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Your 7 Most Embarrassing Period Questions, Answered By a Gynecologist

Photograph by Twenty20

If you’re a woman (and there’s a good chance if you’re reading this, you are), then you have probably, at some point in your life, had a weird or embarrassing period-related question that wasn’t answered in the “What to Expect When You’re Menstruating” manual—you know, the one every girl receives before her period starts (insert heavy eye-roll here).

Never fear. We’ve gathered a list of seven totally normal (and yet, often unasked) period questions and had them answered by an award-winning board-certified gynecologist, Dr. Jessica Ritch, who specializes in minimally invasive gynecology at the Florida Center for Urogynecology and has worked throughout the world, including Africa and India, to provide the most state-of-the-art gynecological treatments to women in need.

Not only does Dr. Ritch have the medical experience to answer our most private period questions, but she’s also a woman who has personal experience with the crazy-weird things that happen during our menstrual cycle. Her answers prove that while women’s bodies are totally unique, we have a lot less to freak out about when it comes to our periods than we may have thought.

“I think it's so important for women to understand their bodies,” Dr. Ritch shared. She wants us all to know that no matter how strange we think our health (read: period) questions are, we should still ask them. Knowledge is empowering, and our doctors can only help us if they know what’s actually going on with our weird and totally wonderful bodies.

1. What exactly are those big red clumps we see in the toilet?

The big red clumps are bunches of blood that have started to clot. When blood sits in the uterus or vagina prior to being pushed out, it can clot together, causing the big red clumps you see.

2. Um, can you please tell us why we poop so much during our periods?

This is a good question that we don't completely know the answer to, but there are two basic theories. The first is that a decrease in hormones (estrogen and progesterone) leading up to menses cause changes in the neurotransmitters (chemical signals from nerves) throughout our bodies, which can cause a variety of different premenstrual symptoms. The second is when the uterus starts to menstruate; it’s inflamed and contracts to expel blood, which can irritate the bowels that typically sit all around the uterus. In addition, some of the blood from menses escapes through the fallopian tubes into the belly instead of out through the vagina. This blood is very irritating to the bowels, which can create either diarrhea or, interestingly, constipation.

3. Why do we have those annoying pre-period pimples?

This is related to fluctuations in estrogen and progesterone levels. Estrogen tends to drop off first and when the ratio of estrogen to progesterone is lower, this tips the scale towards the more androgenic (male-type hormone) properties of progesterone, like acne.

4. Why do so many of us report being hangry a few days before starting our periods?

This relates back to the second question and those neurotransmitters like serotonin. Changes in these neurotransmitters can cause hunger and mood symptoms.

5. Is there a reason some of us feel more sexually aroused shortly before our periods start?

Again, back to the neurotransmitters. The drops in estrogen and progesterone cause fluctuations in neurotransmitters. Serotonin is the most studied, and this is what many people think of as the "happy" chemical. Releases of serotonin are responsible for the exercise high and similar reactions with sex. While changes in serotonin can lead to irritability and mood swings, it can also lead to other feelings, like arousal. Add to that the increased blood flow to the pelvis around menses (and even pregnancy!), which can increase libido.

6. What is that brown discharge at the beginning or end of our periods?

The brown stuff before and after our periods is just blood that has oxidized. Just before and towards the end of periods, the blood flow is light, which means it doesn't quite have the force to push itself out as when the blood flow is heavier. The small amounts of blood sit around in the vagina and become exposed to oxygen, which starts to break down the blood and turn it brown.

7. Are there any health risks with period-control products like menstrual cups and absorbent period panties (and reasons to avoid trying them)?

Nope, there are no significant health risks to these products. It's really just about choice and what is comfortable for each woman!

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