Menstrual hygiene: the health implications

"One in ten girls between 14-21 years in the UK cannot afford to buy pads or tampons" Plan International UK
tenner tampons.jpg

Firstly, I have to say I rather dislike the term ‘menstrual hygiene’ because it has a rather ‘dirty’ connotation. However, I think that’s one of the reasons that periods are such a taboo subject and hence we’re so unaware in the UK that access to pads and tampons is actually even a problem. Plan UK recently revealed the results of their survey that showed one in ten girls between 14-21 years in the UK cannot afford to buy pads or tampons. One. In. TEN… In the UK? With these products costing around £3 per pack, and some people requiring up to 2 or 3 packs per month it’s not actually that difficult to comprehend that if someone is struggling to pay for the basics such as food and rent, the lack of change from a tenner when buying pads could be a massive problem. The homeless are also affected. Not everyone has a bathroom to stash the necessities in…

I’ve never met anyone who loves getting their period, but the lack of access to decent sanitary products surely makes this time of the month a whole lot worse, and can cause unnecessary embarrassment, humiliation and even school or work absence and may prevent participation in sport.

Whilst these are incredibly important factors to consider when trying to lobby for change, no one is actually talking about the health implications of this problem. That’s where I feel the need to wade in...

I like to think that I’m a dab hand at searching for scientific studies, but I can’t actually find any studies looking at the health implications which is because they don't exist and again, this is likely due to a lack of awareness. If you don’t realise something is a problem, you can’t formulate a research question, design a study, or drum up interest from funders.

However, we can definitely infer the health risks from other great studies and I’ll summarise them there…

1.     Super absorbent tampons and toxic shock syndrome

Toxic shock syndrome is a rare, but life-threatening systemic inflammatory condition caused by the toxins produced by Staphylococcus aureus and Streptococcus pyogens and has been associated with the use of excessively absorbent tampons. Whilst buying a really absorbent tampon that you could potentially wear for maybe 24 hours (Rather than the advised 8 hours max) seems economically savvy, it puts you at risk of this condition. I’ve also had patients who supper with irregular bleeding telling me that they wear a tampon on occasions where they really don’t want to be caught short, and this really worries me for this reason. Change your tampons regularly, and wear a pad if you’re not bleeding but want some protection.

2.     Unhygienic substitutes will disturb the vaginal microbiome

vaginal_microbiome.jpg

I’ve heard too many sad tales of incredibly resourceful women using unhygienic substitutes such as rolled up socks and newspaper. The vaginal microbiome is the bacterial population that lives in harmony in the vagina, and is usually composed of Lactobacillus species that has been suggested to work with the immune system to protect us from numerous health complications such as STI’s, HIV, cervical cancer, and pregnancy complications such as miscarriage, ectopic pregnancy and premature delivery. I wrote a summary on this here if you want a geeky read today. By using substitutes you run the risk of introducing unhealthy bacteria, which can halt the growth of lactobacillus and cause something called bacterial vaginosis which is not only irritating and causes an unpleasant discharge, it’s associated with the aforementioned health complications,

3.     Excessive vulval cleaning and douching will also disturb the vaginal microbiome

If you don’t have access to appropriate sanitary wear it could be tempting to clean around the vulva and vagina excessively to compensate. First off, the vagina cleans itself and doesn’t need any internal cleaning, even during your period. I’ve also heard of women using the shower to clean the blood out of their vagina to try and reduce the number of times they’ll need to change their sanitary wear during a busy day out and about. This douching is known to disturb your vaginal microbiome and cause bacterial vaginosis and countless studies have linked this practice with the health outcomes mention in the previous section.

The vulva also doesn’t need anything more than plain water, and I particularly detest all of the ‘fanny washes’ on the shelves because they’re just unnecessary and can actually make smells and irritation worse. Research suggests your vaginal microbiome is influenced by the gut microbiome and some good bacteria may even reach there from what is known as ‘rectal seeding’ – ie. The bacteria goes on a perilous voyage from your rectum and anus across the perineum and eventually reaches the lush havens of your vagina and lives happily ever after (yep, healthy bacterial can come from your bum) . If you’re scrubbing your vulva and perineum with soapy suds, these good bugs get lost in transit and aren’t able to reach their destination. The result: you guessed it – bacterial vaginosis. It’s also another reason that even unhygienic items used externally can cause a problem. Even if bad bacteria are only on the outside, they can make their way in and wreak havoc.

It’s also important to note that you’re more susceptible to getting bacterial STI’s such as chlamydia, and also viruses like HIV and HPV (the virus that causes cervical cancer) around, and just after your period, due to the natural shifts in the microbiome around this time, and also due to hormonal fluctuations. So, this for me really reinforces that this isn’t the time to be using something that’s not clean.

These health-related complications have the potential to be serious and could last a lifetime, yet the solution is quite simple; all women need access to hygienic products that are actually designed to be used for periods. In order to effect change we need awareness. Angela Rayner and Paula Sherriff are both MP’s who has been doing a fantastic job at raising this issue in parliament, which is ultimately change is needed.

bloody-good-period-logo.jpg

But how you can help?

·      Carry a few extra pads and tampons to give out to homeless women you may come across

binti.png

·      Donate a space pack or two to your local food bank – there are often collection points in supermarkets so you can grab a pack whilst doing your shop and drop it off on your way out the door – simple!

·      Check out the incredible work being done by two charities; Binti and Bloody Good Period who you may want to either donate to or lend a hand to.

I recently did an interview about this for Whats Up TV on Sky One which will be coming out in Feb/March so I’ll let you know when it comes out because its my biased opinion that it will be really informative watching!