How can you tell if your vagina smells ‘normal?’

First, it’s worth noting that there’s certainly no rule for what any vagina should (or shouldn’t) smell or taste like. Just like the people who have them, vaginas are all naturally unique and a whole host of factors can determine how yours specifically tastes and smells, says double-board-certified gynecologist Monica Grover, DO, medical director at VSPOT medi spa. What is ‘normal’ for one person may not be normal for another. At the same time, taste is subjective, so what one oral sex-giver might deem pleasant, another might not.

All of that said, there’s not really any reason, per se, to start messing with the taste (or smell, for that matter) of your vagina, whether to purportedly improve it or otherwise. Even so, mainstream culture has unfortunately pushed many people with vaginas to think otherwise.

“People are fascinated with the topic of eating pineapple to change the taste of their vagina because we tend to be overly self-conscious about how we smell and taste during sex,” says sexologist Rebecca Alvarez Story, founder of sexual-wellness marketplace Bloomi. In fact, a 2019 survey of 1,000 people who identify as women found that two-thirds of them have turned down sex due to concerns about the scent of their vagina. But, again, a vagina doesn’t need to smell or taste particularly sweet or floral or anything else. “It’s a vagina, not a piña colada,” gynecologist Jen Gunter, MD, previously told Well+Good.

That said, certain elements of your lifestyle, including what you eat, could affect the usual taste and smell of your vagina (whatever that might be) by altering your vaginal pH and, in turn, supporting the growth of healthy bacteria…or doing just the opposite. “The scent of vaginal discharge can range from normal physiology to abnormal pH, bacterial overgrowth, sexual fluids, exposure to detergents and lubricants, sexually transmitted infections, and even hydration status,” says gynecologist and sexual-wellness expert Christie Cobb, MD. For example, intercourse through sexual penetration or even experiencing a period can change the balance of your pH, as can lifestyle habits such as using certain products like feminine washes or even a build up of sweat and discharge from not showering after a workout.

Given all this, it makes sense that consuming pineapple, which is quite acidic, could have an effect on the pH of a vagina and therefore affect how it tastes and smells. However, adding more pineapple to your diet is not a panacea for a sweeter smelling or tasting vagina because “even if two people have the same exact pH, one may not smell like the other person’s because of our own individual physiologies,” says Dr. Grover.

That’s why a varied diet rich in fruits, vegetables, and fermented foods is generally linked to a healthy V (and, perhaps, “good” vaginal taste) whereas a diet lacking in those nutrients could lead to an imbalance in the bacteria in your bits and maybe a different taste, too.

Does pineapple change the smell of the vagina and vaginal discharge?

With all this said, where exactly does that leave pineapple in the vagina-taste and smell department? Because your vaginal pH depends on so many factors, it’s possible that pineapple could change the smell and taste of the vagina and its discharge in a way that you may like, but it’s not a guarantee.

Though there aren’t any specific studies on the connection between eating pineapple and having a vagina that tastes “good” (again, a tough thing to measure, anyway), research does support that “fermented pineapple juice can help support the growth of healthy vaginal bacteria, just as yogurt and kombucha can,” says OB/GYN Amy Roskin, MD, JD, chief medical officer at Seven Starling, a mental health provider serving mothers and caregivers. And again, healthy bacteria is what a vagina thrives on, so a good bacterial abundance could theoretically keep a vagina from taking on a funkier or stronger odor than it typically has.

“Experienced tasters do report that when you eat sweet fruits, vegetables, and herbs, it seems to heighten the sugary flavor of vaginal fluids and ejaculate.” —Jess O’Reilly, PhD, sexologist

When it comes to regular old pineapple and pineapple juice, though, the intel is more anecdotal. “Experienced tasters—or folks who’ve tasted many a lover’s juices—do report that when you eat sweet fruits [like pineapple], vegetables, and herbs, it seems to heighten the sugary flavor of vaginal fluids and ejaculate,” says sexologist Jess O’Reilly, PhD, host of the Sex With Dr. Jess podcast. “They also suggest that smoking, caffeine, and processed foods can result in a more bitter vaginal taste,” she says, speaking of her clients. For the same reason, Dr. Grover says pineapple may affect the smell and taste of semen by altering the pH. “It’s probably for the same reason and with males their fluids are more alkaline, so you’re adding higher fructose and glucose levels which makes it a little bit more acidic,” she says.

However, these anecdotal associations of pineapple making the vagina taste and smell better nod to the aforementioned benefit for your vagina of just following an overall healthy lifestyle—of which pineapple can certainly be a part. Eating pineapple has a multitude of health benefits, says Dr. Roskin, like fighting inflammation, promoting tissue healing, and boosting your immune system. Not to mention, pineapples are also notably composed of between 85 and 89 percent water, and “staying hydrated is also crucial to promoting natural vaginal lubrication,” says Dr. Roskin. The more lubricated your vagina is, the more diluted its secretions may be, potentially cutting some of the tang from its taste.

When to talk to a doctor about vaginal smells

If you notice any big odor changes from your usual smell (or, perhaps, a partner does), it’s a good idea to consult your doctor.
“If you start to experience a bad or fish-like odor in your vagina, this could be a sign of a medical condition—like an infection or bacterial vaginosis,” says Dr. Roskin. According to Dr. Grover, yeast infections typically are marked by itching and discharge that has the consistency and appearance of cottage cheese, while bacterial infections are more typically associated with an odor. The cure for these is not pineapple, but rather going to the doctor for help.

It’s a really good idea to reach out to your doctor, according to Dr. Grover, if you experience a change in smell paired with other symptoms such as itching, discomfort, or more discharge than usual because something else may be up. “I can’t necessarily say if it’s going to smell a specific way something is off because it could just mean that’s normal for you, but if it’s out of the norm I would say do some investigation,” says Dr. Grover.

So in conclusion, feel free to add pineapple to your diet and see what happens.

Want to incorporate more pineapple into your diet? Check out this video for a healthy pineapple upside down cake recipe:

How yoga can help menstrual cramps and other symptoms of PMS

Melie Purdon, a yoga teacher and prenatal expert at YogaRenew, says that while people experiencing menstrual cramps often feel compelled to lie on the couch and be inactive, doing so actually reduces the body’s ability to work through discomfort on its own. “We can decrease symptoms of period cramps by moving the body in a way that will massage the organs and make room in the abdomen for the uterus to contract and shed its lining without compromising the breath.”

Yoga simply helps you and your consciousness get out of the way and give your body the space to do what it is meant to do according to Purdon, who says that if you practice yoga consistently—especially on the days you don’t feel well—you may actually derive even more benefits from your practice.

“For example, during period cramps and PMS, the body can feel sluggish and heavy, morale may be low, and energy can feel multiple espresso shots away,” she says. “Yoga will improve blood flow and overall vitality.” Blood flow is important during a woman’s period because it helps to expel the built-up tissue and endometrial lining from the uterus. This process helps to keep the uterus clean and healthy and prevents the buildup of bacteria and other debris which can cause infection. Additionally, the blood flow helps to keep the endometrial lining of the uterus thin and elastic, which is important for healthy fertility. Cramps are your body’s way of drawing blood flow to your uterus, so doing exercises like yoga that can help the process are beneficial.

With that said, yoga—especially when you have symptoms of PMS—doesn’t need to be an intense or vigorous workout to be beneficial. “What we want is gentle, targeted movements that will, even in a few minutes, benefit the practitioner’s mind and body simultaneously,” says Purdon.

The best yoga poses for cramps and other period symptoms

1. Supta Padangusthasana II (Reclined Extended Hand to Big Toe Pose) With a Strap

How to do it: Lie on your back with your legs extended long holding a yoga strap (or belt if you don’t have one) by the ends with both hands. Bend your right leg and place the ball of your right foot into the middle of the strap. Extend that leg up toward the ceiling, then let it open out to the right side like a book (leg can be straight or slightly bent if you have tight hamstrings), keeping your left hip heavy on the floor. You can place a pillow under your right thigh for extra support. Flex your thighs and left foot. Hold for 10 breaths, then switch sides.

In general, hip openers like Supta Padangusthasana II are great to do one your period. Find it and more in this 25-minute flow: 

2. Prasarita Padottanasana (Wide-Legged Standing Forward Bend)

How to do it: Stand tall (option to have your back against a wall for extra support). Step your feet wider than your shoulders, then with your hands on your hips, fold forward, leading with your heart, allowing your head lower toward the floor—option to bring your hands to your feet or ankles if they’re accessible, or allow your palms to flatten into the floor beneath you with a soft bend in your elbows. Press the outer blades of your feet down and away from one another, as if you could rip the floor apart with your feet. Keep your legs extended fully and the sides of your torso long. Hold for 10 breaths releasing downward toward the floor. (If a full forward fold doesn’t feel good, Purdon says you can rest your arms and head on a chair in front of you.)

3. Janu Sirsasana (Head to Knee Forward Bend)

How to do it: Start seated on the floor with your open in a straddle (V) position. Bend your right knee, bringing the sole of that foot against the inner thigh of your left leg. Rotate your torso to square your left leg. As you breathe in, extend your torso upward. As you breathe out, fold over your left leg (option to place a pillow or bolster and a blanket on top of your left leg for support). Walk your hands forward on either side of your left leg, pressing into your palms and lengthening your heart forward as you breathe in. As you breathe out, relax your belly over the bolster and rest your head on the blanket.

4. Supta Sukhasana (Reclined Easy Seat)

How to do it: Start seated cross-legged on the floor (you can place pillows under your knees for extra support) with a bolster or two pillows lengthwise on the floor behind you, fold a blanket on the end to support your head. Recline back over your props and allow your arms to open out to the sides. Close your eyes and hold for 10 breaths, then switch the cross of your legs and hold for 10 more.

How often should you do yoga poses for period cramps?

Purdon says that there are no universal guidelines or expected outcomes for how quickly you can expect to notice PMS symptom relief from doing yoga poses for cramps—everyone is different, and our bodies all respond uniquely to yoga, as well as the hormonal fluctuations causing menstrual cramps and other PMS discomfort.

“The main idea here is to realize that the work is gradual and builds on itself–you wouldn’t expect to eat a full orange and the vitamin C to kick your flu symptoms right away” says Purdon. “Therapeutic yoga is very similar; if someone is brand new to the practice of yoga, it will take some time for the benefits to show, especially with such a targeted goal as to ease cramps.”

It’s the practice that you commit to every day—on the days in between your bleeds—that will make the greatest impact, Purson adds.  “The wealth of the practice lies in its adaptability to different seasons of life. The key to making the practice of yoga work for you in every scenario possible is to practice consistently without interruption and over a long period of time,” she says. “You don’t need multiple hours a day, you just need to show up.”

Finally, Purdon notes that severe period cramps can sometimes be caused by endometriosis. Along with a consistent yoga practice, it is important to work with your healthcare provider and medical experts if you’re concerned or distressed by PMS symptoms or not seeing relief from home remedies.

The latest claim circulating TikTok? That doing hip thrusts in the gym will lower your chances of getting pregnant.

Although it’s not totally clear where this idea originated, it’s been making the rounds, with some creators making cheeky videos about adding more weight to celebrate their child-free lifestyle. But before you start swapping your birth control pills for hip thrusts, we spoke with a reproductive endocrinologist to suss out the science behind the bold claims.

Can pelvic hip thrusts cause infertility?

If you do hope to get pregnant one day, we have good news: “There is no known association between this exercise and infertility,” says Lora Shahine, MD, reproductive endocrinologist and program director at Pacific NW Fertility in Seattle. Infertility is often the result of a multitude of factors ranging from hormonal imbalances to reproductive tract abnormalities. It’s unlikely that any single exercise, including pelvic hip thrusts, would lead to infertility, she says.

Some commenters speculated that placing a heavy barbell on your pelvis can cause uterine prolapse, a condition where the uterus drops down into the vaginal canal. But again, Dr. Shahine says there likely isn’t anything to worry about. With proper form and when done in moderation, weighted pelvic hip thrusts are a safe exercise to incorporate into your routine.

Just like any exercise, performing hip thrusts incorrectly can lead to discomfort or injury. When setting up your weighted hip thrusts, place the barbell in the crease of your hips and use a barbell pad if the pressure on your hips is uncomfortable (it’ll also prevent bruising on your hip bones).

And what if you’re actively trying to conceive? Should you lay off the hip thrusts just to be safe?

“In general when trying to conceive, I recommend continuing to exercise and move the body—exercise is very beneficial for physical and mental health,” Dr. Shahine says.

But it’s best to avoid extremes. Adding on significant amounts of weight, dramatically increasing your time in the gym or drastically changing your workout routine can throw off your hormones, alter your ovulation, and make it more difficult to get pregnant, she says. So if your goal is conception, now probably isn’t the time to push for that hip thrust PR or start training for an ultramarathon.

Can you hip thrust while pregnant?

Dr. Shahine says there’s no evidence to suggest women need to stop performing pelvic hip thrusts once they’re pregnant, but it’s best to work with a personal trainer certified in prenatal fitness who can suggest modifications to make the exercise more comfortable as the trimesters progress.

Once your belly becomes a bigger factor (pun intended), the barbell may not feel as comfortable on your abdomen. Instead, swap the barbell for a pair of dumbbells high on your quads or a resistance band.

And while weighted hip thrusts may not be the secret to warding off pregnancy, they are still one of the most effective exercises out there for some serious glute gains. So keep on thrusting.

One country taking this into account, however, is Spain, which made history in February by becoming the first country in Europe to grant workers the right to paid menstrual leave. This means people will be able to take time off work to manage painful symptoms associated with their periods.

This is not just about promoting a healthy workplace culture (though it definitely can help with that). Paid menstrual leave also has the potential to boost productivity.

In fact, several studies have demonstrated that ignoring the impact of periods on employees can have a significant effect on work efficiency. Research indicates that people who menstruate often work through the pain and discomfort of their periods, resulting in decreased productivity. For instance, a Dutch survey of 32,748 women conducted in 2019 revealed that trying to work through painful, exhausting, or heavy periods resulted in the equivalent of nine lost workdays per person, per year, based on the decrease in how much they got done. Think about it: They could have spent those days resting, then come back to work fully charged.

“I think that it is essential to cultivate understanding workplace cultures that are mindful of natural needs and physical pain,” Nadya Okomoto, founder and CEO of August, a lifestyle brand working to destigmatize periods, tells Well+Good. “So many menstruators experience period cramps, and that can range from manageable pain to levels of pain that make it hard to get out of bed or be moving around.”

An estimated 10 percent of American menstruators between the ages of 25 and 45 suffer from endometriosis, a condition that causes excessive cramps, as well as abnormal or heavy flows. Meanwhile, an estimated 26 million Americans have uterine fibroids, which can also lead to severe and frequent pain during periods. According to data from the National Library of Medicine, fibroids are even more common and more severe among Black communities, which puts them more at risk for not being able to fully participate in work.

“We need more understanding workplaces that either have menstrual leave, or allow for more flexibility for physical pain, so that people can focus on recovery to show up feeling better when they aren’t experiencing period pain,” Okomoto says. “Menstrual leave is part of a larger discussion about how we think about work versus rest versus healing.”

“Menstrual leave is part of a larger discussion about how we think about work versus rest versus healing.” —Nadya Okomoto, CEO August

At the moment, only two companies in the U.S. offer paid menstrual leave: software company Nuvento and astrology company Chani.

“It can be incredibly painful to have a uterus and most of us are taught to ignore or push through that pain from a young age,” Chani CEO Sonya Passi tells Well+Good. “At Chani, we don’t want any of our employees to work while they are in pain. We intentionally distinguished this as its own type of leave because if you have period pain, you are not sick, and so shouldn’t have to deplete your sick days. We knew that if we made it its own type of leave, people would actually use it.”

“We don’t want any of our employees to work while they are in pain.” —Sonya Passi, Chani CEO

When asked if she’s noticed an overall change in employees’ behavior at work, Passi’s response is optimistic. “Put it this way: Our staff are using it, our staff are happy, our users love the app, and our revenue keeps growing,” she says.

At the same time, Okomoto acknowledges that paid menstrual leave could be a double edged sword. “We’ve seen examples of paid menstrual leave hurt menstruators’ chances of being promoted or included in work opportunities, given the unfair assumption that they won’t be as available because of the cyclical nature of periods,” Okomoto says. “I think that ideally, we move towards a work culture that just has an overall flexibility about taking time off and resting when in pain.”

In addition to the productivity benefits, there are also significant health and workplace culture benefits when employees are given the flexibility to not work or work from home during their period to better manage the pain.

For one, it could encourage open conversations about periods and the effects could create a more comfortable environment for people to discuss their health with employers and colleagues. This could help to eliminate the stigma around menstruation, leading to improved well-being and increased company loyalty.

“Ideally we would see more employee satisfaction in feeling respected and valued by their employers,” says Okomoto. “People cannot do their best work when they are in physical pain, so we would hope that policies like this help people work smarter, not necessarily harder/longer.”

