Posted in Genitals: A User's Guide, Uncategorized

Seeing Red…

I’d like to take a look at periods!

Even though it’s an *extremely* common experience – there are estimates that 800 million people in the world are having a period every single day – this is one of the topics that often gets the most ‘yucks’ and discomfort in schools.

In my experience, people often have misconceptions about periods in the UK. Despite this, I find that there’s a tendency to talk about period stigma as a purely foreign problem – often only acknowledging problems in low income countries. Unicef recognises that period stigma is a global issue.

As someone who regularly talks to young people about menstruation, it seems sadly alive and well in the UK. Often, just bringing out (completely new and unopened) tampons and other period products is enough to evoke palpable – and audible – signs of discomfort in the classroom. I firmly believe that the way to tackle this is to talk to all people about periods – whether they have them or not themselves…

Firstly, let’s start with the basics – what is a period?

It’s bleeding through the vagina from the uterus, usually for a few days, most often once a menstrual cycle (more on variations and problem periods later). The bleeding is the lining of the uterus being shed. It’s made up of clots, tissue and blood – so is very different to the ‘fresh’, bright red blood you might get from veins or arteries from a cut.

Usually (but not always) people use something to manage this bleeding. Different types of period products include:

Pads: Either disposable or reusable material that is attached to underwear and soaks up blood. Disposable pads are widely available. They usually contain some sort of plastic to make them waterproof and are single use – i.e. they are thrown away after being used. Reusable pads are made from fabric and can be washed and reused. At least in the UK, they can be a bit harder to get hold of. Some brands sell them online, or independent makers sell them through websites life Etsy.com. If you are craft savvy, you might like to make them yourself.

Tampons: These are cylinders of cotton wool-like material. They are inserted into the vagina. The walls of the vagina keep them in place, where they can absorb blood. They are removed by pulling on a little ‘string’ attached to them. Concerns about tampons getting stuck, lost or causing harm seem quite common. Although people do sometimes find they can’t remove a tampon, this doesn’t seem to happen very often. Even if it does, the vagina is a closed ‘space’ and a healthcare professional should be able to remove it using special tools (I have had this job at one point). Like anything that is inserted in to the body from outside (including food) there is always going to be some risk of infection with inserting a tampon. Again, this isn’t very common, especially if tampons are removed and changed regularly and you make sure to wash your hands before removing or inserting one.

Period Cups: Shaped a bit like an egg-cup without a stand and made from a squishy but solid material. They are inserted in to the vagina, where they sit underneath the cervix (entrance to the uterus) and collect blood. They can then be emptied and washed – rinsed out in between uses and sterilised (e.g. in boiling water) in between cycles. They usually have a little ‘pull’ on the end that can be used to remove them – a bit like the string on a tampon. Along with fabric pads, they are another type of reusable period product.

Period Disks: They work in a similar way to period cups – but are shaped differently. They are a flattish ‘disk’ shape, rather than a ‘cup’ shape, but are still inserted in to the vagina, where they sit and collect blood. They don’t have the little ‘pull’ piece, and sit a bit higher up in the vagina.

Pants: These are shaped and worn like regular underwear. But the ‘gusset’ (the bit that sits underneath the vagina in people with vulvas) is made from absorbable material, to soak up period blood. As with reusable pads, these are washed and then reused.

Freebleeding: Some people don’t use any particular product when they are menstruating – bleeding ‘freely’ on to their clothes. This can be by accident, or it has been used as a political statement.

Busking it: Sometimes people use anything to hand, such as tissues or cloth, to soak up period blood. One reason for this might be period poverty – the inability to afford period products. It is thought that millions are affected by this, even if high income countries like the UK.

How do people choose which period product to use? People are different – and what is good for some, isn’t for others. Also, your needs and your cycle might change over time or in different circumstances. For example, personally I like to use a period cup during the day because it can be reused and is fine to take swimming. But at night I prefer period pants, as they feel more ‘secure’ which I’m moving about in my sleep.

Another thing that doesn’t get talked about very much is problem periods. There’s sometimes a feeling that periods are meant to be unpleasant – for example, painful. Whilst some discomfort is common, there is such a thing as as a problem period. A period might be a problem might be one that:

  • Is too painful (e.g. effects your ability to do the things you would usually do), including pain just before your period.
  • Is very heavy (e.g. you have to change pads or tampons very frequently or no period products seem to deal with period blood at all), including last for a very long time (i.e. longer than 8 days).
  • Causes you lots of emotional distress, including just before your period.
  • Is very irregular (e.g. your cycle varies by more than several days between each period).

