cups. So, I think recommendations from gynaecologists and the medical people would play a big role.”
For Dr Riddhima, the issue lies in principles, “In India, culturally a lot of value is put on a woman’s virginity, i.e., an intact hymen. This concept is flawed as only women have to face this archaic cultural mentality. The hymen is just a thin, flimsy tissue covering your vaginal opening, which itself has multiple small perforations to let period blood out. Sometimes the hymen can get torn due to physical activities such as cycling, gymnastics, swimming etc., or even be absent from birth. Yet so much value is put on this insignificant tissue. Because of this mentality, using any period product that needs to be inside the vagina – such as tampons or menstrual cups are still considered a taboo amongst Indians, with the fear of breaking the hymen or “losing virginity “.
4. Why Does Period Blood Smell?
It’s perfectly normal to have an odour in the menstrual flow. The menstrual period typically consists of blood, the uterus lining and some kind of bacterial flow, contributing to the smell. It is not unbearable, and proper hygiene is crucial to avoid any foulness. Sometimes the odour is unpleasant because it’s old blood, with the endometrial tissue (uterine lining) along with a few bacteria mixed along the way.
However, if you think it is extremely foul-smelling, it could imply that there’s a pelvis infection. An infection called bacterial vaginosis typically leads to a fishy odour. If you have an associated discharge that is yellowish or greenish in colour, get a consultation with a menstrual wellness expert.
5. What Do Blood Clots During Periods Mean?
It’s perfectly normal for menstrual blood to have clots. It can vary in amount from person to person and on the days of the cycle. The clots are seen when the flow is heavy, typically during the first two days of the periods, which are the heaviest days. When the uterine lining sheds, an increased amount of blood pools inside the uterus and vagina. It begins to coagulate and is expelled in the form of a clot. This is why when you get up in the morning, you may see a big clot because the whole night, the blood has sort of collected inside the vagina.
But in case the clots are persistent, frequent and come with significant pain there, there could be certain medical conditions associated with it. Uterine fibroids – the communist tumours of the uterus, Soft polyps – soft swellings in the inside of the uterus, and endometriosis or adenomyosis -where the uterus becomes bulky, or PCOD can be possible triggers.
Women who are actually in the process of aborting, a miscarriage or an abortion that can get unexpectedly heavy periods and pass clots. Rarely, people who have bleeding disorders could also pass clots. So in case, you feel that you’re passing clots regularly associated with pain, the flow is heavy. It’s important that you get a proper medical evaluation done.
6. Why Do Periods Increase Your Sex Drive?
At the end of your cycle, progesterone levels fall, and this is what causes your menses to start. This drop in progesterone also causes an increase in sex drive. Apart from this factor, the thought that chances of pregnancy are low on your period and the dispersal of PMS symptoms are other causes why women experience a high sex drive on their periods.
7. Should Vaginal Canal Be Washed During Menstruation?
Your vagina (inner canal) is self-cleaning and never needs to be cleaned. The insides of the vagina should never be cleaned with soap, intimate washes or chemicals. Only the external part, called the vulva, can be cleaned with plain lukewarm water and mild soap. Also, you don’t need a specific intimate wash to wash your vulva. Any regular mild soap will suffice. If you clean the insides, you are unlikely to mess around with the delicate ecosystem of the bacteria there. So not to be done at all.
8. Do Orgasms Help With Cramps?
Theoretically! During an orgasm there are certain hormones which are secreted by the body. Serotonin, oxytocin and dopamine can make you instantly feel better. These happy hormones can work like painkillers for menstrual cramps. Orgasms also makes the blood rush to the uterus, helping to reduce the cramps. Also this is a time when the stress also becomes better. The natural endorphins are released, you feel relaxed, feel happy, and sleep better. So overall a happy feeling!
9. How To Avoid An Emotional Breakdown During The PMS phase?
While having an emotional breakdown while PMSing may be normal, if it is so severe as to disrupt your daily routine, there is no harm in seeking medical help! Your gynaecologist, along with a therapist and psychiatrist, can help you avoid a mental breakdown.
PMS is real – many people experience sadness, unexpected mood changes, crying spells, irritability, trouble concentrating, fatigue, low energy, and feel like a nervous wreck. It happens because of hormonal changes – premenstrually, oestrogen and progesterone levels affect the serotonin levels. This hormone – a neurotransmitter – helps regulate your mood, sleep cycle and appetite. Low levels of serotonin during menstruation leads to irritability.
These symptoms can be managed by lifestyle changes. Make sure that you are exercising and eating healthy. Cut down on sugar, sugar, caffeine and alcohol, fat, salt. Indulge in lots of fruits, veggies and whole grains. Get proper sleep as lack thereof becomes one of the major reasons for PMS. Unmanaged stress also can worsen mood swings. So make sure that you are doing breathing exercises or pranayama, or meditation yoga to calm your body. Calcium supplements help as well – indulge in milk, curd, yoghurt, cheese, green leafy vegetables. Vitamin D six supplements are also known to help with PMS, so you can talk to your doctor about them. If nothing works, your gynac might consider hormonal birth control. Talk to your doctor, find a support group for your friends and family. Also, a distracting hobby such as painting, music or Netflix may help keep you occupied!