Many women around the world lack access to sanitary products or a toilet. Others are told to 'get on with it' if they are suffering with chronic period pain, or due to the taboo nature of the subject, left unaware of physiological changes - such as diarrhoea while menstruating can occur

A coalition of more than 300 organisations from around the world has come together to declare today the first ever Menstrual Hygiene Day. Launched by Wash United, a Berlin-based NGO, the day is intended to break the silence surrounding menstruation.

On any given day more than 800 million women between the ages of 15 and 49 are menstruating - yet periods remain a taboo subject. To mark the inaugural Menstrual Hygiene Day, here’s what you should have been taught about periods back at school - but probably weren’t.

Privacy, safety and dignity during menstruation is a rarity for many people

One in three women around the world do not have access to a toilet during their periods. “Having to find a safe place after dark is both undignified and risky,” says Barbara Frost, CEO of WaterAid, which is backing the campaign.

“Millions more suffer discrimination because of beliefs that they are ‘contaminated’ or ‘impure’,” she adds.

"Stigma about menstruation means women do not seek the help and information they need, while the lack of hygiene facilities in schools is a major reason for young girls dropping out of education when they reach puberty.”

Information about periods is woefully lacking in the UK but in some countries menstruation is so taboo that in many households it is never spoken of, even in private. A recent study found that 70 per cent of girls in India had no idea what was happening to them when they started their period.

Periods can wreak havoc on your plumbing

Prior to a period, increased levels of progesterone help the body prepare for the implantation of an embryo and stop the uterus from contracting. “Progesterone can slow down the muscle activity of the bowel,” explains Andrew Pickersgill, consultant obstetrician and gynaecologist at Stepping Hill Hospital in Stockport, and spokesman for the Royal College of Obstetricians and Gynaecologists in London.

At this point in their cycle some women might find themselves reaching for the Senokot, as the surge of progesterone can cause constipation.

But just as you’ve restored your natural rhythm it’s all change a few days later. Progesterone levels drop when a woman is about to have her period, causing the uterus to shed its lining.

“Around this time the bowels can get a bit looser than normal,” Mr Pickersgill explains.

The release of prostaglandins into the bloodstream is thought to be what causes diarrhoea in some women at this point.

Sanitary wear is considered a “luxury” item in the UK – and you will be taxed accordingly

When the UK introduced VAT in 1973 the Government declared sanitary products such as pads and tampons “non-essential” items and slapped a 17.5 per cent tax on them. In 2001 this was lowered to five per cent but campaigners have insisted that they are in fact essential and should therefore be completely exempt from VAT. 

A recent petition set up by 21-year-old Laura Coryton calling on George Osborne to “stop taxing periods” has amassed over 235,000 signatures.

“Sanitary products control and manage menstruation,” says Coryton. “They are essential because without them, those who menstruate would have no way of pursuing a normal, flexible, public or private life and would be at risk of jeopardising their health.”

Meanwhile, she points out, crocodile steaks, edible sugar flowers and helicopters are just some of the items that are not subject to tax in the UK.

There is a physiological explanation for period pains

Menstrual cramps occur when the muscular wall of the uterus contracts to help expel its lining. Hormone-like chemicals called prostaglandins trigger the uterine muscle contractions but they can cause the uterus to contract too sharply, reducing the blood supply to the womb leading to pain and inflammation. It is thought that a build-up of prostaglandins is what causes some women’s contractions to be so much stronger than others.

Endometriosis is more than “just” period pain

Endometriosis is a disorder where the endometrial tissue that lines the uterus grows outside the womb too, most commonly on the ovaries or the lining of the pelvis. Displaced endometrial tissue thickens, breaks down and bleeds with each menstrual cycle just as tissue inside the uterus does, but it has no way to exit the body, often resulting in pain and sometimes infertility.

“People can be affected by endometriosis in all sorts of ways,” says Mr Pickersgill. “Some women have no symptoms – they may only be diagnosed if they discover they are infertile. Some women have horrendous pain – during their periods and at other times such as during intercourse.” There is often an overlap between endometriosis, Irritable Bowel Syndrome and Chronic Fatigue Syndrome.

“Endometriosis probably affects as many women as asthma does – about 10 per cent of the female population of reproductive age are thought to suffer with endometriosis,” Mr Pickersgill says. “People don’t want to talk about it though, and women are told to ‘get on with it’.”

There will be blood – but not as much as you might think

It is difficult to quantify an “average” amount of blood loss, but the figure is thought to be about 30ml to 40ml over about three to five days. The average sanitary towel or tampon will absorb around 5ml of blood, according to Mr Pickersgill.

However, he adds, it can vary enormously and some people expel “horrendous” amounts of blood. If you want to get your measuring jugs out, a heavy period is defined as over 80ml of blood loss, Mr Pickersgill says.

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