If this or something else is bothering you about your period, it’s probably worth talking to a healthcare professional – like your GP – about it!

Resources:

I cannot recommend the book Red Moon Gang by Tara Costello enough, for anyone who has periods (or who doesn’t, and wants to know more). Informed by Costello’s extensive research, as well as interviews with what seems to be a huge range of people who have periods (including people of different genders). There is also a blog and information site of the same name, which includes a really nice and short article on what a period is!

I wrote ‘The Body’ chapter in Sex Ed: An Inclusive Teenage Guide to Sex and Relationships, which is available from Walker Books now! This chapter includes loads of information about periods, and the rest of the book is full of other RSE info for young people!

This video from Amaze.org is a nice summary of the basic of a period (although briefly gets a bit reproductive focused).

Episode 23 of the Guilty Feminist is all about Periods! Nice, normalising discussion of periods. The guest on this episode is Evelyn Mok, who talks about being diagnosed with PCOS (i.e. problem periods).

This short film about getting a period for the first time might be a nice conversation starter!

Follow the Bloody Good Period campaign on social media for period education.

I am the Co-Founder of PeriodPal – an online app for tracking periods that aims to be inclusive and ethical. This is funded by donations, with no subscription fees. To sign-up for a free account to track periods and your health, go to periodpal.eu.

Posted in Genitals: A User's Guide

Self-Isolation and Masturbation…

In these uncertain times, one thing seems sure… we’ll all been getting a *lot* more time to ourselves and our bodies. Given this, a lot of us will be turning to masturbation.

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Taboo and misinformation surrounds masturbation – genital stimulation for sexual pleasure. However, it is a very natural and health thing to do… So  much so that it is rife in the animal kingdom!

Furthermore, we often assume that it’s not something people with vulvas do. This is simply not true.

People with vulvas do masturbate – for example the vagina, clitoris or anus can be stimulated with fingers or a sex toy.

A pdf with lyrics and (ukulele) chords to this video are available to all subscribers on my Patreon!

Posted in contraception, Genitals: A User's Guide, Uncategorized

Put a Ring On (?/In) It!

Last week I was interviewed for Cosmopolitan about ‘femidoms’ or internal condoms. These are one of a handful of contraceptives that often get talked about in sex ed classes, but appear to be less commonly in use.

Another type of contraception that this can be said about is the vaginal ring.

It gets its name from it’s shape – it’s a ‘ring’ made from a soft rubber like materials, about 5 cm across. It is inserted in to the vagina by the user and once inserted sits just below the cervix.

It’s another type of hormonal contraceptive – which means it protects against pregnancy by affecting the womb, ovaries and the fertility cycle.

It contains the same hormones as the combined pill – oestrogen and progesterone. Because of this, it works in a very similar way:

  1. Stops the ovaries from releasing an egg.
  2. Helps make the lining of the womb stay thin, rather than building up (a thick womb lining is needed for a fertilised egg to implant in and grow).
  3. Helps create a thick ‘plug’ of mucus in the cervix – the entrance to the womb. This helps stop sperm from entering the womb from the vagina in the first place and coming in to contact with an egg.

Also like the combined pill, the vaginal ring is used for three weeks and then not for one week – usually with a ‘withdrawal bleed’ in this week off. The main difference is that whilst the pill is delivered to your system by swallowing a pill, the vagina ring releases these hormones in to your system slowly over time.

After the week off, a new one is inserted. This is done by the user – so no need to attend a clinic or other appointment to get it fitted by a health professional, like with other contraceptive methods such as the coil.

From speaking to friends about their personal and professional experiences it seems like the vaginal ring isn’t something that is as easy to get hold of as other forms of contraception, at least in the UK!

Pros and cons

Because it doesn’t form a barrier between the vagina and the penis, it doesn’t protect against STIs. The vaginal ring is a form of contraception (helps reduce the risk of pregnancy) but not protection (doesn’t help reduce the likelihood of passing on infections through sex).

Some people may find it difficult to use – it involves being quite comfortable with your anatomy, slightly more so than a tampon.

