Menstruation and Diabetes

Menstruation and Diabetes

Diabetes can affect a woman's reproductive health and influence factors contributing to the regulation of the menstrual cycle. This is largely due to the interaction between the hormones that control menstruation – estrogen and progesterone – and the insulin hormone, which is closely tied to blood glucose levels that are controlled in women with diabetes. So how exactly does diabetes affect menstruation? And what can women who are living with diabetes do to regulate both menstruation and the symptoms of diabetes?

Diabetes and the Menstrual Cycle
A woman's glucose levels are controlled by certain hormones, just as hormones regulate the menstrual cycle. Indeed, the interaction between certain hormones can lead to irregular bloods sugar levels. For women with both type 1 diabetes as well as those with type 2 diabetes, fluctuations in blood glucose levels that are associated with menstruation can be a cause for concern.

Most commonly, women with diabetes will experience a rise in blood glucose levels the week prior to menstruation, just after ovulation. Once a woman's period begins, her blood sugar levels will tend to drop. This fluctuation is caused by a rise in estrogen and progesterone levels, which interfere with insulin activity.

Recognizing Your Cycle
Not all women with diabetes experience these corresponding hormonal fluctuations; however, for those who do, recognizing the patterns of glucose and insulin production during your monthly cycle is an important step towards controlling diabetes symptoms.

It is recommended that women with diabetes monitor changes resulting from menstruation the same way they would monitor blood glucose levels. In order to find a correlation between menstruation and diabetes, make a note of the onset of your period in your blood glucose record book, and watch for any emerging patterns between glucose levels and the menstrual cycle over time.

Women with diabetes should already be keeping a record book as part of a standard diabetes management. Women with type 1 diabetes (who should be recording glucose levels at least four times a day) will tend to experience the most fluctuations in the fasting blood glucose measured before breakfast just prior to the onset of menstruation.

Managing Menstruation and Glucose
It is important for any woman who is experiencing glucose fluctuations to speak to an endocrinologist or other health care provider about ways to manage blood sugar, particularly if these are a result of other hormone interactions.

Your doctor may recommend that women with diabetes type 1 increase insulin by adjusting the intermediate acting insulin, NPH, or Lente later in the evenings at different points in your menstrual cycle so as to keep blood glucose levels stable. However, every case is different and only a health care practitioner can advise any adjustments in insulin.

For women with type 2 diabetes, it is recommended that regular exercise be maintained during these times in order to lower blood glucose level if insulin is not taken as part of diabetes management. Regular exercise can also reduce some of the symptoms of premenstrual syndrome such as moodiness, bloating, water retention and food cravings.

Menstruation and the Diabetes Diet
Women with diabetes are well aware that monitoring their diet is an important part of diabetes care. However, some women experience food cravings in correlation with their menstruation and premenstrual cycles. Cravings for carbohydrates and fatty foods can contribute to fluctuations in blood glucose levels.

In order to minimize food cravings and maintain an ideal diabetes diet, it is recommended that women take measures such as avoiding alcohol, caffeine and chocolate, eating regular meals, and eating low-fat snacks that are also low in carbohydrates such as vegetable sticks and unbuttered popcorn.

Vitamins and Menstruation

Menstruation and Natural Remedies: Vitamins and Supplements for Menstrual Relief

Most women seek relief when it comes to the discomforts of PMS symptoms, but common painkillers do not always work, and prescription drugs can have unpleasant side effects. You may want to consider some of the natural health remedies that are available to ease your PMS symptoms. Alternative remedies such as vitamins, herbs, and nutritional supplements may help with some common menstruation symptoms such as menstrual cramps and bloating, when coupled with a healthy diet. In addition, alternative medicine can often sustain emotional wellness that may be disrupted during your menstrual cycle, and cannot be eased by common painkillers offered at a local drug store.

PMS and Vitamins

Eating a diet that is rich in foods containing vitamins and nutritional elements that can specifically reduce menstrual symptoms is an alternative PMS treatment that cuts out any unnatural methods. You may use PMS supplements in addition to a diet that targets PMS symptoms, including vitamin supplements and herbal supplements.

Here is a list of vitamins that can specifically help relieve menstruation symptoms and discomfort:

• Vitamin A has been shown to reduce the symptoms of PMS
• Vitamin B6 reduces bloating since it is a natural diuretic. It can also help with estrogen levels that may be imbalanced during a menstrual period
• Vitamin E can help relieve soreness and tender breasts. It also regulates hormone levels, and can reduce irritability and depression
• Pantothenic acid is a natural nutrient that is commonly used to reduce stress
• Calcium and magnesium are naturally powerful substances that help reduce cramping and muscle tension. These nutrients can also reduce stress

Vitamins and Food

Poor nutrition can lead to deficiencies in the body that affect the factors contributing to PMS symptoms such inflammation control, fluid balance, and mood. By eating certain foods that are known to contain key vitamins and nutrients that help menstruation symptoms, you can provide yourself with a natural remedy for PMS. Here is a list of foods that can naturally provide you with the necessary supplements and reduce menstruation symptoms:

• Fresh vegetables, animal fats, protein and complex carbohydrates should be ample in a diet for PMS relief
• Cod liver oil is a recommended source of vitamin A, vitamin D, and necessary fatty acids
• Butter, liver, and egg yolks are strong source of vitamin A
• Oily fish such as sardines and salmon are another source of vitamin D, fatty acids, and calcium
• Brown rice is a great source of magnesium, pantothenic acid, and vitamin B6
• Lentils, alfalfa sprouts, peas, and cabbage are a great source of vitamin B6 along with whole wheat, rye and oats, beef, turkey, tuna, cashew, and bananas
• Calcium can be found in milk and cheese, sesame seeds, almond and Brazil nuts, watercress, broccoli and leafy greens
• Magnesium is found in all nuts as well as in sunflower seeds and oats, bananas, leafy greens, corn, tuna, and beef
• Pantothenic acid can also be found in Brewer’s yeast, whole wheat and rye breads, and sunflower seeds
• Wheat germ and wheat germ oil along with olive oil, broccoli, peanuts and pecans are a common source of vitamin E

It is also recommended that junk food, partially hydrogenated oils, and stimulants such as coffee and alcohol be avoided, as these can increase the discomfort of menstrual symptoms.

PMS Vitamin Supplements

It is recommended that nutrients such as vitamin A come from a natural food source, as synthetic versions may be toxic. While food should always be your primary source of specific vitamins and minerals, your diet can be supplemented by vitamins found at health stores.

It is recommended that a supplement specifically aimed at treating PMS include vitamins A, C, D, and E along with B-complex vitamins, and calcium, magnesium, manganese, phosphorus, potassium, pantothenic acid, iron, and zinc.

If you take a daily multi-vitamin, you should make sure that using a PMS supplement does not exceed the daily dose limit of the vitamins contained in each. You should also make sure not to take vitamin B6 supplements along with B-complex vitamins to mind the daily dose limits.

The daily recommended limit of vitamin B6 and pantothenic acid is 100 to 200mg, while 1,500 mg of calcium and 800 mg of magnesium is usually allowed daily. Talking to a nutrition expert can help you manage your vitamin dosage as a nutritionist can recommend the best vitamin combinations for your particular concerns. You may find that a standard daily multi-vitamin contains all the supplements you require to help you during menstruation.

Herbal and Natural

Menstruation and Natural Therapy: Herbal Remedies for Menstrual Relief

For those looking for alternative options for the treatment of menstruation, herbs are becoming an increasingly popular natural treatment for common symptoms of premenstrual syndrome (PMS), such as cramping and bloating. Chinese herbs have been touted as being effective in treating many menstruation problems, such as irregular menstruation, as well as alleviating common menstrual symptoms, such as menstrual cramps. But how exactly do herbs treat menstruation and what types of herbs work best in treating different menstruation problems and menstruation symptoms?

How Do Herbs Work?

Herbs contain healing properties that help to alleviate a variety of health problems. Because herbs work to both prevent and treat a variety of illnesses, diseases and conditions, they treat an individual’s overall physical and emotional health and not just a specific symptom.

As such, herbs work best when they form part of a holistic treatment plan, including a healthy diet and a balanced fitness program.

What Can Herbs Treat?

In addition to treating menstruation problems, herbs can also be used to prevent and treat a variety of problems, including the following:

• depression
• stress
• insomnia
• headache
• muscle tension and pain
• anxiety

How Do Herbs Help to Treat Menstruation Problems and Menstruation Symptoms?

Specific herbs are used to treat different menstruation problems.

For example the following menstrual irregularities and menstrual symptoms can be treated using the following herbs:

• menstrual cramps: herbs such as false unicorn root and cramp bark can help alleviate cramps associated with PMS and therefore can bring PMS relief. Red raspberry is another herb that can help bring menstrual cramp relief. Such herbs can be particularly helpful for women who suffer from dysmenorrhea. Jatamansi is another herb that is especially helpful for this condition.
• heavy periods: yarrow, nettles and shepherd’s purse help to reduce heavy bleeding by directing the flow of blood away from the pelvis. Women who suffer from chronically heavy menstruation, known as menorrhagia, can particularly benefit from the healing properties of such herbs.
• irregular periods: for women who experience irregular periods, a condition whose medical name is oligomenorrhea, there are a variety of Chinese herbs which can help to regulate their menstruation cycle. Such herbs include jatamansi, blue cohosh, ginger and skullcap. Parsley can also stimulate irregular or absent periods.