Okomoto believes the path to more U.S. companies offering paid menstrual leave should start with federal legislation. “First we need to see federal legislation that actually acknowledges period care as a necessity for all people,” she says. “Right now we still have 20 states that have the tampon tax, and we are still waiting for there to be free period care in schools, shelters, and prisons. American capitalism is so intense that right now there is not an incentive to offer paid menstrual leave for all workers, especially lower-level employees who either work manual jobs or whose roles involve constant physical activity (for example, working in retail).”

Of course, this is no small ask. Okomoto admits that in order to see widespread policy for paid menstrual leave, the U.S. would need an “extreme cultural change” on how we view labor—and also how we respect people’s biological, natural needs.

In theory, that’s the idea behind syncing the four phases of our menstrual cycles with our fitness regimens. While the fluctuations in estrogen and progesterone influence fertility, they can also impact other bodily functions, including energy levels, the way we process food, and more. Fitness menstrual cycle syncing is about taking the phase of our cycle—and the accompanying hormone levels—into consideration when choosing a workout.

“Women often feel very different during the distinct phases of the cycle, so syncing fitness may help some women with body awareness, symptom relief, personal goals, and overall mood,” says Shannon DeVore, MD, an assistant professor in the department of obstetrics and gynecology at the NYU Langone Fertility Center, and a member of the P.volve clinical advisory board. P.volve launched a menstrual-cycle-linked fitness regimen called Phase & Function in 2021.

Just as in many fitness innovations, cycle syncing came from trying to optimize the performance of professional athletes—the U.S. Women’s National Soccer team famously announced in 2019 that they had been using menstrual cycle syncing to prepare for the World Cup. But research to undergird these pro-athlete strategies has been rare, since a menstrual cycle typically disqualifies people who ovulate from sports research, leading to the vast majority of sports science study participants being men.

However, research is picking up around the world, and places like the Stanford Female Athlete Science And Translational Research (FASTR) Program are specifically working to close that research gender gap. Insights are finding their way into the mainstream, too. Today, the hashtag #cyclesyncingworkout has 11.3 million views on TikTok, and “cycle syncing workouts” was a 2022 Google top trending search term, meaning that it had significantly more search interest in 2022 than in previous years. Along with P.volve, other top fitness programs, including [solidcore], Kayla Itsines’s Sweat, Nike, Tonal, and more have put out regimens, guides, and advice on the topic. After noticing the trend percolating, MindBody added the question of whether respondents structure their workouts based on their menstrual cycle to its 17,000-person wellness trends report survey, and found that 35 percent of women aged 18 to 50 said they do, and that number was even higher for millennials and members of Gen Z, at 38 and 39 percent, respectively.

The trend may be a result of a confluence of factors. The first is technological—the proliferation of period tracking apps have made it easier and much more common to be aware of the phases of your menstrual cycle. The next is scientific, with calls for a much-needed push to close that research gap between men and women in physiological research—and that the aforementioned technology is making this research easier. Finally, more people are exploring whether or not hormonal birth control is right for them, which means more people may be tuning into their “natural” rhythms.

But when we call something “natural,” we run the risk of elevating it as an “essentialist” female quality, and giving it an outsized influence on the role hormones and periods play in someone’s whole personhood.

“I think it’s all about empowerment,” Dr. Devore says. “But a little bit of it feels like, if we’re reduced to these hormones, are we in control of any of our behaviors?” It’s the kind of thinking that could put “us back into the ’50s,” she points out.

“A little bit of it feels like, if we’re reduced to these hormones, are we in control of any of our behaviors?” —Shannon DeVore, MD

Researchers think the need to understand how hormones impact our bodies, including potential benefits to our athletic performance, is what’s actually essential.

“It is amazing that we have these great hormones in our body that we can use to our benefit,” says Jacky Forsyth, PhD, an associate professor of exercise physiology at Staffordshire University and a medical expert for Flo, a period tracking app. She has been studying and advising professional athletes on cycle syncing and exercise for the last 20 years. “It’s a biological function,” she says. “Why not look at it?”

What are menstrual-cycle-syncing workouts?

When Dr. Forsyth works with coaches of women’s athletics teams looking to explore the idea of menstrual cycle syncing, she often has to begin at the same place: premenstrual syndrome (PMS), and the stereotypical symptoms that come with it.

“The (often) male coaches might say, ‘Oh yes, well I’m aware of certain symptoms associated with the menstrual cycle,’” Dr. Forsyth recalls of a lot of her first conversations.

But the idea encompasses a lot more than PMS, because our hormones are active day-in and day-out, not just around our periods—and not just around our ovaries and uteruses.

“There are estrogen receptors right throughout the body that develop in a variety of different tissues,” says Christine Yu, journalist and author of the forthcoming book Up to Speed: The Groundbreaking Science of Women Athletes. “As hormones rise and fall, they actually have a lot of effects throughout the body, so their effects are not just solely isolated to our reproductive system.”

Hormones don’t fluctuate in the same way for everyone, and that’s especially true if you are on hormonal birth control, like the pill. Taking synthetic estrogen and progestin (a form of progesterone) prevents your body from ovulating, which eliminates the hormonal surges that might govern a menstrual cycle-informed workout plan.

However, if you aren’t on hormonal birth control, those surges might be something you want to pay attention to. So menstrual-cycle-syncing workouts involve choosing and modulating your activity based on where you are in your cycle, and the accompanying hormone levels and ratios of each phase.

“Some of the research that is out there seems to suggest that the body responds differently to different levels and ratios of hormones,” Yu says. “The idea of cycle syncing is really this sense of, Can we actually take advantage of those fluctuations in hormones so that we can perform better, eke out some additional intensity, gain some more muscle, gain whatever measures of fitness, recover better if we do certain things that better align with the hormonal phase in which you are in?”

How can hormones impact fitness?

There are some easily understandable applications of menstrual cycle fitness syncing. Fatigue is a commonly reported premenstrual (or late luteal phase) symptom, because you have a deficit of estrogen and higher levels of progesterone. Or you might have a lot of energy during your follicular phase, when estrogen is surging, because estrogen is actually a steroid. So one version of menstrual cycle fitness syncing involves tuning into your mood and energy levels, and busting out higher effort or lower energy workouts accordingly.

But it can get a lot more granular than that.

Dr. Forsyth works with teams throughout Europe who are beginning to implement different versions of the method. There is some evidence that our hormones can impact not just our energy and mood, but our ability to perform.

Specifically, some studies show that people are able to build more muscle in the follicular phase (since estrogen is a steroid, remember?), so this phase would be an ideal time for strength training. Hormones also impact the way that we access our energy (food) stores. While we typically rely on carbohydrates for energy, during the luteal phase, our body turns more readily to fat. That’s why this might be a good time for steady state cardio as opposed to exercise that relies on bursts of energy.

“There’s so much interesting research coming out and people looking at this,” Yu says. “But we’re kind of getting ahead of ourselves.”

A meta-analysis that evaluated 51 studies was not able to conclude that the menstrual cycle has a demonstrable impact on performance. Yu explains that while some studies found that, for example, yes, the follicular phase with its estrogen surge can be an optimal time to build muscle, other studies found no such effects.

A key word to understanding challenges in this research is the word “can,” because how hormones impact the factors that could influence our exercise varies widely from person to person.

“[Some people] will probably be more successful in their plan if they sync it up and follow how their energy levels are feeling,” Dr. Devore says. “But then other women have no symptoms at all and no changes.”

That variability is part of what makes subjecting the theory of cycle syncing to the rigors of the scientific method so difficult. Other challenges include finding large enough sample sizes of subjects with regular periods who are not on birth control, as well as standardizing the data that’s collected across studies (though there is a current push for this standardization). However, Dr. Forsyth, who has contributed much to this body of research (beginning with her PhD in the early 2000s), believes that what meta-analysts describe as a lack of high-quality studies doesn’t mean that the impacts aren’t observable, and ultimately provable, with enough research.

“It’s sometimes hard to actually get a piece of research which is considered to be of high quality when you’re doing a systematic review meta-analysis,” Dr. Forsyth says. “If we were all amazingly controlled, yes we would be able to increase muscle tissue at this particular time when estrogen’s elevated, but actually proving that in a group of women is sometimes difficult.”

As the research stands today, Yu sees stringent forms of cycle syncing as a form of “putting the cart before the horse”—though understandably so.

“We’re always looking for the thing that can help us kind of hack our training, hack our performance, so it’s really seductive to think about our cycles as this crystal ball,” Yu says. “But from my conversations with various researchers and other experts in the field and looking at the research, the science itself isn’t quite there yet—but that’s not to say there isn’t a benefit from paying attention.”

“It’s really seductive to think about our cycles as this crystal ball.” —journalist Christine Yu

Rather than focusing on proven physiological and performance markers, Devore is encouraged by more subjective research that demonstrates how subjects actually felt about the process, how tuning into their energy and mood affected their fitness, and their desire for more openness about the issue.

Bringing our cycles into the open

Menstrual hormone fluctuations have been ignored, misunderstood, and maligned as long as people with ovaries have menstruated and men have been uncomfortable with that fact.

“It’s 2023 and we still don’t openly talk so much about the menstrual cycle and women’s health; there’s still a lot of secrecy,” Claudia Pastides, MBBS, director of medical accuracy at Flo says. “Whether [the menstrual cycle is] a hundred percent relevant and matters every single day or not, we’ll see. But it’s good at least to know and not to just ignore something so big that happens to [the majority of] women.”

Because tracking your cycle requires paying more attention to your body, doing so may also help some women develop a more meaningful relationship with exercise, perhaps while building a more intuitive approach to movement that prioritizes feeling good. That’s true for everyday exercisers, and even athletes who themselves train on how to tune in.

“Every woman is going to be different, and then also could be different from one cycle to the next,” Dr. Forsyth says. “You have to take ownership of your own feelings, your own perceptions of how your menstrual cycle is triggering things for you, and record that so that that then informs your support team, your coaches.”

But whose business is your period, anyway?

In professional training, both male and female teams collect reams of physiological and training data that informs an athlete’s workout regimen. The inclusion of menstrual cycle data—both objective (like hormone levels and cycle days) as well as subjective (like perceived mood or energy levels)—could be seen as progressive, because it treats the menstrual cycle as just one of many data points that could affect an athlete’s training, and not a taboo mystery that nobody talks about.

However, the push for menstrual cycle data in professional sports does not come without concern. Student athletes in Florida are worried that a move to make submitting menstrual cycle data mandatory is an invasion of privacy, and a smokescreen for transphobic bans against non-binary students’ participation in sports. Dr. Forsyth shares that some players on a women’s rugby team she advises are worried that sharing their menstrual cycle data could affect their playing time.

“They are so concerned about being dropped from the team at an elite level, about sitting on the bench, about losing sponsorship if they say something negative about how they’re feeling,” Dr. Forsyth says. “So there’s still some barriers and there’s still some anxieties about collecting the data and using that to change their training.”

The dangers of ‘feminine fitness’

In September, a new women’s lifestyle and subscription service called 28 launched. It’s a company built around cycle syncing your fitness and your nutrition, promising “Fitness tailored to your body’s natural cycle.” It positions itself as a “by women, for women” service, “empowering women to radically improve their health by embracing their nature.”

What is that “nature”? As discussed in Vice, 28 is an offshoot of the conservative women’s magazine Evie, known for articles promoting transphobia, anti-vaccination misinformation, and contraception fear-mongering. Evie has also eschewed both the “body positive movement” and working out “like men.” So for its own fitness venture, founder Brittany Hugoboom describes the vision as “‘feminine fitness’—the philosophy that you should be exercising and eating according to your cycle.”

When 28 launched, it garnered attention from Vice and others because of its adjacency to the overturning of Roe v. Wade, and the fact that conservative donor Peter Thiel’s Thiel Capital is a major investor. Worries were spiking around what period tracking and other health apps—potentially including 28—might do with our menstrual cycle data in a world where, in much of the country, abortion might not just be illegal, but punishable by law.

In addition to these concerns, Evie and 28 are putting forth an idea of womanhood in which our hormones govern our bodies, sweeping aside the idea that people with ovaries have more going on than what’s happening in those ovaries. Menstrual cycle syncing is supposed to be about empowerment, but at its most extreme, it is about promoting one essentialist ideal of what it means to be a woman over the reality that women can gloriously run marathons while bleeding uterine lining down their legs.

“We are not just childbearing vessels,” Dr. Pastides says. “We can’t deny that hormones play some part, but there’s so much to being female and/or having these hormones than just the hormones themselves.”

Cycle syncing also runs the risk of overstating the impact that hormones may play in our lives and our fitness. “Just because some people might feel awful on one particular day,” says Dr. Forsyth, “that doesn’t matter to some people, they will push through and they will do it anyway.”

Empower, don’t prescribe

Alongside all the potential benefits of breaking taboos and promoting female-forward research, the dangers of the trend come when we vaunt one “natural” way of doing things above others, and allow a tracker to dictate our choices rather than listening to how we actually feel.

“It is absolutely essential research that we need to do,” says Yu. “The caution that I have is around getting too prescriptive about it. At least at this stage, the research doesn’t quite support it. And so if you are hearing about the different recommendations or different training programs, you need to be asking questions.”

Before you embark on a cycle-syncing regimen, Yu suggests looking into who the creators are, digging deeper into the research they’re pulling from, checking out the scientific advisory board, “and just being a critical consumer of whatever it is that’s being sold to you.”

Ultimately, taking your menstrual cycle into account in your workouts should be about helping you feel your best and achieving your goals. Like our cycles and our hormones, what that looks like varies from person to person. And while there are red flags and sinkholes on the cycle-syncing workout road, at least we’re saying the words “menstrual cycle” and “ovulation” without shame—and even contemplating the idea that estrogen could maybe help us get yoked. That’s a version of “feminine fitness” we can get behind.

Is that kind of a specific mental image? Sure, but cramp-related pain is also pretty darn specific if you ask me. I have always been the kind of person to have a heating pad within reach of my bed in case that telltale day-before-period back pain hits.

And recently, I’ve added a new tool to my time-of-the-month arsenal. Last year, I was sent a sample of ENUF Period’s The Ritual Cycle Support CBD Balm ($77), and I was so surprised at how effective it is that it’s become a staple in my nightstand drawer. For a few months now, I’ve found myself reaching for this pain-relieving balm and sighing once I’ve rubbed it on. It mercifully quells that classic firebelly period pain that I get on my FDP (first day period).

ENUF Period's The Ritual Cycle Support CBD Balm — $77.00

Designed to help alleviate menstrual discomfort, this balm is infused with CBD, a non-psychoactive component of cannabis, which is believed to have pain-relieving properties. The soothing formula includes shea butter, kokum butter, and jojoba oil to nourish and moisturize the skin while relieving pain. Easy to apply and fast-acting, The Ritual offers targeted relief.

Get It Here

Why this CBD balm is so great for period pain

1. It smells pretty darn good

The first thing I noticed about this balm was the scent. It has a lovely, subtle aroma with notes of essential oils, like something you’d smell after a fancy massage. Many topical pain medicines have a clinical wintergreen, menthol, or even hand sanitizer-y smell that isn’t super relaxing. When I’m not feeling great, I don’t really want to smell such sharp and uninviting things. ENUF’s site explains that their signature scent contains notes of patchouli, cedarwood, lavender, and peppermint.

2. The temperature is always neutral

I can’t stand putting on a cold dollop of goo—be it sunscreen, Icy Hot, or even lube, thank you very much. There’s nothing more off-putting than glomming something chilly onto my skin.

ENUF’s balm delivers here. This is because many of their ingredients, like murumuru butter, kokum butter, jojoba oil, and shea butter, congeal into a neutral-temperature solid at room temperature. Water-based gels and lotions feel cooler because the water draws the heat from your skin and evaporates on contact. That evaporation is what gives you that cold feeling (and is how a lotion dries onto the body). When using an oil or a butter, the water content is much lower.

3. The texture doesn’t make me feel slimy

Despite being an oil- and butter-forward balm, I don’t feel like I’m ready for a greased watermelon race (fellow Hoosiers will know what I mean). Sometimes massage oils feel like they’re getting everywhere and not sinking into your skin. This isn’t the case with The Ritual balm.

4. My pain goes away

Most importantly, my abdominal cramping melts away when I apply this. It’s so reliable. It also doesn’t feel masked like its threatening to come back any moment. The small container is a bigger price point for me at $77, but a little goes a long way, and the jar has lasted me for quite some time.

Using a CBD-based product is definitely a personal decision. But for me, this balm is answers my pain needs around the time of my period. Remember to consult a trusted care provider if you’re experiencing abnormal period pain and are unsure about incorporating something new into your at-home routine.

This is all to say, if you’ve recently had a baby, you may be wondering what to do right now to avoid pregnancy until you’re ready to conceive again (if that’s something you want). Should you immediately go back on the same form of birth control you used before your pregnancy? Should you try an IUD instead? If you don’t have a regular period again, does it even matter?

