Young people's experiences of periods and period pain
Managing period bleeding
Having periods involves managing bleeding alongside any other feelings and symptoms that might be experienced with periods, like pain, sickness, and mood or emotional changes.
This section covers young people’s experiences of the practical aspects of managing bleeding, including the kinds of products they used, and when and how they choose them. We will hear about:
- Planning for/anticipating period bleeding.
- Managing period bleeding: types of products used to manage bleeding
- Managing bleeding at school
Dr Laura Knox, a haematology doctor, explains that if period bleeding impacts on how people feel or what they can do, there are things that can be done to help and encourages young people to see a doctor for any concerns.
Dr Laura Knox, a haematology doctor, explains that if period bleeding impacts on how people feel or what they can do, there are things that can be done to help and encourages young people to see a doctor for any concerns.
Hi. I'm doctor Laura Knox, and I'm a Hematology Doctor that works in Glasgow. Hematology doctors, means that we deal with bleeding disorders or people that have problems with their blood. And I sort of specialize in heavy periods and bleeding disorders.
And I wonder, would you have any, message or explanation for young people who might be trying to work out whether their period are heavy or how they might explain that, or what sort of measures you might use, or what you might ask if you saw them in clinic.
So how do we view heavy periods? It's changed quite a lot in the last few years. NICE, which is one of our organizations has a lot of guidelines and guidance has changed the definition to really reflect on heavy periods being anything that impacts on a girl or woman's life, either in their academic ways, work, school or social activities, rather than a specific measure which it used to be done in the lab.
So in general, I think if you're asking the question, “Are my periods heavy it's very reasonable to be assessed. Things that I sort of look out for in clinic are if you're changing pads frequently, especially if it's within 1 to 2 hours, flooding, changing your pads overnight, clots that are passing.
Those are all features that suggest to me that it's worthwhile getting checked out, but if there's anything you're concerned about, that's usually the time to go and get seen.
So would young people be expected to know how much blood their passing or like an amount of blood. Or you think it's more those practical measures that you use?
I think definitely practical measures. I think it's really difficult to actually estimate blood loss. At the small amount of blood and water can look very, very dramatic or sometimes not very much. So really the things that I look for when I’m assessing these people are whether they have had issues that are impacting them or if it's causing them concern, anything that's causing you worry, it shouldn't be periods are part of life, but they shouldn't be a difficult part of life. There's definitely things we can do to make them better.
You can read more about how periods and period pain could impact on people’s hobbies, activities and school in other sections [see broader impacts of periods on school and exams and broader impacts of periods on social lives].
Planning for/anticipating period bleeding
An important part of managing bleeding was anticipating when period bleeding might happen. Amelia, had regular ‘signals’ which started before her bleeding, so this was relatively straightforward to predict so she ‘could feel it before I started to bleed’, and could be ready with a pad or stay at home if she could. Grace uses her calendar to keep track of her cycle, so that she ‘kind of roughly know when I’m going to start and end’.
Leila has regular periods. Her parents talk with her about what to expect each month about the length and timing of her period to help her manage her pain and bleeding.
Leila has regular periods. Her parents talk with her about what to expect each month about the length and timing of her period to help her manage her pain and bleeding.
And when they did start, and you had it all kind of a bit, did you... were there any resources? Did you find any resource or informational things that worked for Leila to explain about them, or...?
Mum: No.
Dad: Not really.
Mum: We... we usually work on a... on a this-is-when-it-will-finish basis—
Leila: Basis.
Mum: so that to give her a it-will-finish. She’s always been good at days of the week.
Leila: Thank you, lady. Thank you so, so much. Going to get care.
Mum: Can she look after your penguin?
Yeah, it is a really nice penguin.
Mum: So, we’ve got several.
Dad: But even... even though it’s quite predictable, the start, talking about things happening in the future that haven’t begun, I think once a period’s started, you... we can say it will stop on, Sunday, Tuesday, and she’ll understand that,—
Mum: Yes, and that’s what we do to help her manage it.
Dad: —but if it’s not here, and say “it’s going to come...”
Mum: “It will finish on...”
Dad: Yeah, that gets confusing, I think for her. She struggles with the... I suppose, the anticipation.
Mum: We... we haven’t explained really what periods are, because I think that’s a bit beyond Leila’s comprehension. She knows that it will come again and it... they come and they go, they come and they go, but if it starts on a Saturday, we usually say “it will finish on Saturday” so that she knows a week... in a week’s time, it will finish.
Leila: going to my room in minute
Mum: And... and-
And during that really long bleed, was that tricky from that perspective?
Mum: Yes.
Dad: Yes, ’cause it was—
Mum: Because we couldn’t tell her it was gonna finish, so... yeah. And... and she would say, “Oh, no, not again,” every morning.—
“Not again.”
Mum: “Not again.”