How to Take Herbs

In order to try and prevent the above menstrual symptoms and menstrual irregularities, it is advised that herbs be taken one week prior to the onset of menstruation. This is due to the fact that this is the time when hormone levels in the body begin to surge.

Because it can take three months for a woman to notice significant results in the improvement of her menstrual problems and menstrual symptoms, it is advised that she take such menstrual herb treatment for a sustained period of time.

You should also always consult with your doctor before taking any herbs for menstrual relief.

Debating Menstrual Suppression

Menstruation Suppression: The Debate

The development of the new birth control pill, Anya (also marketed under the name Lybrel),has instigated a hot debate over the topic of menstrual suppression. Doctors, researchers, and women the world over, are experiencing mixed emotions about the possibilities that Anya offers. Some support Anya as a way to offer women freedom and choice when it comes to their menstrual cycles, while others worry that Anya threatens the very foundation of womanhood. Many believe that Anya will offer women some excellent health benefits while others are very concerned that Anya will negatively affect reproductive and overall health.

Anya Supporters
Since its development, Anya has gained many supporters, ranging from noteworthy gynecologists to the millions of women who suffer from painful periods every month.

Supporters believe that Anya will offer women more freedom and choice when it comes to their reproductive selves. Instead of being tied down to a harsh 13-period-a-year schedule, Anya allows women to experience life without that monthly curse. Researchers also note that Anya may actually have many health benefits, helping to prevent anemia, migraines, ovarian cancer.

Anya supporters also argue that menstrual suppression is completely safe and normal. In fact, the periods that women experience on the regular 21-day birth control pill aren’t actually real periods at all. Instead, they are merely induced by hormones to replicate a period. Therefore, the continuous use of Anya is not significantly different from prolonged use of conventional birth control pills.

Anya Critics
Not everyone is happy about the introduction of Anya to the contraceptive marketplace. Many women balk at the idea of having no more menstrual periods. Some believe that Anya only propagates the historical belief that menstruation is messy, wrong, and immoral.

Researchers also worry about the long-term health effects that Anya may have on women. The menstrual period has been shown to wash away bacteria from inside the reproductive tract, and also helps the body to get rid of excess iron, which can help lower a woman’s risk factor for cardiovascular disease. The suppression of menstruation may also interfere with breast and bone development as well as long-term fertility. For example, Depo-Provera, which also suppresses the menstrual cycle, has been found to cause irreversible bone loss, so Anya may be found to do the same.

Since the long-term health risks have yet to be assessed, critics feel that the public should not be encouraged to embrace this new contraceptive so quickly. They site the example of hormone replacement therapy (HRT) as an instance where a treatment was purported to be extremely safe and beneficial even when used over a long period of time. However, further research showed that using HRT for a prolonged period was actually detrimental to a woman’s health and increased her risk of various health issues, including heart attacks, strokes and blood clots.

Over the next few years, long-term studies will no doubt give answers to these perplexing unknowns about the future of menstruation.

Periods and Sex

Having Sex During Your Period

Deciding to have sexual intercourse will likely be one of the biggest decisions that you will ever make. After all, choosing to have sex requires knowledge about both the male and female reproductive systems, STDS, and birth control. Sex can become even more complicated when it comes to deciding when and where to do the deed; in particular, you may find that you or your partner want to have sex during your menstrual period. But is sex during your period safe? Here are some answers to a few of the most common questions regarding period sex.

Is it Safe To Have Sex During Your Period?
Many men and women worry that having sexual intercourse during a woman’s period is unhealthy. Though frowned upon in many cultures and faiths, sexual intercourse during menstruation is entirely normal and completely healthy.

Worries about this act generally stem from societal misconceptions about menstrual blood: most girls are taught from a young age that their menstrual blood is unclean and "dirty," and therefore should be hidden and contained at all times. However, menstrual blood is an entirely natural bodily fluid, and does not in anyway affect a man’s penis or a woman’s reproductive tract. As long as you are engaging in safe and protected sexual intercourse, it is entirely alright for you and your partner to have sex during your period.

What About Oral Sex?
Though some men and women may find the thought of oral sex during menstruation a little bit off-putting, many partners do engage in this act. If you and your partner are considering having oral sex during your period, rest assured, it is entirely safe to do so. However, because menstrual blood can contain STD bacteria or viruses, it is essential that you and your partner use appropriate protection. Use a dental dam throughout oral sex as well as a condom during sexual intercourse.

Does Sex Help to Manage Period Pains?
Many women find that sexual intercourse actually helps to relieve period pains and menstrual cramps. This is because an orgasm can cause your uterus to contract, enabling it to use up excess prostaglandins in the process. Prostagladins are hormones produced by your uterine lining. They help to stimulate contractions that move menstrual blood out of the uterus, and are also responsible for those cramps that occur throughout your period.

Can You Get Pregnant During Your Period?
Though possible, it is highly unlikely that you will get pregnant during your monthly menstrual cycle. During your period, your body works to shed the uterine lining that it has been building up over the last month, in preparation for pregnancy. When you don’t become pregnant, small uterine contractions begin, encouraging the unfertilized egg and unused endometrium to be shed from the uterus and through the vagina. This means that there is no egg in the fallopian tubes to become fertilized and no lining to help a developing embryo to implant properly.

This being said, there is a small possibility of pregnancy during your period. Women often mistake slight bleeding that can occur with ovulation as their period. Unprotected sex at this time can greatly increase your chances of becoming pregnant. Additionally, sperm can live in the female reproductive system for up to three days. Because some women ovulate at the very end of their menstrual periods, sperm may still be alive at this point, and able to fertilize an egg.

Can You Avoid Catching an STD if You Have Sex During Your Period?
There are a number of myths going around that it is impossible to contract a sexually transmitted disease if you have sex while you are menstruating. Unfortunately, this myth is completely false, and you and your partner are still at risk for contracting any type of STD if you have unprotected sex during menstruation.

Menstrual blood, like semen and vaginal secretions, contains the HIV virus as well as the bacteria associated with a number of other STDS, including syphilis and chlamydia. Additionally, many women experience herpes outbreaks during their monthly periods, which may actually increase your risk of spreading this disease to your sexual partner. When engaging in sex, no matter what time of the month it is, it is necessary to wear a condom in order to prevent STD transmission.

Can Having Sex During Menstruation End Your Period?
If you have had sexual intercourse during menstruation you may have noticed that your period comes to an abrupt end within a day of intercourse. Though you may be worried that somehow your menstrual blood has "backed up" or gotten stuck somewhere in your reproductive tract, this is not the case. In fact, your period has probably ended because sexual intercourse has stimulated an increased number of contractions in your uterus, causing your body to expel your menstrual blood more quickly.

During orgasm, your uterus goes through a number of muscular contractions, which can help to speed up menstruation; as your uterus contracts, the endometrial lining begins to shift and is forced out through the vagina. Additionally, semen contains prostaglandins, hormones responsible for causing uterine contractions. The combination of prostaglandins and orgasm may contribute to an increased number of uterine contractions and therefore cause the rest of your menstrual blood to be quickly shed.

How do You Avoid Making a Mess When Having Sex During Your Period?
Women and men often dislike having sex during menstruation because of the mess that it can cause. However, with a little careful planning you can keep the mess contained and focus on enjoying the experience.

If you are going to have sexual intercourse, try to get your partner to straddle you while you are lying on your back: this will help to slow the bleeding. Lay down some spare towels or sheets beforehand, so that it will absorb any excess blood. You may want to think about wearing a diaphragm or cervical cap during sexual intercourse. These will protect you from pregnancy and work to contain any menstrual fluid. However, these barrier methods of birth control should not be used on an everyday basis to collect menstrual blood. Although they are similar, diaphragms and cervical caps are not the same as menstrual cups.

Anovulation

Anovulation

Periods can often be very troublesome, and some women suffer relentlessly when it is their "time of the month." After all, periods cause backaches, mood swings, and, of course, those awful menstrual cramps. But menstruation is a necessary part of being a woman; it is what allows you to conceive a child. Some women, however, suffer from a disorder in which they do not release viable eggs during their menstrual period. This can cause serious problems and often makes it difficult for women to become pregnant.

What is Anovulation?
Anovulation is a condition that affects between 6% and 15% of all women of childbearing age. It is a disorder of the menstrual cycle, in which a woman does not release an egg for fertilization every month.

Typically, your body sends specific hormonal signals that trigger ovulation once every month. An egg is released from your ovaries and into your fallopian tubes, where it can be fertilized. Women who are anovulatory though, do not release an egg every month. Instead, they may ovulate intermittently throughout the year, or they may not ovulate at all. Anovulation is especially worrying for some women as it can signal an underlying fertility or reproductive disorder.

Who Suffers from Anovulation?
Anovulation can affect any woman of childbearing age. However, there are some risk factors that increase your chances of suffering from anovulation. These risk factors include:

• having PCOS (polycystic ovarian syndrome)
• suffering from hursutism, or other hormonal disorders
• extreme weight loss or obesity

What are the Symptoms of Anovulation
The symptoms of anovulation can sometimes be difficult to recognize. After all, women rarely experience any overt signs of ovulation. However, there are a few symptoms that may indicate that you are suffering from the condition. These symptoms include:

• abnormal or erratic basal body temperature (BBT)
• fewer PMS symptoms
• irregular periods
• amenorrhea

What Causes Anovulation?
Anovulation is the result of hormonal imbalances within the body. Your hormones, including estrogen and progesterone, help to trigger your body’s reproductive cycle, including ovulation and menstruation. Without the proper levels of these hormones, your reproductive system can be thrown off course, preventing your ovaries from releasing an egg every month. There are a variety of different factors that can contribute to a hormone imbalance including:

• breastfeeding
• weight gain or loss
• too much exercise
• extreme stress
• frequent travel
• eating disorders, like anorexia or bulimia

Complications of Anovulation
Anovulation can result in a number of health complications, especially if it is left untreated. An imbalance of hormones can sometimes result in the loss of certain sexual features, including menstruation and ovulation. Chronic anovulation can also lead to partial or complete infertility. Many women who suffer from anovulation find it difficult, or even impossible, to become pregnant.