We asked a few OB/GYNs and fertility pros to share the ins and outs of going back on birth control after childbirth so you can take the guesswork out of the equation and just focus on you and your new baby.

First, know that you can get pregnant almost immediately after giving birth

Though it’s unlikely, you can get pregnant again as early as three weeks after childbirth. To be fair, it’s entirely normal if you don’t want to have sex quite so soon after giving birth—and most OB/GYNs recommend waiting until at least six weeks to allow the body to heal.

But once you are getting intimate again, another pregnancy is entirely possible. “Right after you give birth, the body is undergoing drastic changes in hormones,” says Nicole Avena, PhD, author of What to Eat When You’re Pregnant as well as a professor of neuroscience specializing in nutrition at Mount Sinai School of Medicine. Specifically, progesterone and estrogen both drop significantly following childbirth. And while your hormones may continue to fluctuate for at least six weeks postpartum (what’s commonly referred to as the fourth trimester), you can very much still get pregnant during this time, she adds.

That’s true no matter if you haven’t had a period or are actively breastfeeding—two common misconceptions, says Rachel Danis, MD, a reproductive endocrinologist, infertility specialist, and board-certified obstetrician and gynecologist at RMA of New York. “I have seen women get pregnant very quickly after delivery because, even though they haven’t had a regular cycle, they’re forgetting that you don’t need to have a regular cycle to ovulate,” Dr. Danis says.

Upon delivery, there’s a steep rise in the hormone prolactin, which is released from the brain to your breast tissue in order to produce breast milk, Dr. Danis explains. This increase in prolactin causes a suppression or a decrease in the production of FSH (follicle stimulating hormone) and LH (luteinizing hormone). When those two hormones are not actively being released from your pituitary gland, you’re not going to start having a cyclical, or predictable menstrual cycle, she adds.

Actively breastfeeding will sustain your prolactin production, which could prevent menstruation, but “you can still have a sporadic ovulation,” says Dr. Danis. “You ovulate two weeks before a period, so you may think you haven’t ovulated because you haven’t had a period, but yes you certainly could have ovulated.”

There are risks associated with getting pregnant again too soon

The American College of Obstetricians and Gynecologists (ACOG) recommends avoiding another pregnancy entirely within six months after giving birth and cautions of “adverse outcomes” associated with getting pregnant before 18 months postpartum, including uterine rupture for those who previously had a cesarean delivery.

The window of time for the greatest concern is actually rather short, though. “If you’re getting pregnant within six weeks of your last delivery, then the mom is at risk of all of the things that women are at risk for when they’re pregnant, but even more so because they have the fourth trimester [postpartum period] plus this new first trimester,” says Dr. Danis. ”So you’re at a higher risk of blood clots, which is number one, and getting a hypertensive disorder during pregnancy; your cardiovascular volume is increased and your respiratory reserve in your lungs is lower. All of that is exacerbated when you’re pregnant.”

Still, ACOG also reports that one in three people who give birth do get pregnant again before the optimal 18-month mark, and experts emphasize that there’s no need to panic if this happens to you. “It is important to not worry and keep in close communication with your healthcare provider as they can answer questions and monitor any changes,” Dr. Avena says. The most common things to be aware of are low birth weight, preterm birth, and small size for gestational age, she adds. And of course, there’s a chance you simply may not know you are pregnant again, especially if you have yet to return to a typical-for-you menstrual cycle and period, Dr. Danis adds. So, getting prenatal care ASAP is key.

So, when should you get back on birth control?

Getting back on birth control postpartum will not only help prevent an unplanned pregnancy, but protect you from the increased health risks of back-to-back pregnancies. Plus, depending on the type you choose, you can start as quickly as the same day you give birth.

You can have an IUD inserted within the first 10 minutes after delivering your baby and placenta while you’re still in the hospital, Dr. Danis says. “I personally love [opting for the IUD] immediately because the person typically has an epidural or some sort of anesthesia whether you’re having a vaginal delivery or a c-section,” she says. “IUDs are the best. It’s a set it and forget it [type of birth control]. They last for seven to 10 years, but you don’t have to keep it in for that long. Even if you just want it for two years, keep it in for two years.”

ACOG cautions against going on an estrogen-containing birth control, such as the pill, vaginal ring, or patch, for the first couple of weeks postpartum since these may increase your risk of a blood clot.  This type of birth control could also diminish your breast milk supply, but as long as there is proper nipple stimulation and consistent feeding or pumping, the difference should be negligible, Dr. Danis says.

While your doctor may discuss birth control options during your six-week postpartum appointment, Dr. Danis cautions against waiting that long to get back on birth control due to all of the risks of early, unplanned pregnancy. The ACOG takes this recommendation one step further, noting that a good time to choose a postpartum birth control method is when you’re still pregnant.

Regardless of which type of birth control you choose or when you decide to go back on birth control after having a baby, you will need a back-up barrier method for the first five to seven days. This allows your body adjusts to the new method, and solves for any lapse in protection, Dr. Danis says, who cautions that even a slight deviation from taking a birth control pill as prescribed can impact its efficacy. That means, for the first week starting any kind of birth control (pill, IUD, or otherwise), or switching birth control types or brands, you’ll also need to use a condom.

You see, tampon applicators aren’t recyclable after use. As for pads, most are 90-percent plastic, meaning that they can take 500–800 years to decompose. What’s more, all conventional period products contribute to our microplastic problem by contaminating water systems. Finally, one year’s worth of feminine hygiene products (and all of the materials that comprise them) translates to a carbon footprint of 5.3 kg, or nearly 12 pounds of CO2 emissions.

“Single-use disposable period products aren’t only wasteful, they’re unsustainable, unsafe, and unaffordable for many,” says Helen Lynn, environmenstrual campaign manager at the Women’s Environmental Network. If it sounds like a toxic relationship, that’s because it is.

How to kick your tampon habit

The ecological damage that tampons and pads cause is clear, but they pose risks to our health, too—a fact that may make it easier for many to part ways with the products.

“Cosmetics are better regulated than period products,” Lynn says. “This is a huge concern given the number of toxic chemicals that have been found in period products all over the world, most recently in India. Toxic chemicals have no place in products intended for use in or near such an absorbent part of the body, i.e. the vagina and vulva.”

Phthalates, bisphenols, and parabens are among the chemicals commonly found in period products, those linked to cancer, reproductive and developmental disorders, asthma, allergies, and more—and that’s not even taking the synthetic fragrances (which can contain up to 3,000 chemicals) into account.

In short, period products cause both personal and environmental harm. So, are you ready to break the cycle and break up with your tampons for good? These alternatives will help ease the transition and improve your relationship with the planet in the process.

5 sustainable pad and tampon alternatives

1. Menstrual cups

One way to combat the waste problem associated with period products is to opt for something reusable—like the menstrual cup. Crafted from silicone, these cups are designed to be inserted into the vagina to sit and collect menstrual blood. Once full, the cups can be emptied, washed, and reused for anywhere from one to three years (though some claim to last much longer), saving the planet (and your wallet) from waste.

As for emissions, exchanging your tampons for a menstrual cup can lessen your carbon footprint, saving .007 tons of CO2 (or 17 miles in a standard gasoline-powered car) from entering the atmosphere.

2. Period underwear

Modern period underwear is sleek, hyper-absorbent, and downright convenient. Once purchased, these helpful undies can be worn and washed like any other pair; though, Lynn notes that some period underwear may contain PFAS, known as “forever chemicals” because they can say in your body for long periods of time and disrupt your endocrine system among other negative side effects, so keep an eye on materials and makeup.

3. Reusable pads

A single disposable pad and the packaging that accompanies it can contain as much plastic as five plastic bags! Reusable cloth pads help to mitigate this waste.

Made from sustainable fabrics like bamboo and organic cotton, the simple solution can work to absorb the same amount of blood as two to four tampons and last for up to five years. Once you wrap your head around the concept, you can even try your hand at a DIY version.

4. Plastic-free or reusable applicators

This is not a wholesale solution, but it’s certainly a step in the right direction. If you don’t see yourself eschewing tampons entirely, and you can’t imagine insertion sans an applicator, start by going plastic-free or reusable. That said, a finger alone really works.

5. Biodegradable pads and tampons

If you cannot fathom the thought of ditching your go-to period product, work toward a healthier future by purchasing biodegradable pads and tampons. Brands like Natracare and Saathi craft offerings from plant materials and organic cotton, ditching all synthetics so that the products can decompose in your home compost pile or bin, all while saving the world on plastic waste.

Keep in mind that cutting up pads and tampons will help them break down more quickly in your healthy compost. Even with the extra aid, the process can take up to two years. But hey! That’s literally hundreds less than a traditional period product.

“Women weren’t required to be in clinical research until 1993,” says Priyanka Jain, who co-founded Evvy, a femtech startup, in 2021with Laine Bruzek. “And that lack of information leads us to the state of today that women are on average diagnosed four years later than men across over 700 diseases.”

It’s because of shortcomings such as these that Bruzek and Jain decided to start Evvy, which offers a vaginal microbiome test that uses special metagenomic sequencing (using DNA samples) to detect specific types of bacteria in the vagina.

Evvy Vaginal Microbiome Test — $129.00

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So why a vaginal microbiome test specifically? According to Jain, there are many biomarkers that only exist in female bodies that tend to get overlooked by the medical and scientific communities. So Jain and Bruzek considered which ones weren’t being looked at—but had plenty of potential to improve healthcare outcomes for women. “As we were exploring where to start, we honestly couldn’t escape the vaginal microbiome,” Jain says.

Even though scientists have know of the importance of the vaginal microbiome for 20 years or so, much of the research was focused on how the biome relates to childbirth, according to gynecologist Suzanne Fenske, MD who is the founder of TaraMD, an innovative gynecology practice in New York City. But the implications of vaginal microbiome extend far beyond childbirth. A compromised or abnormal vaginal microbiome is linked to gynecologic issues including an increased risk of vaginal infections such as yeast infections and bacterial vaginosis (BV), sexually transmitted infections (STIs), and preterm labor according to Dr. Fenske.

As a health writer, I’ve always known about the gut microbiome, and I found it so interesting and helpful to learn about how my own was doing by having it tested in the past. So after learning about Evvy, I was curious to discover what I could learn about my vaginal microbiome, too. In particular, I wanted to know what could potentially change or disrupt it over time. I was also curious to learn if birth control could affect my microbiome since hormonal contraceptives have been shown to change the vaginal microbiome in some studies and I’d started a new form six months ago.

Here’s how the test works: Evvy is an-at home test kit (a single test is $129, or a membership is $99 per test shipped every three months). You send your sample (a vaginal swab) to a lab for processing. Each step along the way, Evvy sends you an email letting you know where your sample is and when you can expect your results—it takes about two weeks.

In the report, you get a detailed look at what kinds of bacteria are present in your vaginal microbiome (both good and bad) with detailed information on what that could mean for your health. You also get a customized action plan with lifestyle recommendations (like info on how using condoms can cut down your risk of yeast infections) and next steps to improve your symptoms (or prevent future issues). Each Evvy test includes a call with a health coach who can help walk you through your test results and action plan or answer any questions you have.

What trying the Evvy vaginal microbiome test is like

When I got my Evvy test kit in the mail, I found everything was labeled clearly, and it was easy to collect my sample. I did have to wait to take it, though, since I happened to have my period when the test arrived, and the instructions say you can’t test if you’re menstruating, had sex in the past 24 hours, used any kind of vaginal creams or suppositories, or if you’ve used antibiotics in the last seven days, BTW.

In the meantime, I activated my test online and filled out a detailed questionnaire that asks you to report information about your current symptoms, health history, and sexual history.

Once I activated my test, filled out the questionnaire, I collected the sample to send to the lab. The test kit comes with a swab and collection tube—it doesn’t look all that different from a Covid-19 test, TBH. To collect your sample, you insert the swab into the vagina and circle it for 20 seconds. Then you place it in the collection tube where it remains sealed. You place that into the return box and drop it in the mail, and then it’s shipped off to Evvy’s lab.

The results of my vaginal microbiome test

After about two weeks, I got my results back in an email from Evvy. Once you click into them, you’re taken back to the Evvy site where you can see a detailed overview of your results, learn about your microbiome type (more on that later), see trends and insights (this is where you can track your results over time if you continue to test regularly), and curated content and insights based on what you reported in your health evaluation— mine included content on oral contraceptives and how the use of combined oral contraceptives is linked to a reduced risk of BV and a balanced microbiome.

My results overall were what I expected given that I’m not currently experiencing a lot of symptoms—it said my microbiome contains 99 percent protective bacteria, and only one percent harmful bacteria. Evvy also reports your microbiome type, or Community State Type (CST), categories that researchers have used to group vaginal microbiome types. My microbiome type is 1-A, which research shows is the best type for preventing vaginal infections. This type is characterized by having the dominant bacteria Lactobacillus crispatus, which is a protective bacteria found in the vagina.

My health plan (which Evvy points out is not a diagnostic plan but a wellness screen that should be shared with your doctor) includes some pointers on what to do next. The first tip I get is to talk to my doc about further testing for disruptive bacteria (although I appreciate the tip, my good bacteria is so high and my symptoms are low that I don’t think it’s necessary right now).

The next tip involves maintenance, where it’s suggested that I take probiotics only as necessary (like when I’m on antibiotics for example) since taking too many probiotics could cause yeast overgrowth. While I don’t take a probiotic every day, I found this interesting since so many people do. The report says, “There is also the potential for continued probiotic use to result in lactobacilli overgrowth (cytolytic vaginosis). For this reason, the evidence would point to just letting your microbiome do it’s thing!”

This is accompanied by two research articles on the subject and Evvy calls out that this rec is based on evolving research, so it’s solid but still evolving. I also ran the test by Dr. Fenske, asking her opinion on the test method and results. Her take? “I think it could be a very useful tool for understanding the root cause of recurrent vaginal infections and, possibly, etiologies [causes] of vulvar/vaginal pain,” she says.

Overall, I walked away learning a ton about the vaginal microbiome and the potential that more research on it can have on big health issues like knowing more about problems that many women experience but lack answers to—like chronic BV, painful sex, and vulvodynia (chronic, unexplained pain around the vagina or vulva).

Personally, I’ll continue monitoring my microbiome and test again if I have symptoms or even a few times a year just to see how things are doing.

Why knowing more about the vaginal microbiome has big implications for closing the health gap for people with vaginas

Speaking of more research, Evvy is using the data from the test (which is de-identified before it’s used for research) to partner with researchers and health experts in the scientific community to fill in the gaps on vaginal health, improve research, and help the medical community understand more about the female body.

As of 2022, Evvy has created the largest data set that anyone has on the vaginal microbiome. And this dataset is a launching point the founders hope is the start of progress for closing the gender health divide. “For us to actually enable better care outcomes across the board, we first need to start with all of that better research,” Jain says. “And we’re really hoping to help pioneer that so that everyone experiencing care—through Evvy or anywhere—can access much better care from their physicians.”

The news made its way from the headlines onto Twitter and TikTok feeds and into many group chats, reigniting calls for Black women to ditch the chemicals and go natural for the sake of our health. But unfortunately, the quest to avoid harmful ingredients isn’t as simple as just “embracing” our curls.

Black women are held to an impossible beauty standard (it’s worth noting that hair-based discrimination is still legal in 31 states), and are expected to meet that standard with products that aren’t designed with us in mind—which means piling on more and more products to achieve our desired look. Not only does this keep us tethered to an arsenal of beauty products, but it also heightens our exposure to potentially harmful ingredients—heightening the risk of turning our self-care routines into self-destruction.

The complex relationship between Black women and their beauty routines

In Black culture, whether you wear your hair natural or chemically treated, it must always look on point. We dedicate hours—and tons of products—to twisting, setting, laying, greasing, and wrapping so that no baby hair is out of place and no curl is undefined. “The big picture is that Black women, we use more personal-care products in general,” says Heather Woolery-Lloyd, MD, a board-certified dermatologist in Miami. “It’s not a roll-out-of-bed culture.”

Black Americans spend more on beauty products than any other group. A 2021 study found that while Black people comprise 13 percent of the population, we account for 22 percent of the $42 billion spent on personal care. This all ties back to the ridiculously high standards Black people are held to both by others and ourselves.

“When you talk about beauty as currency for women in general and how complicated that gets for Black women, you understand the importance of trying to look as perfect as you can at all times,” says Alese Adams, a 23-year-old beauty enthusiast from Nashville, Tennessee, whose relationship to beauty has been shaped by these pressures. “You’re not only criticized for your race, you’re criticized for your womanhood, so your looks are criticized twice as hard as everybody else’s. There is a lot of pressure to try to look put together at all times.”

So a decade ago, when millions of Black women began wearing their natural hair (in a move to step away from Eurocentric beauty standards while cutting down chemical exposure), the drive toward perfection didn’t disappear—it shapeshifted. Though sales of hair relaxers marketed to Black women decreased by 40 percent between 2008 and 2015, sales of natural hair styling products increased by 27 percent between 2013 and 2015. And there’s nothing “natural” about using half a bottle of conditioner to detangle, then layering on fifty ‘leven products to smooth, define, and perfect.