On the other hand – it works very well. If used correctly, the vaginal ring is more than 99% effective. For comparison, this is more effective than condoms (98% effective). It only needs removing and replacing every four weeks – unlike the pill, which you need to think about every day.

For further details see:

NHS Contraception advice 

 

Posted in Genitals: A User's Guide

Reduce and reuse…

Just a quick reminder that not all period products are disposable. We already looked at period products in some detail here.

When we talk about periods in schools, most people seem to know about tampons and sanitary pads. Menstral or ‘moon’ cups however, seem to be a little less well know about and to cause alarm. Made from a soft rubber-like material, they can be squigged a little to fit in to the vagina, where they they retain their shape and stay in place in the vagina. There it collects blood. It can be emptied, washed and reused. They can also be sterilised in between uses – the one I use recommends either boiling it or using baby bottle steriliser in between cycles.

Several companies have started making moon cups. Most are a basic ‘cup’ design but come in different sizes. oftentimes the little ‘pull’ at the bottom of the cup to help remove them is a slightly different shape too.

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Washable pads are a bit more conceptually easier to get your head around! Just like disposable sanitary pads, they can be washed after each use.

Or of course, there’s… IMG_0746.jpeg

‘Freebleeding’ means not trying to stop the blood flowing in any way. For now, accounts of free bleeding seem largely restricted to those making a political statement or investigative journalists… but maybe that’s something that will change in the future!

 

 

Posted in Anatomy, Genitals: A User's Guide

Rubber Band Theory…

In schools at least, some variation of this question is reasonably common – people worry either that a vagina isn’t big enough to accommodate a penis/sex toy/ tampon, or that it will become stretched out of shape by any of those things.

The vagina is a tube, about 8cm long. It isn’t quite hollow – but it can stretch a lot. To make space for a baby’s head, for example – which is much  bigger than pretty much any penis.

The vagina might change shape after childbirth (after any number of children). But the idea of it becoming ‘baggy’ is probably more of an exaggeration.

 

 

Posted in Genitals: A User's Guide

Just Add Water…

There are a vast array of sprays, wipes, lotions and potions to clean the vagina on sale. They are often sold under the umbrella of ‘feminine hygiene products’. But remember…

Unusual discharge (i.e. in smell, colour or consistency) can be a sign that something isn’t right. However, it is a normal function of the vagina to produce secretions…

See here for more details.

Posted in Genitals: A User's Guide

Bloody Periods

Much of my primary school experience rolls in to one, but learning about periods is one of the more vivid memories I have.  All of the girls in year 6  were segregated from the boys, marched off into an assembly room and shown a video.  We were each given a bag of period products at the end.  I don’t know what the boys learnt about.   They might have been shown the same video.   They were definitely not given the goody bags, as this later became a point of contention!

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This was in the 90s, so we were limited to being told about disposable tampons and sanitary pads.  Overall, we weren’t given any guidance on why we might want to use a certain type of product over another.  We were only told how they worked in very basic terms.  Talking to other friends about managing periods, very specific individual needs and preferences need to be taken in to account.  For example, I hate using anything disposable because of the environmental impact.  I also can’t get over the similarity in principle between nappies and sanitary pads and find this really off-putting.  One of my friends however, just doesn’t feel she would every be comfortable inserting a tampon.  Another feels the same way as I do about disposable period items but can’t bring herself to wash and use a menstral cup.  Here’s a rundown of some of the things people do with their period blood.  I’ve based this information on mine and friends’ experience of using various methods and medical experience, as well as questions that come up a lot in sex ed workshops…

TAMPONS

A bundle of soft, absorbent material which is inserted in to the vagina to soak up blood.   They sometimes come with ‘applicators’ – card or plastic tubes that help to insert the tampon further in to the vagina.  There is a string that sits outside the vagina, which can be pulled to remove the tampon.  The tampon (but not the packaging or any applicator) is designed to be flushed down the toilet, like toilet paper.   They are a disposable method, so obviously have an environmental impact.   Manufacturers often suggest leaving them in for between 4-8 hours.  They come in various sizes – smaller tampons absorb less blood and so are for lighter periods, larger ones for heavier periods.   Tampons seem to be the period product that people frequently concerns about:

