Is the old brown blood that comes out after a menstrual cycle supposed to stink?

Answer 1

No, it isn't supposed to have a foul odor. This sometimes happens at the peri menopause stage and is a sign that you may be entering menopause. Regardless of your age, this can happen.

You should tell your doctor about this. He may be able to prescribe medication to stop the odor and the brown blood too.

Answer 2

1

Answer 3

After a period, it should not have a foul odor. There is likely an infection present if this is the case.

Answer 4

mine never does .so i dont think so

Answer 5

Kind of long but good info!

THIS PAGE SERVES as a refresher course on the menstrual cycle and explains some of the common menstrual cycle problems women have, along with ways to remedy them. Safety and environmental issues surrounding menstrual products are discussed in the section "What to Wear for Your Period."

The first period, clinically known as menarche, is probably one of the most powerful psychological, sociological, and physiological occurrences in any woman's life. It is her rite of passage. Once we begin our menstrual cycle, we enter into a completely different physiological phase: our reproductive years.

Even today, many young women don't understand what the menstrual cycle is; they feel shame, fear, anxiety, and depression about their first periods, and as a result, they have very negative experiences. Sometimes the negative experience of the first period has to do with painful periods and cramping (discussed later in this chapter), but often the negative experience is linked to false information about what the period actually is and what it means. The negativity of menstruation is then reinforced when we become sexually active. For example, many men are repulsed by the menstrual flow and refrain from petting or having intercourse with menstruating women.

There is also a negative mythology about menstruation that traces all the way back to the book of Genesis. The phrase the curse, for example, comes from the story of Adam and Eve. In a nutshell, Eve's punishment for biting the apple—the forbidden fruit from the Tree of Knowledge—was to be cursed with painful childbirth ever after. The historical and completely erroneous translation is that the period is a monthly reminder to women that it is they who kicked man out of paradise.

Unfortunately, the negative mythology and imagery associated with menstruation are both a cultural reaction to it as well as a patriarchal one. Until the twentieth century, very little was understood about the menstrual cycle, and nothing was known about hormones. Menstruation was thus seen as a mysterious enigma, and the emotional premenstrual signs leading up to menstruation were feared, branded as a kind of hysteria by the male medical profession. Since women have been living in a patriarchal society for so many centuries, they, too, have become quasi believers in the "evils" of menstruation, believing that medicating and masking our cycles is appropriate.

The Moon Cycle
A normal menstrual cycle is actually more like a moon cycle. Interestingly, the only event in human life that corresponds to the lunar calendar is menstruation. Time itself was probably first measured by the moon's phases. One of the problems with the current English calendar is that the months don't coincide exactly with the solar year. In our current system, the months were made to fit by Gregory XIII, who gave them an arbitrary number of days unrelated to the moon calendar. So our calendar actually puts us out of sync with the moon.

The word menstrual comes from the Latin word mens meaning "month"; the word month comes from the root word moon. The Greek word for moon is mene, while menstruation actually means "moon change." (In some dictionaries, the root word for month and menstruation is measure.) The point of all this is to simply establish that a far more accurate and positive interpretation of menstruation was recorded in our history through language.

Countless other languages and cultures link menstruation to the moon as well. German peasants literally refer to menstruation as "the moon," while the French term for menstruation is le moment de la lune ("the moment of the moon"). The Mandingo, Susus, and Congo tribes also call menstruation "the moon," while in parts of East Africa, menstruation is thought to be caused by the new moon. The Papuans believe that the moon has intercourse with girls, triggering their periods; the Maori call menstruation "moon sickness"; the Fuegians call the moon "The Lord of the Women." Clearly the belief that the lunar cycle is identical to the menstrual cycle is universal. There is even some remarkable physical evidence that connects the moon to menstruation even more; for example, the cervix, metra in Greek, referring again to the word measurement, and also called the "meter of a woman," changes color, size, and position during menstruation. In fact, when it's viewed with a speculum (an instrument doctors use to open up the vagina), the cervix has been said to resemble a globe. Even in pregnancy, the embryo is shaped like the moon; the embryo starts out round and full, and as it becomes a fetus, it curves like the half-moon.

All this evidence suggests that women are perhaps far more in tune to the natural rhythms of the universe than they think. Meanwhile, comprehending the similarities between the menstrual and lunar cycles is crucial in order to understand what a healthy, normal menstrual cycle really is. Women are also in tune with other women's cycles; two women living together will often synchronize cycles. The rhythmic timing of menstruation also provides women with a sense of their own timing, other than just daylight.

What Is "Normal"?
It's more accurate to call a menstrual cycle a "hormonal cycle" because that is in fact what the menstrual cycle is. The menstrual cycle is driven by a symphony of hormones that trigger each other, stopping and starting, flooding and tapering in a regular rhythm each month. Every woman's hormones dance to a different tune—but rarely does the menstrual cycle correspond to the English calendar.

Low levels of sex hormones are continuously produced during a woman's reproductive years. But it is the continuous fluctuation of hormones that establishes the menstrual cycle and the understandable premenstrual symptoms (described in the section "Premenstrual Signs and Symptoms").

The main organs involved in the cycle are the hypothalamus (a part of the brain), the pituitary gland, and the ovaries. The hypothalamus is like the omniscient figure, watching over the cycle and controlling the symphony of hormones from above. It tells the pituitary gland to start the hormonal process, which signals the ovaries to "do their thing." The hypothalamus is sensitive to the fluctuating levels of hormones produced by the ovaries. When the level of estrogen drops below a certain point, the hypothalamus turns on FSH-RF (follicle-stimulating hormone–releasing factor). This stimulates the pituitary gland to release FSH. FSH triggers the growth of ten to twenty ovarian follicles, but only one of them will mature fully; the others will start to degenerate sometime before ovulation. As the follicles grow, they secrete estrogen in increasing amounts. The estrogen affects the lining of the uterus, signaling it to grow or proliferate (proliferatory phase). When the egg approaches maturity inside the mature follicle, the follicle secretes a burst of progesterone in addition to the estrogen. This progesterone-estrogen combo triggers the hypothalamus to secrete more FSH-RF—this time with LH-RF (luteinizing hormone–releasing factor). These releasing factors signal the pituitary gland to secrete FSH and LH simultaneously. The FSH and LH levels peak and signal the follicle to release the egg. (This is ovulation.)

