Why is there blood coming out of my vagina?
This is your period, a natural and healthy cycle that starts around the ages of 10-14. The blood is the inner lining of your uterus; it builds up and then sheds every month.
Imagine your uterus as a baby room that gets decorated with new wallpaper every month, in anticipation of an egg being released. About halfway between 2 periods (so 2 weeks after your period), an egg is released by your ovary - this is called ovulation. If an egg released by your ovary meets a sperm and becomes fertilized, it will find a cozy spot in the uterus to grow into an embryo and eventually a baby. If the egg is not fertilized, the wallpaper will be peeled off the baby room, and you will see this lining come out of your vagina as blood. Then the whole process restarts!
What does a menstrual cycle look like?
Cycles are usually 26-31 days long, with 3-7 days of bleeding on average.
During the first 1-2 years of having your period, your cycles will likely be more irregular, meaning you might not have one every month, or you might bleed longer than 3-7 days. If you bleed for more than 14 days, see a doctor as soon as possible.
How much is too much bleeding?
If you're bleeding through more than a pad an hour, or through more than a tampon an hour, you should definitely see a doctor.
If you bleed as much as pad #4 in 4 hours or shorter, you are bleeding too much.
If you bleed as much as tampon #4 in 2 hours or shorter, you are bleeding too much.
Just because your family says your bleeding is normal does not mean it is normal! Your family members might also be bleeding too much.
Bleeding too much can cause serious health effects, such as fatigue and fainting from low red blood cell counts.
How much is too much pain?
It is normal to experience some pain and/or discomfort during your period. However, if your period pain is severe, your doctor can help with treatments, including medicine.
Call the doctor if you:
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don't feel better after trying home treatments
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can't do your usual activities because of your symptoms
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have symptoms that don't go away after the first few days of your period
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feel very sad or hopeless
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ever think about hurting or killing yourself
What if I don't get my period?
If you haven’t noticed changes in your body indicative of puberty (like pubic hair, armpit hair, breast development) by age 13, or if you don’t get your period by the age of 15, this could be abnormal, so make sure you talk about it with your doctor.
If you get your period, but then it goes away, there are a few potential reasons:
Stress
Eating
Pregnancy
PCOS
Birth Control
In the same way that other bodily functions can be affected when you’re stressed (like your sleep or your bowel functions), your period can also be affected. A good place to start if you haven’t gotten your period in a while is to check in with your body about what might be causing you stress.
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Have you been staying up late studying every night?
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Have you been constantly worrying about something going on with your friend group?
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Are you worrying about family?
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Are you balancing caretaking, school, and work?
Consider spending more time on selfcare! You can check out our section on mental wellbeing here for tips.
PCOS stands for Polycystic Ovarian Syndrome. This is a very common disease where a woman’s hormones are unbalanced, meaning she might not get her period and she might notice excess body hair (for example on her face) or be gaining excess weight. It can make it harder for a woman to get pregnant when she wants, and it can increase the chance of diabetes. You should feel free to ask your doctor to help you figure out if you might have PCOS, because there’s various medications and lifestyle changes that can help! For example, starting a birth control pill could make your periods more regular.
Have you been skipping meals so your body doesn’t have enough energy to do processes important for your health like having a period? Or have you been over-exercising and not letting your body recover physically between sports practices? It’s really important to talk to someone about this, even if it seems normal to you. It’s a lot easier to talk it out and figure out what’s healthy early on, rather than continuing down a vicious cycle. You can consult with a trusted adult, a doctor, or a counselor/therapist.
If you have had penetrative sex since your last period, and now your next period is late, you could be pregnant. It can be scary, but it is super easy to take a pregnancy test, and then you’ll have more info about what might be going on. The sooner you take it, the more options you have, and it will always be up to you what you want to do next.
Different types of birth control methods can affect your period in different ways. People who have the hormonal IUD often won’t get their period anymore. That's totally normal and safe, but also it’s totally up to you—if you prefer to get your period every month, your doctor can provide you with other options.
Managing Period Pain
Pain meds you can buy at the drug store
Examples include ibuprofen, Tylenol (acetaminophen), and naproxen. Aspirin is not recommended for those under 18 yrs old. They work best if you take it in advance - as soon as you feel cramps!
Get moving
Light exercise can help with blood flow, which can relieve cramps.
Apply heat
Place a heating pad on your back or stomach, or take a warm bath. The heat helps improve blood flow and can relieve cramps.
Birth Control
Some methods of hormonal birth control can help reduce menstrual flow and pain, such as the pill, patch, ring, implant, or hormonal IUD.