  1. Toxic Shock Syndrome.  This is an infection that can be caused by a foreign object left in the body for a long time, including a tampon.  It is quite rare though, especially if tampons are changed regularly.
  2. Penetration.  Many people have worries about it being painful to insert a tampon.  Tampons are typically only a couple of inches long though, which is much smaller than some of the other things that people easily fit in and out of vaginas (baby’s heads, dildos and penises for a start!).   It might take a bit of practice to do it easily, but many people find that this is something they can learn to do.  Others worry that it ‘counts’ as losing your virginity if you’ve used a tampon before you’ve had penetrative penis-in-vagina sex.  ‘Losing your virginity’ is a social construct which relates to what you find arousing so this is just not true for most people!
  3. Getting stuck.  As someone who’s been the oncall doctor for an out of hours Gynaecology service, this is something this does sometimes happen.  People do insert tampons which they later feel they can’t remove.  However, there are manoeuvres you can try that really do work… and if it doesn’t I’ve never seen a ‘stuck’ tampon that couldn’t be removed easily in a clinic setting.

MENSTRUAL CUPS

These are my personal period product of choice!  The can take some getting used to and you may well splash a small amount of blood about getting to grips with them.  But once you have you may grow to love these reusable, washable devices that sit in the vagina and collect blood.  This is then emptied in to the toilet bowl.  The cup can be washed with water in between uses and sterilised in between cycles, so is completely reusable and produces minimum waste.  Cups don’t seem to be very widespread at the moment – I found out about them from a sticker on the back of a loo door!  There are several different brands.  I use Mooncup – basically because this was the only one that was available at the Chemists when I bought mine.  I’ve been told by a friend that their sizing is not the best however.  All manufacturers make cups of different sizes, again according to how heavy a person’s period is.

SANITARY TOWELS

Pads or towels are absorbent material made in to a pad that lines your underwear.  Unlike tampons, there is usually a large plastic component, which is not possible to flush down the toilet.   Reusable pads – ones that can be washed and reused – are becoming more widely available. They can be bought or made.  Free patterns for making your own are available online, such as here from Luna Wolf.  More recently pads seem to have been extended to ‘period pants‘ – where the bit that soaks up the blood is built in to underwear and the whole thing is washed.  

FREE BLEEDING

There is of course the ‘do nothing’ option.  Some people choose to sidestep all of the above and opt for free bleeding.  This is when nothing is used to collect period blood and someone simply allows their clothing to soak it up.  This often seems to be done as a point of political protest, such as against the ‘tampon tax’.  This might partly be because free bleeding in and of itself is seen as a political act, such as when runner Kirin Gandhi free bled during the London Marathon.  There are probably many more people who unintentionally or unwillingly free bleed, due to lack of period product resources.   ‘Period poverty’ seems to be an issue worldwide, with campaigns against it evident in both developed and developing countries.

Posted in Genitals: A User's Guide

Blue Waffle with a Side of Misogyny…

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Sometimes being a facilitator for Sexplain involves attempting to hold the attention of young people through wit, honesty and sheer confidence as you explain a specific curriculum point as your unembarrassable self.  At other times it involves asking questions your audience may not have considered before and standing back whilst a tide of answers hits you.

“Can anyone name any sexually transmitted infections?”  My colleague asked of a group of year 10 students just outside of London.  Three off us were delivering a workshop on sexual health.  This was definitely going to be one of the latter type of encounters.  Luckily, this group wasn’t a shy one and answers came flooding forward.

“Chlamydia”, “syphillis”,  and “gonorrhea” were proffered.  All good answers and affirmed as such.

“Mono” was suggested, the infection also going by the name of ‘mononucleosis’ or ‘glandular fever’ – the ‘kissing disease’.  By our extremely wide definition of ‘sex’ (any behaviour that someone finds arousing) completely valid and a good opportunity to bring this in.

“HIV” was another suggestion, to me offered surprisingly late.  Once seen as the sexually transmitted infection in the UK, hopefully this reflects a reduction in stigma and fear around this disease as treatment and prevention becomes so incredibly effective.

“Crabs” one pupil proffered- a nice segue in to talking about parasites.  Another good talking point.

And then it came. The complete surprise.

“Blue waffle” one student called out.

This caught me by surprise a little.  I had heard of this before, but only come across it in training and never actually in the classroom before.