“I felt a huge, huge, huge pressure to make my natural hair as perfectly coiled as I could possibly make it. I have 4C hair—it took everything to get my hair to try to force it to be what I wanted it to be,” says Adams. “Having natural hair is so expensive, those products cost so much money, and you have to have five, six different products just to get through one wash day. And you have to use so much of the product to get your hair to be slippery enough to be able to detangle without losing half your head to shedding.”

Relaxers are only part of the risk

The issue with slathering on so many products is that the more of them you use, the more likely you are to expose yourself to potentially harmful ingredients—and this is especially true for Black women. In 2016, the Environmental Working Group (EWG) assessed almost 1,200 products marketed specifically to Black women and concluded that fewer products made without hazardous ingredients are available for this group; and in 2019, researchers found that the prevalence of endocrine-disrupting chemicals is higher in hair products used by Black women than in products used by white women.

These endocrine-disrupting ingredients were the focus of the NIH study, and according to Dr. Woolery-Lloyd,  can bind to and activate hormone receptors, throwing off function and leading to a range of health issues. Phthalates and some parabens (which are commonly found in beauty products, including relaxers) are the most well-known ingredients under the endocrine disruptors umbrella, but they are only a small part of the problem. Even natural oils, like lavender and tea tree, are proven endocrine disruptors, and a small 2018 study linked the use of these oils on baby boys to breast development.

“It’s not so clear-cut because, unfortunately, we’re exposed to endocrine disruptors in things that we consider ‘natural,'” says Dr. Woolery-Lloyd. “Someone who doesn’t use a relaxer but puts 16 products on her hair every single day, she’s getting a lot of exposure to endocrine disruptors too…it’s not like she’s safe.”

It’s also worth noting that potentially harmful ingredients can be even more harmful when they’re found in hair products (than, say, in skin- or body-care products) because your scalp tends to absorb chemicals more easily than other areas of skin. Your hair routine shouldn’t need to involve tons of different creams, oils, mousses, and sprays. (Not only is that expensive and potentially harmful on a hormonal level, but product overload can clog the scalp, creating an unhealthy environment that makes it difficult for your hair to truly thrive.)

“[As Black women], we’re constantly covering our hair, scalp, and body with products that have endocrine-disrupting chemicals,”  says Dr. Woolery-Lloyd. “This study showed a higher rate of uterine cancer with relaxer use, but there are studies that have shown a higher rate of early periods with hair oil use. There’s another study that shows a higher rate of breast cancer with hair dye use. I don’t know if it’s specific to relaxers—it’s unique to all of the chemicals that we put on our skin and hair.”

It’s not only the fact that the recipe is so simple that has TikTokers dedicated to this side dish—it’s also the purported hormonal health benefits it packs. Many claim it helps them with menstrual cramps, clearing up acne, and ending brain fog. But is it truly magic? To find out, we spoke to a nutritionist, hormone specialist, and doctor.

Ray Peat’s Raw Carrot Salad

Yields 1 serving

Ingredients

1–2 carrots
1 tsp olive or coconut oil
1 tsp apple cider vinegar or white vinegar
Salt and pepper to taste

1. Shave carrots lengthwise then add them to a bowl with all other ingredients and enjoy.

Does raw carrot salad help to balance hormones?

The simple answer is, yes, according to holistic nutritionist Elissa Goodman. “Carrots contain unique fibers that help to detox excess estrogen from the body,” she says. This is a common symptom of estrogen dominance, “which is a state where someone has a higher ratio of estrogen compared to progesterone,” says Bill Rawls, MD, co-founder and medical director of Vital Plan, naming two the primary reproductive hormones, alongside testosterone.

Side effects of estrogen dominance include symptoms like PMS, heavy/painful menstrual cycles, headaches, or excess weight around the midsection/hips, acne, but the condition isn’t exclusive to women only. “It absolutely can affect everyone,” says integrative health practitioner and hormone specialist Jenny Branco. “The symptoms really shine through when progesterone, our calming hormone that is supposed to oppose estrogen, is lower than estrogen levels.”

In Bronco’s experience, estrogen dominance is becoming more and more widespread. “It’s the most common hormone imbalance I see, and it’s becoming more and more prevalent due to so many estrogen-mimicking chemicals in our environment, known as endocrine disruptors,” she says. “These can be found in everyday products like plastic Tupperware or bottles.” And Sara Gottfried, MD, author of The Hormone Cure and The Hormone Reset Diet, previously told Well+Good that “most women, starting around age 35, develop estrogen dominance.”

In addition to helping eliminate excess estrogen, “carrots contain antibacterial, antifungal, and antimicrobial properties which enable them to act as a natural antiseptic and antibiotic in the gut, without all the unwanted side effects,” Branco says. And while carrots are clearly the main character of this salad,, the other ingredients offer their own perks, too.  “The coconut oil and vinegar help to further reduce harmful bacteria in the digestive tract, normalizing gut bacteria and therefore rebalancing hormones and supporting metabolic health,” Branco adds.

Should you eat raw carrot salad every day?

While it may be TikTok viral and have hormonal benefits, our experts have mixed reviews on whether eating the salad every day is good for you. Branco recommends eating the raw carrot salad once or twice per day consistently. “It can help to open up those detoxification pathways and fight against hormonal imbalances,” she says.

However, Dr. Rawls isn’t so sure. “Everybody tends to overdo things, especially when something has reached ‘trend’ status,’ he says. Carrots are hardly the only food that can help eliminate excess hormones. “There’s significant evidence that cruciferous vegetables such as broccoli, cauliflower, cabbage, and Brussels sprouts, normalize estrogen dominance.” And eating a variety of nutritious foods is necessary for overall health.

Rawls emphasizes that balance is key here. “My top tips to balancing hormones include eating enough protein every day, staying hydrated, regular exercise, proper gut health, lowering blood sugar levels, and getting at least eight hours of sleep each night,” he says. “With that said, I eat a carrot just about every day and I think the antioxidants are beneficial, but I wouldn’t start eating bowlfuls of carrot salad every day with expectations that it might balance my hormones.”

For instance, bleeding during the full moon is referred to as a red moon cycle, indicating you’ll experience creativity, mentorship, and healing during each period. However, if you bleed during the new moon (first of all, same), you have a white moon cycle which has a totally different vibe and spiritual significance. Read on to learn what that is, plus tips on harnessing the power of a white moon cycle. 

What is the significance of a white moon cycle or menstruating through a new moon?

“Many people believe that if your period comes on the new moon each month, what is called a white moon cycle, that you are connected to the energies of Mother Earth, meaning that you are in a fertile, creative, and nurturing time of your life,” says Serena Poon, a celebrity nutritionist, reiki master, and longevity wellness expert. 

In other words, the white moon cycle is seen as the mother or caregiver phase of life. “This can mean that you are in a time in your life that you are either nurturing a family or starting one, or in a caregiver role in some way in your life,” explains Rebecca Rankin, a yoga teacher, reiki master, and holistic hormone health practitioner. 

That said, a white moon cycle is not just about taking care of others—it’s also about tending to yourself. “A white moon cycle indicates you want to give more energy to yourself and is your body’s way of gently reminding you that you need more TLC,” explains Desiree Roby Antila, author of Sun Signs in Love. “During your cycle, devote your resources inward instead of outward.” 

And, this nurturing energy is also good news for your goals and dreams. Antila describes it as “fertilization for powerful manifestations.” For that reason, having a white moon cycle serves as a time to create space for new beginnings. 

How to harness the power of a white moon cycle

Double down on self-care

Energy levels tend to naturally wane during menstruation thanks to estrogen and progesterone levels being at their lowest. Poon’s advice: “Don’t fight these energies; instead, lean into the energy of rest and renewal that the new moon calls for.” That can look like taking a new moon bath, journaling, getting a massage, or any other act of self-care that nourishes your physical, emotional, mental, and spiritual needs. 

Set intentions

The new moon is also the best time to set intentions. Think about what you want to bring into your life in the month ahead. “If you’re not particularly excited about fertility, consider that the energy used to make a baby is, in fact, creative energy,” Poon says. “Creative energy can be useful in many other avenues of life as well. The beginning of your menstrual cycle can become a time for preparing to call in a new creation of any kind.”

Focus on letting go

The new moon and menstruation have an out-with-the-old-in-with-the-new type of energy. So, Poon says doing anything that helps clear out old energy and create space for new beginnings is ideal during a white moon cycle period. In particular, Rankin recommends playing with this theme by asking yourself: “To make room for more of what I want, what am I ready to let go of?” She adds that reciting the affirmation “I shed old habits that no longer serve me, and I listen deeply to my intuition” can also be supportive during a new moon bleed. 

Celebrate during the full moon

If you have a white moon cycle, that also means that ovulation will sync up with the full moon phase. Poon notes you’ll notice an increase in energy as the moon gets fuller because estrogen levels are at their highest during ovulation. 

The full moon is also when the intentions you set during the new moon start coming to fruition. For this reason, Poon suggests celebrating what you’ve created over the last couple of weeks and reflecting on what else you want to release and what you want to expand during the remainder of the cycle. 

Rankin adds that the full moon also has an energy of fertility. So when you pair that with ovulation, that energy is magnified, making this a great time to tap into your creativity and be seen and social. 

More than anything, Rankin says understanding what sacred cycle you’re on is an opportunity to slow down and do some self-inquiry. “Your period will attune to different cycles over the course of your life, so it’s fascinating to note what’s going on in your life energetically as your body cycles,” she says. 

“Your eczema sometimes can fluctuate with your hormone levels,” says Marisa Garshick, MD, a board-certified dermatologist in New York City. “We know that week before your period, when your estrogen level is lower, you may experience more dryness of the skin. And we know that when the skin is dry, it can predispose to a flare-up of eczema. We don’t warn patients about this but if somebody said they it, the rationale is there.”

The available research on eczema flares in the week before a period is varied. “The research really shows that maybe about 20 percent to about 50 percent of people may experience a flare during or before their periods,” says Ivy Lee, MD, a board-certified dermatologist in Pasadena, California. “The hard part about that information is, how do you know if it’s timed to their menses or not? Is it related to stress? Is it related to the period itself? Is it related to different surges in hormones? So, it probably varies a lot based on any given individual.”

Albeit very rare, if you notice eczema flares exclusively in the days leading up to your period, it might not be eczema at all. It could be worth chatting with your doctor about autoimmune progesterone dermatitis. “It’s a cyclical, autoimmune eczema-type of rash that’s related to the progesterone cycle,” says Dr. Lee. It’s an allergy to progesterone, whether it’s progesterone from oral contraceptives or whether it’s from our natural progesterone. And it usually happens like three to seven days before our period, which is also when we can get premenstrual symptoms.”

She goes on to explain that while autoimmune progesterone dermatitis is rare, it may be underdiagnosed because derms don’t always look for it. “But it is something where if this patient comes in and they say, ‘Ivy, it’s always around my period, I’m getting this on a monthly basis,’ then it’s something to consider,” she says.

Treatment for autoimmune progesterone dermatitis is something to discuss with your doctor, but if you’re just experiencing regular-old eczema that flares before your period, prevention is pretty straightforward.

“When our skin is irritated—a little more sensitive or itchy—we’re really good about putting on moisturizer and maybe not being as harsh in terms of hot showers,” says Dr. Lee. “It’s when our skin gets better that we get a little lazier and a little bit more lax in terms of being as diligent about this maintenance and preventive care.”

Dr. Garshick says it’s key to stay on top of the tried-and-true rules that help calm eczema. “Eczema is very responsive to how you care for your skin,” says Dr. Garshick. Use a gentle cleanser, pat dry when you get out of the shower instead of vigorously rubbing, put on moisturizer right away, and keep up with your moisturizer throughout the day. “Sometimes for people with eczema, that can be two or three times a day,” says Dr. Garshick. “If you know you’re susceptible to a flare-up at this time, do everything you can to keep that skin barrier intact and keep as much moisture in the skin.”

3 products to help prevent an eczema flare before your period

Dove Sensitive Skin Body Wash — $10.00

This is one of Dr. Lee’s favorite body washes for those with eczema. It’s made with moisturizing ingredients and a blend of prebiotics to nourish your skin and its microbiome.

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Vanicream Gentle Facial Cleanser — $12.00

This is a great gentle option for your face. It helps remove dirt, oil, and makeup without making your skin feel dry or squeaky.

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La Roche-Posay Lipikar AP+M Triple Repair Moisturizing Cream — $15.00

For your face and your body, turn to this cream from La Roche Posay. It’s got the Seal of Acceptance from the National Eczema Association, so you know it’s free of any irritants that irritate eczematic skin. It’s made with soothing niacinamide and deeply moisturizing shea butter to diminish symptoms of eczema, hypersensitivity, and dryness.

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Want even more beauty intel from our editors? Follow our Fineprint Instagram account for must-know tips and tricks.

First, let’s break down the likelihood of your period aligning with the full moon. The average menstrual cycle lasts anywhere between 21 and 32 days as you move through the follicular, ovulation, luteal, and menstruation phases. When your progesterone levels drop in the luteal phase, you pave the way for your period, which lasts an average of two to seven days.

Of course, the moon is also on a cycle (albeit one that’s notably more predictable). The full moon occurs every 29.5 days—meaning there is a good chance that your period could fall on a full moon day. “If you find yourself ovulating during the new moon and bleeding during the waxing and full moons, then you’re following what is traditionally known as the ‘red moon’ menstruation cycle,” says Syd Robinson, author of the forthcoming astrological book Who Do the Stars Say You Are? 

If you happen to have this moon alignment, says Robinson, it’s likely you’ll witness a few major (and often lucky!) themes in your life during each period: creativity, mentorship, and healing.

“In ancient times, this cycle was symbolically tied to shamanism and healers, and largely associated with feelings of creativity, passion, and mentorship,” she says. “Since waxing and full moons are typically linked to outgoing, inspiring energies, you may find yourself more focused on lending your maternal spirit outward.” This could inspire you to mentor others or dive headfirst into your own creative projects.

“In ancient times, this cycle was largely associated with feelings of creativity, passion, and mentorship.” —Syd Robinson, author of the forthcoming book Who Do the Stars Say You Are? 

That said, the anecdotal and historical astrological significance of having your period on a full moon isn’t backed by science (at least, not yet). “Although some studies have demonstrated a possible connection between getting your period and a new moon, there is no conclusive evidence that suggests that your period and the full moon are linked,” says Laura Purdy, MD, Chief Medical Officer of online health-care provider Wisp.

Dr. Purdy caveats that some recent research indicates that if there were a connection between the menstrual and lunar cycle in the past, the increasing amount of artificial light folks are now exposed to at night may have severed it. (Meaning, it may have formerly been a thing!) Now, though, “if your period is synched up with the full moon, this is likely a random occurrence, rather than anything else,” she says.

But, that’s the studied, medical take. As for the spiritual significance, you can freely be the judge. And fortunately, there’s really no harm in following the call of the red moon cycle and unleashing your creativity and flexing your mentorship muscles anyway. In fact, if you’re feeling yourself when your period comes along—no matter when in the moon’s cycle that happens—go ahead and shine like that ultra-bright full moon.

“Titanium dioxide is the naturally occurring compound created when titanium reacts with oxygen in the air,” explains endocrinologist and advisor at reproductive-health company Natalist Aimee Eyvazzadeh, MD. “As an oxide, titanium is found in minerals in the earth’s crust and is also found with other elements, including calcium and iron.”

The U.S. Food and Drug Administration (FDA) approved titanium dioxide for human consumption in 1966, cementing its presence in a variety of foods, including candies and other processed foods. It’s primarily used to help make white foods appear whiter (like milk and candy) or to lengthen the shelf life of foods that are sensitive to UV light. (The FDA says that manufacturers can have no more than 1 percent TiO2 in food.)

However, trouble arose for the ingredient in 2021 when the European Food Safety Authority (EFSA) issued a statement that titanium dioxide “could no longer be considered safe” as a food additive. In its report, the EFSA reported that they couldn’t rule out the possibility that titanium dioxide caused damage to DNA (“genotoxicity”)—and thus couldn’t establish a safe level of daily intake. This finding prompted the European Union to ban TiO2 as a food additive earlier this year, but in the U.S., the ingredient is still considered to be safe in food at the limits set by the FDA.

However, titanium dioxide isn’t just a popular ingredient in food. It also appears in sunscreen and cosmetics, two categories in which the ingredient is also generally considered safe. It’s also is often used to make things like paint, and most relevant for our purposes, it’s used to make pads and tampons appear whiter. 

It’s unclear exactly how many brands use TiO2 in their menstrual products. The FDA classifies tampons and pads as medical devices, and thus manufacturers of these products are recommended, but not required, to list their ingredients. (That’s slowly changing after New York passed a law requiring ingredients lists on menstrual products sold in the state). That said, well-known brands like Tampax and L. include TiO2 in their products, while brands like Rael, Cora, and The Honey Pot currently do not have this ingredient in their pads or tampons.