“Not again.”
Mum: “Not again.” And that’s how usually when it starts she’ll tell us: “Oh, period again.”
OK. So, for the very long bleed,—
Leila: Oh, tired.
—every day was “oh, no, not again”?
Mum: Yeah.
But each month, it’ll be “period again”?
Mum: Yes, “period again.”
Leila: “Period again.
“Period again.”
Mum: “Period again.”
Leila: Oh, no. Oh, no.
When Leila had an injection form of hormonal contraception, her bleeding timing and length became unpredictable, which meant the system of telling her what to expect each month about the length and timing of her period didn’t work as well.
Those whose periods were unpredictable, irregular or prolonged found it harder to keep track with calendars or apps. Lola explained her period ‘was really irregular, so I didn’t... I wasn’t able to use a tracking app or anything on it, it was just a case of if it happens, it happens, and some days I wouldn’t have anything on me, so I’d have to kind of run around to all of my friends and just go: “Please, have something,” because the school, it wasn’t until I was in Year 11 that they started doing a period box’.
As well as carrying spare period products, some young people like Zaynah carried emergency changes of underwear and clothing with them, in case of unexpected or very heavy bleeding. For Lily, this means she has ‘to remember to pack extra underwear and extra trousers and extra different period products. It’s a lot to carry in my school bag, definitely’.
Elsa’s periods have changed between light and heavy, and regular to unpredictable. She feels “constantly on edge” and always “prepared” for bleeding – for herself and anyone else who might need something.
Elsa’s periods have changed between light and heavy, and regular to unpredictable. She feels “constantly on edge” and always “prepared” for bleeding – for herself and anyone else who might need something.
Can you tell me a little bit more about that transition?
Yeah. So, they used to be pretty light. And then when I was about, ooh, no,12, 13, they got really heavy, but they were consistent.
Yeah.
And then when I was 14, sort of starting the new school year, they became very inconsistent, still heavy when they came, but it was sort of a bit more unpredictable.
OK.
And they’ve been not completely unpredictable, but not very consistent since I was about 14. And just this summer, they started being just ridiculously long, so...
Mm, OK. And how has that kinda impacted on you, the inconsistency? What’s that been like to kinda manage?
It’s just been a bit like I’m sort of constantly on edge that I’m going to start at a very inconvenient time. So, it’s sort of like, all... like always, always carrying pads and stuff just in case, and also for other people but, you know, sort of trying to be prepared. Yeah, and the heavy flow does mean, like, I have to change like every hour or so, which sort of, I have to plan around that just to, you know, make sure that there’s a toilet or something nearby.
As well as trying to predict when periods would come young people also planned for how heavy their periods were likely to be. A number of the young people we spoke with experienced heavy period bleeding. While this might be consistent, for Sarenna, her periods could be ‘really random, cause sometimes they’ll be like really heavy, or... or like sometimes they’ll be light, and then sometimes they’ll... or sometimes they’ll be like something in between’.
It was sometimes difficult for young people to make sense of what was normal bleeding and what was unusually heavy [see Learning about periods: learning from experience]. Jayden described their irregular heavy bleeding as ‘quite scary’ because they hadn’t known what was happening and Lola was surprised by the heaviness of the flow.
Lily learnt about the menstrual cycle at school but used Google to work out what period products to use, as this wasn’t covered.
Lily learnt about the menstrual cycle at school but used Google to work out what period products to use, as this wasn’t covered.
Can you remember what they said in that assembly or... or what sort of things they covered, and was it just girls or was girl... was it like mixed?
It was mixed and it was more of the menstrual cycle and what happened on it, and it was sort of the biological side, but I... I don’t think I’ve ever had an assembly or a talk on what sort of products you should use or when you should use them and sort of like the level of heaviness to lightness and how to sort of differentiate... differentiate them I guess, which I guess as kind of hard ’cause you had to sort of figure it out yourself or ask other people.
Yeah, and I think that’s really, really interesting and... and something that I’ve heard from quite a lot of people. So that kinda process of figuring out kind of level of heaviness, level of lightness that you figure out for yourself, can you tell me a bit about kinda what that was like for you, maybe how you did that working out?
I think I did a lot of Googling. I... I did search up online sort of like when you should use pads or what’s better, pads or tampons, or sort of they were the only sort of options in my mind anyway before we had period pants and DivaCups and loads of other options. So, I sort of just Googled things, and I went into shops and sort of went: ‘right, OK, how heavy am I?’ And I would just kind of sort of guess and would just think, ‘right, OK, I’ll get normal ones. If they’re not... if they haven’t got the right amount of absorbency, then I have to try heavy ones,’ and I sort of just sort of trial and error.
OK. And did you ever... so when you Googled it, did you... what did you find? Did you find any kinda information that was helpful? What was that like?