To simplify this process, think of it like a thunderstorm. The lightning that precedes the storm is the hypothalamus, sending out FSH-RF. The thunder that follows is the pituitary gland, answering with FSH. Then the rain starts, lightly at first. The ovaries, which are beginning to grow follicles and trickle estrogen and progesterone into the bloodstream, are the rain. This light rain goes on for a few minutes until suddenly, two bright bursts of lightning ignite the sky—the hypothalamus again, this time sending out two releasing factors, FSH-RF and LH-RF. Then, bang, bang—the pituitary gland answers the lightning, sending out FSH and LH simultaneously. The intensity of the rain increases, and it starts pouring—the follicles burst, and estrogen and progesterone pour out into the bloodstream, which is when you ovulate. Slowly the rain dies down, as hormonal levels taper off until the storm stops. It is at this point that you menstruate.

Under the influence of LH, the follicle changes its function and is now called a corpus luteum, secreting decreasing amounts of estrogen and increasing amounts of progesterone. The progesterone influences the estrogen-primed uterine lining to secrete fluids that nourish the egg (the secretory phase). Immediately after ovulation, FSH returns to a normal, or base, level, and the LH decreases gradually, as the progesterone increases. If the egg is fertilized, the corpus luteum continues to secrete estrogen and progesterone to maintain the pregnancy. In this case, the corpus luteum is stimulated by HCG, a hormone secreted by the developing placenta. If the egg isn't fertilized, the corpus luteum degenerates until it becomes nonfunctioning, at this point called a corpus albicans. As the degeneration progresses, the progesterone levels decrease. The decreased progesterone fails to maintain the uterine lining, which causes it to shed. Then the whole thing starts again.

The first period usually starts about the middle of puberty, at about eleven or twelve years of age. The first few periods are sporadic, and it's not uncommon for periods to be irregular for a couple years. A woman continues having her period until she's about forty-eight or forty-nine years of age, at which point the period starts to get sporadic again, tapering off as menopause sets in. Few cycles are absolutely twenty-eight days. Where does that number come from? Twenty-eight is only an average representing the cycle length of thousands of women added together and divided by the number of women. It is therefore a statistical average, not a figure that refers to the typical number of days in a woman's cycle. Menstrual cycles range anywhere from twenty to forty days, and the bleeding lasts anywhere from two to eight days, with four to six days being the average.

There's a big difference between your own cycle and a calendar month, however. When you tell your doctor that your period starts on the fifteenth of every month, for example, you're actually stating the impossible. Since the number of days varies per month, unless you were consistently irregular, you wouldn't begin menstruating exactly on the fifteenth of each month.

Finally, it's important to count the first day of bleeding as day 1 of your cycle. Many women count the first day of clear discharge after their periods as day 1, but this is not as accurate. What's the difference? Since ovulation always takes place roughly fourteen days before your period, five days off in your counting could radically interfere with your family planning. Secondly, if you're on the Pill, the first day of bleeding is always counted as day 1. If you're planning to go on or off the Pill, your cycle is more accurately tracked by using the same counting method. Thirdly, doctors always count the first day of bleeding as day 1 of the cycle.

Many of us assume that our menstrual flow is strictly blood, but this is not so. The menstrual fluid is made from a variety of ingredients: cervical and vaginal mucus, degenerated endometrial particles, and blood. The fluid does not smell until it makes contact with the bacteria in the air and starts to decompose.

Irregular Cycles: Metrorrhagia
One of the most common gynecological problems is an irregular menstrual cycle. But before you jump to the conclusion that you're irregular, it's important to remember that being regular doesn't mean your cycle is the same number of days each time. One month your cycle may be twenty-nine days, and the next month it may be thirty-one days. This is still considered the norm. It's also normal to be lighter one month and heavier the next. So long as you're menstruating every twenty to forty days, it's a sign that you're ovulating. Another common misperception about irregular cycles is the belief that unless you have a period every four weeks (again, the statistical average) you're irregular. This is not true. Some women menstruate every three weeks, which is normal for them; some menstruate every five weeks, which is normal for them. The only time you should be concerned is if your period consistently yo-yos: three weeks, then four weeks, then five weeks, then three weeks, and so on. When this happens, it's usually a sign that you're not ovulating regularly. This is common in young girls after they first begin menstruating. If your period only jumps around once or twice a year, there isn't anything to worry about. Occasional stress is usually the culprit when this happens.

When You've Skipped a Period

Women may skip a period from time to time and then experience a heavier flow with their next period. This is extremely common. Women who are trying to get pregnant, however, often fear that this is a mild miscarriage—so mild that it simply feels like a heavy period. This is usually not the case. Although it's possible for a pregnancy not to take and instead to expel in the menstrual flow, it's rare and occurs in less than 1 percent of women. If this were to occur, it would be so early a pregnancy that the term miscarriage would be inappropriate; it would simply be a pregnancy that wasn't yet established, technically called a blighted ovum. Skipping one period, in most cases, is caused by stress. The flow is heavier after a skipped period because the estrogen has been building up in the endometrium longer, and there is more lining than usual that needs to be shed. In essence, you would have built up two cycles' worth of lining, so the flow is naturally heavier than normal.