So the million-dollar question: is it safe to have titanium dioxide in pads and tampons? Below, Dr. Eyvazzadeh and Erin Flynn, MPH, DNP/FNP, an LGBTQ+ care expert with birth control startup Favor, share the complicated truth behind this question. Just bear in mind: If you have any specific health concerns to weigh, it’s critical to reach out to your gynecologist or primary care physician to make the right choice for you.

What are the potential adverse health effects of titanium dioxide?

One of the tricky things about titanium dioxide is that it can be consumed in a myriad of ways, making risk calculation difficult. “The potential risks of titanium dioxide vary depending on the method of exposure,” says Dr. Eyvazzadeh. Inhaling titanium dioxide while you’re painting a room or working on a construction site, for example, may irritate the eyes, nose, and throat. But there’s not much research to tell us what the potential effects are of TiO2 in certain other formats,  like if you eat a little bit of it in food, or regularly insert small amounts of it in your body via a tampon for a few days each month.

“There is no published research available currently that has examined the impacts of vaginal or vulvar exposure to titanium dioxide.” —Aimee Eyvazzadeh, MD

There is some evidence to suggest that titanium dioxide may have a carcinogenic effect in some formats. “[TiO2] may cause cancer based on studies done on animals, and it has been associated with lung cancer when inhaled,” says Dr. Eyvazzadeh, which is why the government sets limits on exposure for workers. Other human studies, however, have not found any clear link between lung cancer and titanium dioxide. And there honestly isn’t a ton of reliable data on the ingredient to help us draw better conclusions, argues the authors of this 2011 review.

There’s also a little bit of evidence to suggest that the common ingredient may be an endocrine disruptor, says Flynn—meaning it may affect a person’s hormonal system. “[P]revious studies have shown that titanium dioxide can cause alterations to the reproductive system, including reducing the ovarian follicles and leading to the formation of ovarian cysts,” she says. However, these studies were conducted on mice who orally consumed titanium dioxide, so we’ll still need extensive clinical research on humans before we can definitively link TiO2 with reproductive disruption—or assume those risks definitely come from other intakes of the ingredient.

As for the potential risks (or lack thereof!) of using pads and tampons with titanium dioxide…we just don’t know for certain. “There is no published research available currently that has examined the impacts of vaginal or vulvar exposure to titanium dioxide,” Dr. Eyvazzadeh. “But while no study has positively linked titanium dioxide exposure to ovarian cancer, miscarriages, or UTIs, we also don’t have the science to assure us that this kind of exposure is perfectly safe either.” This lack of data is incredibly frustrating, given that 26 percent of the global population are of reproductive age and presumably using pads and tampons on the regular to manage their cycles.

What this means for the titanium dioxide found in menstrual products—and how to make a conscious purchasing decision next time you stock up

Because there’s so little conclusive research on the potential effects of titanium dioxide, you’re not going to find clear, concise guidance for tampon shopping by studying up. So what do you do instead?

Some experts say that there’s no need to lose sleep over having titanium dioxide in tampons. “If this worries you, then don’t use products that have this,” Jennifer Lincoln, MD, shared in a video. “But it’s the dose, it’s the route that makes the ‘poison,’ and so just because something might cause lung cancer, for example, doesn’t mean it’s going to cause an issue in a tampon.”

Dr. Eyvazzadeh and Flynn agree that it’s okay to approach the ingredient with caution. “If you feel uncomfortable with the potential risks associated with titanium dioxide, look for products that don’t include titanium dioxide on the ingredients list,” says Flynn. “While most cosmetic products will disclose whether or not titanium dioxide is an ingredient—some states require it—it is important to note that the FDA does not currently require brands to disclose this information.”

Fortunately, many new wave period-care companies are extremely transparent about their ingredients lists. As a result, it’s not too difficult to shop for TiO2-free tampons if you’re concerned—and have the financial means to do so. It’s also worth being skeptical of any definitive claims that titanium dioxide in tampons is super harmful. As Dr. Eyvazzadeh points out, we just don’t know either way—no matter how certain Becky on TikTok seems.

Naturally, this impacts many menstruators. More than 40 percent of people with a period have struggled to purchase products at some point, according to a YouGov survey on behalf of U by Kotex. And people in marginalized communities are affected most: A BMC Women’s Health study found that Black and Latina respondents reported period poverty at higher rates, as did first-generation college students.

Ultimately, period poverty has more negative effects than you might realize. It can hurt people’s physical and reproductive health, mental health, ability to go to school or work, and more. In honor of Period Poverty Awareness Week, we talked to a passionate expert about those effects and how you can help reduce the rates.

How period poverty affects your…

Mental health

“We know that people who experience period poverty are more likely to suffer from moderate to severe depression,” says Jennifer Lincoln, MD, IBCLC, a board-certified OB/GYN and popular TikToker. “This makes sense, since not being able to meet your basic needs is a huge stressor and source of anxiety for many.”

Physical and reproductive health

When people don’t have the money for period products, they may have to use things like toilet paper, rags, or towels, Dr. Lincoln says. She adds that some people may have the money, but not enough—which leads to them wearing a tampon, for example, for too long.

“This can definitely increase your risk of developing infections of the skin, vagina, and uterus. Toxic shock syndrome is one of those that we know is made more likely if tampons are used for longer than is recommended,” she explains.

Ability to go to work or school

Not only is period poverty a health issue, but it can make you more likely to miss school or work. “It’s hard to go to your job or a class if you don’t have a hygienic way to stop from bleeding onto your clothes,” says Dr. Lincoln. “When people miss work or school, and they are already living in poverty, this only perpetuates the cycle and widens the gap.”

Missing work or school is something many people experiencing period poverty have to face. Dr. Lincoln shared a survey that showed more than 4 out of 5 teens had missed school or knew someone who did because of their lack of access to products.

Getting behind on work and not being able to make money can also exacerbate someone’s depression and anxiety. It’s a cyclical problem that could easily make someone feel hopeless.

How we can work to end period poverty

Many necessary changes need to be made on a legislative level. “The biggest thing I can hope for is a change in what SNAP (previously known as food stamps) funds cover,” Dr. Lincoln says. She says that period products are not included right now, but they are essential.

Dr. Lincoln also talks about how we need to eliminate the tampon tax. “Tampons are not luxuries—save that tax for yachts and jewelry,” she says. (Thankfully, some congresswomen do care about that and are working to make change.)

However, there is something you can do on a more individual, local level: donate. Give some of your money to mutual aid funds, which are organizations that provide direct support for individuals within communities. Other ways to help? Put free products in the bathrooms at your workplace. Donate them to shelters if they’re in need.

And if you need period products, these five organizations offer free tampons and pads you can access.

As Dr. Lincoln says, it’s time to level the period playing field, and pads/tampons/et cetera should be just as accessible as toilet paper.

“The Dobbs decision argued that the ‘liberty’ interest in the 14th Amendment’s guarantee that all citizens have the right to ‘life, liberty, and property’ did not encompass the right to make private reproductive decisions,” says Cynthia Daniels, political scientist at Rutgers University and director of the Informed Consent Project, a research organization that evaluates information about fetal development held by various states.

And with that right to make private reproductive decisions no longer firmly protected, she suspects that, like abortion, access to contraception could soon be legally challenged, and in the worst-case scenario, face a similar fate. At the same time, certain anti-abortion politicians are working to categorize particular kinds of contraception as abortifacients (despite medical evidence against this), grouping them in a way that could similarly restrict legal access.

The legal argument calling contraception access into question

This domino effect is not baseless conjecture: In Supreme Court Justice Clarence Thomas’s concurring opinion, he explicitly called for the Court to “reconsider all…substantive due process precedents, including Griswold, Lawrence, and Obergefell.” Griswold v. Connecticut protects the right of married couples to access contraception.

Though Thomas didn’t note it directly, the 1972 decision of Eisenstadt v. Bard used the same 14th Amendment interpretation to protect the right of unmarried folks to access contraception. “Both of these decisions [Griswold and Eisenstadt] were based on the right to privacy and the liberty to make one’s own reproductive choices, which have been thrown into question with the Dobbs decision,” says Daniels.

Underscoring the Dobbs decision is an approach to interpreting the Constitution called originalism. “This tries to figure out what the Framers were thinking when they drafted the Constitution and the amendment in question—so, in this case, that would put us at either 1791, when the Bill of Rights was drafted, or 1868, when the 14th Amendment was ratified,” says Khiara M. Bridges, JD, PhD, professor of law at University of California, Berkeley, School of Law. “And in both years, I can assure you that the Framers were not thinking about reproductive rights. And they were certainly not thinking about the ability of people to use contraception. So, it simply wouldn’t be a right that the Constitution explicitly contemplates.”

The reason contraception was legally protected in both Griswold and Eisenstadt is the establishment of substantive due process, a term that refers to the Court’s ability to protect rights that are not explicitly listed in the Constitution. And now, Thomas is suggesting, from an originalist approach, that we reconsider all the decisions springing from that perspective. Ostensibly, that could tumble an entire edifice of cases, says Dr. Bridges, including all of those above (affecting key LGBTQ+ rights and contraception access) and dating back to cases from the 1920s, like Meyer v. Nebraska and Pierce v. Society of Sisters, both of which surround the right to raise a child how you see fit.

How the threat against contraception access is likely to pan out

While contraception could certainly get swept up in the crackdown on privacy rights if the Court starts reversing other cases decided with the same logic as Roe, it’s unlikely that this will happen until the Court is pressured by state legislators—in the same way that Roe was only judicially called into question when certain states proposed abortion bans. “Right now, there are no similar trigger laws in place for contraception, and criminalizing it is still an unpopular opinion,” says Dr. Bridges.

“Right now, there are no similar trigger laws in place for contraception [as there are for abortion], and criminalizing it is still an unpopular opinion.” —Khiara M. Bridges, JD, PhD

But, public opinion can change fast, and anti-abortion rights activists and legislators are likely to garner the political momentum from Roe‘s reversal to push an anti-contraception agenda. In fact, some anti-abortion rights politicians have previously claimed that certain types of emergency contraception (like the Plan B One-Step pill) and IUDs actually constitute abortion and should be similarly restricted.

This logic stems from their belief that life begins at conception, or the moment a sperm fertilizes an egg. Using this line of thought, it follows that any type of contraception that they suspect may prevent the implantation of a fertilized egg—including Plan B, certain IUDs, and progestin-only birth control pills—could be effectively terminating a life (as they define it).

But the very belief that a just-fertilized egg is a person is not the medical consensus, says Dr. Bridges. By contrast, the medical community is aligned on the fact that pregnancy begins only when a fertilized egg implants into the uterine lining (and not beforehand). And, notably, this medical consensus is also separate from the question of when life begins, at some point after implantation.

It’s also worth noting that medical evidence does not support the claim that any of the above-mentioned contraceptives typically prevent implantation, either. Instead, according to reproductive endocrinologist and advisor at reproductive-health company Natalist Aimee Eyvazzadeh, MD, they make the uterus inhospitable to sperm (copper IUDs) or prevent fertilization of an egg by a sperm (progestin pills and Plan B). “Even so, particularly in the trigger-ban states and others looking to criminalize abortion, we should be on the lookout for the criminalization of these kinds of contraception, too,” says Dr. Bridges.

In certain states, recent political action already points to that potential. For example, in Missouri, lawmakers tried to restrict Medicaid funding from covering Plan B and IUDs last year in legislation aimed at Planned Parenthood; Idaho Rep. Brent Crane announced that he would hold hearings on legislation banning emergency contraception earlier this year; and just this past month, a Louisiana house committee passed a bill defining human personhood as beginning at the point of fertilization, which could be used to justify outlawing both emergency contraception and certain IUDs. (While these actions predate the overturning of Roe v. Wade, they serve as compelling evidence of what we may expect to come.)

Notably, access to other types of contraception—like combined estrogen-progestin birth control pills, Depo-Provera shots, patches, vaginal rings, and hormonal IUDs—is less at risk right now, mostly because these work by preventing ovulation, says Dr. Eyvazzadeh. And that makes it tougher to conflate them, in any way, with abortion: By preventing the ovaries from releasing an egg, these contraceptives remove the potential for an egg to be fertilized in the first place, eliminating any gray area about whether they’re interfering with an already living thing.

What this means for contraception methods available to you

Though none of the above anti-contraception stances have been codified as law just yet, political movement in that direction doesn’t just threaten access for all people; it also stands to widen an already existing contraception gap. That is, any restriction in access to contraception will disproportionately affect people of color and folks of lower socioeconomic status—people who are already more likely to live in contraception deserts, or areas lacking in federally funded reproductive-health clinics.

Anti-contraception stances stand to widen an already existing contraception gap.

In the meantime, experts suggest getting ahead of your reproductive-health care, if possible, by considering getting an IUD (if you have long-term contraception needs) or replacing yours, if it’s nearing its expiration date. And given that there have been reports of increased interest in IUDs following the leaked draft opinion for the Dobbs case in May, it’d be wise to consider your options sooner than later.

The same goes for purchasing Plan B now, if you suspect there’s any chance you might need it in the future. (Already, Amazon and several drugstores are running low on stock, and, in some areas, sales are restricted to three units per person.) Alternatively, you may also be able to get birth control or Plan B online by turning to telehealth providers like Favor (previously known as The Pill Club), Nurx, and Hims & Hers.

Potential shortages aside, “in general, it’s most important for people in states where abortion has been banned or a ban is forthcoming to stock up [on these contraceptives], since those are the states that are most likely to extend those bans to IUDs, emergency contraception, and potentially even hormonal contraception in the future,” says Daniels.

“Cooling sprays can be helpful as they can create an immediate cooling sensation due to the liquid evaporation from the skin,” says Emily Hu, MD, OB/GYN and medical director at women’s health company Evernow. “Other components in a spray, such as a menthol or peppermint oil, can heighten that cooling sensation.”

As far as immediate relief goes, these sprays are your best bet—just know that they don’t actually offer any long-lasting benefits. “Cooling sprays are a great low-risk feel-good therapy,” says Dr. Hu. “They will not actually reduce the frequency or severity of hot flashes. For actual long-term reduction in hot flashes, I would recommend speaking with a provider about hormone therapy and non-hormonal therapies to manage symptoms.”

Kourtney Sims, MD, OB/GYN and chief medical advisor at menopause wellness brand Phenology, says that pairing cooling sprays with “ongoing lifestyle changes like nutrition, exercise, and stress management can be part of an overall hot flash management approach.”

Pause Well-Aging Cooling Mist — $39.00

This mist blends anti-inflammatory false daisy extract, soothing holy basil leaf extract, and cooling menthone glycerin acetal. It creates a sensation of lowering the body’s surface temperature, reduces,  calms skin, and delivers instant relief from hot flashes, night sweats, or overheating.

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Phenology Cool Mist — $23.00

“Phenology Cool Mist provides fast-acting, unscented cooling relief from troublesome hot flashes or night sweats with a blend of proprietary ingredients clinically proven to offer both immediate and longer-lasting relief, plus skin-strengthening benefits,” says Dr. Sims. It contains a sensory agent, that freshens and cools both on contact and for up to two hours. It also hydrates skin with hyaluronic acid and uses a proprietary ingredient that combats environmental stress-induced collagen loss, helps visibly reduce fine lines and wrinkles, and improves skin elasticity.

 

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Kindra Cool Down Mist — $27.00

This mist provides a cooling sensation that lasts for up to two hours through a proprietary cooling complex along with aloe and cucumber. It reduces the intensity of hot flashes and night sweats while also relieving skin sensitivity, boosting collagen, and nourishing skin.

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Womaness Gone In A Hot Flash All-Over Cooling Mist — $17.00

This deodorizing micro-mist cooling spray is menthol-free and has a soothing floral scent that uses essential oils. Use it anywhere to neutralize odor while enjoying getting a fresh cooling sensation.

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State of Menopause Cooling Spray — $12.00

Made with peppermint and menthol oils, this all-natural spray provides instant relief. You’ll get a sharp, refreshing cooling sensation that will make your skin feel revived.

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In many cases, the specific tampon brands that have available stock have been able to get around a number of supply-chain issues because they utilize different materials than the drugstore brands—and typically, more sustainable materials at that (win, win). For example, period-care companies like Viv, Flo, and August use materials like organic cotton and bamboo, corn fiber, and sugarcane-derived applicators in their pads and tampons (as opposed to plastic), which has insulated their production processes from many plastic-centric supply-chain issues.

“Inflation on many of the plastic composite parts in pads, for example, is as much as 20 percent,” says Nick Jain, co-founder and COO at August. “As a commodity at such a low price point, a 20 percent increase in raw-material cost either forces a company to increase prices or take a hit on product margins, which limits their cash flow.” In that scenario, it also becomes tougher for a company to hold a bunch of inventory in stock (already an expensive thing to do), adds Jain. And now, the companies that chose not to hold that inventory are facing significant shortages, as plastic becomes more challenging to procure.