Diagnosing Anovulation
If you suspect that you may be suffering from anovulation, it is important that you visit with your health care provider. She can perform certain tests that may help to discern whether or not you are ovulating.

Your health care provider may first ask you to record your daily BBT for a period of up to a month or more. Irregular or abnormal measurements may indicate that ovulation is not taking place when it should. Your health care provider will likely perform a series of blood tests in order to measure the levels of specific hormones in your body. These exams will test for hormones that play a specific role in the ovulatory process, including:

• luteinizing hormone (LH)
• follicle stimulating hormone (FSH)
• thyroid-stimulating hormone

If you are experiencing problems with your menstrual period, your health care provider may also perform a pelvic examination and an ultrasound. A pelvic examination is performed at your local health clinic and involves manual palpation of your abdomen to check the size and shape of your uterus, ovaries, and fallopian tubes. An ultrasound uses high frequency sound waves to create a picture of the internal organs in your pelvic cavity. Your health care provider can analyze this image for any changes to your reproductive organs.

Treating Anovulation
It is important that the underlying cause of anovulation be treated, in order to restore proper ovulation. Lifestyle factors such as nutrition, stress, and exercise, may be contributing to your hormone imbalance, and these factors must be assessed during proper treatment. Easing up on exercising or eating a healthy balanced diet can go a long way to helping treat anovulation in some patients.

You may also be treated using a number of different medical approaches. Medicines to induce ovulation can be used, especially if you are actively trying to become pregnant. Fertility drugs like Clomid and Pergonal are often used to treat anovulation. If your anovulation is accompanied by amenorrhea, your health care provider may try to normalize your menstrual period by prescribing Depo Provera, a medication that can help to trigger menstruation.

Ovulation

Knowing When You Ovulate

Menstrual cycles can be tricky business sometimes: they aren’t always regular, they can come and go when they please, and sometimes you can even have two periods in one month. This is because every woman’s menstrual cycle is different and, depending on factors like stress, physical activity, and hormone levels, your monthly cycle may be hard to keep track of. Whether you are trying to get pregnant, trying to guard against pregnancy, or are just interested in keeping track of your menstrual cycle, knowing when you ovulate can be a great help to any woman.

What is Ovulation?
Ovulation refers to a specific phase in your menstrual cycle. Known as the ovulatory phase, it is during this time that your body releases an egg for fertilization. During the ovulatory phase, your body sends a series of signals that trigger an increase in the levels of estrogen in your body. In turn, this increase sets off a rise in luteinizing hormone (called the LH surge), a special hormone that helps you ovulate. When this LH surge reaches a certain point, one of your ovaries releases an egg. This egg will then travel down the fallopian tubes in order to be fertilized.

When Does Ovulation Occur?
It can be hard to predict exactly when ovulation occurs. This is because every woman’s cycle is different and can even vary individually from month to month. Typically, it is assumed that every woman has a cycle around 28 days in length. However, your cycle may last anywhere from 21 to 35 days in length. Ovulation occurs at different times in different women, depending upon the length of your menstrual cycle.

A good rule of thumb is to remember that ovulation typically takes place about two weeks before menstruation. This means that, if you have a 28-day cycle, you will ovulate around Day 14. However, few women ovulate like clockwork. As a result, ovulation can occur anywhere from Day 8 to Day 20 depending on the length of your cycle. In order to find out when you ovulate, it is necessary to look closely at specific signs that your body gives off.

Why You Need to Know
So why would you want to know when you are ovulating in the first place? Well, women find that knowing when they ovulate helps to provide them with control over their own fertility. Knowing when you ovulate can help you:

• Track your menstrual period: Keeping track of your ovulation will help you to predict when your menstruation is going to arrive, so you won’t be caught off guard. It is also especially useful for women with irregular periods or endometriosis, who often don’t ovulate.
• Get Pregnant: It is during ovulation that you are at your most fertile. If you are trying to get pregnant, timing intercourse around your ovulation can greatly increase your chances of conception.
• Preventing Pregnancy: Women who are sexually active but who don’t want to get pregnant sometimes monitor their ovulation in order to prevent pregnancy. By refraining from sexual intercourse around the time of ovulation, you can reduce your chances of getting pregnant.

Signs of Ovulation
Humans are unlike most other animals in the world because we don’t give off overt signs that we are fertile. Instead, our signs of fertility are much more subtle, and this can make it challenging for us to discover exactly when we are ovulating. However, there are a few physical signs that the body gives off when ovulation is occurring. Some common signs to watch out for are:

• Tender Breasts: Before and during ovulation your breasts may become more tender than usual, due to the rise in your hormones.
• Mittelschmerz: Mittelschmerz is the name given to abdominal pain felt during ovulation. Some women experience sharp twinges in the lower abdomen during the ovulatory phase.
• Body Temperature: During ovulation, your basal body temperature (BBT) will increase slightly.
• Cervical Changes: Your cervix will change shape, position, and texture during ovulation. It will also produce a different type of cervical mucus.

Finding out When You Are Ovulating

There are various ways to find out when you are ovulating. No method is foolproof, so it is important to take extra precautions if you are having unprotected sex at any time during your menstrual cycle. Choose a method that you feel most comfortable with and practice it for at least a couple of months, in order to determine when you are ovulating.

Charting Your Menstrual Cycle
Many women choose to chart their menstrual cycle in order to determine when they are ovulating. Ovulation charting is also useful for predicting when your next period will be. All you need is a calendar that marks all the days in each month. When your period comes, mark that day on the calendar. This is known as Day 1. Next month, you will also record the first day of your period on the calendar. Count the number of days in between to find out the length of your cycle. To determine when you ovulate, count back 14 days from Day 1 of your cycle. This method will not be completely accurate – it may be a few days off – but it should give you a good idea as to when you are ovulating.

Basal Body Temperature (BBT): Monitoring your basal body temperature is also a good way of determining when you are ovulating. When you begin to ovulate, your basal body temperature increases, as a response to hormone levels. If you can find out when this temperature increases, you can determine when you ovulate. All you need is a special thermometer, which you can get from your local drugstore or pharmacy. Each morning, take your temperature and record it on an ovulation calendar. When you begin to ovulate, you should notice a slight increase in your BBT, typically between 0.5 and 1.6 degrees.

Cervical Mucus
Cervical mucus can also provide clues to your ovulation date. Cervical mucus changes throughout your cycle; during ovulation, you will find that your cervical mucus becomes thin, clear, and stretchy. There will also be lots of it. Every morning, check your cervical mucus and record its texture and appearance on your calendar. Stretch the mucus between your thumb and forefinger. When you can stretch it a few inches without breaking it, you are ovulating.

Ovulation Predictor Kits
Ovulation kits are now widely available to help you to determine when you are ovulating. These ovulation tests measure the amount of LH in your urine, allowing you to predict when you are ovulating. These tests are fairly inexpensive and easy to use – all you have to do is place a special stick in your urine flow and then wait for the results.

Dysmenorrhea

Dysmenorrhea

No woman enjoys getting her monthly period. Uncomfortable period symptoms, like menstrual cramps, bloating, headaches, and fatigue, can cause you to feel miserable. However, if you are experiencing extreme cramping during your menstrual period, you may be suffering from dysmenorrhea. Dysmenorrhea can cause severe pain, making life very uncomfortable. Dysmenorrhea can also signal underlying reproductive complications. However, dysmenorrhea is treatable. Depending on the severity of your condition, you may find relief through over-the-counter medication or botanical supplements.

What is Dysmenorrhea?
Dysmenorrhea is the name given to painful menstrual periods. A fairly common condition, dysmenorrhea can result in severe cramping, nausea, and other menstrual symptoms. There are two main types of dysmenorrhea:

• Primary Dysmenorrhea: Primary dysmenorrhea tends to occur in younger women, a few years after menarche and before a regular pattern of ovulation has developed.
• Secondary Dysmenorrhea: Secondary dysmenorrhea occurs years after menarche, and interrupts a seemingly regular pattern of ovulation.

Who Gets Dysmenorrhea?
Menstrual pain is not uncommon at all - more than 40% of American women report some type of pain during their monthly periods - however, for some women this menstrual pain is much more intense. In fact, 10% of women report that their menstrual pain has left them incapacitated for a day or more. Though any woman can develop dysmenorrhea, some women are more at risk of experiencing these painful periods. Risk factors include:

• obesity
• cigarette smoking
• high stress levels
• family history of dysmenorrhea
• history of pelvic infection
• history of STD infection

What Causes Dysmenorrhea?
Dysmenorrhea can be the result of various different factors. Causes depend upon the type of dysmenorrhea you are suffering from.

Primary dysmenorrhea appears to be caused by an excess of prostaglandins. Prostaglandins are hormones that cause your muscles to contract. During menstruation, prostaglandins trigger your uterus to contract, helping you to shed your menstrual blood. Some women seem to have an excess of these prostaglandins in their uterus, though. As a result, they experience very painful periods.