Change your position
Lie down in a fetal position (knees to your chest, on your side), or lie on your back with a pillow under your knees. This may help relieve some stomach pressure.
Get sleep
Get lots of sleep and rest! 7-9 hours is recommended.
Change your product
Using pads or period underwear instead of tampons may help relieve discomfort.
Eat well
Avoid foods that can cause bloating and water retention, such as fatty and salty foods, carbonated drinks, and caffeine.
Tracking Your Period
Why should I track my period?
1. Be prepared with period products
2. Tell when there are changes in your health
3. Know when you're likely to get pregnant
Tracking your period can help you prepare for when it's coming, and anticipate mood changes or pain.
When you track your period, you're more likely to know if you've missed a period or your period is late, which could be an indicator of pregnancy, poor eating, PCOS, or other conditions.
Tracking your period can also inform you of when you're most and least likely to get pregnant during the month. You are least likely to get pregnant in the time during and around your period. You are most likely to get pregnant around the time of ovulation - if you get your period once a month, that means you are most likely to get pregnant around 2 weeks after your period starts.
How to track your period
There's an app for that!
There are many mobile apps that allow you to track when you get your period every month. As you enter more data, the app will average out how many days your period lasts and your average cycle length (how many days from the beginning of one period until the beginning of the next). You'll know when you are most fertile (most likely to get pregnant), and when your period is likely to come next.
You can also use the built-in apps in an iPhone or Fitbit, if you have access to these devices.
Menstrual Hygiene Products
Pros
Tampons
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feels secure for exercise, swimming
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pretty easy and small to insert
Pads
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comfortable
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usually don't have to worry about leakage into underwear
Menstrual Cups
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long-lasting (12 hours)
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most economical (cheapest and lasts 1-2 years)
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environmentally friendly
Period Underwear
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long-lasting (12 hours)
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no leakage
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environmentally friendly and lasts several years
Cons
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change it out often (every 3-4 hours)
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vagina can become sore after prolonged use; toxic shock syndrome
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might get blood on underwear if moving around a lot
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may feel bulkier than a tampon
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can be difficult to insert or remove until you get the hang of it
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if you're out and about for a long time, cleaning it out in a public restroom can be hard
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have to wash and dry by hand each night
A tampon is a little plug made of cotton that catches blood inside your vagina. Watch a great video on how to insert a tampon here.
Tampons
Pads
Pads (or sanitary napkins) are thick napkins that catch your menstrual blood. You peel off a sticker to attach the pad to your underwear. Some pads also have sticky wings, or flaps on the sides, to help secure the pad by wrapping the flaps around both sides of your underwear.
The menstrual cup is a soft and bendable cup made of medical-grade silicone, latex, or rubber. It sits in your vagina, and is held in place by your vaginal muscles, which the cup naturally suctions to without any extra effort required on your part. Most brands offer a small and a large size to help fit your vagina.
Watch a video here on how to insert a menstrual cup. With clean and dry hands, you insert a washed menstrual cup into your vagina (same place a tampon would go) by folding in the cup and gently releasing so it opens against your vaginal walls.
Menstrual Cup/Disc
Period underwear are reusable for virtually forever, and absorb your period blood securely. To clean, you just wash in cold water and hang dry.
Period Underwear
More about the period cup
Not sure if you would like using Menstrual Cups or Period Underwear?
Here are some concerns young people have about using period cups:
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It might be uncomfortable
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It might be messy putting it in and taking it out
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It might be complicated to put in and take out
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It might be hard to change in a public bathroom
Here are some concerns young people have about using period underwear:
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It might leak or could be messy
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It might smell
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It would feel like a diaper
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It might feel like you’re sitting in your period
Toxic Shock Syndrome
What is Toxic Shock Syndrome, and what does it have to do with menstrual hygiene?
Causes
Keeping a tampon or menstrual cup in too long (more than 8 hours) can cause dangerous bacteria to grow in your vagina.
Did you know?
Some common bacteria causing TSS include:
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Staphylococcus aureus
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Streptococcus pyogenes
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Clostridium sordellii
Signs & Symptoms
If you have your period and feel very dizzy like you want to pass out, then call your doctor or seek emergency care. This could be a sign of Toxic Shock Syndrome.
Remember, however, that Toxic Shock Syndrome is pretty rare.
TSS effects 0.8 – 3.4 in every 100,000 people in the United States.
What to do?
If you have more than one of these symptoms, see a doctor immediately. A doctor can treat you with:
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Antibiotics
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Fluids
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Extra oxygen
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And more, depending on the progression of your condition.
Menstrual Disorders
Experiencing painful periods?