It's also common to skip a period altogether and not experience a heavier flow the next time around. This means you actually skipped an ovulation cycle and had not produced a lining in your endometrium that would support a pregnancy. In this case, there wasn't a lining to shed. It's not unusual to skip one or two periods a year; it is unusual to skip them more often than that, however.

The Need to Bleed

Today, women have to deal with having more periods in their lifetime than women did in the past, due to fewer pregnancies and a longer life cycle. Also, in the past century, women have experienced a radical change in their diet, environment, stress levels, and career and family expectations. Understandably, the accumulated effect of all these factors has affected the hormonal cycle of women, which, of course, affects the menstrual cycle.

Again, it's fine to skip a period once in a while or experience some occasional fluctuation. But if you've missed more than two consecutive periods and you know for certain that you're not pregnant (either confirmed by a pregnancy test or the absence of any sexual activity), then you should investigate having your period induced through a natural progesterone supplement, which will kick-start your cycle again. It's dangerous to go longer than three months without "a bleed"; if the uterus isn't regularly "cleaned out," your risk of uterine cancer can increase. Click here for more information.

Heavy Flow: Menorrhagia
If you have an extremely heavy flow, it may be normal for you. This is known as primary menorrhagia, which means that your flow has been heavy since you first began menstruating. If this is the case, there isn't anything to worry about. You should regularly (every six months) have your blood levels checked, however, because consistent heavy flows could cause anemia. In fact, the number-one cause of anemia is a heavy menstrual flow.

If a lighter flow slowly develops into a continuous heavy flow, this is known as secondary menorrhagia. When this happens, as long as you're having annual pelvic exams and biannual blood tests, you shouldn't be concerned. If, however, your flow suddenly becomes unexplainably heavy, see your doctor. This kind of menorrhagia may signify other problems, such as fibroids, tumors, and so on. Flows are considered dangerously heavy if you need to change your pad or tampon every hour.

A Word About Clots

A clot looks like a tiny sample of raw liver or raw oyster and often comes out with a heavy menstrual flow. Clots are normal and do not mean you're hemorrhaging. Blood naturally clots, and often when you're sleeping during a heavy period, the blood will collect in clots and expel in the morning. The only time you need to worry about clots is if you're passing them after your period is over, passing them with a prolonged period, passing them midcycle, or passing them while you're pregnant. (Similarly, if you're bleeding at all during these times, you should see a doctor.)

When You Experience Abnormal Heavy Bleeding

Abnormal heavy bleeding is when your bleeding is suddenly heavy or significantly heavier than what your normal menstrual flow "pattern" is. In fact, it is your own perception of what's heavy that's more important than your doctor's perception. And good doctors will try to get you to describe your impression of "heavy" and have you compare it to your normal pattern. If your doctor tries to determine exactly how much blood you've lost, this is a waste of time for both of you.

Clinically, an abnormally heavy menstrual flow is defined as being more than 80 cc of blood lost per cycle. But studies show that many women who complain of an abnormally heavy flow have lost much less than that. In fact, a more "scientific" measurement is to simply take inventory of the number of pads and tampons you're going through and compare that with your normal pattern.

But Why Is It Suddenly So Heavy?

Your age has a lot to do with your menstrual flow. In fact, teenaged women and women approaching menopause will have similar cycles, often characterized by changes in flow. Women between the ages of twenty and forty will have (or should have!) regular patterns that do not fluctuate that much from period to period.

If you are under twenty and are noticing heavy bleeding, ask your doctor to check you out for a blood coagulation disorder known as van Willebrand's disease or for platelet disorders, such as thrombocytopenia or thromboasthenia.

Most of the time, however, abnormal heavy bleeding is caused by some sort of hormonal disorder, which can be investigated by a reproductive endocrinologist.

If you're over forty, abnormal heavy bleeding is usually caused by what's known as the anovulatory period. Here, you make estrogen in the first part of your cycle, but for some reason (often unknown) you just don't ovulate. Therefore, you do not produce progesterone and you develop an unusually thick uterine lining, which is expelled during your period. This translates into abnormally heavy bleeding.

No matter how old you are, one of the chief culprits of abnormally heavy bleeding in women is often high doses of acetylsalicylic acid (ASA), or aspirin. So if you're fighting off headaches or other ailments before your period, you may want to use an alternative pain reliever.

Sometimes your contraception method can affect your menstrual cycle. For instance, an IUD (intrauterine device) or hormonal contraception can sometimes trigger heavy bleeding. Click here for more details. Changes in exercise patterns (usually less exercise) can also affect your menstrual flow.

What Your Doctor Should Rule Out

If you notice abnormal bleeding either during or between periods, make sure your doctor rules out the following: hyperthyroidism or hypothyroidism (an over- or underactive thyroid gland), ovarian cysts, abnormal tissue within your uterus, and endometriosis. Your doctor should also perform a pelvic exam as well as a transvaginal ultrasound. The latter is a procedure where a dildo-shaped transducer with a condom on it is inserted into your vagina by the ultrasound technician. Transvaginal ultrasound produces much sharper images than abdominal ultrasound. And, of course, your doctor should be ruling out symptoms of possible sexually transmitted diseases.

See the "Flower Power" section for natural remedies used to treat abnormal heavy bleeding. Natural progesterone therapy is also helpful in regulating flow and cycles. A less invasive traditional medicine approach may be taking a nonsteroidal anti-inflammatory drug (NSAID), which will reduce your menstrual flow. A common prescription NSAID is naproxen sodium (Anaprox). The usual dose is 275 milligrams (mg) two to four times a day.

If none of these treatments help, you should be evaluated for more serious conditions, such as endometriosis.

