Menstrual Hygiene

Menstruation is part of a cycle that happens for people who have a uterus. During that cycle, the lining of the uterus builds up. At the end of the cycle the lining breaks down. As the lining is breaking down, blood exits the body through the vagina.

This usually happens monthly and lasts for 3 to 7 days. This can be less regular in the first 2 years after menstruation starts.

Menstrual hygiene is routinely cleaning when taking care of bleeding that happens during a menstrual cycle.

Wash your hands with warm water and an antibacterial soap for at least 20 seconds. Throw away single use products in a trash can or personal bins that are in some restrooms.

There are many different products for menstruation. What you use is a personal choice.

Some products are worn externally, and some are inserted into the vagina. Some are single use, and others are reusable and designed to be cleaned between uses. Some people switch between different products depending on the day or activities planned.

Absorbent cotton pads stick to your underwear to collect blood throughout the day.

• Pads should be changed regularly depending on the amount of blood and size of pad (light, regular, heavy).
• Most pads are single use and should be put into the trash after use.
• Some pads are reusable and made from cloth. These may secure to your underwear with snaps or other fasteners. They should be changed regularly and washed after use as directed by the company.

Absorbent cotton pressed into a cylinder that is put into the vagina to absorb blood before it exits the body.

• Tampons should be changed every 2 to 4 hours and should not be worn for more than 8 hours at a time.
• Tampons are single use and should be thrown away in the trash after use.
• Once put in correctly, you should not feel the tampon inside and it should not be uncomfortable.
• Consider trying smaller tampons first to check for comfort.

Menstrual underwear is made with layers of cloth that soaks up blood.

• It usually includes a layer of moisture-wicking fabric for comfort.
• It is available at different levels of absorbency. The levels of absorbency are often described in the number of tampons or pads worth of fluid that the underwear can hold.
• It comes in many different styles, colors, and patterns.
• It is washable and reusable. It may need to be changed throughout the day depending on the amount of blood and level of absorbency.
• Follow directions for washing from the company.

Menstrual cups are small, flexible cups made of silicone or latex rubber. They are put into the vagina to catch menstrual blood.

• It is folded before being put into the vagina. The menstrual cup opens after it is inserted and may need to be adjusted to be positioned correctly. This creates a seal to avoid leaking.
• It collects blood rather than absorbing it.
• Most menstrual cups are reusable, but some are disposable.
• Reusable menstrual cups should be washed with soap and water between uses and cleaned in boiling water after each cycle.
• Menstrual cups should be removed and emptied at least once every 8 to 10 hours. Menstrual cups may need to be removed sooner or later, depending on the quantity of blood your body creates.
• Removal can be tricky until you have practiced. It may be helpful to practice using a menstrual cup somewhere you feel safe and comfortable for a few days before using it in public.
• If you have an IUD (intrauterine device), menstrual cups are not recommended.

For some people who are trans and nonbinary, menstruation can be uncomfortable. It can cause increased gender dysphoria. Here are some tips for how to take good care of yourself.

• Remind yourself that menstruation is not just a “feminine thing.” Bodies of all genders menstruate.
• Try humor. Some people who are transgender and nonbinary find it helpful to make jokes or use funny words to talk about their menstrual cycle.
• Talk to other people who are transgender or nonbinary about their experiences. It can be helpful to know you are not the only person who feels this way about your menstrual cycle.
• Distract yourself during your cycle. Spend time doing things that feel gender affirming.
• Make time for things that make you feel good. Treat yourself to your favorite snacks, movies, activities, and self-care.
• Heating pads can help with physical discomfort associated with menstrual cycles.
• Talk to a medical provider if your cycles are often painful or limit your ability to participate in activities.

Yes, there are medicines that can decrease or stop menstruation:

• Pills (oral medications)
• Injections
• Implants that go under your skin
• Devices that are inserted into the uterus (IUD or intrauterine device)

For more information, see our handout “Menstrual Suppression and Breakthrough Bleeding.”

seattlechildrens.org/pdf/PE3715.pdf

Some of these medicines can also prevent pregnancy. Talk with your medical provider if that is something that is important for you. Some medicines used for gender-affirming medical care can decrease or stop monthly bleeding. Please reach out to your medical provider to discuss these potential effects.