“In a time where things feel especially fragile, it’s more important than ever to have our basic biological needs covered.” —Tara Chandra, co-founder of period-care company Flo

But while these differences in raw materials have certainly made it easier from the outset for some eco tampon brands to keep their product available, it’s not to say they’ve all been immune to other supply-chain issues, like staffing shortages and congested ports. And these logistical holdups might’ve very well still affected their ability to keep product well-stocked, had it not been for their deep-rooted values to protect menstruators at every turn. “We’ve been acutely dialed in to building our supply over time, and our operations team has made it a top priority from the beginning of this year to secure weeks of supply for our menstrual-care products,” says Beatrice Dixon, CEO of intimate-care brand The Honey Pot Co.

Simply acknowledging that these products are essential has also led many smaller tampon companies to structure their supply chains around ensuring availability, often by placing large orders in advance (at whatever cost necessary)—and particularly right now, given the bleak reproductive-health landscape. “In a time where things feel especially fragile, where we’re struggling to get our hands on formula and our reproductive rights are at risk, it’s more important than ever to have our basic biological needs covered,” says Tara Chandra, co-founder of Flo.

It’s worth pointing out that because a number of the materials used in the available tampons are more premium than those in their drugstore counterparts, they may come in at a higher price point per box. But, for folks who have a flexible spending account (FSA) or health savings account (HSA), most are eligible to expense, thanks to the CARES Act. Below, find the tampon brands taking special care to support menstruators with readily available products for this basic, biological function.

9 online tampon brands with lots of stock available right now

August Tampons — $8.00

Founded last year as a gender-inclusive, eco-friendly, and financially accessible alternative to traditional period-care brands, August launched amid the pandemic. Because of that timing, founders Nadya Okamoto and Nick Jain were ready to incorporate resiliency into their supply chain from the start. “We made the decision to keep four to six months of inventory on hand at any given time, so that when the production cycles slow down [as they are now], we have reserve stock that we can sell through,” says Jain.

The tampons, which cost $8 for a box of 18 tampons, are made with 100-percent organic cotton (including the string), and an extra-long BPA-free plastic applicator that’s recyclable when washed off.

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The Honey Pot Company Organic Tampons — $12.00

Part of why you can always count on The Honey Pot Co. to have tampons in stock is because of the many different varieties they offer “for differing needs and humans,” says Dixon, ranging from regular to super absorbency to compact and even compact super-plus. They’re all made with certified organic cotton and a BPA-free applicator.

Though the brand also sells a variety of other menstrual-care products, including a menstrual cup, Dixon is committed to always keeping tampons, at $12 for a box of 18, in stock. “Much like pads, tampons have been at the core of menstrual products for much of the last century, so while providing new options is great, you cannot ignore the cultural implications of such a key product as a tampon,” she says.

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Viv Tampons — $9.00

Viv tampons, which come as a box of 16 tampons for $9, have the distinction of being fully plant-based, thanks not only to the organic-cotton core, but also, a sugarcane-derived (rather than plastic) applicator. (Notably, the company’s pads and liners are made with bamboo and corn fiber.) “Because our material-sourcing and manufacturing processes look very different from those of traditional big-box brands, we’ve been able to stay secure in our supply chain,” says Katie Diasti, founder and CEO.

Given that Diasti’s goal is equally centered on reducing period stigma as it is on minimizing the environmental impact of periods, she’s also working to build a community around uplifting menstruators of all kinds—especially in the current climate. “The tampon shortage is not just a headline or trend; it will directly impact the most marginalized menstruators and is a reflection of the ways in which menstrual health has been neglected and hush-hush for far too long,” she says.

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Cora Comfort Fit Tampon — $10.00

Making safe period-care products available to all and busting period poverty has been at the heart of Cora’s purpose since the company was founded in 2014. And according to chief marketing officer Dana Cohen, that won’t be changing anytime soon: “As a female-owned brand, we believe that no matter what, menstruators need access to period-care products.”

At the moment, Cora, which sells boxes of 16 tampons for $10, has plenty of available stock (both through the Cora website and across retailers like Amazon), though Cohen notes that they anticipate some issues with demand for their organic-cotton tampons in the coming months. In the meantime, though, Cohen says Cora has also seen increased interest in the brand’s reusable period products—particularly the period disc, which launched last year and which she suspects may help offset some of the demand for the brand’s tampons.

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Rael Organic Cotton Tampons — $7.00

Made with tip-to-string organic cotton, Rael’s tampons, $7 for 16, also have an organic-cotton protective “veil” to prevent fabric from shedding within the vagina and minimize leaks. And this full-organic construction (plus BPA-free plastic applicator) has also helped the brand maintain good stock amid the shortage, as did planning in advance.

“When the supply-chain problem started happening [over the past couple years], we foresaw the issues that many brands are facing now and made sure to ramp up the number of products we typically order for production,” says Yanghee Paik, CEO and co-founder.

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DeoDoc Cotton Tampons — $8.00

A biodegradable cardboard applicator (and biodegradable packaging to boot) makes DeoDoc organic-cotton tampons, $8 for 14 or 16 tampons depending on absorbency, particularly eco-conscious. And like the Rael tampons above, they sport an extra layer of cotton netting around the cotton core to ensure there’s no shedding or irritation to the vaginal wall—a particular goal for the gynecologist behind the brand, Gunvor Ekman-Ordeberg, MD.

Similar to the founders of Rael and The Honey Pot Co., cofounder of DeoDoc Hadieh Asadi, MD, says she chose to make larger orders several months back in order to avoid running out of stock. “As a female-founded company, we are in power to choose what we would like to focus on, and for us, women’s health and women’s needs will always be of the highest priority,” says Dr. Asadi.

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Flo Organic Tampons — $16.00

As with Viv, Flo organic-cotton tampons, $16 for 14 tampons, replace a typical plastic applicator with a sugarcane-derived one in order to be wholly plant-based, which has “helped us avoid many of the shortages that mainstream brands are facing,” says Chandra. Because the brand recently launched at Target, though, she anticipates running more quickly through their stock, and as a result, is now ramping up production.

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Athena Club Tampons — $8.00

With both fully organic-cotton and organic-rayon blend tampons, Athena Club, which sells 18 tampons for $8, has options depending on what you’re going for. The variety has also helped the company keep ample stock available, even now. “We plan ahead with our suppliers, and work diligently to ensure we never stock out—especially for our period-care products and particularly because we are a subscription-based business,” says Maria Desmarais, cofounder and co-CEO of Athena Club, which also makes a range of other personal-care products.

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Blume Organic Tampons — $10.00

Because Blume’s organic period-care products are sold at 600-plus Ulta locations across the country (alongside the brand’s beauty products) and on Ulta’s site, CEO and co-founder Taran Ghatrora was conscious of supply-chain issues before the brand even really started, and then planned accordingly.

“We have effectively projected our period product supply through the remainder of this year,” says Ghatrora, “and we’re confident we won’t be selling out of our supply.” The tampons themselves, 16 for $10, are made of 100-percent organic cotton and are woven for max absorbency, with a soft outer layer and a dense, absorbent inner one.

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“Generationally, we’ve been taught to internalize shame about menopause,” London says, referencing the resulting dearth of information, products, or services catering to menopause up until this point. But now, there’s a confluence of forces pushing innovators like London, one of Well+Good’s 2022 Changemakers, to fill that gap. Up first is the fact that Gen-X is largely entering or in menopause at the moment, and “we, as a generation, do not take aging lying down,” says London. “We’re like, you’re going to tell me every person before me just white-knuckled this? Well, there’s no way I’m doing that,” she says, with a laugh.

What helps the cause is that technological advances across the health industry are allowing us to live longer—regularly, through and beyond menopause, for folks who menstruate—and consumer knowledge about health has grown by leaps and bounds, too. “We’re all more aware of how to take care of ourselves, physically and mentally, than we’ve ever been,” says London. “That’s creating longevity, such that menopause is really no longer the autumn stage of someone’s life.”

“Menopause is mother nature’s way of forcing us to refocus our energy on ourselves.” —Stacy London, CEO of State of Menopause

Instead, London sees menopause like a prolonged mercury retrograde: “It can feel like nothing is going right or like every circuit in your body and mind is shorting out,” she says. And as any astrologer will tell you ahead of a retrograde transit, you’ll be better off anticipating that and even embracing it by “slowing down to pause, relax, and receive,” says London. “That, to me, is what menopause is: It’s mother nature’s way of forcing us to refocus our energy on ourselves.”

To do that requires both education about and tools to handle this phase—all of which London has been working to provide with State of Menopause, since acquiring and formally launching the brand last year. Below, she and I chat about the evolution of the company and her vision for a future where menopause is as openly discussed and solved for as menstrual periods or pregnancy.

Well+Good: What initially inspired you to take over State of Menopause and launch it as your own brand?

Stacy London: It’s important to know that I had absolutely no interest in business at all before coming to this. But the reason I became so acquisition-minded is that I was a beta-tester for some of the products for what was initially going to be a menopausal skin-care line. And I felt real investment in a company that was already starting to think about menopause in 2018, mostly because I’d just started to become aware that what I was experiencing at the time was menopause through having to hunt for information.

I wasn’t getting the help I needed from doctors because I didn’t even know what to ask them, and my brain was doing gymnastics to try to explain what was happening to me. First, I assumed that recovering from spine surgery was the reason I felt anxious. Then, I got night sweats and depression, which I just assumed was the anxiety. And then, once my father got sick with heart disease, I started getting heart palpitations, skin rashes—I just thought it was the physical manifestation of grief. And when my doctor finally told me, “Oh, it’s just menopause,” I assumed I was overreacting.

I had antidepressants thrown at me. I had anti-anxiety medication thrown at me. But once I realized the role of hormones and menopause in all of my symptoms—the real one-two punch of experiencing menopause on both a physical and psychological level—I was like, it’s time to stop treating the problem and treat the person. I wanted the bigger context for what was happening, and there was none to be had. So for me, it was important not to sunset a line that had the potential to address some of this, but also to reconfigure it in the market. Menopausal skin care is part of it, sure, but I saw a much bigger play in terms of the acute symptomatic relief of menopause symptoms across the board.

W+G: Why did you feel that direct symptomatic relief was so important?

SL: Menopause happens at warp speed, and everything changes at once: Your taste changes, your feelings change, and hormones control all of that. So, I was like, “Why aren’t we talking about all of the things that we can do to optimize this time of life?” And that means creating products for symptoms, specifically, so that there are options. One person might say, “Hey, maybe I don’t need an estrogen patch, and I just need a cooling spray.” And another person just needs something for when they’re feeling muscle fatigue or breast tenderness. Well, great, our CBD oil is perfect for that.

Basically, I wanted to provide products for instantaneous relief—which is also why we’re going to be phasing out the supplements we launched with this year. It’s not that I don’t believe in supplements, but they put the onus on the consumer: You have to remember to take them every day, and medical professionals will tell you that you need to wait three months for any potential changes. Well, I don’t want you to have to wait three months to know if something of mine works; I want you to know within 30 minutes… or 20 minutes or two minutes, in some cases. So, when you’re bathed in sweat in the middle of a meeting and you’re making excuses or apologies, instead, you can be like, “I’ve got this,” and you can reach for something from your arsenal of tools.

W+G: So then, how will you address the menopause symptoms that can’t be treated instantaneously?

SL: Definitely, there are things that fall into that category, with weight gain being a big one of them. Where I see us going in terms of those things is partnerships with other companies where we can say, “Hey, are you doing an incredible program for menopause? Let us do that with you.” For example, we’re working with a nutrition company to help them create a program geared toward menopause and the specific weight-distribution changes it can bring. We’re also working with an exercise company that is creating a menopause-focused regime. But generally, if someone comes to us with something that falls outside our scope, we can at least point them in the right direction and educate them about it.

W+G: You’ve spoken a lot about the need for education about menopause. Why is that, and how are you working to provide that?

SL: People need to know upfront that there are options available for them to treat their symptoms because I didn’t know that at the time. And I don’t want anyone to go through what I went through. I had a crisis of confidence that really threw me off my game and broke my heart. But to have at least a little bit of knowledge about this phase of life beforehand would’ve changed the way I experienced it.

“We can offer products to help with menopause, but you can’t buy what you don’t understand. And you can’t make informed choices if you don’t have education.” —London

We can offer products to help with menopause, but you can’t buy what you don’t understand. And you can’t make informed choices if you don’t have education. That’s why, on our new website, you’ll find an option on the navigation bar called “Learn More,” and it has two sections. The first is “Menopause 101,” which includes articles on how to manage the more difficult aspects of menopause that were written by doctors or approved by our medical advisory team. And the second is our blog, “On Pause,” which includes archived newsletters from me, and for which we’re about to start allowing our customers to write first-person pieces—not product testimonials but essays about their experience with menopause.

Eventually, I’m interested in becoming a destination where people can interact the way that we now do on social platforms. We want our site to be a safe space for anyone going through menopause to connect. And that includes not only people within the chronological age group of 40 to 60, but also people going through medical menopause or surgical menopause or gender non-binary menopause at any point in life.

W+G: That’s awesome. What’s up next on the docket for State of Menopause?

SL: We knew that sex during menopause was the next thing we had to tackle. It is probably the number-one request I receive. So, we actually just launched a CBD suppository to help with vaginal moisture and painful sex, and we did that in partnership with a company called In Your Pleasure, who came to us and said, “Our biggest customer category is in menopause.” I was like, “Yes, we need to collaborate right now.”

We also have four more new products slated for this year, and some of those will also be collaborations because that’s also something I really believe in.

W+G: How do you see State of Menopause best serving that menopausal consumer in the future?

SL: Menopause companies have a lot to gain by working together. If we’re promoting each other’s companies, then we are really proving to our consumer that this is about her experience or their experience or whomever is experiencing this stage.

The fact is, menopause has so many distinct symptoms that we need to be thinking about the best way to tackle each of them—and no one company is going to be the winner on that. We need to be working together in order to say, “Hey, we do need our own aisle in the store. We do need our own shelf. We do need our own footprint.”

What I don’t want is for menopause to be this new thing that people invest in because nobody’s done it before, and then the fad fades. This needs to be part of the firmament. We need [menopause care] as much as we need tampons. And why is this something that we’re not talking about in the same way?

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But sex hormones—progesterone, estrogen, and testosterone—don’t just control the ovaries. “This link of the so-called sex hormones to all body systems is what is behind the surprising menopause symptoms in organs and structures that are not recognized as being highly regulated by the ovarian hormones,” says Felice Gersh, MD, board-certified OB/GYN, founder of the Integrative Medical Group of Irvine, and the author of Menopause: 50 Things You Need to Know.

Here are five surprising menopause symptoms you may not be aware of but should

1. Jaw pain

“All joints are impacted by hormones, and estrogen is essential for optimal joint lubrication, collagen production, and bone health,” Dr. Gersh says. “Ligaments and tendon health and function are estrogen dependent, and loss of estrogen in menopause causes a deterioration of all joints, including the jaw, which can result in pain and arthritis development.” What’s more, new research indicates that if you suffer from jaw pain and TMJ, you may find symptoms worsen as you go through menopause.

One way to help alleviate or offset this symptom is by eating a rich supply of healthy protein throughout the day—with an emphasis on plant-proteins as a preferred source due to their vast array of essential vitamins and minerals, antioxidants, and fiber. “Antioxidants and polyphenols in foods can help, as well as use of hyaluronic acid and taking collagen, curcumin, Boswellia, omega-3 and CBD,” Dr. Gersh says. Additionally, a holistic wellness practice that includes “acupuncture, heat compresses, and red light therapy can be beneficial,” she adds.

2. Dry eyes

“Estrogen and testosterone have receptors in the glands that produce tears and tear components, and menopause and aging leads to a reduction in the amounts of these hormones and thus results in lowered quantity and quality of tears,” Dr. Gersh explains. “Using over the counter liquid tears and eye drops can help, as well as working with an ophthalmologist for treatment and using prescription eye drops, if necessary.” A humidifier may also provide some relief, especially if the air is very dry in your home.

3. Heart palpitations

“At least a quarter of menopausal women develop heart palpitations,” Dr. Gersh says. “Usually palpitations are not serious, but rarely they can progress to a more serious condition that’s known as atrial fibrillation.”

Heart palpitations occur due to the drop in estrogen production. “Estrogen helps to regulate heart rate and rhythm, and without ovarian estrogen, the autonomic nervous system becomes imbalanced, which results in over-stimulation of the sympathetic nerves to the heart and heart palpitations,” Dr. Gersh explains.

According to Dr. Gersh, treatment includes hormone therapy, mind-body medicine, and other holistic wellness techniques for preventing chronic stress and anxiety, magnesium supplementation, and use of certain pharmaceuticals, such as beta blockers, which may provide relief in mitigating symptoms.