Painful Periods: Dysmenorrhea
Primary dysmenorrhea means that you've always had painful periods—ever since you started menstruating. Secondary dysmenorrhea means that your periods have become more painful with time. In either case, painful periods are common. Cramps are simply caused by uterine contractions, which is how the lining is pushed out; some uteri contract more than others. It is also believed that cramps may be caused by low levels of calcium. Drinking alcohol or eating lots of eggs, meat, and dairy foods can worsen menstrual cramps.

There are a number of herbal supplements (see "Flower Power") that can help regulate your cycle and reduce heavy flows, thereby lessening cramping as well. That said, many women turn to traditional medicine for severe cramps. Taking an analgesic such as ibuprofen before your period starts can really help; this will also reduce flow. Oral contraceptives also reduce cramping and flow, which is known as one of the noncontraceptive benefits. Click here for more information on oral contraceptives. It's also important to recognize the difference between normal cramping and unusual, debilitating pain during your periods. Often the culprit behind severe pain during your period is endometriosis, a serious disease affecting women in their reproductive years, which until recently was widely undiagnosed. For more details, click here.

Periods on Oral Contraceptives
It's common for younger women in particular to be placed on oral contraceptives as a way of controlling their cycles. If you are uncomfortable with taking an oral contraceptive solely for cycle control and are using another method of birth control, there are natural ways to control your cycle, which are discussed further on under "Flower Power." If you're happy on an oral contraceptive, as long as you don't smoke and don't have any adverse health problems that oral contraceptives can complicate, you can be on them for a long time if you're regularly monitored by a doctor. There are two kinds of oral contraceptives: combination (which contain synthetic estrogen and progestin, a synthetic progesterone) and progestin-only (which contain no estrogen). Oral contraceptives are said to have noncontraceptive benefits that include a reduction in ovarian cysts, ovarian cancers, endometrial cancers, and, of course, premenstrual discomforts. That's because oral contraceptives stop ovulation. Women who have never breast-fed or been pregnant stand to benefit the most from noncontraceptive benefits as pregnancy and breast-feeding are designed to give your ovaries a natural break from ovulating.

When you have your period while taking combination oral contraceptives, it is a chemically induced period called withdrawal bleeding. On some progestin-only contraceptives, you may also shed the uterine lining once a month. If you're on Depo-Provera, your periods will be less frequent. Periods while on the Pill, as many of us know, are a dream come true: relatively mild cramps, medium-to-light flow, and punctual to the point where you can set your watch by them. For more information on oral contraceptives, click here.

Periods After Oral Contraceptives

Many women are surprised to find that when they go off oral contraceptives, their menstrual problems return. Women whose cycles were irregular before taking oral contraceptives will continue to have irregular cycles after going off them; women who suffered from painful periods before will probably have painful periods after. And so on. Oral contraceptives are only a temporary panacea for menstrual cycle problems.

Often women will remain regular when they go off oral contraceptives. This is usually because when the women initially went on oral contraceptives, they were younger and had less mature ovulation cycles. Ovulation cycles do mature as we get into our twenties and thirties, which is why the cycles will normalize. But often, as just mentioned, the original cycle—however flawed—returns. Frequently, not only will your original cycle return (many women actually forget what their true cycle was like), but it can take up to six months for your ovulation cycle to kick in and return to normal. If you're planning to get pregnant, allow at least that much time. Doctors will tell you to wait until you get two natural periods before you try to conceive, which is fine—but don't panic if you don't conceive by your third, fourth, or fifth cycle. There is a delusion that as soon as we go off oral contraceptives we'll get pregnant. This is just not true. Couples having intercourse every other day can sometimes wait a year before conception actually takes place.

What to Wear for Your Period
In the early 1990s, women began to be much more aware of products that harmed the environment. For example, washable diapers are now back in vogue as a way to reduce our trash. Menstrual products became the focus of much debate when it was learned that plastic tampon applicators are commonly washed up on beaches all over North America because the plastic does not break down in sewage treatment plants. (Many women flush them even though they are meant to be disposed of in the garbage, which just means more garbage.) For these reasons, women are encouraged to use applicator-free tampons (there are many brands).

Green Periods

Reducing "period trash" can mean two things: reducing back-end garbage or improving front-end cleanliness, which involves reducing the amount of chemicals used in the initial manufacture of menstrual products, thereby helping to reduce environmental exposure to contaminants overall. Green menstrual products are also safer for women, reducing our exposure to bleaches and other questionable chemicals and ingredients currently in use to make our pads and tampons "clean and white" so we feel psychologically cleaner around our periods.

Reducing back-end garbage involves choosing a reusable product, such as washable pads. There are now a few companies that produce washable pads made from organically grown cotton that is undyed and unbleached, reducing both garbage and chemical usage. Check out the following:

Gladrags: Visit gladrags.com.
Lunapads: Visit lunapads.com.
Mama Elle: For information, send E-mail to [e-mail] or phone [phone].
Many Moons: Visit pacificcoast.net/~manymoons/.
Pandora Pads: Visit pandorapads.com.
Alternatives to pads are tampons, but there are safety issues revolving around tampons (which I'll discuss further on) that require you to use unbleached tampon products—even if you don't care about the environment! There is also the new menstrual cup, which is shaped like a small diaphragm that sits just under your cervix (no applicator or creams necessary) and catches the flow. The Keeper is a cup that you remove and wash. Another brand, Instead, gives you disposable cups, which does not solve the garbage problem but does solve the safety problem for women who want an alternative to tampons. (See the next section, on tampons.)

Improving front-end cleanliness by reducing the amount of chemicals used in the manufacture of pads and tampons involves using menstrual products made from natural materials that don't form chemical by-products. All of the reusable pads are made from organic cottons that do not involve the use of pesticides or other toxins. Nonbleached tampons are another way to go. These can be purchased at any health food store, as well as most drugstores now. Popular brands include Eco Yarn, Terra Femme, Natracare, and Organic Essentials.

