I was 10 years old the day I got my first period. My mom handed me a maxi-pad and a book about menstrual cycles and said, “Let me know if you have questions.” And that was it. There were no conversations about options for menstrual care, and my menstrual products were the same ones my mom used. As a pelvic health physical therapist for the past 15 years, I have become much more well-informed about my body, my menses and my overall pelvic health.
Here are some pelvic health tips for your period that I am super glad I know and think all menstruators should know as well.
Period products should not hurt
Often people discover something feels wrong when they try to insert a tampon for the first time. Your pelvic floor has two layers of muscles, and the outer layer at the vaginal opening needs to be relaxed for insertion of a tampon. If you experience pain, burning, or feel like you are “hitting a wall” when trying to insert something into your vaginal canal, your pelvic floor muscles may be to blame. Period panties are a great option if you find discomfort wearing tampons, and work with a pelvic floor physical therapist on relaxation techniques for your pelvic floor.
Why your period may be irregular
The average menstrual cycle is 28 days long, but it can vary from woman to woman, especially after giving birth, getting closer to menopause, or due to a gynecological condition like hormonal imbalances, endometriosis or polycystic ovarian syndrome. Ovulation occurs before menstrual bleeding occurs, which means there is a chance you may get pregnant if you are not using contraception or tracking your ovulation window. So heads up! Notify your medical provider if these fluctuations persist as some blood work and tracking your cycle may be able to give you some insight as to the reasons for the irregularities.
Your First Postpartum Period
Your body goes through a LOT of changes after giving birth, and the hormonal rollercoaster is no joke. After giving birth, The average time to resume menstruation is anywhere between 45-60 days, even longer if you are breastfeeding or lactating. Prolactin, the hormone that aids in breastmilk production, works inversely with estrogen. So if you are lactating, we want your prolactin to be high, which means estrogen may be low leading to a delayed onset of your cycle, increased vaginal dryness, and decreased sexual desire. Using a water-based lubricant for intercourse and working with a pelvic floor physical therapist if you experience painful or uncomfortable sex can help. As you get further out from birth and/or your location production decreases, your menstrual cycle should return.
And when it does… your first postpartum period is likely to be really heavy. Like, really heavy. You may want to consider using period panties as a back up throughout the day or night as a heavier flow is common after giving birth. If you are unsure if your postpartum periods are normal, consult with your healthcare provider or reach out to a pelvic floor specialist today!
Pressure or Heaviness
A heavy flow or increased pelvic floor laxity may lead to pressure or heaviness in the vaginal area. All the blood flow may make you feel achy, especially in standing or at the end of the day. To combat this, lie on your back with a pillow under your hips and place a frozen bag of peas (or ice) over your vagina. (My family knows these are my vagina peas – not to be consumed!) Checking in with a pelvic floor physical therapist if you experience heaviness or weakness in the pelvic floor area may help.
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Interested in more tips on how to prevent or overcome Pelvic Floor Problems?
Download this free guide for some simple, do-able, totally-not-weird tips to take better care of your down there.
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Sara Reardon PT, DPT, WCS is the owner of NOLA Pelvic Health and founder of The Vagina Whisperer, a resource for online pelvic health education and therapy to help women worldwide with pelvic health conditions. She is a board certified women’s health physical therapist with a special interest in treating pelvic pain and pregnancy and postpartum conditions.
