Periods: Everything you need to know and how to make the most of your cycle (yes, really)

We've answered all the questions you've been too shy to ask

We currently live in an era of oversharing, and yet one bodily function is still hidden by euphemisms, code words and tampons smuggled in purses. But in the past 12 months, periods have been everywhere – from the public push for the removal of tampon tax to women live-tweeting their periods. The latest development? Bristol-based company CoExist is offering employees ‘period leave’.
Despite this, a recent study of 90,000 women found that we refer to our periods with more than 5,000 ‘code words’ to avoid even having to utter the word. Which would be comedic in one sense, except that many women are suffering from pain, fertility issues, medical conditions, fear and discomfort in silence. It’s time to shine a light on menstrual health – here’s what you should know.

Tampon Tax around the world – and where does the UK fit in?

Eat right for your cycle 
Step away from that extra-tall caramel latte. According to a Harvard Medical School study of girls between nine and 14, those who consumed more than 1.4 servings of sugary drinks a day tended to start menstruating earlier than girls who drank less. The cause? Increased insulin levels, which can affect sex hormones. 
The white stuff is just as troublesome in adulthood. ‘One of the biggest fertility disruptors in our modern diet is sugar,’ says Dr Nat Kringoudis, author of Well & Good: Supercharge Your Health For Fertility & Wellness. ‘Your hormones are forced to ride insulin highs and lows, which leaves our bodies and endocrine system exhausted. And sugar is inflammatory, which can heighten period pain.’  
Sugar’s not the only food to avoid: ‘Cold and raw foods can aggravate symptoms of menstrual issues such as endometriosis,’ adds Kringoudis. ‘Our body has to heat food up to 37°C before digestion occurs and, with PCOS (Polycystic Ovary Syndrome) or endometriosis, any stress load on the body worsens symptoms. Warm foods help blood to circulate, which can ease period pain.’ 
Small changes can also make a big difference. A study in the Journal Of Clinical And Diagnostic Research found that adding less than a teaspoon (420mg) of cinnamon to your diet daily reduces period pain, because it acts as an anti-inflammatory.

Work out smarter 
Exercise can assist uterine contractions during periods, helping to expel the uterus lining. But, instead of following the same regime every week, take your cycle into consideration. 
‘On the first day of your period, lower back pain and cramping can be a symptom of inflammation and often hypermobility in the lower back, which can be dangerous if you’re doing weights or an intense yoga class,’ says Niki Rein, founder of the ballet-inspired regime Barrecore. 
‘Lay off the workouts on the first two days – or stick to endorphin-boosting sprints or even a brisk walk. After day three, carry on with your usual workouts. It is often days three to six when we feel strongest, so schedule power sessions, such as spinning and boxing then.’ 
Consider the week before your period, too. Researchers at the University of Texas found that a woman’s knee joints can become more unstable at this time, because the nerves around the knee fire more often in the ‘late luteal phase’ of the cycle. But when you’re ovulating (roughly halfway through your cycle) oestrogen levels peak, so it’s 
a good time to up the intensity. Studies at the University of North Carolina found that endurance increases as oestrogen is elevated. Women on a treadmill could run an extra ten minutes or more when their oestrogen levels were higher. Cheeky 10k anyone?
Take on cramps 
According to the American Academy of Family Physicians, dysmenorrhoea (painful menstruation) affects one in five women. Cramping is caused by the muscles in the uterus contracting to dispel blood, but it can be a sign of a greater problem, such as endometriosis, fibroid issues or an infection. Studies have shown that magnesium can relax uterine muscles, so include leafy greens in your diet, as they are rich in the mineral. Researchers at the University of Maryland also found that increasing your calcium intake may help. 
It could be time to switch your usual towels or tampons, too. There’s been a renewed interest in the Mooncup – the reusable silicone vessel designed to collect blood that first found popularity in the 80s – to deal with period pain. It’s reportedly more comfortable than a tampon as it sits lower down in the vagina. If you have a heavy flow, menstrual cups can hold up to 28g of fluid at a time, which is far more than the average tampon. Prone to thrush? Choose tampons made from unbleached cotton, so they’re less likely to cause irritation. 
 
Ask your GP for help 
Figures from the NHS state that over 2 million women in the UK suffer from endometriosis. This is a condition where cells from the uterus migrate to other parts of the body, such as the ovaries, bowel or bladder, causing symptoms that include abdominal pain, heavy bleeding between periods and pain during sex. Another common condition is irregular periods due to an overproduction of male hormones or PCOS. If your period disappears or is erratic, or you notice excess 
facial hair, it could be PCOS. But both conditions are hard to diagnose, because the symptoms vary. However, they are among the leading causes 
of female infertility, so see your GP 
if you are concerned.
Commonly prescribed treatments for endometriosis include Lupron, which Lena Dunham, Girls creator and sufferer, was injected with in an online video. Lupron temporarily stops a woman’s period to alleviate the symptoms. PCOS sufferers are often prescribed Metformin, a diabetes drug that helps to regulate high insulin levels (that PCOS sufferers can have). 
But if you favour a more natural approach, dietary changes could help. A Rome-based 2012 study found 
that endometriosis pain decreased after 12 months following a gluten-free diet. PCOS symptoms can be reduced by following a low-GI, unprocessed food regime that aims to stabilise hormones. 
It’s not in your head  
In the two weeks before their period, three in four women suffer from behavioural shifts. ‘PMS is a real condition that can cause severe depression and suicidal thoughts,’ says Nick Raine-Fenning, medical director at Nurture Fertility. Five per cent of the population suffer such extreme side effects, and one in five women* say that their fluctuating hormones hold them back in life. 
So, what’s the solution? ‘You could try the combined oral contraceptive pill or the contraceptive coil with oestrogen tablets or patches,’ says Raine-Fenning. These stop ovulation – the time when PMS often peaks – by adjusting oestrogen and progesterone levels artificially. There are alternative treatments, too. ‘Irritability will also be worse if a woman is low in magnesium because it’s key in stabilising mood,’ says nutritional therapist Alison Cullen. ‘To help, you can take magnesium supplements or top up levels with foods such as almonds, buckwheat and kidney beans.’

Work with your cycle
Sadly, not all companies offer period leave. So Alisa Vitti, author of the TED talk ‘Loving Your Ladyparts As A Path To Success, Power And Global Change’, reveals how to maximise your menstrual cycle at the office 

DAYS 1-7: Menstrual stage 

This is the time when you have the clearest conversation between the right 
and left hemisphere of the brain because hormone circulation is at a low so 
we can think clearly. Neurologically, it’s a prime time to analyse, review and think strategically. Look back on last month – how did it go?
DAYS 7-14: Follicular stage
When the eggs are coming to maturity during the follicular stage, you have the 
most access to creative energy. A slight increase in oestrogen and the follicular stimulating hormone (FSH) makes you naturally more interested in trying new things. This is an ideal time to get planning and compile a to-do list.
DAYS 14-21: Ovulatory stage
Oestrogen peaks this week and stimulates the verbal centres of your brain, which optimises your communication and relationship skills. Schedule meetings that focus on brainstorming, collaborating, negotiating or interviewing. It’s an ideal time to ask your boss for a raise – you’ll have the power of persuasion.
DAYS 21-28: Luteal stage
Progesterone enters the picture and stimulates a woman’s nesting instinct.  
At work, that means you’re eager to get things done. Review your to-do list from the follicular stage and carve out time to check things off it. 

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