What You Ought to Know About Bleached Tampons

Women use a lot of tampons. Just in North America alone, more than eighty-five million women use tampons; the average woman may use as many as 16,800 tampons in her lifetime, and if she is on hormone replacement therapy after menopause, that figure may jump up to as many as 24,360 tampons in her lifetime.

Since 1980 there has been a lot of press questioning the safety of tampons. The first reports that tampons may not be safe surrounded toxic shock syndrome, which I discuss further on. The most shocking tampon revelations arose from an independent study in 1991, which found that tampons usually contained one of the following additives: chlorine compounds, absorbency enhancers (which can be toxic), natural and synthetic fibers (such as cotton, rayon, polyester, and polyacrylate), deodorant, and fragrance.

The main concern over tampons is the bleaching of the product, which produces dioxin, a chemical the Environmental Protection Agency and the International Agency for Research on Cancer say probably cause cancer. (For more information on environmental carcinogens, see my book Stopping Cancer at the Source, which can be ordered from sarahealth.com.) The extent to which dioxins are in tampons has been a source of debate, but since dioxin is a by-product of chlorine-bleaching processes used in the manufacture of paper products, including tampons, sanitary pads, panty liners, and diapers, it stands to reason that tampons do contain dioxin. There are bleaching processes that do not produce dioxin, but unfortunately, the paper manufacturers (which produce the raw materials used in tampons) use either elemental-chlorine or chlorine-dioxide bleaching processes, which we know do produce dioxin. The Food and Drug Administration (FDA), however, insists that the raw materials used to produce tampons now involve chlorine-free bleaching processes, but it also says that "some elemental chlorine-free bleaching processes can theoretically generate dioxins at extremely low levels, and dioxins are occasionally detected in trace amounts."

As a result, women have been unwittingly exposed to more dioxin than most men because of their use of tampons and other menstrual products. According to the FDA, "State-of-the art testing of tampons and tampon materials that can detect even trace amounts of dioxin has shown that dioxin levels are at or below the detectable limit. No risk to health would be expected from these trace amounts." But trace amounts of dioxin are not considered safe by most environmental groups and women's health groups.

The questioning of tampon safety led the U.S. Congress to introduce in 1999 the Tampon Safety and Research Act, which has yet to be passed. The purpose of this bill is to research the ingredients used to make tampons, such as dioxin, synthetic fibers, and other additives, and to investigate the true health effects and whether these ingredients place women at risk for cervical cancer, endometriosis, infertility, ovarian cancer, breast cancer, immune system deficiencies, pelvic inflammatory disease, and toxic shock syndrome.

What About Asbestos?

Some women's groups have published that U.S. tampon manufacturers add asbestos to their products to promote excessive menstrual bleeding in order to sell more tampons. This isn't that crazy a claim, considering that the tobacco industry added substances to cigarettes to make them more addictive. The FDA maintains that the asbestos charges are purely rumor and that there is no evidence that asbestos is used in tampons. Nonetheless, to confirm or negate such claims, it's important that independent studies are done on tampons.

Who Regulates Tampons?

Tampons are considered medical devices and as such should be regularly assessed, tested, and monitored as vigorously as bandages or heart valves. But they're not. The U.S. government has determined that the FDA has not adequately investigated the safety of tampons because of the FDA's reliance on safety data provided by the tampon manufacturers rather than independent peer-reviewed scientific studies on the safety of the products. And tampon manufacturers do not make their data available to the public. This is how the tobacco industry escaped as long as it did with not disclosing all the ingredients in cigarettes. In Japan, however, there are strict tests that the government applies to tampon manufacturing and testing. No level, including trace levels, of dioxin is considered acceptable by European health authorities or the World Health Organization.

Aside from toxic shock syndrome, there are other problems tampons can cause. Because tampons actively absorb menstrual blood and do not differentiate between blood and vaginal mucus, the skin that lines the vaginal walls dries up. That can lead to microulcerations and infection. Artificial fibers such as rayon, which most brand-name bleached tampons contain, are abrasive; when the tampon expands, it can cause tiny cuts and embed pieces into the vaginal tissue. To read information directly from the FDA on tampons, see www.fda.gov/bbs/topics/consumer/con00116.html or www.fda.gov/fdac/features/2000/200_tss.html. Keep in mind, though, that many health experts do not feel the FDA's take on tampon safety is accurate or acceptable. But it's worth a read.

Tampon Hygiene Rules

Tampons should therefore never be used between periods, during pregnancy (to absorb mucus, for example), or when you already have a vaginal infection. In the United States, to help tampon shoppers compare absorbency from brand to brand, packages use terms that determine thickness, such as junior, regular, super, and super plus.

Many women with extremely heavy flows are in the habit of using more than one tampon at the same time. If you're among them, get out of the habit. The second one can "get lost"—pushed up so high in your vagina, you can't retrieve it yourself. The general rule with tampons is to change them every four to six hours. Official warnings state that tampons left for twelve to eighteen hours may put you at risk for toxic shock syndrome.

Toxic Shock Syndrome (TSS)

Toxic shock syndrome is a group of symptoms caused by a bacterium already present in the vagina that adheres to the tampon. The bacterium then starts producing a toxin that attacks other parts of the body. The initial symptoms of TSS are fever, nausea, vomiting, diarrhea, sore throat, and dizziness. Other symptoms include a sunburnlike rash, peeling of the skin (especially on the hands and feet), and low blood pressure. All of these symptoms are, of course, vague and can be attributed to a host of other diseases. So if someone has TSS, she can easily be misdiagnosed, particularly if she has only a few symptoms. These days, TSS caused by tampon use is considered pretty rare now that we have warnings about it in tampon packaging. The Centers for Disease Control and Prevention reports a great reduction in tampon-related TSS. For example, in 1997 only 5 confirmed tampon-related TSS cases were reported; in 1980 there were 814 cases. The higher the tampon's absorbency, the greater the risk of TSS regardless of whether the tampon is made with rayon or the purest, most organically grown cotton.