It was... it was sort of helpful. It was... there is a lot of information out there. I... I can’t particularly remember what I would Google, but it would be something along the lines of sort of: ‘when should you use tampons and when should you use pads?’ ’cause we were educated a lot about toxic shock syndrome, quite a lot with tampons, ’cause one of the girls in my school passed away from it. So, we... I think we were educated a lot more than other schools were educating others on it. So, I was a bit scared to try tampons at first, so I sort of was more Googling pads and absorbency. And you see a lot of adverts online for... for pads, and so I sort of just, I guess, trial and error with Google and a mixture of going into shops and... yeah.
The heaviness of periods affected how often products needed to be changed through both day and night. This affected their decisions about which products to use and how they planned their day.
Bella has heavy periods. She plans her bus journey timing and clothing choices around this, but it is a constant worry, especially during school. She manages with extra absorbency products.
Bella has heavy periods. She plans her bus journey timing and clothing choices around this, but it is a constant worry, especially during school. She manages with extra absorbency products.
So, the managing the flow and the possibility of leaking sounds like it was quite a big stress for you in those early years?
Yeah, definitely. I mean it was... it was quite bad. I remember I used to get so anxious about going to school, and when I’d need to go out with my period, I’d just wear the baggiest joggers that I possibly could because I just... like most of my... I didn’t really know how to cope with it, and my Mum tried to help me cope with it, but my flow is just... I don’t know why, it’s just really heavy and so we try and take measures to try and help me, but my favourite pyjama bottom’s completely ruined. My mattress, you know, it’s got, you know, some residue on it, and just all my stuff just seems to get ruined and I’ve just kind of reached a point of I just feel a bit... like it’s a bit unmanageable.
That sounds... that sounds quite difficult.
Yeah.
Have you... have you... is that something you’ve ever kind of gone and asked for help about, or have you tried any medical measures for any of your periods?
No, I don’t think there’s anything really that can help. I... I’d... I’d not really looked into that, I just kind of deal with it and just extra... extra-large tampons and extra-large—
And pad.
—pad and call it a day.
Yeah. And what about things like when you were at school, if you hadn’t... did you say you were having to change your pad like every 45 minutes? How did you manage that at school?
So, every 45 minutes at home sort of time, but every hour at school, so I’d go in between lessons and just check everything was OK. ’cause sometimes I’d get like I think I’d get from coming into school up until break I think sometimes, and from that break to the end of the day. But I mean my bus trip was an hour long, so I’d have to go before the bus trip, sometimes I’d even miss the bus ’cause I’d just be like rushing to a toilet ’cause I got out a bit late. But yeah, and the bus trip as well, it’s horrible being sat down for so long ’cause I’m just so paranoid that I’m gonna get up and something’s gonna be there, but... yeah.
Some young people who had heavy or irregular bleeding went to see a doctor about periods [see Deciding to see a GP]. Poppy went to her GP and was prescribed a medication called tranexamic acid which can help reduce bleeding, that she found ‘really helped’ with her pain and her bleeding.
Managing period bleeding: types of products used to manage bleeding
A consistent priority when choosing products for period bleeding was how reliable they were. Avoiding leaks of menstrual blood was a priority for most young people. Worrying about the possibility of a leak was ever-present, especially among those who had heard about, experienced, or seen this happening to others. They worried how other people would react, for example fearing ridicule or laughter from boys, or being told off by teachers.
Although some people had difficult experiences, those had ‘leaked’ at school usually said that friends and school staff had been supportive and kind.
Bella Z has not had a visible leak at school though was often worried that this might happen. However, when a friend of hers ‘leaked’ on a school trip, she and the teachers supported her.
Bella Z has not had a visible leak at school though was often worried that this might happen. However, when a friend of hers ‘leaked’ on a school trip, she and the teachers supported her.
But I guess I’m kinda hearing that quite... ’cause the bleeding is harder, maybe, to talk about than... than the pain?
Yeah. Yeah, no ’cause I think it’s weird, like you shouldn’t feel embarrassed about it, but like if you leak like... or like a lot of people would feel embarrassed about that. And I don’t really know what it is ’cause obviously it’s so normal, but I think it’s just with anything. Like, obviously if you like wet yourself, you’d find that embarrassing, and then it’s probably like... like it’s... it’s kinda the same thing, but then a different colour. Like I think it’s just kind of just not being in control of it and it like... I think from other people, you more... If like you saw someone that had leaked, you feel bad for them, like it’s not... ’cause obviously it’s permanent as well, like it’s... it’s just obviously not... not a nice thing to experience, so...
No. Is it something... Have you ever experienced that, or...?
I actually... not in public, like I’ve been quite lucky with that. Or if I have, like it hasn’t shown up on like whatever bottoms I’m wearing. Like, yeah, it wouldn’t be noticeable, only really like onto like pants and stuff, so I’ve actually been lucky with that. But I know one of my friends like had... like that did happen to them, like it’s obviously not a nice experience. So that was obviously when we were quite a lot younger. So, it is... I think people just find it quite embarrassing, like and I don’t... yeah.