It tends to be much more difficult to find the cause of secondary dysmenorrhea. Secondary dysmenorrhea is usually a side effect produced by some other reproductive complication. Common causes of secondary dysmenorrhea include:

• endometriosis
• pelvic inflammatory disease
• uterine fibroids
• use of an IUD

Symptoms of Dysmenorrhea
Dysmenorrhea symptoms do vary from woman to woman. However, all women with dysmenorrhea suffer from painful cramps, beginning with the start of menstruation and lasting anywhere from several hours to two or more days. Other common symptoms of dysmenorrhea include:

• sharp pains in the lower abdomen
• pain radiating from the abdomen down to the thighs and legs
• nausea
• vomiting
• diarrhea
• fatigue
• depression
• irritability

Diagnosis
If you are suffering from severe pain with your monthly periods, it is important to see your health care provider. Your health care provider can perform a series of tests to see if you are suffering from dysmenorrhea, and to determine the cause of the condition. Your health care provider will begin by asking you about your medical history and about the symptoms that you have been experiencing. You will likely be given a pelvic exam, during which your health care provider will check the size and shape of your uterus and ovaries. Further tests that may be performed include:

• blood tests
• urine anaylsis
• pelvic ultrasound
• laparscopy

Treatment for Dysmenorrhea
Treatment options will depend upon the type of dysmenorrhea that you are suffering from.

• Primary Dysmenorrhea: Primary dysmenorrhea is typically treated with prescription or over-the-counter medications. First-line treatment for painful periods typically involves non-steroidal anti-inflammatory drugs, referred to as NSAIDS. Commonly used NSAIDS include ibuprofen, naproxen, and acetaminophen. Anti-prostaglandins are also used to treat primary dysmenorrhea. Anti-prostaglandins block the effects that prostaglandins have on your body, preventing severe cramps. These medications work effectively in 80% of dysmenorrhea sufferers.
• Secondary Dysmenorrhea: Treatment for secondary dysmenorrhea depends upon the underlying cause of the condition. Your health care provider will discuss appropriate treatments with you.

Menorrhagia

Menorrhagia

Periods can be a real pain. Those menstrual cramps, headaches, and muscle aches that come with your period can really make life difficult. To make matters worse, some women have to deal with heavy menstrual bleeding during their periods. Everyone has a heavy period now and again, but if you are bleeding excessively every month you may be suffering from menorrhagia. Menorrhagia can increase your period discomfort and may signal underlying reproductive complications.

What is Menorrhagia?
Menorrhagia is one of the most common forms of irregular periods. It causes you to experience heavy and prolonged bleeding every month, along with a variety of other symptoms. Women with menorrhagia lose more than the typical 60mL of blood during menstruation. It may require you to frequently change your tampon or pad, and can affect your daily routine. If left untreated, menorrhagia can result in a number of complications.

Who Gets Menorrhagia?
Any woman of childbearing age can develop menorrhagia. However, some women are more likely to experience heavy menstrual bleeding than others. Risk factors include:

• being a young adolescent or pre-menopausal woman
• being overweight
• using certain medications, such as blood thinners
• having a hereditary bleeding disorder

What Causes Menorrhagia?
Menorrhagia can be the result of a number of different causes. In order to determine what may be causing your heavy periods, it is important that you have a physical exam performed by your health care provider.

The two most common causes of menorrhagia are hormone imbalance and uterine fibroids:

• Hormonal Imbalance: An imbalance of the hormones estrogen and progesterone is the most common cause of menorrhagia. In order to build up your endometrial lining, your body releases estrogen and progesterone. If these hormones become imbalanced, your endometrium can continue to build up and bleed excessively.
• Uterine Fibroids: Uterine fibroids are non-cancerous growths that form inside your uterus. These can interfere with your reproductive system, causing irregular bleeding.

Other common causes of menorrhagia include:

• an improperly fitted IUD
• ovarian cysts
• certain reproductive cancers, like uterine and ovarian cancer

Menorrhagia Symptoms
The main symptom of menorrhagia is excessive menstrual bleeding. Women with the disorder also tend to bleed more than once a month. You may have menorrhagia if you:

• have to change your pad or tampon every hour
• have to change your pad or tampon overnight
• bleed in between periods
• experience prolonged menstrual bleeding
• have short or irregular menstrual cycles
• experience continuous cramping during your period

Complications Associated with Menorrhagia
If left untreated, there is a possibility that you could experience a menorrhagia-related health complication. Some possible complications of heavy menstrual bleeding include:

• Anemia: Many women with menorrhagia experience iron-deficiency anemia. Your blood contains red blood cells, which carry oxygen and nutrients around the body. If you experience heavy monthly blood loss, you may not have enough red blood cells to keep your body energized. Anemia can cause extreme fatigue, shortness of breath, fainting, and heart complications.
• Toxic Shock Syndrome (TSS): TSS is an infection that can occur when you wear a tampon for longer than 8 hours. Because women with menorrhagia wear tampons more frequently than other women, their risk for TSS increases. TSS symptoms include vomiting, diarrhea, weakness, and sore throat.
• Infertility: It is possible that your menorrhagia could also affect your fertility. Menorrhagia may indicate that you are suffering from reproductive complications like endometriosis, uterine abnormalities, or ovarian dysfunction.

Treatment for Menorrhagia

It is important to receive menorrhagia treatment, to prevent any possible complications. Both non-surgical and surgical options are available.

Non-Surgical Options
Non-surgical options are usually the first line of defense against heavy menstrual bleeding.

• Over-the-Counter Pain Relievers: Over-the-counter pain relievers like ibuprofen and acetaminophen help to reduce cramping and excessive bleeding.
• Progesterone: The hormone progesterone is often given to women suffering from prolonged heavy bleeding. Progesterone can help to normalize the menstrual cycle.
• Hormonal Birth Control: Hormonal birth control, like the birth control pill, can help to regulate your menstrual cycle and make your periods lighter.

Surgical Options
If your menorrhagia is severe, your health care provider may suggest that you pursue surgical options.

• Endometrial Ablation: Endometrial ablation involves using intense ultrasound waves to kill the endometrial lining. This will stop heavy bleeding, but it will interfere with pregnancy.
• Hysterectomy: A hysterectomy is a major surgical procedure in which your uterus is removed. It is offered only in severe cases in which fertility is not a concern.

Mittelschmerz

Mittelschmerz

Millions of women around the world suffer from painful periods. That aching and cramping can really make life difficult, zapping your energy and making daily chores difficult. But a lot of women also experience painful cramps in between their periods. Known as mittelschmerz, this abdominal pain can be just as painful as menstrual cramps, and can occur every month for years on end. Luckily, mittelschmerz can be dealt with to help get you back to enjoying life again.

What is Mittelschmerz?
Mittelschmerz refers to abdominal or pelvic pain that is experienced between periods. The word mittelschmerz actually means "middle pain," because this pain is felt during the middle of your menstrual cycle. Typically occurring around Day 14 of your cycle, mittelschmerz pain coincides with ovulation. The abdominal pain is typically low and one-sided, occurring on the side of the pelvis that you are ovulating from. As many as 1 in 5 women experience mittelschmerz pain every month.

What Causes Mittelschmerz Pain?
There is no known cause of mittelschmerz ovulation pain, however, there are a number of theories as to why women experience these mid-cycle cramps. During ovulation, your egg is released from a casing, known as a follicle. When the follicle breaks, it releases fluid and blood. This fluid and blood may actually irritate the lining of your abdomen, causing pain. Mittelschmerz may also be caused by the growth of the ovarian follicle, which can stretch the surface of you ovary, causing pain.

Symptoms of Mittelschmerz
Mittelschmerz syndrome symptoms can range in severity from woman to woman. The main symptom of mittelschmerz is lower abdominal pain that occurs on one side. This pain can:

• be mild to severe
• be intermittent or constant
• switch from side to side every month
• last for a couple of minutes or up to several hours

Other common symptoms of mittelschmerz include:

• mild nausea
• light vaginal bleeding
• headaches

Diagnosing Mittelschmerz
Your health care provider can diagnose mittelschmerz fairly easily. If your symptoms are similar to those of mittelschmerz, your health care provider will ask you to monitor your cycle, to find out when you are ovulating. If your symptoms occur during ovulation, it is likely that you are experiencing mittelschmerz. More severe symptoms may be a sign that something else is going on.

Warning Signs of Possible Complications
If you are experiencing any abdominal pain or cramping, it is important to keep an eye on your symptoms. If your symptoms escalate, it is a good idea to visit your health care provider in order to rule out any possible complications. Warning signs include:

• severe cramping or pelvic pain
• cramps that last longer than a day
• fever
• dizziness or fainting
• painful urination
• swelling of the abdomen
• bloody stool or vomit

Complications of Mittelschmerz
Mittelschmerz pains are very normal, and, on their own, they do not pose any physical risk. However, if your symptoms are severe, you should have your health care provider check you out for any other complications. Your health care provider can perform a pelvic exam or a pelvic ultrasound to make sure that you are not suffering from:

• appendicitis
• endometriosis
• ovarian cysts
• polycystic ovarian syndrome (PCOS)

Treating Mittelschmerz Pain
Unless your pain is severe, you likely won’t require any treatment for your mittelschmerz pain. Many women do find that over-the-counter medications like ibuprofen, acetaminophen, and naproxen help to relieve cramps and related aches and pains.

If your mittelschmerz cramps are particularly troublesome, you may ask your health care provider about trying a hormonal method of birth control. The birth control pill, the birth control patch, and the birth control ring, all release combinations of hormones, including estrogen and progesterone, to stop ovulation. Once you are no longer ovulating, your mittelschmerz pains should stop.