Menstrual Websites

Premenstrual Signs and Symptoms
Virtually all women in their childbearing years have premenstrual signs (as opposed to "symptoms," which make our normal hormonal changes sound like a disease). As we age, our premenstrual signs can become more severe, especially as we approach perimenopause, a term that means "around menopause," which usually occurs when we're somewhere in our mid-to-late forties. Premenstrual signs occur roughly fourteen days before your period and disappear when, or just after, you get your period. The main questions are: Ought premenstrual signs be treated? Is it right to think of these signs as a disease or disorder, medicating them with antidepressants, tranquilizers, water pills, or synthetically produced hormones? (Even if you are the one who wants your doctor to prescribe medication for your premenstrual changes, you should still consider these questions.)

Traditionally, women's complaints about premenstrual signs have been either viewed as psychological or written off as part of the biological lot of women. Many women have difficulty admitting they suffer from them for fear of compromising their position in the workplace. But virtually all women experience some premenstrual signs. It's how you experience these signs and how severely they affect you that determines whether these premenstrual signs warrant remedying through natural means or, in the extreme, through medical interventions, such as harsh medications or synthetic hormones.

Some 90 percent of women who menstruate experience premenstrual signs of some sort. Of this group, half will experience the more traditional premenstrual signs, such as breast tenderness, bloating, food cravings, irritability, and mood swings. These signs, for many women, are often perceived as a sign that their bodies are "in tune" or "on schedule" and that all is well. In other words, these signs are natural markers of a healthy menstrual cycle. If you fall into this group, you may find that moderately adjusting your diet, or adding one or two of the dietary or herbal supplements discussed further on, can dramatically improve your premenstrual discomforts.

About 35 to 40 percent of menstruating women experience the same signs of the first group, but in a more severe form. In other words, these women have really tender breasts, so sensitive that they hurt if someone just lightly touches them. These women have severe bloating to the extent that they gain about five pounds before their periods. Instead of just food cravings, these women may suddenly find that they have voracious appetites. Instead of just being irritable, these women may find that they become impossible to be around. And so on. Even these more severe signs are considered to be very normal experiences. If you fall into this group, you may find that more rigorous dietary adjustments, supplements in combination with herbal remedies, and increased physical activity can dramatically decrease your level of discomfort. You may also benefit from ruling out other causes for your discomforts and may even want to explore natural progesterone supplements.

Roughly 3 to 10 percent of menstruating women (the latest statistics hover around 3 to 4 percent) suffer from incapacitating discomforts that affect their ability to function. These women experience discomforts that interfere with their quality of life, such as profound mood swings, sudden or unexplainable sadness, irritability, sudden or unexplainable anger, feelings of anxiety or being on edge, depression, hopelessness, self-deprecating thoughts, and a range of physical discomforts, such as tender breasts, bloating, and so on. In the psychiatric literature, even women with hysterectomies and oophorectomies (removal of their ovaries) were found to experience these symptoms. It is considered sound and good medicine to offer this group of women antidepressants as a treatment for their premenstrual syndrome (PMS), even though incapacitating discomforts can still be managed through natural remedies. If you fall into this group, it's important to first rule out other causes for your physical and emotional discomforts, such as stress or an underlying depression that has social causes and has more to do with your life's conditions. Or determine if you may be having reactions to other synthetic hormones or medications you are taking, which get aggravated by fluctuating hormones around the time of your period. Next, take a long hard look at your diet and activity patterns. Adjusting your diet, adding supplements and herbs, and becoming more active can really make a difference. Finally, you may benefit from natural progesterone supplements, which was discussed here. I urge you to consider synthetic hormones, antidepressants, antianxiety agents, and other medications as a very last resort. These are strong medications that carry a long list of side effects.

PMS is understandably a complex topic that I felt demanded a separate book. For more information, please consult my book Managing PMS Naturally.

What to Eat
Most women will want to use diet and nutrition to control premenstrual discomforts, which can range from emotional to physical discomforts. One of the first dietary rules is to keep blood sugar levels stable, which experts on PMS believe is essential in order for the progesterone receptors to function properly. Premenstrual discomforts worsen when progesterone receptors are not functioning, which causes the progesterone symptoms of bloating, cravings, and so on.

Vitamins and Minerals

There is so much solid evidence on the benefits of vitamins and minerals in improving PMS that the American College of Obstetricians and Gynecologists, in April 2001, revised its recommendations on PMS to include them. Keep in mind, though, that once you're eating more regularly and eating the right balance of a variety of foods, you may not need further supplements.

Vitamin B6
This is an old standby that has raised some controversy. Most studies on vitamin B6 conclude that up to 100 mg per day can improve PMS-related depression in particular. But at high doses, there are disturbing side effects, known as neurotoxicity or nerve damage, which include the feeling of pins and needles in the arms and legs or of an electric current running through the arms, supersensitivity or burning of the skin, muscle weakness, numbness, shooting pains, and generalized itching. Some B6 side effects can easily be mistaken for PMS: headaches, irritability, tiredness, depression, and puffy eyes. So please approach B6 supplements with caution and do not exceed the 100 mg per day dosage.

Calcium
Adding 1,200 to 1,500 mg calcium daily has been shown in several clinical trials to significantly improve PMS. When progesterone receptors are blocked by low blood sugar levels or adrenaline, not enough progesterone can get to the cells, which means that important bone-building cells called osteoblasts are not being produced. This may explain why calcium supplements help.