Yeah, no, I think that’s your... I’m sorry, and you poor... your poor friend.
Mm.—
How... how did...—
Mm.
—can you... did you... were you kind of able to support, and how did people around her react, can you remember?
Yeah. Well, it was like I don’t think many people actually really like noticed. Like I... I don’t think anyone actually noticed like apart from me, ’cause I was obviously sitting next to her. And we were actually on a school trip as well, so she... I think she just went... I think she did tell a teacher, and then she went to the toilets and it was all basically sorted out in the end, but it was more like she was... but I think she was wearing dark colours, so it wasn’t as noticeable, so... But obviously, it was when we were younger, so even I hadn’t started yet, so it was like quite hard obviously to relate, but obviously I was still like there for her like, and tried to help, but you can’t really do much, but... yeah.
Yeah. But there’s something about the worry of it.
Yeah, exactly. I think that’s what a lot of people... Like you hear like a lot of my friends will be like: “Oh, like, I leaked.” Like a lot of people, it’s like, if you’re on your period, you’re... you are just worrying about like leak... as long... like if you’ve forgotten about it, but you are just worrying about leaking and like all of this stuff.
Sage started her periods at primary school, and it took time to learn how to confidently manage the bleeding. She worried a lot about leaking through, but her friends and teachers were kind and supportive which helped her.
Sage started her periods at primary school, and it took time to learn how to confidently manage the bleeding. She worried a lot about leaking through, but her friends and teachers were kind and supportive which helped her.
And what was that like kinda managing periods when... at primary school in terms of kinda the setup for it, or... or how that worked?
Well, ’cause in primary school my like actual cramps hadn’t started yet, it was more like I was just really scared of like bleeding through into my trousers, which had happened quite a few times, ’cause I still wasn’t used to the blood flow. And like I didn’t know anything about like period underwear at the time; I only learnt about that recently actually. So, I just, I would put on pads, and sometimes I would even put on two pads ’cause I was just really worried about it going through. But like my friends are all really nice about it, ’cause like none of them got it until like a few years later, but they like understood I was having it, and like they had all had talks with their parents about it, so everyone was really nice, and like, you know, my friends would check me. And like the teachers, like they knew to like... they know in general to let the girls go to the toilet because of periods, but also like whenever I have started my period, I would kind of go to like one of the teachers I trust and tell them, just ’cause I was always really worried they just wouldn’t let me, and then I would bleed through onto the seat.
And when that... So that was a re... so that kinda worry about bleeding through, and the trousers, sounds like it was quite a big part of your primary school kinda, well, and possibly beyond.—
Yes.
When it did happen, can you remember how people reacted, or... or... or was it more just the worry about it?
It was more the worry about it. Like my friends like if they noticed they’d like give me a jumper to wrap around my waist, and they’d tell me about it, so I can try and like wash it off in the bathroom. But like other than that, I didn’t really... that was it. Although I do... I have a friend who once bled through, and like some guy pointed out that like there was blood on her chair, and like she like ran to the bathroom crying. So, I think that might have also added to being scared.
Young people wanted period products that could manage heavy sudden flows or flooding. Even with these, Elsa worried about where and how to sit when they were on the heavy days of their period: ‘if I’m going to sit on the white sofa, remember to like put a towel underneath just in case, or like if I’m going to sit somewhere, I sit straight on, not like sort of twisting or like legs crossed or anything’. Both she and Candice sometimes have to get up in the night to wash and change bedding, which adds to the tiredness that can come with having periods [see broader impacts of periods and period pain: symptoms experienced periods].
The risk of bleeding through, not being able to find a bathroom, or developing pain made Zaynah feel fearful of going out. She tends to defer plans because of this.
The risk of bleeding through, not being able to find a bathroom, or developing pain made Zaynah feel fearful of going out. She tends to defer plans because of this.
I think... I think it was mostly was built on like fear of like if you went out with like your friends for like the whole day and like there wasn’t a bathroom nearby, like was that worth doing, because if you leaked or if you ended up in pain, like what would you do if you’re just out like somewhere and how would you get home, and things like that. I feel like often that... like even now I still do cancel plans if I’m in pain, I’ll just be like: ‘I’m in pain,’ like I’d... I’d rather not go out because I don’t... I won’t be as engaged in whatever we’re doing as I usually would be, so it’s just worth postponing, maybe, yeah.
Although we will talk about product types separately below, many young people used products in combination, for example pads and period pants, or pads and tampons together. This was something that often evolved over time. For example, many people started out using pads, often because these were seen as straightforward to use, easily accessible, and often what they were first given or taught about in schools. With time, experience and discussion with friends, they might also add in or swop over to other products like tampons, period pants, or menstrual cups. They might use a range of options, alone or in combination, depending on what they wanted to do that day, or what they wanted to wear.