Self Treatment for Mittelschmerz Pain
Self treatment is often the best way to alleviate cramps that you experience mid-cycle. Here are some tried and tested ways of getting rid of those aches and pains.

• Drink Water: Try to drink between six and eight glasses of water every day. Water will help to keep you hydrated, which will alleviate those cramps.
• Use a Heating Pad: Heat helps to soothe cramps. Get an electric heating pad and keep it on your abdomen for 15 minutes or so.
• Take a Warm Bath: Fill your tub up with warm water and just relax. The heat of the water will help to relieve any pain.

Amenorrhea

Amenorrhea

Periods are often very annoying, because of the cramping, bloating, and PMS symptoms they cause. But even though that period can sometimes be taxing, if you are getting your period every month it is a good indicator that your reproductive system is working properly. If you haven’t gotten your period lately, you may be wondering what the problem is. If you have been missing out on your period for a while, though, you may be experiencing amenorrhea, a menstrual cycle disorder. It is important to be treated for amenorrhea, because it can cause problems with fertility as well as signal underlying health issues.

What is Amenorrhea?
Amenorrhea is a menstrual cycle disorder characterized by the absence of any menstrual periods. Amenorrhea is a fairly common disorder, affecting between 2% and 5% of women in North America. It occurs naturally in women who are pregnant or who are going through menopause. It can be particularly worrisome in other women, though, because it can indicate health complications.

Most women get their periods every 28 days or so. Of course, there will be some fluctuation in your monthly cycles, especially if you have just begun to menstruate. For instance, some women only get their periods every 35 days or so. Your period is caused by the release of a variety of hormones in your body, including estrogen and progesterone. Just the right levels of hormones are needed to stimulate your body to produce your period. Sometimes, women don’t have enough hormones to produce a period, and as a result, develop amenorrhea.

Types of Amenorrhea
Amenorrhea is classified into two types:

Primary Amenorrhea: Primary amenorrhea occurs when a girl hasn’t gotten her period by age 16. On average, most girls hit puberty around age 11 or 12. This causes an increase in hormones, stimulating your body to produce a period. Girls with primary amenorrhea don’t have enough of these hormones in their bodies to produce a period. Primary amenorrhea is common among girls who are very thin or highly athletic, because they do not have enough fat to help produce sex hormones.

Secondary Amenorrhea: Unlike primary amenorrhea, women with secondary amenorrhea at one point experienced normal periods. Then, for some reason, their periods stopped. In order to have secondary amenorrhea, your periods must have stopped for at least three months. It is usually the result of reproductive problems or hormonal complications.

Causes of Amenorrhea
Your menstrual cycle is actually quite responsive to environmental stressors. Little things like nutrition and stress can actually wreak havoc on your period. If you have amenorrhea, it is likely that something has caused your hormone levels to fall out of sync. As a result, your body is no longer producing a period. Factors that can contribute to hormonal problems include:

• improper nutrition
• strenuous exercise
• rapid weight loss or gain
• disordered eating, anorexia, or bulimia
• stress
• problems with your pituitary gland, hypothalamus, or ovaries

Amenorrhea Symptoms
The most obvious sign of amenorrhea is the absence of your monthly period, but sometimes amenorrhea is also accompanied by other, less-obvious symptoms. These include:

• change in sexual drive
• secretions from the breasts
• reduction in size of breasts
• deeper voice
• the appearance of facial hair

If you notice any of these symptoms of amenorrhea, it is important that you contact your health care provider for a check up. Your health care provider will be able to reverse these symptoms and hopefully, restore your period.

Complications of Amenorrhea
Amenorrhea isn’t something you want to mess around with. If you have noticed that your periods have stopped it is important to find out why, so that you can try to restore them. Amenorrhea is often associated with infertility, and can cause long-term problems when it comes to conception. Women who have amenorrhea don’t always produce mature, healthy eggs for fertilization, making it difficult for them to become pregnant. Amenorrhea can indicate reproductive health problems including:

• polycystic ovarian syndrome (PCOS), in which tiny cysts form over the ovaries
• uterine fibroids, a condition where wart-like growths form in the uterine cavity
• hirsutism whereby the pituitary gland produces too much of one hormone

Amenorrhea Treatment
There are effective treatments for amenorrhea, which should help to restore your periods and preserve your fertility. However, treatment varies depending upon the causes of your amenorrhea. Treatment options include:

• Hormonal supplements, like the birth control pill or patch, or hormone replacement therapy. These supplements aid in regulating your hormones, helping to trigger regular menstrual periods.
• Dietary changes, including an increase in fat and calories in order to stimulate estrogen production.
• Counseling for eating disorders.
• Using stress reduction techniques to help regulate your period.
• Surgery to remove cysts or fibroids

Premenstrual Syndrome Relief

Premenstrual Syndrome (PMS) Relief

If you are suffering from the ravages of PMS, don’t give up hope! There are a variety of things that you can try in order to reduce your PMS symptoms. Get rid of those PMS blues or that PMS bloating by trying these simple suggestions. If you are suffering from severe symptoms of PMS, ask you health care provider for additional support. There is help for PMS out there.

Self Care Tips
If you're looking for natural PMS relief, then treating yourself right is one of the best ways to help relieve those signs of PMS. Aside from taking vitamins and specially formulated botanical supplements, there are a variety of simple things that you can do in the comfort of your own home to help you reduce your suffering.

Take A Warm Bath
A warm bath can help to soothe your body and your mind. It’s great for increasing blood flow to stiff and sore muscles, and to help eliminate back pain and cramps. A 20-minute soak will melt away stress and tension caused by PMS. It can also help you to get a handle on those PMS mood swings.

Get Some Sleep
Sleep helps your body to renew its energy and rebuild essential cells and tissues. If you are well-rested you will find that both your physical and emotional PMS symptoms are much less intense.

Watch Your Diet
Diet is thought to have a major impact on the severity of PMS symptoms.

• Reduce your salt intake during the last weeks of your cycle – this will help combat bloating.
• Limit your alcohol consumption to reduce PMS depression. Alcohol is a depressant and will only make you feel worse.
• Try to avoid coffee, tea, chocolate, and anything else that contains caffeine. Caffeine has been linked to mood swings.
• Increase your carbohydrate intake. Carbohydrates increase serotonin levels in the brain, which are responsible for boosting mood.
• Satisfy your cravings! If your body is telling you to eat something, it is probably because it is craving a nutritional component contained in that particular food.

Relieve Your Stress
Stress will only compound your PMS symptoms, making your mood swings, depression, and fatigue worse. Try exercising moderately 3 times a week. This will help you to relieve some stress and also works to balance out your hormones. Meditation is also a good way to center yourself and forget about all of your worries.

Educate Yourself
Learn as much as you can about your PMS symptoms. Look through pamphlets, books, magazines, and even search the Internet. The more you know about your symptoms, the better you will be able to deal with them.

Premenstrual Syndrome (PMS)

Premenstrual Syndrome (PMS)

Do you keep crying at those silly ads on television? Are you happy one moment but angry the next? Do you feel bloated, headachy, and tired? If so, perhaps you can blame these symptoms on PMS. If you are suffering from a variety of physical and emotional symptoms around the time of your period, than you may be among the millions of women worldwide who suffer from PMS. Though it is often joked about, PMS is no laughing matter. It can leave you feeling depressed, tired out, and unable to face the world. But effective treatment is available, from diet changes to botanical supplements.

What is PMS?
PMS is a syndrome that occurs just before your monthly period is supposed to begin. It actually encompasses of a bunch of horrible symptoms, ranging from PMS mood swings to the PMS blues, and it affects about 80% of all menstruating women. PMS tends to onset about midway through your cycle (around day 14 or about the time of ovulaiton) and continues until your period has begun. PMS can affect any woman at any time during her reproductive life and, unfortunately, tends to persist until after menopause. Luckily, there are a variety of PMS treatments that you can try to get relief.

Cause of PMS
Even though it affects so many women, researchers are still unsure why PMS happens. PMS is probably the result of changing hormone levels caused by your menstrual cycle. Because so many symptoms occur just before your period is due, it is probably the drop in estrogen and progesterone levels that is causing them to happen. However, it is also thought that diet may play a role in exacerbating symptoms.

PMS Symptoms
What makes PMS so irritating is that it causes symptoms that affect all the different aspects of your life. It causes physical complaints, mental problems, and it often wreaks emotional havoc. In fact, over 150 PMS symptoms have been documented through various studies. Most women exhibit just a handful of symptoms during their PMS, however, some women experience up to a dozen or more at one time.

Physical Symptoms:
We are all familiar with the physical signs of PMS. They include:

• breast tenderness
• back pain
• muscle aches and pains
• headache or migraine
• bloating
• weight gain
• nausea
• diarrhea or constipation
• hunger cravings

Emotional / Mental Symptoms
PMS can also play games with your emotions and mental acuity. Mental symptoms of PMS include:

• depression
• irritability
• mood swings
• unexplained crying
• difficulty concentrating
• decreased sex drive
• indecision

Premenstrual Dysphoric Disorder (PMDD)
For most women, PMS is just a pain in the neck, but for others it can be a severely debilitating disorder. In fact, almost 5% of American women suffer from severe PMS, and many have to rearrange their work, school, or social schedules around their symptoms. This severe form of PMS is actually called premenstrual dysphoric disorder, or PMDD. PMDD generally lasts longer than PMS, and for some women, it can last all month long.

