We can’t escape them, but you don’t need to let a period get in the way of enjoying your expedition or making it more challenging than it needs to be. Hopefully this information will empower you to make the decision that is right for you, by informing you of the many options that are out there. Every woman is different so what works for some may not work for others, but luckily there are lots of choices.
Things I think are worth considering…
-Expeditions may impact upon your regular cycle – in general, physical and emotional stress can influence menstruation, as can the physiological stress imposed by ascent to high altitude. Although changes in menstrual cycle hormone profiles have been documented, this is not an exact science and is different for every woman.
-What sort of activity and environment will your expedition involve and how may this impact upon your ability to manage your period? For example, six to eight hours of trekking daily with no “formal toilet facility” and little place for privacy means that as a woman, emptying your bladder isn’t always straightforward (don’t even get me started on a “she wee”– they work for some but not me) let alone managing a period!
-What level of hygiene can you realistically expect to achieve on your trip? For example, will you get a shower every day, are you on an organised trek with a bowl of warm water to wash with each morning or trekking for ten days without a chance to wash?
-Do you normally have associated symptoms on or around the time of your period like breast tenderness or abdominal cramping – if so, will these be manageable on expedition?
-Will you be able to responsibly dispose of any sanitary products you use or is it best to consider reusable items such as a menstrual cup (examples: mooncup, divacup)?
-Do you also need to consider contraception?
If you feel that managing your period on your expedition won’t be too challenging, that’s great, just remember to pack plenty of sanitary products (more than normal) with you and store them in dry bags or similar to keep them clean and dry.
For some women however, the thought of having a period during their expedition is not an option they want to consider. So here are some medical options available in the UK (after consultation with a medical professional) that can help you have more control by delaying or stopping your period.
Option 1 – Norethisterone
Example – Primolut N, Utovlan
Quick Facts – A synthetic progesterone tablet that delays the onset of your period.
Advantages – Started three days before your period, it can delay it for up to 20 days. Contains progesterone and therefore does not increase the risk of clot formation.
Disadvantages – Needs to be taken three times a day. It is not an effective contraceptive. It can lose its effect if you develop a GI upset.
Option 2 – Combined Oral Contraceptive (COC)
Examples – Microgynon, Marvelon, Yasmin
Quick Facts – An oestrogen based oral contraceptive that is usually taken on a daily basis for 21 days. This is followed by a 7 day break or 7 days of inactive tablets when ‘withdrawal bleeding’ similar to a period occurs.
Advantages – Bleeding is generally lighter and less painful. It is an effective contraceptive. For most types, the active pills in the packets can be taken “back to back” for up to three months to avoid having bleeding.
Disadvantages – Needs to be taken daily. Oestrogen increases the risk of clot formation, though risks are small unless climbing to very high altitudes. It can be lose its effect if you develop a GI upset.
Option 3 – Progesterone Only Pill– “Mini Pill”
Example – Micronor, Cerazette, Cerelle
Quick Facts – A progesterone based oral contraceptive that is taken daily
Advantages – Contains progesterone and therefore does not increase the risk of clot formation.
Disadvantages – A tablet has to be taken at the same time every day. Bleeding occurs in the majority of women. This can often be irregular and unpredictable. It can lose its effect if you develop a GI upset.
Option 4 – Depot Injection
Example: Depot-Provera
Quick Facts – A contraceptive injection that is administered every 3 months.
Advantages – Contains progesterone and therefore does not increase the risk of clot formation.
Disadvantages – Bleeding can occur in the first few months
Option 5 – Implant
Example: Nexplanon
Quick Facts – A small plastic rod is implanted under skin that provides effective contraception for up to 3 years.
Advantages – Contains progesterone and therefore does not increase the risk of clot formation.
Disadvantages – Bleeding can occur in the first few months
Option 6 – Intra Uterine System
Examples: Mirena, Levosert, Kyleena, Jaydess
Quick Facts – A small plastic hormone containing device is inserted through the cervix and into the uterus. It can provide effective contraception for up to 5 years. It is effective in reducing heavy menstrual bleeding and often eliminates bleeding entirely.
Advantages – Contains progesterone and therefore does not increase the risk of clot formation.
Disadvantages – Bleeding (usually light) can occur in the first few months.
But, as with any drug, all of these options have the potential for side effects which affect people in different ways so it’s well worth trying them out before you’re due to leave on an expedition. Many of these options also take a few months to ‘settle into’ so again, trying things early is the key…