Cost and environmental impact were also important to young people when they were choosing period products. Yvette started her periods when she was staying with her grandparents. She didn’t tell them and for the first year, she used her lunch money to buy period pads. When she went back to stay with her mother, this became easier for her, and she was offered a choice of period products.
Jian thinks that pads are really expensive, but that period pants are ‘less known about’. Her school gave her a menstrual cup, but not any advice on how to use it. It’s still in her room, but she plans to learn how to use it someday (read by an actor).
Jian thinks that pads are really expensive, but that period pants are ‘less known about’. Her school gave her a menstrual cup, but not any advice on how to use it. It’s still in her room, but she plans to learn how to use it someday (read by an actor).
So, pads, yes.
Yeah, they’re so incredibly expensive, and considering they’re not reusable at all; whereas period pants, how much are they?
They’ve got a lot cheaper.
Uh-huh.
They used to be... they did actually used to be... I mean they’ve only been around... they haven’t been around for that long.
Oh, really?
No. And they’ve got a lot cheaper in that time, or more... or more people make them.
Uh-huh.
But they are reusable.
But they also... I don’t think they’re quite known about at all,—
No.
— considering like... I’m... I’m assuming they’re also like a lot more eco-friendly and things like that, sustainable, and stuff like that as well. So, the fact that like tampons and pads are just the most predominantly known product is bizarre, considering they’re so expensive and just... I... I don’t even know what to say, they’re so expensive, yeah….
They... yeah, yeah, yeah, no they are, which... well, so I’m glad they were freely available in your school. I think you said your school gave away menstrual cups as well?
Yeah, yeah, my school... It was very well advertised. They’d be on every single toilet stall. They’d send out emails and you’d just go to the reception. But I think no matter how... like our school is quite open about it, but like... like I remember me and my friends going there, so it would be quite a shy experience and going and coming and getting our first menstrual cup. I never ended up using it because I didn’t know how to use it, but...
So... so they gave them out but didn’t give you any instructions?
Yeah. But I still have it in my room, and one day I’ll know, yeah.
Pads were often a preferred option for managing bleeding and were often the first product people used or encountered. For Lucia and Mia, pads were straightforward to use and manage at school. Anayaa finds them ‘easier to use’ and worried other products would be uncomfortable. The range of options for different flows was helpful, including options for night pads, which Candice and others tended to use for sleeping. She also sometimes wore ‘three pads like together, connected’ although even this was not reliably leak-proof for her. Elsa sleeps on her back when she has her period, as a way of reducing leaking from pads in the night when they might move with body position.
Pads were easy to carry in school bags, or share with friends, and were a product that was consistently available and taught about in school settings. Some people, including Emily Z, Willow Z and Rahma find the feeling of pads uncomfortable or do not like the exposure to blood or odour Bella Z worried that pads could be visible with movement or with certain types of clothing. Some others preferred not to use pads when playing sport, although Mia says that pads work well for her during sport. Emily X tends ‘to wear a sanitary pad while I am just at home but I prefer to use tampons while outside of the house.’
Another product type that young people might use are tampons. Young people who used them found that these could be helpful for wearing for activities like sport or swimming. Ela, liked using tampons and had used them from when their periods started. Anayaa hadn’t felt confident to try them. Some worried about how their use of tampons might be seen or thought about by others.
Rahma would like to diversify the conversation about menstrual products to include other options, and demystify tampons. She thinks reducing stigma would help women keep active and champion women’s sport (read by an actor).
Rahma would like to diversify the conversation about menstrual products to include other options, and demystify tampons. She thinks reducing stigma would help women keep active and champion women’s sport (read by an actor).
I think as well, education around especially destroying the idea... I think for a lot of conservative backgrounds as well, a lot of people associate the tampon with like that... the virginity, and stuff, ‘and you shouldn’t put anything up there,’ or like: ‘it ruins your virginity,’ when it’s like, that’s ridiculous. It’s plastic, you know? I think that as well because I think for a lot of conservative communities, it’s just pads, pads, and pads, rather than looking at other alternatives. ’cause I do know that for a lot of young girls, obviously ’cause you’re young and, you know, it’s... it’s a boundary thing, you don’t wanna be uncomfortable, pads are just so much easier. But I do think that actually being in class and saying, “Hey, menstrual cup.” “Hey, this.” “Hey,” that is so good, you know?
Yeah, but it’s not happening, is it?