Symptoms of PMDD are generally similar to PMS however they tend to be much more severe. Additionally, women with PMDD can experience severe depression and anxiety. Treatment for PMDD includes:

• antidepressants, like Prozac, Celexa, and Paxil
• anti-anxiety drugs, like alprazaolam
• hormone therapy, including estrogen, progesterone, and GnRH

It’s Not Just a "Woman Thing"
Though you may be cursing every male you know when you are suffering from PMS, recent evidence has shown that men actually suffer from PMS too. Irritable Male Syndrome, or IMS, produces symptoms that are very similar to those caused by PMS. Between 30% and 50% of men are thought to suffer regularly from male PMS symptoms including:

• depression
• fatigue
• headaches
• back pain
• hot flashes

Like PMS, IMS is thought to be triggered by fluctuations in hormones, specifically testosterone, the male sex hormone. This is often brought on by episodes of stress and by high fat diets. In order to get male PMS relief, stress reduction and a low-fat, balanced diet is recommended.

Endometriosis

Endometriosis

Most women experience some type of discomfort when they get their period, including menstrual cramps, stomach pain, and diarrhea. But what if your pain is particularly bad? Well, if you are plagued by persistent cramps and painful bleeding, you may have a menstrual complication called endometriosis. Endometriosis, or endo, can wreak havoc on your body and your lifestyle, leaving you tired, sick, and perhaps even unable to go on with daily activities. If you think you may have endometriosis, it is important to discuss the issue with your doctor. However, because it is easy to misdiagnose endo, knowing just what to say and ask your doctor can help you get a proper diagnosis sooner.

What is Endometriosis?
Endometriosis affects more than 5 million women in North America every year. Millions more worldwide also have the disease. Endometriosis is a chronic disease that affects a woman’s menstrual cycle. It causes tissues similar to the lining of your uterus (called the endometrium) to grow in different areas of the body, resulting in pain, bleeding, and other symptoms.

If you have endometriosis, uterine tissue can begin to take root on your ovaries, fallopian tubes, rectum, or uterine wall. In some cases, this tissue can even grow on the bladder, bowel, vagina, and in surgical scars. Eventually, this tissue grows into lesions, which can form scar tissue and cause organs to adhere. Like the endometrium, this rogue tissue sheds every month, causing severe pain and discomfort. Because this discarded blood and tissue has no way to leave the body, it remains, causing internal bleeding and scarring.

Causes of Endometriosis
Unfortunately, to date there is no determined cause for endometriosis; however, there are a number of theories as to why it affects some women. Some theorists assert that endometriosis may be the result of genetic complications passed down through a family. Others point to the lymph and blood systems as having a role in distributing endometrial tissues to other areas of the body. Or, endometriosis may be caused by a backup of menstrual fluid that happens during your period. Sometimes, blood and tissue can reverse through the fallopian tubes, allowing the tissues to implant and grow in parts of the abdomen.

Symptoms of Endometriosis
The most obvious endometriosis symptom is severe pelvic pain during your period. However, this does not occur in all women who have endometriosis. In fact, many women suffer no symptoms despite having the illness. Symptoms for endometriosis do tend to get worse over time though. If you are worried, be on the lookout for these signs and symptoms of endometriosis and get checked by your health care provider regularly.

• painful periods, with cramping in the lower back and abdomen
• pain during ovulation
• deep, stabbing pains during sexual intercourse
• painful bowel movements or urination, especially during your period
• heavy bleeding or bleeding between periods

Endometriosis Complications
Endometriosis is not something that you want to leave untreated. The disease can result in infertility because tissue adhesions can prevent your eggs from entering the fallopian tubes. Unfortunately, between 30% and 40% of women with endometriosis are unable to have children. This is not to say that you won’t get pregnant if you have endometriosis. However, the risk of infertility rises the longer the disease is left untreated.

Endometriosis Treatment
There is no cure for endometriosis, although there are a variety of treatments for the disorder. Treatment for endometriosis is aimed at reducing symptoms, preserving fertility, and preventing later reoccurrence of the disease. If you have endometriosis, speak with your health care provider about your treatment options.

Medical Treatments
There are a number of effective medical treatments for endometriosis. These treatments include:

Pain Killers
Over-the-counter painkillers may be an excellent endometriosis pain treatment. They should reduce your pain and allow you to return to your usual activities. Generally, aspirin and ibuprofen are effective enough to minimize pain. If your pain is extreme though, you may be advised to take a mild narcotic.

Hormonal Contraceptives
The combined birth control pill, which delivers estrogen and progesterone to the body, is helpful in reducing symptoms of pain associated with your period. It will also help to regulate your period and minimize your bleeding. Birth control for endometriosis can also be taken continuously in order to limit the number of periods you have in a year. One recent study reported an 80% satisfaction rate with this method of treatment. Side effects may include weight gain, nausea, headache, and irregular bleeding.

Gn-RH Agonists
This is a type of hormone therapy that helps to control your menstrual bleeding. Gn-RH is a synthetic form of gonadotropin releasing hormone, which your body needs to regulate its monthly cycle. Injections of Gn-RH help to control estrogen production in your body, which is responsible for tissue growth. With this treatment, your bleeding should stop within 2 months and other symptoms will disappear within 4 to 6 weeks. Unfortunately, this treatment does not come without side effects. You will experience symptoms of menopause, such as hot flashes and mood swings. Gn-RH also causes the loss of bone mass. After six months of treatment you will lose between 4% and 6% of your bone density, which can increase your risk of osteoporosis.

Surgery
If your symptoms are particularly bad or if your abdominal growths are large, you may decide to undergo surgery to have them removed. Conservative endometriosis surgery uses lasers to destroy growths. Sometimes this form of surgery can stall the illness long enough for you to become pregnant and give birth. Sometimes endometriosis is so developed that a hysterectomy is required. A surgeon will remove your uterus and ovaries in order to reduce your pain and bleeding.

Alternative Therapies for Endometriosis
If you find that conventional medications just aren’t for you, you may want to look into natural treatment alternatives. Most natural treatments focus on reducing the amount of estrogen in the body. Estrogen is often responsible for excess tissue growth. Here are some treatments that might work for you. Remember to consult your health care provider before trying any type of alternative treatment.

• Vitamin E: Vitamin E is known to reduce inflammation and inhibit pain. It can also be helpful in balancing estrogen levels in the body.
• Natural Progesterone Creams: These creams, which are available over-the-counter or in naturopathic stores, contain the hormone progesterone. This will help to level out the amount of estrogen in your body, inhibiting tissue growth.
• Estrogen-Reduced Diet: Diet and endometriosis are often linked. Following an estrogen-reduced diet may be helpful in preventing further tissue growth and scarring. Products like milk and meat, and the plastic containers we use to reheat food in, often contain xenoestrogens, a type of synthetic estrogen which can promote estrogen levels in the body. Avoid any non-organic meat products, as these have been injected with xenoestrogens. Also, try to increase the amount of fiber and vegetables in your diet.

Irregular Periods (Oligomenorrhea)

Irregular Periods (Oligomenorrhea)

Periods can sometimes be a real pain. They can make you feel sick. They can give you a headache. They can make your stomach ache. Yes, periods can be a real pain, and things can be even worse if they decide to become irregular. Irregular periods are one of the most common menstrual complaints around. Usually, irregular periods are nothing to worry about, but on occasion, they can signal health complications.

Regular Periods
Before we can define an irregular period, we must first determine what a regular period is. People often say that a regular period occurs every 28 days, but actually, every woman’s menstrual cycle is different. Depending on your body and your hormones, you may get your period every 20 days or your may get your period every 35 days. A good way to determine if your periods are regular is to keep a chart and count the number of days between each period. If they occur with roughly the same number of days between each cycle, then your periods are regular. A regular period typically lasts 5 days, but it is completely normal to menstruate for anywhere between 3 and 7 days.

Irregular Periods
Irregular periods aren’t unusual – they affect about 30% of women in their reproductive years. An irregular period is any type of bleeding that is abnormal when compared to your usual menstrual cycle. This can include a late period, an early period or bleeding between periods. It can also appear as particularly heavy bleeding (menorrhagia) or scanty bleeding. Many women also experience irregular periods in the form of a missed period, continuous periods, or periods that occur twice in one cycle.

Causes of Irregular Periods
Irregular menstrual periods are usually the result of hormonal signals that have been thrown out of sync. In order to produce a period, your body makes hormones, like estrogen and progesterone. These hormones are kept in the hypothalamus, pituitary gland, and ovaries inside your body. In order to trigger ovulation and menstruation, these parts of the body need to send signals to one another. Sometimes, these signals get crossed or skipped, causing irregular periods.

But what causes these hormone signals to get out of whack? Well, there are actually a number of things that can easily cause your hormone levels to change.

• Pregnancy: If you are pregnant, your body will begin producing different levels of hormones. This will cause numerous pregnancy symptoms, including an end to your period.
• Stress: Stress is a common cause of irregular periods. If you are fatigued, worried, or anxious this can cause your hormones to become unbalanced.
• Diet: A poor diet or extreme weight loss or gain can also affect your hormones. Women with anorexia or bulimia often have no period or irregular periods.
• Exercise: Intense exercise can wreak havoc on your body, often causing irregular periods.
• Menarche: the cycles after a girl’s first period may be irregular for some time. It can take up to 3 years to get regular periods.
• Menopause: Menopause causes changes in your hormone levels, and is often signaled by irregular periods.
• Hormonal Birth Control: Birth control pills and irregular periods sometimes go hand in hand. It can take a while for your body to adjust to the new levels of hormones delivered by hormonal birth control.