4. Change in body odor

“Bacteria metabolize sweat to create distinctive odors, and so after menopause, bacteria change on the skin, and these different bacteria can lead to different scents being produced,” Dr. Gersh explains. “Use of a gentle body wash may help, as well as moisturizers, such as those containing shea butter, as well as other kinds of soothing essential oils,” says Dr. Gersh.

5. Increased mood swings

“The brain has receptors for estrogen throughout all regions, and estrogen is a key player in the maintenance of serotonin neurons and oxytocin—serotonin is a neurotransmitter involved in the ability to feel calm and happy, while oxytocin promotes feelings of love and bonding,” Dr. Gersh explains.

Reduction in these happiness-boosting hormones due to lower levels of estrogen leads to greater incidence of mood swings and heightened anxiety and depression, as is found in many women going through menopause.

You may treat mood swings by taking estrogen and progesterone, which can be helpful, as well as with a course of antidepressants or tranquilizing medications, suggests Dr. Gersh. Holistic wellness techniques and therapeutic rituals can also help to stabilize mood swings, improve happiness levels, and promote self-love and healing, too. These include regular massages, which can boost serotonin levels, meditation, and physical activity.

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Around 80 percent of women (plus trans men and nonbinary people) experience period pain at some point. Several options for pain relief exist, thank goodness, from ibuprofen to heating pads and more. But what does an OB-GYN recommend starting with?

“My number one must-have for period cramps is an over-the-counter pain reliever,” says Kenosha Gleaton, MD, an OB-GYN and Natalist’s medical advisor. “My goal is to take it prior to the actual start of my cycle and continue taking it every six hours until 24 hours past the start of my cycle.”

Taking medication preemptively—about one day before the pain starts—can help stop cramps before they come. Dr. Gleaton explains once the uterine line starts shedding, prostaglandins (aka fat compounds with hormone-like effects) are released, which causes inflammation and a narrowing of the blood vessels. “If anti-inflammatories, such as ibuprofen, are taken before the uterine lining begins to shed, they counteract the prostaglandins and help prevent the pain cascade from starting,” she says.

While there isn’t much research saying which pain reliever is most effective, NSAIDs (such as Advil, Motrin, and Aleve) may work better than acetaminophen (aka Tylenol). So it’s probably best to go with what you have in the cabinet that works for you. And, of course, check with your provider before taking any medications regularly.

It’s also okay to do different things for relief, especially given periods can come with several side effects. For Dr. Gleaton, exercise is something that addresses multiple PMS symptoms. “I’ve also found that exercise—any cardio with high cardiac output—seems to decrease bloating and mobilize extra fluid from my mid-section,” she shares. “In addition, the serotonin release and endorphins decrease my PMS-related moodiness and give an immediate energy boost to combat excessive fatigue.”

Both medication and exercise work pretty quickly, she says. “When taken promptly, an over-the-counter pain reliever works within five to 10 minutes. Exercise also yields pretty immediate relief once the heart rate is elevated sufficiently.”

As far as exercise goes, if you don’t have it in you to go super hard. Light walking, yoga, Pilates, and low-volume strength training are also solid options that’ll do the trick. Research backs this up: In 2019, a couple of review authors looked at studies that measured the helpfulness of exercise for cramps, and they found both low-intensity and high-intensity exercises were effective.

If you’re feeling yoga, stick to period-friendly stretching positions such as cat-cow pose, head-to-knee pose, child’s pose, and supine twist. Since they keep you upright, they won’t add pressure or mess with your flow.

While having cramps on your period can feel almost certain as taxes, pain relief medications and exercise (plus some chocolate and your bed) can help. If the pain is severe or comes with excessive bleeding or a fever, though, it’s best to see your doctor.

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ADHD is a neurodevelopmental, behavioral, and mental health condition characterized by difficulty with attention, routine, hyperactivity, fidgeting, focus, organization, and planning. It’s considered more common in young boys; however, research shows that the disorder is under-diagnosed and under-researched in young girls, adult women, and people assigned female at birth (AFAB). Consequently, it makes sense that the disorder’s relationship with estrogen and PMS might fly under the radar. A 2021 article published in the International Journal of Molecular Sciences suggests ADHD symptoms frequently worsen a week before menstruation and improve during the first two weeks of your cycle (as well as during pregnancy). The reason? Estrogen fluctuation.

Your menstrual cycle is characterized and orchestrated by changes in the levels of hormones like estrogen and progesterone, according to Tina Gupta, MD, a medical doctor who specializes in women’s reproductive health, including dysmenorrhea, PCOS, and infertility. “Estrogen leads to a release of the ‘feel good’ hormones such as dopamine and serotonin, which leads to fewer ADHD symptoms. So when these are not being released (i.e., during the last premenstrual period), ADHD symptoms are often worse.”

 Why estrogen levels are important

“During the luteal phase, which is the third or fourth week of a menstrual cycle, hormone levels change: progesterone increases and estrogen levels drop,” says James Gohar, OBGYN, CEO and ObGyn at Viva Eve, a women’s health & fibroids practice in NYC. These hormone fluctuations are part of your menstrual cycle, and they signal that it’s time to ovulate and menstruate. When it is time to menstruate, both estrogen and progesterone levels drop even more, signaling the body to begin menstruation. Increasing progesterone and decreasing estrogen levels often affect mood, sleep patterns, and irritability, he says. And, as a result, ADHD symptoms can also be impacted.

These fluctuations occur every month during the last two weeks of your menstrual cycle, but they’re also prevalent during puberty and menopause, Dr. Gupta says. And even though estrogen is typically associated with sexual maturation and reproduction, it also affects the brain quite a bit.

How to manage worsened ADHD symptoms

What does this mean for menstruators who have ADHD? Well, being aware is the best place to start, Dr. Gupta says. Pay attention to changes in behavior, mood, and concentration leading up to and during menstruation. This can help you approach a professional (like a primary care physician, therapist, or specialist) to develop a treatment plan, she says.

Dr. Gupta recommends strategies to manage exacerbated symptoms. Get enough sleep, food, and water for starters. Dr. Gupta also recommends eating foods higher in phytoestrogens like soy, flaxseeds, walnuts, lentils, tempeh, apples, and carrots. Your body registers phytoestrogens as something similar to estrogen and responds to them accordingly, which can cause a potential reduction in symptoms, she says. However, research on phytoestrogens is inconclusive.

“People who menstruate should try to adopt regular stress-reducing techniques to help keep serotonin and dopamine levels high as well,” Dr. Gupta says. These include activities such as yoga, Tai Chi, meditation, nature walks, meditating, dancing, or anything that combines light movement with relaxation. And, if you think you might have low estrogen levels, Dr. Gupta suggests speaking with a healthcare provider about options. Dr. Gupta adds that combining therapy with a stimulant, antidepressant, and estrogen may be incredibly beneficial for folks finding the symptoms disruptive to their lives.

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What are Kegels anyway

Kegels are a repetitive strengthening exercise that involve the contraction and relaxation of the pelvic floor—a combination of muscles that act as a hammock at the base of your groin, bladder, uterus, rectum, and prostate area. To do a Kegel, you clench the muscles and release them. If you’re curious about how to locate this area of your body, one method is to lay down on your back and take a few deep breaths to relax your body. Then clench your groin as if you were trying to stop yourself from peeing. This is your pelvic floor, according to Dr. Jeffcoat.

The problem that arises with Kegels is that not everyone can clench their pelvic floor muscles correctly, and some people don’t need to. In fact, a 2014 study showed that one-third of participants could not contract their pelvic floor for various reasons. “It’s easy to say, ‘Hey, just do some Kegels for your pelvic floor dysfunction,” says Dr. Jeffcoat. “But that doesn’t align with normal muscle function and how underlying dysfunction can be exacerbated by performing inappropriate exercises.”

Pelvic floor disorders fall into two categories and Kegels don’t help with both

Hypertonic (non-relaxing) pelvic floor muscles occur when the muscles are overly tight, contracting at the wrong times, and potentially weakened. This is where Kegels could do more harm than good, Dr. Jeffcoat says. Symptoms of a hypertonic pelvic floor include chronic pelvic pain, vulvar burning or itching, painful intercourse or orgasm, constipation or urinary urgency, and frequency with or without bladder pain—all of which could worsen with repeated Kegels.

“When performing Kegel exercises, the contraction creates a shortening of the muscle fibers. If your pelvic floor muscles are already overactive, tight, or non-relaxing, this shortening can worsen symptoms or at least not improve them,” says Dr. Jeffcoat. So if you’re dealing with non-relaxing pelvic floor symptoms like pain in the area, constipation, trouble with bladder and bowel function in general, painful sex, and painful orgasms, it’s best to consult with your provider.

Hypotonic pelvic floor muscles mean that the muscles are over-relaxed, too loose, and likely causing incontinence, according to the Mayo Clinic. This is a situation where Kegels have the potential to help. Pelvic floor looseness is linked to bladder leakage and urination; Kegels help strengthen that clenching reaction and prevent accidents, the Mayo Clinic says.

In these cases, Kegels have shown to be effective with clinical oversight and improve people’s symptoms. For example, providers often recommend Kegels to people healing after childbirth. A 2015 study published in the Iranian Journal of Midwifery and Nursing Research found that eight-week Kegel regimens did help postpartum pregnant people who needed to rebuild their vaginal strength.

There is also some evidence that Kegels are beneficial for sexual health. Still, there isn’t significant, recent research that shows they enhance orgasm satisfaction in instances that don’t also require strength rehabilitation, Dr. Jeffcoat says. “Providers need to take more of an orthopedic approach to treating the pelvic floor, and if they aren’t licensed or trained to prescribe exercise—they should step back from making those recommendations,” she says.

Dr. Jeffcoat adds that over-exercising is harmful for any muscle dysfunction. For example, you don’t start doing a bunch of hamstring curls if you strain your hamstring. Hamstring curls tense the hamstring, which would not be ideal in the event of a strain or injury, she says. “Once you have healed and want to regain some strength, you could proceed with strengthening techniques,” says Dr. Jeffcoat. This applies to Kegels as well.

So even though Kegels are genuinely helpful, they aren’t a blanket solution for every pelvic floor condition. There’s no shame in wanting to be more in touch with your body or improve your pleasure, and there are numerous ways to enhance sexual satisfaction if Kegels end up not being the right choice for you. Dr. Jeffcoat stresses that the pelvic floor should be approached like other muscle injuries and with the same amount of care. One-size-fits-all approaches rarely work, especially in the case of the pelvic floor.

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This is because of how heat therapy works.  Any time you apply heat to your uterus specifically, the heat helps to increase blood circulation to that area, according to a 2018 study. As a result, your muscles can relax a bit, and you may experience some pain relief. This can also be the case when it comes to taking hot a warm bath or using a hot compress like a patch.

Ahead, we’ve curated the top heating pads for cramps to add to your self-care routine when your period shows up. And you don’t even need to be on your period to get the benefits of a heating pad—they’re great for any kind of muscle pain or tension (like an aching back).

Best heating pads for cramps

Pure Enrichment® PureRelief XL Heating Pad — $35.00

With over 50,000 five-star reviews, this Pure Enrichment heating pad is a match made in heaven for those with painful cramps and muscle tension. For starters, it heats up within seconds, and puts out a steady amount of high heat (you can choose from 6 levels, going up to 140 degrees) for up to two hours at a time before automatically shutting off. Additionally, it’s made with super plush fabric is large enough in size to reach your entire back muscles.

 

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Comfytemp Heating Pad — $26.00

If you like a bit of variety in heat range, you can’t go wrong with this Comfytemp heating pad. It comes with nine different settings, which makes it easy for you to find just the right temperature to help relax your body and ease your muscles. At the same time, you also can choose how long the the pad stays on, thanks to five different preset timing options.

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UTK Far Infrared Natural Jade and Tourmaline Heating Pad — $139.00

Originally $219, now $139

What makes this heating pad so unique is how it provides heat to the body. Infrared heating pads, like this one, use infrared light to help distribute heat deep within the layers of your skin and beyond the immediate surface of the skin. As a bonus, this heating pad also includes jade and tourmaline stones, both of which are believed to help boost your body’s energy by emitting negative ions.

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BUEHUO Portable Electric Heating Pad — $30.00

If you rather not deal with a lengthy cord or being glued to an outlet all day, this Buehuo heating pad is worth adding to your self-care routine. Unlike many other heating pads, this one is powered by a battery back that allows you freedom to be at your desk, bed or car without ever having to take off the device.

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Soothing Company Store Extra Large Heating Pad — $40.00

In terms of versatility, the Soothing Company Store Extra Large Heating Pad checks all the right boxes. you can use it to help reduce discomfort and pain across your shoulders, neck and stomach. All you have to do is throw it in the microwave, tie it around the area you want, and you’re good to go. The pad provides immediate heat for up 20 minutes at a time to any area you choose.

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HOMECH Electric Heating Pad — $21.00

Originally $40, now $19

The Homech Electric Heating Pad comes with a super functional remote that you can use to adjust one of six heat levels. It should be noted that the device heats up quickly, but to be careful not to fold it. Once you do, the pad will cease to provide any heat in that position.

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WeightedWarmth 2-in-1 Weighted Body Pad — $55.00

It’s a weighted blanket *and* a heating pad: The best of both worlds! The benefits of weighted blankets are well-documented, with many people using them to help reduce anxiety, and to stay extra cozy. And this heating pad does exactly that—and then some. It weighs in at just over seven pounds and comes with three different heat levels that you can adjust based on your needs.

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Banne 24"x12" Electric Heating Pad — $20.00

Another safe pick that shoppers can’t stop raving about is this Banne Electric Heating Pad. Similar to other devices on the list,  this one is designed to help reduce the pain in cramps and body aches. It comes with a sleek controller that you can easily use to turn up the heat. It has three warmth levels and can stay on for 90 minutes at a time.

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Bedsure Weighted Heating Pad — $60.00

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Attmu Rubber Hot Water Bottle — $10.00

And last but not least, for those who don’t like any electric tools, you are in luck with these Attu Rubber Hot Water Bottles. All you have to is fill the bottle with water which you can turn into an effective ice pack or a hot compress for your stomach. Not to mention, it comes with a small carrying case which is a knit version of the bottle (aka, it’s a little sweater, and what can be cuter?).

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The menstrual cycle has four phases—and they impact your entire body

As you probably know, your menstrual cycle isn’t just the days you spend cramping and bleeding. Your cycle has four distinct phases, and your hormone levels fluctuate throughout. Your cycle starts on the first day of your period when your body sheds uterine lining.

Estrogen levels are low during menstruation, but during the follicular stage, your body releases a hormone called follicle-stimulating hormone (FSH), which encourages your eggs to grow and mature. Your estrogen levels get progressively higher until ovulation when your ovaries release an egg and progesterone production increases, according to Elizabeth Poynor, PhD, MD, surgeon and oncologist at Memorial Sloan Kettering and clinical professor of obstetrics and gynecology at NYU Langone Medical Center.

Progesterone levels continue to rise during the luteal phase,  and this is when you’re most likely to experience PMS. At the end of the luteal phase, estrogen and progesterone levels drop very quickly, which initiates bleeding or menstruation. And, the cycle begins once more.

These phases serve specific reproductive purposes, but they affect more than just your uterus. Everyone’s hormonal fluctuations are different, and the symptoms that occur are unique, Dr. Poynor says. Still, she explains a few unexpected areas of the body that are frequently affected by your cycle.

1. Joint pain, soreness, and stiffness

There are estrogen receptors in muscles and cartilage, Dr. Poynor says, so changes in your hormone levels can affect your muscles and bones. Studies indicate that estrogen is connected to pain threshold, and drops in estrogen point to lower tolerance. This means that when your estrogen levels drop during your period, you can experience pain at a stronger level, Dr. Poynor adds.  If you feel surprisingly stiff and sore, warm baths and nonsteroidal anti-inflammatory drugs (NSAIDs) can help ease the pain.

2. Headaches and dehydration

If you frequently get a headache during or around your period, you’re not wrong to assume menstruation is the culprit. Drops in estrogens have been linked to headaches and even migraines. Though the reason this happens isn’t abundantly clear, Dr. Poynor says hormonal headaches can occur due to fluctuations in, you guessed it, your hormones.

Estrogen and progesterone affect neurotransmitter receptors in the brain, so fluctuations and changes can result in mood shifts or headaches. It’s not necessarily how much you have of these hormones that cause adverse symptoms; rather, it’s the rate at which they fluctuate.

Headaches might also happen during your period due to hydration levels. A 2020 study published in Frontiers in Physiology suggests that estrogen and progesterone impact how the body stores and uses water through the menstrual cycle. The researchers also suggest that dehydration can often increase pain reception, which can lead to feeling the sensation more intensely. Combined, these two factors indicate that staying on top of your water intake is a good idea.

3. Breast pain, tenderness, and swelling

If your bras suddenly feel super uncomfortable, you might be able to blame it on an ill-fitting bra, but it could also be an unexpected period symptom. Breast pain, though quite common, is usually caused by higher progesterone levels, which occur during your luteal phase, Dr. Poynor says. This is because progesterone often encourages water retention, and that can make breasts feel swollen, tender, or sore. Estrogen and progesterone also stimulate milk glands and ducts in the breasts, whether you’re pregnant or not, according to the Mayo Clinic. And this can also make your breasts more tender.