It’s not happening and I think it’s so important because when I started using tampons, I realised this is it. I think a lot of people stop doing sports because pads are just so sad. You know, pads are just not great, like they... they squish and they’re not... you know, they don’t do what they should be doing when you’re walking around. So, when I started wearing tampons, I felt this is exactly what I needed. This will help me swim, this will help me actually not miss out, you know? I think that was a thing when I was younger and going to swimming lessons, I felt like I had to miss out, but then I discovered...—
That you didn’t.
—didn’t, because there’s tampons, there’s menstrual cups, which again, environmentally friendly as well and very good. Reusable. So...
But you’re not given the information to make those decisions.
And it’s just pads, pads, and pads, and that’s not a bad thing, but I think—
But there’s...
—in order to champion women’s sports and bring more women to be active, it’s so important to diversify and lessen the stigma, because tampons have such a stigma, so lessen the stigma is one thing.
While they were often familiar and widely available, people were not always taught or advised how to use tampons. Bella first tried a tampon when she was given one by her school friend: ‘So one of my friends at school told me. She didn’t really give me an in-depth explanation, she gave me a tampon, ’cause she didn’t have a pad, and she said to try it, and in the school toilet she gave me a little demonstration. And I went there and it was fine.’
Sarenna and her friend wanted to learn how to use tampons before going on a holiday. Their Mums found them some instruction videos on You-Tube about how to put a tampon in which they watched together.
Sarenna and her friend wanted to learn how to use tampons before going on a holiday. Their Mums found them some instruction videos on You-Tube about how to put a tampon in which they watched together.
And did they teach you how to use them at all?
No, they didn’t teach that. Like I think to... and this is a bit weird, but like basically me and, like, my other friend, so she’s like the same age as me, I think, yeah, she’s like four months older, or something, and then I think we were going on holiday, or something like that, and then we were like... ’cause I... we were both like gonna be on our period, or something, so I was like: ‘why don’t you try using like a tampon, or something, instead?’ ’cause you don’t wanna be swimming, like obviously like that, and then we were both like: ‘we don’t even know how to put... like use one,’ or something, so we had to search it up on YouTube, or something, how to put it in; but that was really weird. But yeah, we didn’t know how to do that, and stuff, so...
So, you managed to find... so... and you found a YouTube video about how to put a tampon in?
Yeah, our Mums found it for us, and we just ended up watching it, but...
Brilliant. So, you did... but you did that with your Mum?
Yeah.
And how did you... and then... and then were you able to kinda get them to work, was that OK?
So, it took... like it took a... it took a few times, but we ended up managing to do it, but... yeah.
Menstrual cups were another option, and valued for being environmentally friendly, though not everyone was taught how to use them. For those who had heard about and used them, period pants were often a comfortable option, sometimes with pads. River said that wearing pads inside period pants helped him feel secure, though he and his parent were mindful of the cost of period underwear, and worried that this could exacerbate inequalities and period poverty. While Sage didn’t learn about period pants for a couple of years after starting, when she did find out about them, her school had free period underwear as an option in their free period product box. Period pants are very helpful for Leila who is supported to change them by her school support worker and at home by her family. When Eve started her periods, her mother found out about period pants, so they both tried them at the same time and learnt together. Her mother said: ‘I didn’t have them, so we’ve kind of looked at it and tried it together and it’s not something I’ve been through, so I’ve not known how to advise you, really, so that’s why I just think it’s... it would be good to have more information about... about them.’ [See Parents perspectives].
Ivy prefers period pants at home, because they are the most comfortable. Changing underwear and menstrual cups when out of the house, or at school, can be difficult, which for her limits when she uses these options.
Ivy prefers period pants at home, because they are the most comfortable. Changing underwear and menstrual cups when out of the house, or at school, can be difficult, which for her limits when she uses these options.
Absolutely, so...
Its quite hard to use the other products?
Ab... absolutely. So, at... at home, I... I mostly use period pants because I find them the most comfortable, but obviously when you’re at college, or wherever, it’s not practical ’cause you like can’t be...—
Be change.
—be... be changing your underwear every two, three hours, you know? And yeah, cups and stuff, obviously, if you’re emptying in college, it’s not very... that sanitary; I don’t... I don’t use them personally, but if you do... And then also sterilising them, because they have to be sterilised quite often, you can’t just try and do that in college, you know, so there’s a... a lot of, like, discomfort with that.
A specific worry about using tampons was the possible risk of toxic shock syndrome (TSS – this is a rare but potentially serious infection which can be associated with use of tampons, menstrual cups or other non-specific skin wounds). Lily, had been taught about this in school, because a previous pupil had been affected by TSS. Others learned about it from the internet or from friends and this possibility added to worries about being able change tampons or menstrual cups at school, or using tampons or menstrual cups overnight.
[See Learning about periods: what young people wished they had known].