Four glasses of milk is equal to about 1,200 mg calcium. In one study, women on calcium supplements for three months found that most of their PMS problems improved, with the exception of fatigue and insomnia.

When you're trying to increase calcium in your diet, you should avoid foods that cause you to use up or "pee out" calcium, such as alcohol or coffee.


Maximizing Calcium Absorption.

Calcium is best absorbed in an acidic environment. To increase acidity, do any of the following:

Drink lemon juice in water with or after your meal.
Add two tablespoons (30 ml) apple cider vinegar and two tablespoons raw honey or blackstrap molasses to one cup (250 ml) water, and drink with or after your meal.
Use calcium-rich herbal vinegars in your salad dressing.

Calcium Greens.

A number of leafy greens also provide calcium:

One serving of broccoli, kale, turnip greens, or mustard greens contains about 200 mg calcium.
One cup cooked collards, wild onions, lamb's-quarter, or amaranth greens contains about 400 mg calcium.
The following greens are not high-calcium sources but rather are high-iron sources: spinach, Swiss chard (silver beet), beet greens, wood sorrel, and rhubarb.

High-Calcium Sources.

Some of these you probably already know about, and others you might not:

tahini
soy or tofu (not all tofu contains calcium—check labels)
oats/oatmeal
seaweeds
sardines
yogurt
nettles
dandelion leaves
dried fruit (65 mg calcium is in three small figs, a handful of raisins, four dates, or eight prunes)
corn tortillas (high in calcium because they are made with lime)

Calcium-Rich Herbs.

A big mug of infusion using any of the following herbs is equal to 250 to 300 mg calcium. Add a big pinch of horsetail and increase the calcium by 10 percent.

nettles
sage
chickweed
red clover
comfrey leaf
raspberry leaf
oatstraw
The Uni-Tea Company makes a calcium-rich tea called FemininiTea, which contains raspberry leaves, nettles, ginger, licorice, chamomile, sarsaparilla, rosemary, rose petals, yellow dock, uva-ursi, dong quai, peony, lavender, and angelica. You can find this product in some health food or natural food stores.


Calcium in Dairy Products.

The highest-calcium dairy product is live-culture yogurt (from milk without hormone and antibiotic residues). Yogurt also strengthens the digestive system, boosts the immune system, eases the nervous system, and helps prevent vaginal infections. Yogurt is much lower in fat than other dairy products, in case you want to stay heart healthy. In fact, 25 percent (350 to 400 mg) of your 1,500 mg daily calcium requirement can come from one cup (250 ml) of yogurt, which is equal to one cup of milk, one ounce (30 gm) of hard cheese, or one-half cup (115 gm) of ricotta cheese. One cup of soy milk yields 80 mg calcium, and one cup of almond milk yields 165 mg calcium.


Calcium Supplements.

If you can't get enough calcium in your diet, there are always supplements: 500 mg magnesium (not citrate) with calcium. Calcium supplements are more effective in divided doses. Two doses of 250 mg, taken morning and night, actually provide more usable calcium than a 500-mg tablet. New research also shows that the amount of calcium absorbed from calcium citrate supplements is consistently higher than the amount absorbed from calcium carbonate supplements. Popular supplements include:

Calcium-fortified orange juice: This is easier to digest and absorb than other supplements.
Calcium citrate in tablet form: Crushed tablets are better absorbed.
Calcium gluconate, calcium lactate, and calcium carbonate (if chewable): You can take 1,500 mg daily of one of these.
Magnesium
Some studies are showing that small amounts of magnesium (no more than 200 mg per day) help to reduce water retention and bloating. Magnesium is found in leafy greens, seaweeds, nuts, whole grains, yogurt, cheese, potatoes, corn, peas, and squash. Herbal sources include oatstraw, licorice, kelp, nettles, dulse, burdock, chickweed, althea root, horsetail, sage, raspberry leaf, red clover, valerian, yellow dock, dandelion, carrot tops, parsley, and evening primrose.

Vitamin E
There are some studies showing that a dose of 400 International Units (IUs) of vitamin E per day is also useful in improving cramps and breast tenderness. To get vitamin E out of food sources, the key word is color. Vitamin E is highest in nongreen vegetables. The richer the color, the more E you get. Beets, carrots, yams, and so on, are all good sources. Otherwise, you can take a supplement. Vitamin E is also found in nuts, seeds, whole grains, fish-liver oils, fresh leafy greens, kale, cabbage, and asparagus. Herbal sources of E include alfalfa, rose hips, nettles, dong quai, watercress, dandelion, seaweeds, and wild seeds.

Flower Power
Many women rely on traditional medicine to help regulate their cycles or to cope with heavy flows and cramps. Regulating the cycle, one of the keys to reducing premenstrual discomforts, can be done through natural means.

For Irregular Cycles

First, it's been found that both regular orgasms (through self- or partnered stimulation) and pelvic floor exercises can help maintain regular periods. For irregular cycles, including amenorrhea, the following are reportedly helpful:

Raspberry leaf: Best as an infusion here for directions), raspberry leaf nourishes the ovaries as well as the uterus and helps with erratic periods.
Dong quai compound: As a tincture, this warms, regulates, and gently heals the entire reproductive system—especially useful if your irregular cycles are accompanied with premenstrual discomforts. (Note: dong quai can aggravate fibroids.)
Liferoot blossoms: As a tincture, five drops taken daily helps tone the reproductive hormones, ovaries, uterus, adrenals, liver, and pituitary gland.
Vitex: As a tincture, this helps with irregular periods. Use one dropperful in a small glass of water two or three times daily for six to eight weeks after every irregular period.
Cinnamon bark (Cinnamon zeylanicum): This invigorates the blood, helps regulate the menstrual cycle, and helps with very heavy flows as well, especially during perimenopause. Sip a cup (250 ml) of infusion, use five to ten drops of tincture once or twice a day, gnaw on a cinnamon stick, or simply sprinkle cinnamon on everything.
Estrogen Herbs