If you have unexplained breast pain that does not go away after two periods, you should check in with your medical professional, the Mayo Clinic says.

4. Back pain and stiffness

“There is a hormone-like substance called prostaglandin that causes uterine contractions, and might also affect back muscles and contribute to back pain,” says Amy Roskin, MD, a board-certified obstetrician and gynecologist.

Prostaglandins cause intermittent blood flow in the muscles, which induces contractions. During your period, you experience uterine contractions, which encourage menstrual blood flow. This is ultimately a good thing,  but those contractions can agitate nerves and muscles in your back.

If you need relief, a heating pad encourages blood vessels to expand, which improves blood flow. This can, in turn, reduce the pain from this period symptom. NSAIDs like ibuprofen help block prostaglandins and reduce pain, too, Dr. Raskin adds.

If back pain disrupts your life during menstruation, it’s important to be evaluated by a doctor, Dr. Poynor says.

5. GI discomfort, diarrhea, and gas

A 2014 study published in BMC Women’s Health surveyed 156 participants who menstruate regularly,  and 73 percent of individuals reported one or more GI symptoms, including 28 who reported having diarrhea. So if you regularly deal with stomach issues, gas, diarrhea, or even constipation, your cycle might be to blame.

Hydration and hormone level fluctuations can contribute to GI symptoms for a few reasons. These factors affect how quickly you move waste through your body and how much gas you release.

Additionally, the colon and lower large intestine can experience friction as the uterus contracts during menstruation. This movement, because of the colon and pelvic floor’s proximity to the uterus, can loosen stool and encourage more frequent bowel movements. Every month, I forget about this and am filled with renewed annoyance about my GI-related period symptoms.

There is still a lot of research to be done about these hormones and how they impact your body. Dr. Poynor points out that studies are beginning to indicate that progesterone may have a more significant impact on the body than its more obvious menstrual cycle purposes. So, even though period symptoms are multifaceted and individualized, It’s worth remembering that you know your body best. If a period symptom concerns you—it’s always worth checking in with a provider to chat about your concerns.

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What causes cramps in the first place

In case you want a refresher, menstrual cramps are throbbing or pulsating pains in your lower abdomen that start one to three days before your period and usually peak 24 hours after you start bleeding, according to the Mayo Clinic. They can also produce radiating pain in your lower back and thighs. Other period symptoms include diarrhea, sensitive stomachs, headaches, and even dizziness.

Cramps, however, happen because your uterus contracts to expel the uterine lining during your period. As the uterus contracts, it expels the lining as a mixture of blood, cells, and vaginal fluids out of the vagina, according to the American Society of Biochemistry and Molecular Biology. “Hormone-like substances called prostaglandins are released in order to control the muscle contractions of the uterus,” says Amy Roskin, MD, JD, a gynecologist and adjunct professor at Nova Southeastern University. Prostaglandins work to constrict and slow blood flow which causes muscles to contract—and also causes your period pain. Higher levels of prostaglandins are therefore associated with more severe menstrual cramps, Dr. Roskin adds.

What can you do at home to help period cramps

The good news is that, even though cramps are painful, there are a handful of things you can do to feel better. For instance, you can fight cramps with over-the-counter pain relievers, called non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and acetaminophen. “NSAIDs work as anti-inflammatory agents and block the enzyme that makes prostaglandins (cyclooxygenase), resulting in lower levels of prostaglandins,” says Alyssa Dweck, MS, MD, FACOG, a practicing gynecologist that specializes in female sexual and reproductive health. “Less prostaglandin means less muscular contraction and less pain.” Though all of these experts recommended using them—consult your doctor before taking medications.

Additionally, applying a heating pad to your abdomen or lower back can help alleviate pain. This is because heat encourages blood vessels to expand, which in turn increases blood flow and relaxes muscles, Dr. Roskin adds. Just remember to put your heating pad on a timer or take it off your body before you fall asleep. Prolonged use of heating pads can potentially cause burns and other safety risks. Dr. Ritch adds that a warm bath can reduce pain as well.

Another tactic for reducing cramps at night is sleeping on your side in the fetal position, sometimes with a small pillow between the knees, Dr. Ritch says. This position can help take pressure off the muscles and joints surrounding the uterus, and it’s especially helpful if cramping radiates to the back or down the legs, she adds.

How can you prevent them in the future

When you’re not doubled over in pain from cramps in the middle of the night, there are some preventative measures that you can take to keep intense cramps at bay. Dr. Dweck recommends that you track your period with an app, so you can make sure to hydrate, have your heating pad ready, or take preemptive medicines.

“It may feel counterintuitive, but light exercise like walking or yoga can be beneficial,” Dr. Roskin says. A cursory trial published in the Journal of Alternative and Complementary Medicine found that yoga helped reduce the pain of cramps as well as psychological stress, she explains.

When should you see a doctor

If your period cramps disrupt your life every month, progressively worsen, or you just started having severe cramps after the age of 25, the Mayo Clinic suggests that you seek medical advice. Intense period pain isn’t normal and conditions that impact cramps include endometriosis, uterine fibroids, pelvic inflammatory disease, and cervical stenosis.

To be clear: Period cramps aren’t automatically a sign of reproductive illness, know that it’s always a good idea to listen to your body and pay attention to your symptoms. Chat with your medical provider if you’re concerned. Yes, some light discomfort is common, significant suffering is not an inherent part of menstruation and you deserve to not be in pain.

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Menopause occurs when your ovaries significantly decrease estrogen and progesterone production. You’re not officially diagnosed with menopause until you’ve gone 12 months without a period, and your estrogen levels fall at or below 30 picograms per milliliter (pg/mL), according to the University of Rochester Medical Center. However, perimenopause refers to the years that your body transitions toward menopause. It includes symptoms like hot flashes, emotional changes, sleep disturbance, vaginal dryness, lower energy, slowed metabolism, the Mayo Clinic says.

A more surprising feature of menopause? You could also be more prone to urinary tract infections (UTIs). You might be aware that sexual activity is the most common risk factor for UTI, but hormone-related disturbances and bladder weaknesses are more common causes of UTIs during menopause. Below, a few experts break down why you might be dealing with UTIs more frequently and how to prevent them.

What causes a higher risk of UTIs during menopause

Menopause occurs for many people with vaginas and uteruses in their late 40s or 50s, but one can undergo “the change” any time if estrogen production is halted. This includes individuals who have their ovaries removed due to illness or gender confirmation surgery, and people who begin hormone replacement therapy on testosterone. Decreased estrogen impacts your vulva and vagina in ways that increase the risk of UTIs.

Typically, your vagina is usually quite acidic that helps fight harmful bacteria. However, when you transition through menopause and your body makes less estrogen, your vaginal pH lowers. The pH level of the vagina refers to how acidic the environment is, which is typically a four on the pH scale. However, a pH level of around seven is a strong indicator of menopause, according to the Journal of Midlife Health. Less acidity encourages less protective and more pathogenic bacteria to grow, Sharon D. Malone, MD, FACOG, NCMP, and medical director of Alloy Health says.

Essentially, estrogen helps promote an environment in your vulva that protects the urethra from infections. How does it do this? Well, estrogen promotes glycogen (the storage form of glucose) production within healthy vaginal lining cells, Felice Gersh, MD, a gynecologist and founder/director of the Integrative Medical Group of Irvine and the author of Menopause: 50 Things You Need to Know says. The good bacteria feed on the glycogen and release lactic acid—which acidifies the vagina, promoting the maintenance of optimal pH. This further encourages the establishment of friendly bacteria and thwarts the growth of rectal bacteria.

Waning estrogen levels also impact lubrication, which can put you at significant risk for pesky UTIs. With less lubrication, the tissue of the vagina dries and thins over time. This makes it susceptible to small, often unnoticeable, trauma either during intercourse or even with normal friction, Dr. Malone explains. These micro-tears or abrasions allow bacteria to penetrate the bladder and cause infections. The most common signs of this reduction in natural lubrication include general discomfort in the vagina, painful and dry sex, urinary frequency, and an itchy, dry vulva, says Dr. Malone.

Finally, you’re more at risk for UTIs during menopause because estrogen aids bladder strength. When you go through menopause, especially if you are older, your bladder and pelvic floor muscles can weaken, impacting how effectively you are peeing, says Lucky Sekhon, MD, a reproductive endocrinologist at Reproductive Medicine Associates of New York. When you don’t empty your bladder completely, any residual pee can put you at risk of a UTI as well.

Prevention techniques to try

First things first, if you suspect you have a UTI, all of these experts recommend contacting your doctor. UTIs don’t heal independently, so you want to make sure that you don’t have an infection that could get serious if left untreated.

The most common ways to protect yourself from UTIs during menopause are pretty similar to the tried-and-true UTI prevention methods. This includes peeing after sexual activity, staying well hydrated, frequently emptying the bladder, wiping from front to back, wearing clean underwear, and cleansing the area with water when you shower.

Additionally, since menopause significantly reduces the estrogen in your body, Dr. Malone says you can talk to your doctor about topical estrogen products or Dehydroepiandrosterone (DHEA) suppositories. Dehydroepiandrosterone is a hormone that promotes the production of estrogen and testosterone, according to the Mayo Clinic. So using it or estrogen products might encourage vaginal lubrication and preserve good bacteria in the vulva (which can help alleviate UTI culprits). It’s also worth mentioning that topical and localized treatments are more effective than other hormone therapies because they’re applied directly to the zone you are trying to treat, Dr. Gersh says. Still, you should talk to your doctor to troubleshoot any UTI symptoms and discuss potential medications for prevention.

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Here’s how a period tracker app can help you see how your hormones affect everything, from your mood to sleep and more.

What is a period tracker app?

At its most basic, a period tracker is used to record your menstrual cycle, specifically, the fourth phase (aka menstruation), which typically lasts between 1–5 days). By entering those data points, the app does the rest, learning the patterns of your period—whether regular or irregular—giving you estimates of ovulation and when you can expect the different phases of your cycle to begin and end.

Yes, you could totally do that yourself on a calendar, but there’s something helpful about having the app do it for you and then send push notifications to give you a heads up about any pain during ovulation you may encounter. Or how to sync your exercise routine to your cycle. In addition to this, however, period trackers now also provide intel on fertility, mood and more, as well as keep tabs on any trends and health issues that may be directly related to your hormones.

Why should you track your menstrual cycle?

Beyond just knowing when to expect the menstrual phase to begin, having a regular snapshot of your period can help you manage your overall health. “Tracking your cycle is important because major irregularities in it can be a sign of hormonal, thyroid, or hematologic (bleeding) issues, especially if you have too much bleeding or bleed too often,” explains Whitney Casares, MD, a pediatrician and author of The Working Mom Blueprint: Winning at Parenting Without Losing Yourself.

Of course, it isn’t all just about seeing red flags; it can actually help you live a better life, too. Dr. Casares notes that knowing what phase of your menstrual cycle you are in can help you know when to get more rest or even when your body may benefit from some exercise.

“Your menstrual cycle certainly doesn’t affect every aspect of how you are feeling, but it can be more significant than most people realize,” agrees Stacie J. Stephenson, DC, CNS, a functional medicine specialist and author of Vibrant: A Groundbreaking Program to Get Energized, Reverse Aging, and Glow. “Knowing where you are in your cycle also allows you to leverage this information for better productivity, communication, and energy expenditure. You’ll learn over time when you are more likely to need some downtime and when you are more likely to have plenty of energy or want to socialize.”

What information should you log in a period tracker?

The very least you want to log in a period tracker is the start and end of the menstrual phase. To get even more out of yours, though, Dr. Casares recommends tracking this basic information:

• The date you start and stop bleeding
• How many pads or tampons you use per day
• How heavy your flow is (mild, moderate, or heavy)
• The severity of your cramps
• Any nausea
• Any other concerns, like lightheadedness or non-menstrual bleeding

Tracking every day can feel a bit cumbersome, but the more data you have, the more you’ll be able to look for connections between how you feel and what menstrual phase you’re in at that time. And if that feels like too much to handle, know you only need to really record when something out of the ordinary occurs, says Dr. Stephenson.

“I wouldn’t worry about tracking on the days when you don’t notice anything unusual, but when something new happens—even if you aren’t sure whether it’s related to your cycle—record it,” she suggests. “It could be something uncomfortable like a menstrual migraine or something great like a boost in libido or a high-energy, super-productive day. The more information you track, the more easily you can determine patterns and once you see those patterns, you will get a better idea of what’s coming and when.”

3 of the best period tracker apps to download now

Flo

Perhaps one of the most popular period trackers, Flo is available with limited free options and even more data that can be unlocked when you upgrade to a premium membership. Not only will you get generated predictions and insights about your menstrual cycle, you’ll also get content and video recommendations tailored to what phase you are in and insights into issues that may be affecting your body.

Download on iOS

Download on Google Play

Ovia Fertility

This period tracker is one of three apps under the Ovia Health umbrella, taking you from fertility monitoring to pregnancy and even through parenting. While seeing “fertility” in the name may scare some users away, it offers the same predictions about your cycle length as the other apps, all for free. What sets them apart is that some employers and health plans actually cover the premium version, giving you even more features including access to registered nurses should you have any questions about your menstrual cycle or health.

Download on iOS

Download on Google Play

Eve

If you don’t want to see direct mentions of your fertility and aren’t looking to get pregnant now, then Eve by Glow Apps—which has a number of other tracking apps, including one for people who are actively trying to conceive—is what you’re looking for. Like the other apps, there is a free and premium version, and it uses the data it collects from users to show you where you fall on the spectrum of  “Is this normal?” when it comes to symptoms and side effects of your menstrual cycle.

Download on iOS

Download on Google Play

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First, know that you can absolutely have sex safely during your period without encountering any inherent medical concerns, says fertility specialist and board-certified OB/GYN Lucky Sekhon, MD. But, as with any sex involving vaginal penetration with a penis, there is still a chance of pregnancy, says board-certified OB/GYN Alyssa Dweck, MS, MD, sexual and reproductive health expert for health-care brand Intimina. (And that’s particularly important to reiterate, given the fact that almost half of respondents in a recent survey conducted by Intimina of more than 1,000 people with penises thought pregnancy during period sex wasn’t possible.)

Even so, you can also enjoy period sex (as you could non-period sex) without any such risk by getting it on solo. And in either case—solo or partnered—period sex comes with its own share of unique health benefits, say the experts.

The potential benefits (and a few downsides) of having period sex

Whether you have solo or partnered period sex, it’s the climax that really counts, says sex coach and speaker Sarah D’Andrea, MEd. “An orgasm releases so many pleasure hormones,” she points out, noting that these feel-good chemicals, including endorphins, can improve your post-sex mood. Beyond that, however, they can also act as an antidote to menstrual insomnia, cramping, headaches, and other symptoms linked to PMS, says Dr. Sekhon.

The hormones released during orgasm can be an antidote to PMS symptoms.

Many people who menstruate also reportedly experience shorter periods when they have sex during that time (although D’Andrea says there’s not much clinical research to back that up). One potential reason why this may happen? “Sometimes, the muscle contraction that can happen during orgasm [helps] release the uterine lining more efficiently,” says D’Andrea.

And as if those perks weren’t enough, consider that menstruators who do engage in penetrative period sex may find that “menstrual blood is a great lubricant,” says D’Andrea. “A lot of people may not have as much natural arousal lubrication as they want. If you’re having your period, that’s just extra fluid in your genitals that will make things a little bit slipperier,” she says.

That said, the presence of menstrual blood during sex may also increase the risk of passing a sexually transmitted infection, since the blood itself can be a carrier for it, says Dr. Dweck. But, of course, STIs can move between partners without any blood in the picture, so it’s always a smart idea to get tested before having penetrative sex (while on your period or not) with a new partner.

Expert advice for having good period sex

Assuming that you’re sure of your own and your partner’s negative STI status or you’re just planning a solo period-sex sesh, the experts suggest going forth with whatever usually gets you going. Just be sure to remove any tampon or menstrual cup you might be wearing during your period ahead of engaging in sex play, in order to avoid it becoming impacted or difficult to retrieve, and to limit any risk of infection, says Dr. Sekhon.

If it’s your first time having sex on your period with a partner, it’s also wise to broach the topic before you dive in, just to ensure everyone’s feeling comfortable and on the same wavelength, says Dr. Dweck. Many people with penises are less familiar with menstruation than you might think, and might feel frightened or embarrassed simply due to fear of the unknown, she adds.

In terms of the potential messy-sheets scenario, your simplest solution is to employ a dark-colored towel. Another option? Avoid the clean-up entirely by moving your sexual experience to the shower. Whatever you choose, though, know that there are minimal downsides to having sex while menstruating beyond the surface (or should we say, sheets) level. And in fact, the health benefits of period sex may make it well worth the extra load of laundry.

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