Managing period bleeding at school
Managing period bleeding at school involved practical considerations, like what young people needed to pack in their school bags, thinking about where toilets were, when and how often they would be able to get to toilets to change period products. It also involved emotional and thinking work, including being vigilant about leaking or bleeding through [see Managing periods: support structures in schools]. For many, this this added up to a significant emotional load, which could affect their concentration and enjoyment of school and other activities, alongside any pain and discomfort that were associated with periods. It could also impact on people’s sleep [see broader impacts of periods and period pain: impacts on school and exams].
Some people, like Lucia, could sometimes manage a whole school day without changing their pad or period pants, but most young people needed to do this at least once during the school day.
Many young people didn’t especially enjoy using school toilets. Chloe described the toilets at her school as: ‘really gross, so people don’t wanna use them, so I feel like they just put it off as long as possible’. Ela finds that the narrow cubicles can make it hard to fit a school bag in and change period products, though she has learned to manage this. The bins for menstrual products could also be a problem. Sometimes they were not in all the cubicles, especially at primary school. Eve was told which toilets she could use. River remembers ‘being in Year 6 and... there was still no, like, sanitary bins in the toilets, and I remember them putting all the girls in one room and they... they didn’t even say ‘period’, they just said, “We put bins in the girls toilets, and if you know – you know,” and like some girls were... were just like: “I don’t know what they’re... they’re talking about.” They were so ashamed to say the word ‘period’, and that’s sort of where the stigma sort of started for me’. For Sage, managing period product bins was so unpleasant that ‘it’s so unsanitary and it’s just disgusting because it sort of adds to the shame of already having to... to manage your period, and stuff from that’.
Bella says the toilets in sixth form are nicer, but found them difficult in lower school. Overflowing period product bins are distressing and could be avoided.
Bella says the toilets in sixth form are nicer, but found them difficult in lower school. Overflowing period product bins are distressing and could be avoided.
Now I’m in sixth form they have nice toilets there, so they’re fine, but in younger years, I... I just... it was horrific. I didn’t go to the toilet generally, I’d sneak into the staff toilets near reception, or I’d go and ask the school nurse to use her toilet and like that was the only times I’d use them because I’d like... And when I’d have to go into the actual school toilets like I did that one time, ’cause I had to change my pad so often, I just... I couldn’t touch the bin. A lot of them obviously had a pushdown thing, you didn’t have to lift it up, but sometimes you’d push it down, it wouldn’t work, so you’d have to go to the next door push it down and they were overflowing, just tampons falling on the floor, which was absolutely a health hazard – it’s just gross – absolutely grim. I don’t think... they need to teach people how to actually... you know, it’s got a wrapper for a reason, you roll up and then you put it in the bin, you don’t just put... So maybe something like teaching people how to use sanitary bins and to dispose of sanitary products, ’cause you’re not taught it, you just kind of put two and two together all the time.
A big worry for many young people was whether they would be able to access the school toilets when they needed to. Young people were encouraged (and tried) to use the toilets at break time, but this was not always possible. Reham finds the toilets are usually crowded during break times which means she does not feel comfortable being in them when she has her period and needs to change her pad. She has learned to ask her welfare support worker for permission to use the staff toilet. Willow said that access to the toilet has been straightforward and not a problem. Her only worry was that her PE kit doesn’t have pockets in it, which could make carrying period products a bit tricky in those lessons.
Young people understood why missing bits of class was not ideal for them, their teachers, or the class, but sometimes they were not been able to get to a toilet in break time, or they only became aware that they were bleeding heavily during the class. For those with very heavy bleeding even if they had changed their product in the break, they still might not be confident that they would be able to make it through the lesson without bleeding through. This could be a major worry for the young people.
Leaving classrooms to go to the toilet typically required asking a teacher. This could feel quite exposing or embarrassing, especially if the young person was asked to explain in front of the whole class why they needed to leave. Emily started her period unexpectedly in a class just after lunch. When she asked to leave, a boy in her class asked why she hadn’t gone at lunchtime. She didn’t know what to say, but luckily her teacher was kind and just let her go, saying she could ‘go whenever she wants’.
April finds that some teachers can be quite strict about letting people go to the toilet in lessons. One made her give up 5 minutes of her break, she thinks people should be able to go to the toilet when they need to (read by an actor).
April finds that some teachers can be quite strict about letting people go to the toilet in lessons. One made her give up 5 minutes of her break, she thinks people should be able to go to the toilet when they need to (read by an actor).
I... I do get a little bit anxious when I’m at school with like... ’cause like obviously of like leaks and stuff, but obviously like none of that’s happened. I do get like quite anxious, but like I know like it’s gonna be all right, so...
I feel like teachers maybe just have a little bit more understanding and let girls go to the toilet a bit more often ’cause it can be like quite bad at my school, ’cause I know some of the teachers can be really strict. Like, I don’t really wanna get into a lot... a lot of detail about it, but like I’ve had a geography teacher and I’ve had pe... and like girls in my classroom ask, can they use the toilet, and he’s saying that we’re gonna have to give up five minutes of my break to go to the toilet. And I just think it’s a bit like stupid because like obviously people need to go to the toilet if it’s like for medical reasons, but sometimes they do give like out toilet passes if it’s like... if you have a reason for it.