The following herbs help promote estrogen production, help stabilize infrequent periods, and may reduce the severity of estrogen-loss discomforts during perimenopause:

alfalfa and red clover flowers or leaves
black cohosh roots
hops (female flowers)
licorice roots
sage leaves
sweetbrier hips or leaf buds
pomegranate seeds
any herb containing flavonoids
Progesterone Herbs

The following herbs help promote progesterone production and help stabilize too-frequent periods, which can occur as you approach perimenopause:

chaste tree (Vitex) berries
sarsaparilla roots
wild yam roots
yarrow flowers and leaves
For Menstrual Cramps

The following herbs are helpful in relieving cramps. Many have an antiprostaglandin effect, which is why they work.

black yaw
blue cohosh
cinnamon
cloves
cramp bark
evening primrose
false unicorn root
feverfew
flaxseed
garlic
ginger
hops
meadowsweet
motherwort
red raspberry
thyme
wild yam
yarrow
For Heavy Flows

If you're coping with very heavy menstrual flows, then it's important to consume roughly 2 mg iron from herbs or foods while the bleeding persists. This will help to prevent anemia. Iron is best in small doses throughout the day, rather than in one big gulp. Coffee, black tea, soy protein, egg yolks, bran, and calcium supplements over 250 mg can also impair iron absorption. Bleeding can be aggravated by aspirin, Midol, and larger doses of ascorbic acid (vitamin C supplements) because they thin the blood. In general, foods rich in bioflavonoids and carotene such as the following will help decrease blood loss:

Dandelion leaves: This is the best source of usable iron, containing roughly 30 gm iron per ounce.
Yellow dock root: An alcohol or vinegar tincture is best: twenty drops of alcohol tincture or three teaspoons (15 ml) vinegar, taken in tea or water, gives you 1 mg of iron.
Lady's mantle (Alchemilla vulgaris): This alchemical weed controlled heavy bleeding in virtually all of more than three hundred women in a recent study.
Wild yam root: As a tincture, twenty to thirty drops daily for the two weeks before your period can help reduce flow.
Cinnamon bark: See earlier, under "For Irregular Cycles," for how to take it.
Shepherd's purse: Commonly used to stop bleeding or reduce flow, it is available dried and as a liquid extract. It can cause heart palpitations in large doses and should not be taken with an anticoagulant.
For Dealing with Odor

Because we are conditioned to feel unclean during our periods, we are tempted to cover up odor with feminine deodorant products. The odor is normal and natural, and the commercial deodorants sold can irritate your vaginal ecosystem. There are natural ways to deal with the odor, which I discuss below. Furthermore, never use commercially scented tampons or pads; they can cause irritations and infections due to the chemicals used in them.

Don't douche—ever. Douching rids your vagina of friendly bacteria, which are very important for maintaining its ecosystem. Douching is never recommended after menstruation, even though many women practice it. As long as you regularly bathe, your vagina and uterus are self-cleaning and will do everything that's necessary on their own. Finally, avoid perfumed or colored toilet paper. Again, the perfumes can irritate your vagina and cause infections.

Natural Ways to Deal with Menstrual and Vaginal Odor

The cheapest natural "odor eater" during your period is baking soda. Simply bathe in about a cup of baking soda per tubful.

Aromatherapy is a wonderful way to smell good below the belt. Purchase essential oil in any health food store. Make sure the label reads "100% essential oil" or "pure essential oil." Fill your bathtub, and add about six to eight drops of the oil in the bath. A ten-to-twenty-minute soak in the tub is all you need. Essential oils can be used for all kinds of health problems, including the full range of premenstrual discomforts, allergies, fatigue, depression, and so on. Depending on the health problem, there are other ways to apply the oils, such as to the soles of the feet or via a diffuser. But for vaginal odor, sit in a tub! Here are the best oils to have on hand during your period. You can combine them for a real treat, or just use them as single "shots" in the tub.

Lavender: This is the most useful oil to have on hand as it not only nourishes the female reproductive system and improves vaginal health, but it is also a natural antidepressant and sleep aid.
Geranium: This also nourishes the female reproductive system and has a strong floral scent.
Ylang-ylang: This nourishes the female system and acts as an antidepressant as well as an aphrodisiac! (Try it, you'll like it.)
Rose: This nourishes the female system and also acts as an antidepressant.
If you don't have a bathtub you can use, dilute the oils in a bowl of warm water and take a washcloth or cotton ball to apply as a wipe around the vaginal area. This can be done after bowel movements, too, to keep your rectal area nourished and clean.

For Cramps

The following oils are recommended to relieve cramps, in order of best known: clary sage, cypress, chamomile (Roman), geranium, jasmine, and lavender. Also recommended are peppermint, sage, tarragon, and thyme, but it's best to apply these to the soles of the feet as they're very strong.

How to Move
Performing the maintenance exercises discussed in Understanding the Basics is vital for maintaining cycle control. The following yoga postures are also helpful for menstrual cramps:

The Butterfly
Squatting Posture
Knee and Thigh Stretch
Chest Expander
Supine Knee Squeeze
Fish Posture
Legs Up
Pose of Tranquility
The Crocodile
Star Posture
Spread Leg Stretch
Child's Pose
Pelvic Stretch
The Camel
Lying Twist
Side Leg Raise
Half Moon
Spinal Twist
Many women also find that acupuncture and reflexology help alleviate menstrual cramps.

Answer 6

If you put your nose up to it............ wtf