In some cases, painful periods may be indicative of bigger health problems. If any of the below seem to apply to you, it may be wise to consult a doctor about your period pain:
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None of the above pain management techniques lessen your pain
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Your pain affects your ability to focus in school or participate in the activities you usually do every day
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Your periods have suddenly become a lot heavier than they usually are (you are going through many more pads or tampons than usual)
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Your periods suddenly become a lot more painful than they usually are
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You are feverish during your period
You can also read through the disorders below to learn more.
PMDD (Pre-Menstrual Dysphoric Disorder)
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PCOS (polycystic ovarian syndrome)
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Endometriosis
Talking with your Doctor
Visiting the OB/GYN (or any doctor) can be intimidating, and you may not feel heard. It is important for you to take charge of your health and freely ask questions. Here's a few examples of questions to get you started. Be bold, you got this!
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What health topics can you help with as my OB/GYN?
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Why is ––– happening to me?
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On a regular check-up, is it necessary to look at my private parts? Can you tell me when you do?
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Can you explain why you are asking those questions?
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Can you explain why you are doing that procedure (or test)?
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How often should I come see you?
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Will I see you every time I come in for an appointment? Or will I see a new doctor?
Navigating Period Stigma
What is stigma? Stigma refers to the discrimination of, and/or disapproval, against an individual or group baced on perceived characteristics that distiguashes them from other members of society.
Period Stigma: How it Holds Back Girls and Women
The authors of this piece begin by debunking several false myths. The whole article centers around how cultural beliefs, myths, and lack of knowledge at age earlier age contribute to the stigma. Along with women and girls not knowing how to manage menstrual hygiene. The author goes on to discuss how these myths contribute to period stigma, exacerbated by cultural views. Making menstruation something to be ashamed or embarrassed by. After that, the author discusses how this hinders women and girls. The argument that most women and girls stay inside their houses or avoid going out in public is made by the perception that periods are filthy (for example, across Africa it is estimated that one in 10 girls will miss school when they have their periods, and can miss approximately 10-20 percent of school days). Lastly, how a lot of women are unable to manage their periods properly in their own homes, because of inadequate bathrooms.
“Due to the conversation around menstruation being suppressed, beliefs about people on their periods being unclean are widespread. This often leads to women and girls feeling confined to their homes, being excluded from public spaces, or considered to be bad luck or harmful to others for about a week every month.”
“Devastatingly, this period stigma (along with poverty) has a huge impact on girls' education. For example, across Africa it is estimated that one in 10 girls will miss school when they have their periods, and can miss approximately 10-20% of school days – factors which can lead to them dropping out altogether. This puts them at greater risk of child marriage, and getting pregnant at a younger age, which comes with heightened health risks.”
“The result of not educating girls about menstruation before it starts means that their initial reaction is likely to involve fear, shame and embarrassment. Additionally, poor period education means a lack of knowledge around what menstrual hygiene products are out there. As a result, many women, girls, and people do not have real control over the products they use, and do not have the ability to dispose of or clean these products in an appropriate manner, in line with personal, environmental, cultural, and other considerations.”
Removing the Shame and Stigma from Menstruation | OHCHR
In this article, the authors talk about period poverty, and how the stigmas around periods contribute to the discrimination of women and girls. Period poverty is described as the shortage of access to menstrual products and the restricted available options; secure space and a person to confide in, and absence of education about menstruation. They go on to say these experiences are not “homogenous but shaped by intersecting factors such as age, gender, race, disability, economic, social, migration” Furthering the narrative that menstruation poverty is and has an underlying issue with race involved. Lastly making the claim that to end period stigma young girls need adequate information. Something easy to access and available at all times.
“Menstrual experiences of women and girls are not homogenous but shaped by intersecting factors such as age, gender, race, disability, economic, social, migration and other status and contexts, be it in peace, conflict, disaster or within a health crisis.”
“Because of social taboo and gender stereotypes that stigmatize menstruation as dirty, many people experience menstruation with shame and without access to the resources needed to manage their menstrual health safely,” she said. “Menstruation is a human rights issue. It is also a public health and development issue.”
“Tampon shaming is the judgement over tampon usage and choices. This goes beyond stares from individuals who do not have periods – it may go as far as receiving negative, unsolicited input from other women regarding sanitary product preferences.”
“Using tampons does not impact virginity status. The cultural concept of ‘losing your virginity’ is based on breaking your ‘hymen’ through penetrative vaginal sex. Tampons are big enough to absorb blood, but small enough to fit perfectly within the vagina without affecting the hymen. The hymen is not like a mesh; it is a ring. If it is a mesh, visit your doctor to have it corrected.”