Sometimes people worried about asking male teachers, but others said their male teachers were more understanding or less likely to challenge people about needing to leave the classroom. Young people who were managing heavy bleeding often learned which lessons and teachers might be more supportive.
Elsa tries to talk to teachers at the start of the lesson, to explain that she might need to leave because of her period bleeding. She has had to learn to speak about her periods because of this, and has found people supportive.
Elsa tries to talk to teachers at the start of the lesson, to explain that she might need to leave because of her period bleeding. She has had to learn to speak about her periods because of this, and has found people supportive.
Well, actually, it was sort of because my classes are an hour long, so it was sort of knowing that at the end or the beginning of each lesson, like I would have to go to the toilet. So, it was like going into class sort of before the lesson started, because you don’t know how it’s going to end or if the teacher’s going to hold you back or anything. So, at the beginning of the lesson, just going to the teacher and being like: “Hey, I need to go to the toilet,” and sort of like usually they would let me go because I was a pretty quiet kid, like I didn’t cause a lot of trouble, but sort of on the odd occasion that they were like: “No, sit down,” I’d be like: “No, I need to go to... like, I have to go.” So that probably also helped with my... well, not wanting to sort of be ashamed, I guess, or like I’m happy to speak about my period because it’s like I have to,—
You’ve had to.
—so...
Have you ever had any kinda difficult responses, or has that mostly been OK?
I think it’s mostly been OK, actually, especially because the resistance that I do get is normally from male teachers, so as soon as you say, “I’m on my period,” they’re like: “Oh, sorry, sorry, sorry,” like, “go,” whatever, whatever.
OK. OK. And...
And, so... yeah.
—and you’ve learnt to be comfortable doing that?
Yeah.
Did it affect you, would you say in class, kinda holding all of that stuff to be aware of and to be thinking about?
It’s... I mean it’s sort of always for that week, or whatever, it’s always kind of nagging at the back of my mind, like: ‘oh, God, I really hope I don’t bleed on this chair,’ ’cause it has happened a couple of times and it’s just really awkward after class trying to like clean the seat. But yeah, it’s not... I mean I wouldn’t say it’s bad enough to be distracting from class. And again, it’s nowhere near like having cramps where it’s like I can’t physically concentrate or do anything. It’s just a bit like in the back of my mind, having... like, knowing that. I’ve just... I’m... I don’t know, I’m very aware of it now, so it’s not something that I... that’s difficult to keep on top of.
Candice, River and others told us that they had a ‘toilet pass’ to allow them access to the toilets when they needed. They had got these by sharing medical reports with the school. These could be for periods, but were sometimes for other medical conditions, for example Chloe and Anayaa had toilet passes because they have other medical conditions.
Candice has a medical pass which lets her go to the toilet when she needs to. Her heavy period bleeding led to frequent leaking at school and needing to change or borrow school clothing (read by an actor).
Candice has a medical pass which lets her go to the toilet when she needs to. Her heavy period bleeding led to frequent leaking at school and needing to change or borrow school clothing (read by an actor).
OK. And how... how do you kinda manage that at school with the bleeding: have school been with all of that?
So, I’ve got a toilet pass. They’ve given me a toilet pass for it ’cause when I went, yeah, I asked for a paper. And for that, like one of my medical... like the teacher downstairs in the medical room, like I’ll just be hoping that she knows about it already now. But like I used to go down to the office like every hour. Like I used to go down like five times a day and I’d have to change and take like some of the school’s spare skirts; that was quite a mess.
And has... has any... have you ever had kinda any reactions from anyone or... if you have had a difficulty with leaking at school?
It’s just the people spotted the blood from the back, like my friend. Or like sometimes if I’ll tell a teacher, like, or... and you’re trying to cover up the skirt, and I’ve got a really long jacket on, they’re like: “Take your jacket off,” and I’m just looking at her like: ‘no, I can’t take it off.’
And have they understood, or did you have to say?
Like at the end... like if it’s a female teacher, at the end, she’ll keep arguing about it and then at the end I’ll go to her on the side and I’ll say, “Miss, I can’t, I’ve leaked through it,” and then she’s like: “OK, I’ll let the next teacher know, but you can’t be in that lesson, you need to go sort yourself out.” But kind of like if it’s like a male teacher, I won’t really be able to speak about it.
OK. So, you’d be happy to have that conversation with a female teacher?
Yeah. With a guy it’s a bit more awkward.
But like before that it was all messed up, I was missing most of school ’cause of it. And then last year, like... and the year before, I got the medical pass. And this time, like they’re slowly looking at it.
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