If you haven’t come across it before, blue waffle is a fictional STI.  It was something that Amelia and Hazel, Sexplain’s Founders had come across when talking to children in their research original work.  The story doing the rounds at the time was that blue waffle was a disease contracted by women who had had a large number of sexual partners.  At the time a google image search would return pictures of vulvas covered in lesions- very nasty looking lumps and bumps.  To my clinical eye, some of the images looked to be lesions caused by genital warts.  Others looked like erosion and growths caused by vulval cancers.  Interestingly (and perhaps not surprisingly) the rumour ran that it was transmitted to people with vulvas and did not trouble penises at all.  Even though this is how the disease was said to be spread.  Turns out misogyny can be a powerful vehicle for keeping a lie alive – who’d have thought it!

This turned out to be the case for the young person who had introduced it in to the classroom in this instance.  He was quite resistant to my telling him that it was a made-up thing.

“But Miss, if you look on Google, there are pictures!”

I tried to gently unpack this, explaining what I thought these images were actually of.  It was a nice opportunity for a discussion about being critical of sources, particularly those on the internet.  However, I left with the distinct impression that I had only created an aura of doubt in this person’s mind.  I had not completely convinced him it was a total urban myth and an element of belief in blue waffle remained.

Posted in Genitals: A User's Guide

Trouble Down Below

**TW:  mentions of rape**

There are a wealth of products designed specifically for genitals.   Some for aesthetics, some for convenience, some for hygiene, some for pleasure.  It’s certainly true that there needs to be less stigma around products to help with basic bodily functions and/or sexual pleasure.  Take the stigma surrounding period products for example – literally decades of advertising aimed at showing us how unacceptable and dirty periods are.   However, not all products are equal.  Some things that are sold to help your genitals are unnecessary or problematic.   Here are four of (what I think are) the worst!

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Femfresh (other brands exist). 

Femfresh is a range of products for ‘feminine hygiene’ – e.g. washes and scented wipes.   The vagina is self cleaning and the only thing you need to use to keep a vulva clean is warm water and unscented soap.  However Femfresh and its ilk push an agenda that they are vital, with their vagina friendly pH balance giving them the edge over soap (which is the same for water, which is free and comes out of the tap).  The Femfresh website promotes the products using a smiling face of a gynaecologist, ‘Dr Sara’, with a list of advice on how to ‘care for down there’.  Much like the period adverts, euphemisms abound – the implication being that your vulva is smelly and dirty and only buying this type of product can fix that.  The branding is phenomenally successful.  As a facilitator for Sex Ed classes to young people, I am often asked about this product, by name.  It can be quite difficult to assert that it is unnecessary and a person’s genitals are completely normal and healthy in the face of such advertising and branding.

 

Vaginal Douches

Like Femfresh, but super-charged!  Vaginal douches are devices and products that ‘flush out’ the vagina – unfortunately taking all of the natural bugs and secretions that keep the vagina health with them.  Just say no!

 

The Consent Condom

This is definitely one from the ‘road to hell is paved with good intentions’ department.  Sold with the tagline ‘consent is the most important thing in sex’, this is a condom that requires two people (or at least four hands working together) to open the packet.   It received quite a backlash when it came out.  People were quick to point out that flaws – such as rapists not necessarily caring about using condoms, or having the ability to work in pairs.  The consent condom also implicitly buys in to the idea of consent as a single moment of ‘yes’/ ‘no’.  Consent should be reversible and always up for discussion.  Even if you’re in a long term relationship and sex is something you do regularly.  Even if you said ‘yes’ at first and then changed your mind.  Even if you helped someone open a condom packet holding two of the four pressure points.

 

Anti-Rape Wear

This is underwear marketed as only being able to be removed by the wearer.  It is reinforced to prevent cutting and tearing off by an attacker.  Originally designed and crowdfunded by a victim of sexual assault, this is probably again something made and marketed with noble intentions in mind as well as profit margins.  Given the state of the world, fear of sexual assault is very understandable.  However, I just don’t want to live in a society we focus our efforts on designing things to make people less rapeable.  We need social and structural change, not ‘rape-proof’ clothing.  Additionally, anti-rape wear reinforces the idea that sexual attacks are committed by strangers when a person is out and about in the world.  In fact, most victims of sexual assault know their attacker – be it a family member, friend or partner.   It is hard to see how anti-rape wear will be of much use  unless it is worn at all times and in all places – except for those brief moments when you need to either pee or have penetrative sex with someone and definitely won’t change your mind at any point (which we’ve already established you have a complete right to do).

These are my four.  Tweet me if you think of any more or disagree – @squisquasque…