Complications
For most women, an irregular period is nothing to be worried about; the majority of women will eventually develop a regular cycle with regular periods. Sometimes though, underlying complications can be the cause of these period problems. If you are noticing particularly irregular periods, or have gone a year or more with missed periods, see your health care professional. If you experience extreme cramping, heavy period bleeding, dizziness, nausea, or fainting you should also visit with your health care provider.

Polycystic Ovary Syndrome
Polycystic ovary syndrome, or PCOS, is a fairly common complication, affecting about 10% of all women. PCOS causes cysts to form on the ovaries, interfering with regular ovulation. Symptoms of this syndrome include: excessive hair growth, weight gain, acne, dandruff, high blood pressure, and infertility. If you display any of the symptoms, you may want to make an appointment to get checked for PCOS. Left untreated, it can lead to other more serious complications, including endometriosis, heart disease, and ovarian cancer.

Inflammatory Bowel Disease
Inflammatory bowel disease causes inflammation of the lower intestines (also known as the bowel). It is linked with irregular periods, and may also be accompanied by symptoms of weight loss, abdominal pain, and diarrhea. Inflammatory bowel disease can become severe, and sometimes requires hospitalization or surgery. If you have any of these symptoms, ask your doctor to check you for inflammatory bowel disease.

Treating Irregular Periods
Depending on the cause of your irregular periods, there may or may not be much you can do about them. If you have only been experiencing irregular periods for a short time (less than 7 months), it is likely that your periods will become regular again on their own. However, if there is an underlying medical condition that is causing your irregular periods, then receiving treatment for the condition should help to get your periods back on track. If you find that irregular periods are becoming annoying, there are some things that you can try to help regulate your hormones.

• Reduce your stress levels. Take time to meditate, relax, or just hang out. This may help put your cycle back on track.
• Get help for your eating disorder. If you are anorexic, bulimic, or if you suffer from other types of disordered eating, you must seek help. Not only will these eating disorders interrupt your menstrual cycle, but they can also severely affect your liver, bowel, throat, and heart functions.
• Don’t over exercise. While it is important to exercise regularly and keep fit, exercising too much can be problematic. If you are an endurance athlete, try to cut back on your training a little bit, until your irregular periods return to normal.

Medical Treatments
There are a few medical treatments which may be helpful in regulating your period:

• Hormonal Contraceptives: Hormonal contraceptives are often used to help regulate menstrual cycles. These contraceptives combine estrogen and progesterone and maintain your body’s hormones at specific and balanced levels. They are available by prescription and come in oral, patch, ring, and injectable forms.
• Hormone Supplements: If you have a specific hormone problem, such as overproduction of testosterone, hormonal supplements may be able to help regulate your periods. Speak with your health care provider for more information.

Menarche

Menarche

Every woman goes through it at one time or another – her first period. It may be exciting, it may be scary, it may be reassuring – every woman feels a different way when it first happens. However you may be feeling, the start of menstruation is a real sign that you have moved from adolescence into womanhood. It may not seem like you’re any older, but your body is now physically prepared to have a baby of its own. This can be a scary thing, but by being knowledgeable and prepared, you can put any fears you have about menstruation and womanhood to rest.

What is Menarche?
Your first menstrual period is referred to as menarche. You will probably notice it as a blood spot on your underpants when you go to the bathroom or change your clothes. This blood spot can look dark brown or bright red, so don’t be concerned if it isn’t the color you expected. You can use either a sanitary pad or tampon to catch the blood that comes out. From now on, you will receive a menstrual period according to a cycle that your body determines.

Each woman has her own individual cycle, usually lasting between 21 and 40 days. The beginning of each cycle is marked by your period. Usually lasting between 3 and 7 days, your menstrual blood will change color slightly throughout the duration of each period that you have. Your periods will probably start off light and then get heavier, eventually tapering off. It will probably take about 2 years for your period to become regular. You may miss a period here and there in the beginning, but don’t worry, this is a normal occurrence. And if you find yourself dealing with menstrual cramps, you may want to taske a pain reliever or a natural supplement.

Age of Menarche
Menarche usually occurs about two years after your breasts develop (thelarche) and between 4 and 6 months after the growth of your pubic and underarm hair. The age of menarche in most North American women is around 12 or 13, though your first period can come anytime between 9 and 16, depending upon your height, weight, and cultural background. Early menarche is occurring more and more - girls as young as 8 have been known to get their periods. This is referred to as premature menarche. Girls who haven’t gotten their period by the age of 16 are described as experiencing primary amenorrhea. Sometimes external factors or complications may prevent your period from arriving when it should.

Certain factors are thought to affect the age of menarche. Cultural and genetic factors play an important role in determining how fast your body will develop. Girls from different races all seem to develop at a slightly different rate. You may notice that some of your friends have already gotten their periods and you haven’t. You may even be wondering if something’s gone wrong with you. Rest assured, every girl develops at a different pace.

If you haven’t gone through menarche by the time you are 15 or 16, though, you should make an appointment with your doctor to determine if there are any underlying problems. Many girls who are underweight or undernourished will not get their periods. It is generally thought that a certain weight (around 100 pounds) must be attained in order for your brain to send signals to your body to start menstruating.

Symptoms of Menarche
You will probably feel some moderate symptoms when you first get your period. You may notice that you feel bloated or uncomfortable – this is caused by water that your body retains during menstruation. Other signs of menarche include a slight headache, leg ache or backache for a few hours. The most common symptom of menarche, is cramping. You may feel abdominal cramping, similar to a stomachache for the first few days of your period. Try taking an over-the-counter pain medication, such as Advil or Tylenol, for the pain.

You may notice some emotional changes too before your period. You may feel tense, angry, or sad because of the hormones your body is releasing. Don’t get too discouraged. These symptoms won’t last long.

Menarche Rituals
Every culture deals with menarche in different ways. Some cultures recognize menarche as an important time in a girl’s life and celebrate it in order to welcome the girl into the world of womanhood. Others view menarche as just an unimportant physical occurrence.

Historically, menarche has been celebrated with detailed menarche rituals. The Ancient Greeks mixed corn with menstrual blood to celebrate fertility. The Hopi Indians secluded their daughters during menarche, welcoming them back to the community 5 days later, as women.

Although many people today overlook menarche as an important stage in a young girl’s life, increasingly, more and more mothers are beginning to hold their own personalized menarche rituals, using music, jewelry, flowers, and dance to celebrate their daughter’s move into womanhood.

Toxic Shock Syndrome

Toxic Shock Syndrome

Many women have heard of toxic shock syndrome or TSS. If you’re a regular user of tampons, then you’ve probably read the warnings that come in every package about TSS. Unfortunately, other than informing you that the use of tampons is associated with the risk of developing TSS, those warnings don’t really tell you just what toxic shock syndrome is. So read on to learn the facts you need to know about this potentially lethal infection.

What is TSS?
Toxic shock syndrome is a kind of blood poisoning that results in a person becoming extremely ill in a very short amount of time. TSS is caused by the Staphylococcus aureus bacterium. Although the bacteria are naturally found within the human body, under certain conditions, the bacteria can multiply leading to toxic shock syndrome.

TSS can occur as a result of using tampons or intravaginal contraceptive devices (i.e. the sponge) or as a result of an infection from surgery, an insect bite or burns. TSS can affect women and men, adults and children alike although it is thought that those under the age of 30 are more likely to suffer from TSS because their immune systems have yet to develop the appropriate antibodies.

Nowadays, occurrences of TSS are fairly rare. In 1996, the U.S. reported less than 100 cases of TSS. From these cases, less than half occurred as the result of tampon usage. This is a dramatic decrease from twenty years early, when 90% of all TSS cases were linked to tampons. In the United Kingdom, only about 40 cases of toxic shock syndrome are reported annually. Similar to the U.S., half of these cases are linked to women using tampons. Two to three people die every year in the U.K. as a result of toxic shock syndrome.

TSS and Tampons
When the United States first began paying attention to toxic shock syndrome in 1978, the vast majority of incidents were the result of women using tampons. Because of this, tampon manufacturers went about altering the makeup of their tampons. Since research has shown that using tampons with a higher absorbency can increase the risk of TSS, tampon manufacturers have also changed the absorbency levels in their tampons.

However, the connection between tampons and toxic shock syndrome has yet to be fully understood. It is assumed, though, that the Staphylococcus bacteria thrives and proliferates in warm, moist areas thereby making a high absorbency tampon the ideal breeding ground for the bacteria. The bacteria may enter your blood stream if the tampon causes a laceration in your vaginal lining. In the case of super absorbency tampons, the tampon may expand to such an extent that it sticks to the vaginal wall. Upon removal, the tampon pulls at your skin causing some of the lining to come off and the bacteria to get in.

Toxic Shock Symdrome Symptoms
Signs of TSS can appear suddenly, usually within 2 days of infection. In women, symptoms often show up around the time of menstruation. Common symptoms of toxic shock syndrome include:

• High fever
• Chills
• Nausea or vomiting
• Diarrhea
• Muscle aches
• Lightheadedness or dizziness
• Fatigue
• Rash that resembles a sunburn
• Confusion
• Sudden drop in blood pressure
• Blood shot eyes
• Peeling of skin on palms of hands and soles of feet
• Organ failure

If you experience the sudden onset of any of these symptoms, especially while you are menstruating and/or wearing a tampon, you should seek immediate medical attention. If you are wearing a tampon or a vaginal barrier contraceptive, remove it.

