Periods: Debunking Myths And Understanding Facts

Due to misrepresented facts and scaremongering, many women face a challenge in separating reality from fiction regarding their periods. Ann Mullen, director of health education at Cycle Technologies, spoke to Medical Daily to answer some important questions and debunk a few menstrual myths along the way.

Age at menarche can be a source of confusion, as many girls may worry if they start earlier or later than the average age of 12. But Mullen states that while "there are some differences between racial groups", the overall age range is 9 to 15. However, she recommends a medical evaluation if menarcheal age occurs outside that range or right at the upper/lower limits. While early-onset menstruation is linked to obesity, not starting periods by the age of 15 could be a more serious sign of diabetes, cystic fibrosis or kidney disease.

Some women worry that using tampons could hurt their vagina while others have more serious concerns such as the risk of toxic shock syndrome. "Women are smart to be aware of what they are putting into their bodies," Mullen says. "A tampon can certainly stretch or tear your hymen and cause vaginal dryness. Toxic shock syndrome, while rare, is a serious deadly infection."

To counter these risks, two guidelines should be remembered. Firstly, to use the lowest absorbency based on the type of flow experienced. "So don’t use a 'Super' tampon, if you’re trailing off at the end of your period," she says. Secondly, Mullen advises against leaving a tampon in beyond 4-6 hours. "If you use highly absorbent tampons or leave a tampon in too long, it can cause vaginal dryness, or alter the pH or the normal flora of your vagina. In rare cases, you could get toxic shock from bacteria growth."

Premenstrual syndrome (PMS) is considered a normal part of periods. However, Mullen advises that it's time to consult the doctor if symptoms become severe ("excessive or heavy flow lasts more than a few days" or "moods swings turn into debilitating episodes"), adding that these symptoms could indicate underlying problems like endometriosis or PCOS.

Moving onto the subject of fertility, some women are told that it is impossible to get pregnant during menstruation while others are informed the opposite. So what is the truth?

"You cannot get pregnant during the first days of your period. But sometimes the end of a period overlaps with the beginning of fertile days," Mullen explains. Women who experience relatively short or longer-than-average cycles may be at risk for this. "If the fertile days begin on day 5, 6, or 7 and her period is still trailing off, she could become pregnant," she says, adding that fertility tracking apps can help women plan or prevent pregnancy. 

Speaking of cycles, is it actually worrying to have an irregular one? When the cycle is shorter or longer than usual, many wonder if they need to intervene with the pill.

"Everyone’s cycle varies in length by some amount. It’s normal, for example, to have a 25-day cycle, then a 30-day cycle," Mullen says. It is also common to experience a one-time event when the cycle is off due to stress. But cycles that consistently vary by more than 8 days should be evaluated by a doctor to rule out any potential problems, she says. "Each case is different, so there is no set-in-stone treatment, but birth control pills are often prescribed for this purpose."