Diagnosis and Treatment
Toxic shock syndrome is usually diagnosed through blood tests that evaluate how well your liver and kidneys are working. In some cases, your doctor may choose to do some additional blood tests in order to rule out the possibility of other illnesses. Once TSS has been confirmed, you will likely receive antibiotics to treat it. If the TSS has been caused by an infection of a sore or surgery, your doctor may drain the area.

It is important to seek help quickly if you suspect TSS. Left untreated, toxic shock syndrome can quickly get worse, leading to organ failure and possibly death.

Prevention
To help avoid and lower your risk of TSS, don’t use tampons or alternate between tampons and pads during your period. If you are a sworn tampon user, then use the lowest absorbency tampon necessary for your period and change the tampon every 8 hours or less.

The Staphylococcus bacteria can live on your hands and is therefore consider to be contagious. Make sure you wash your hands properly, especially before and after inserting a tampon, to prevent the spread of the bacteria.

Alternative Menstrual Products

Alternative Menstrual Products

Each woman has her own reason for deciding to use alternative menstrual products. Perhaps she is concerned about the chemicals that disposable pads and tampons contain. Maybe she is looking for a more cost-effective menstrual product. Possibly she is doing her part to keep the environment healthy by choosing alternative menstrual products that can be reused. Or it could just be for all of the above reasons that she has decided to no longer use disposable pads or tampons. If you are interested in learning more about alternative menstral products, then read on.

Reusable Menstrual Pads
Reusable cloth pads have been around for centuries. Before disposable pads came along in the 1940s, women used cloths or rags to absorb their menstrual blood. When the cloth became saturated, a woman just replaced it with another and rinsed the soiled cloth so she could use it again. Unlike the days of yore, though, reusable menstrual pads of today’s generation come in a variety of styles, absorbencies and even thickness to ensure that you have the coverage and the comfort you want.

Reusable cloth pads consist of a removable liner that sits in or on top of a holder. Unlike disposable menstrual pads, which use sticky adhesive to stay in place, the holder will have clips, buttons or Velcro to keep the pad in place. This means you don’t have to worry about the pad sticking to your leg or pulling your hair when you try to change it. Generally, all manufacturers of reusable pads make their liners using 100% organic cotton that has not been exposed to or chemicals or processed with any bleach or chemicals.

Depending on how you wash and care for the pads, a reusable menstrual pad can last you anywhere from 3 to 10 years. Prices for the pads can vary (from approximately $12 to $20) depending on the brand and size of pad you select. Since you will need a few pads to get you through one cycle, the initial cost of using these pads may seem a bit expensive. But considering that they can be used for many years, the pads will pay for themselves within the first year of use.

Menstrual Cups
A menstrual cup is a popular alternative to tampons. Worn internally, a menstral cup has a bell shape with a stem at the bottom that you use to pull the cup out. Measuring about two inches across, the opening of the cup forms a seal with your vaginal wall, allowing the cup to catch your menstrual flow.

In the past, menstrual cups were often made of latex. However, due to the irritation and discomfort experienced by women who have a latex allergy, most manufacturers now offer at least one version of a latex-free menstrual cup. One of the oldest and most well known brands is The Keeper. This menstrual cup is made from gum rubber and has been on the market since the early 1940s. Another popular name is the DivaCup, a great alternative menstrual solution that is made from medical grade silicone.

Although their large size can seem rather intimidating, menstrual cups are quite flexible therefore allowing you to bend and fold it when you insert it. On average, a menstrual cup can hold about one ounce of blood. You should empty the cup every 6 to 12 hours but be aware that it can be tricky to remove the cup without spilling when you first start using it. A menstrual cup will cost between $30 and $40 but can last for up to 10 years.

Silk Sea Sponge Tampons
Natural sea sponges work exactly like a tampon. They are worn internally, held in place by your vaginal muscles, and absorb your menstrual flow. Similar to tampons, they do need to be changed every few hours. However, unlike a tampon, you do not throw the sponge away. Instead, you either insert another dry sponge or rinse the one you were wearing and then reinsert it. Sea sponges do not have an applicator; instead you use your finger to insert the sponge.

Although silk sea sponges are harvested, they are done so in a sustainable and responsible fashion. The sponges are completely natural and biodegradable. They are not treated with any chemicals or bleach, so you will need to boil your sea sponge before you use it the first time. A package of 2 sea sponges will cost between $7 and $12 and can be reused for up to 8 months.

Tampons and Pads

Conventional Wisdom: Tampons and Pads

Take a stroll down the feminine hygiene aisle of your local supermarket or pharmacy and you will see row upon row of pads and tampons. The most commonly used menstrual products, pads and tampons come in a wide variety of absorbencies, styles, lengths and sometimes even colors. If you’re not already familiar with tampons or pads, perhaps it’s time you learned a bit more about the products you use every month to absorb your menstrual flow.

Tampons
Many women prefer the use of tampons to pads because they find them to be much more comfortable and discrete than menstrual pads. Tampons are worn internally, held in place by your vaginal muscles, and absorb your menstrual blood before it leaves your body. Contrary to what some women may think, tampons do not block the flow of your period blood. Once the tampon has reached its absorbency capacity, it is possible for you to experience a leak.

Tampons themselves are usually made of cotton, some of which are completely organic (check the box), or a cotton/rayon blend. Most tampons have an applicator, made of either plastic or cardboard, although some brands don’t use an applicator. For these tampons, you use your finger to insert the tampon into your vagina. At the end of the tampon is a cotton string that hangs outside your body. To remove the tampon, you pull on the string to pull to the tampon out.

You can buy tampons in a variety of absorbencies, from light to super heavy. Since most women experience different levels of flow throughout their period, most tampon manufacturers now offer multi-packs that contain tampons of different absorbencies. Tampon applicators and wrappers must be thrown in the garbage as do some tampons. Check the instructions that come in your tampon box to find out how to properly dispose of your tampon. You should change your tampon every four to eight hours depending on how heavy your menstrual flow is. If you are experiencing a very heavy menstruation, it may be necessary to change your tampon more frequently.

Tampons and Toxins
One of the main concerns with using tampons is the risk of experiencing toxic shock syndrome (TSS). Because of this risk, tampons should never be left in for more than eight hours. You should also use the lowest absorbency necessary for your period as higher absorbency tampons have been found to increase the risk of TSS.

Since tampons are worn internally, many women are concerned about the chemicals used during the manufacturing process of tampons. In order to make sure the tampon fibers are clean, they do need to be bleached in order to ensure that they have been totally purified. Most tampon manufacturers use a chlorine-free bleaching process, commonly consisting of hydrogen peroxide or dilute sodium hypochlorite, to clean their tampon fibers. These bleaching processes are thought to be much safer than using bleach that contains chlorine.

The levels of dioxin in tampons are another source of worry for some women. Dioxins are a type of environmental pollutant and can cause problems when people come into contact with high levels of dioxins. However, in North America, tampons are regularly tested for dioxin levels and all are either at or below the detectable level. This means that the level of dioxins found in tampons is actually less than what is normally found in your body and therefore poses such a small hazard to your health that the risk is considered to be negligible.

For many years, a rumor has been swirling about that tampon manufacturers have been adding asbestos, a very dangerous and toxic chemical, to their tampons in order to cause women to bleed more and therefore buy more tampons. Absolutely no truth has been found in this rumor, though. In the United States, the Food and Drug Administration regulates the making of tampons. This means that tampon manufacturers must follow the regulations imposed by the FDA on the materials and substances they use to make their tampons. It also means that the FDA regularly inspects the manufacturing practices of tampons. And so far, no asbestos has turned up. In Canada, Health Canada regulates the manufacturing of tampons and they too have not found any asbestos.

Pads
Pads go by many names: maxi pads, sanitary napkins, napkins, menstrual pads, rags. No matter what name you prefer, those pads that you normally find in your local pharmacy are all the same. They are made with an adhesive plastic back that sticks onto the crotch of your underwear. The over side of the pad (the side that sits against your body) is made up of absorbent wood cellulose fibers, similar to paper, and usually an additional top layer of perforated plastic that helps to keep you dry.

In the past, women didn’t have too much choice when it came to using a pad. There was one thickness, one type of absorbency and one length. Nowadays, women have the choice between thick, thin and ultra-thin pads; pads with or without wings (flaps that wrap around the sides of your underwear); regular length, long or extra long/overnight length; curved to fit your body better; and, finally, tapered at the end for thongs.

Similar to pads are panty liners. These are designed for those days when your menstrual flow is very light or when you experience spotting during your cycle. This pads are generally extremely thin and do not offer as much coverage as a regular menstrual pad. Again, though, there is a fair amount of variety in terms of style: with or without wings; regular length or long; tapered for thongs; scented or unscented; there are even some panty liners that come in different colors.

Pads usually need to be changed every four to six hours, although, if your flow is very heavy, you may need to change the pad more often. Since the pad is worn externally, there is no risk of TSS. However, you may notice a slight odor if you have not changed your pad for a while. This is due to your menstual blood being exposed to the air.

Reasons for Alternative Menstrual Products
While pads and tampons are convenient, they do have their drawbacks. Using tampons does increase your risk of TSS. Although pads do not have the same chemical concerns associated with them as tampons, many women are put off pads because of the amount of waste they produce. Since pads are not biodegradable, the only place for them to go is the landfill. Moreover, the long-term cost of using pads or tampons has lead an increasing number of women to seek out menstrual products that are more environmentally responsible and cost-effective. Some of these natural menstruation products include a menstrual cup and reusable menstrual pads.