Today we are talking about the handling the menstrual cycle. Also known as that time of the month, a period, Aunt Flow, on the rag, lady business, the red badge of courage, the red baron, red flow, the crimson tide, and the time when every woman wonders how many years do I have left until menopause. 

I assume the vast majority of people know what a menstrual cycle is, but I will give a brief overview for the few that do not. Once a month, women ovulate. If they do not become pregnant, then two weeks later, she will start to bleed from down below for two to seven days. Most women average out at about five days. We also have painful cramps in the pelvic region, bloating, and moodiness, known as PMS. The cycle repeats once every month, averaging about every 28 days. Most girls start at about 12 and will continue until they go through menopause. Menopause means they are too old to conceive children; at least naturally conceive. The average age for menopause is 51, but this can vary greatly. Early-onset menopause happens between ages 40-45, and late-stage onset menopause occurs in the late 50s into the 60s. That means it will happen for a large portion of a woman’s life. 

Let’s start with the obvious, handling the blood. The amount of blood a woman can lose during this time is anywhere from a couple of drops to 2 cups of blood. I’ll be honest, I don’t know a single woman that found the sign-up sheet for the low amount, but the high amount would concern most women enough to see a doctor. Why? Because the average is two to four tablespoons. 

Some ancient societies saw this as a time of cleansing, while some religions saw this as a curse to be endured and suffered through. Make sure to think about this and do any research you need for the era, religion, culture, place, tribe, or whatever else you can think of if you want to be historically accurate. Some cultures even practice free bleeding. That means they do not try to capture or cover up the blood. Definitely not my choice, and frankly, I would think things would smell and attract bugs. That is just a whole new level of gross, if you’re writing a horror, I guess. If you are writing fantasy, you will need to decide how the culture thinks and feels about periods. Now onto the how-to. 

Let’s first cover blood collection. This can be done in many ways depending on the time period and/or place. Things that have been or are currently used are pads, tampons, cloth pads, menstrual cups, sea sponges, moss, fur, and more. 

Before we get into these, let me make sure that everyone knows that anything placed inside of a female’s nether regions comes with the risk of toxic shock syndrome (TSS). This is a very real and very deadly bacterial infection that enters the bloodstream though tiny abrasions, or mico cuts in the skin, and infects the organs. It can lead to amputations of fingers, toes, limbs or even death. It is thankfully rare. According to the National Institute of Health (in the United States), it is estimated that around 0.8 to 3.4 per 100,000 people are affected by TTS. Personally, that sounds like a high number, but Google has assured me it is rare.

Let’s start with pads. These are products that catch blood from outside of the body. Modern ones are thrown away after use, while cloth pads are washed and reused. In history, cloth pads have been made of many things. Wool, cotton, rags, moss, fur, knitted pads, grass, and more. Some of those things sound painful on delicate areas, and I am unsure of the absorbency of grass, but a girl has to do what a girl has to do. 

Unlike modern pads, historically, cloth pads were held on by being tied to a belt. Modern cloth pads have snaps or buttons to keep them wrapped around the underwear. Modern panties were invented toward the end of the 18th century, which is why belts or suspenders were required to hold them on before then. The use of cloth pads is where the phrase, being on the rag, comes from. 

The first modern pads to be used and thrown away were made by nurses in France. They were made of wood pulp because it was cheap. Manufacturers borrowed this technique, and by 1888 pads were sold commercially. At that time, the price was so high that most women could not afford them. It was in the 1920s they became more affordable and slowly grew in popularity. I suspect the great depression had a hindrance on the affordability of them, but that was slightly before my time, and I do not know for sure. In the 1980s, the manufacturers added an adhesive backing to keep them in place. 

While cloth pads are made of natural materials, modern manufactured pads are made primarily of bleached rayon, cotton, and plastics. There has been a lot of research about modern pads and their negative effect on women’s health, something I only learned after our home burned down, and somehow a package of pads mostly survived. Trying to understand why I stumbled upon an entire community that is antichemical and hates all things involving modern pads. Some of them can get very aggressive and downright scary about this topic, which would be an interesting twist to a modern story. 

There are also modern-day period panties. These are basically cloth pads built directly into waterproof panties. The waterproofing materials are actually breathable. That means that they do not stop airflow. They are washable, and many women use them today. They are most often saved only for that time of the month, because who wants to wear that when you don’t have to!

Next thing to cover is tampons. The word “tampon” comes from medieval France. I do not know what they called them before that. These are placed inside the woman to absorb the blood before it leaves the body. Fifth century BC Egyptians used papyrus leaves to make tampons, the oldest known tampons. Romans used wool wrapped around a stick. African women made them from grass, and the Japanese made them from paper. All of that sounds painful! 

Now if you think that weird items are all from the distant past, you would be wrong. In America, ocean-harvested sea sponges were sold as tampon alternatives until the 1980s. While the use of sea sponges as tampons dates back further than anything else on this list, it was actually the last one I learned about. In the 1980s, the University of Ohio did testing and found that these sponges still contained grit, sand, bacteria, and other contaminates. The risk of toxic shock syndrome is the number one concern with these. After this came to light, the FDA made selling them in the United States illegal. 

The first type of “modern” tampon was patented in 1931. These were made of cotton, with a string for easy removal. The first tampon applicators were trademarked in 1936. These were originally made of cardboard but have since been replaced with plastic. If you are wondering what they used before, then let’s say they had to insert and remove it themselves. It was messy, and we will leave it at that. 

Tampons are also bleached white, and we end up down the same bunny hole with angry people hating them. Again, more intriguing characters for modern books. Crazy, it must be all-natural, and nothing else, people. I feel like I should add hippy to the list, but not all hippies take things this far. 

Next is the menstrual cup. Menstrual cups also go inside the woman to collect blood. The first cup was patented in 1932. It looks nothing like the ones used today. Today menstrual cups are made of medical-grade silicon. These can last from five to ten years before needing a new one. They come in different sizes and lengths because, like men, women are not all the same down below. Most people believe this is very messy, but they are wrong. Menstrual cups are inserted and collect blood like a cup, hence the name. When it is full, or even before, it is removed and dumped out like any other liquid from a container. There is actually little or no contact with blood. This will take practice, and there is a learning curve. 

There have been confirmed cases of toxic shock syndrome with them; however, the number is significantly smaller than with any other inserted thing for periods. That said, proper cleaning is important to these, and it will need to be sterilized between each period. Sterilizing them, in this case, means boiling them in water for five minutes over a fire or stove, not the microwave! Let’s not get crazy! I will leave a link on my website if you want to learn more. 

Another thing women deal with during this time is pain in the form of cramps and backaches. This can be mild pain to severe and debilitating. Thankfully the debilitating ones are not common for most women. There have been many things women have used throughout history. Today, Midol, Tylenol, Aleve, or something similar are our go-to methods of dealing with cramps; painkillers have not always been an option. My grandparents used to make raspberry or willow bark tea to help relieve the pain. Other herbs used to make teas throughout history included catnip, ginger, lemon balm, motherwort, peppermint mixed with yarrow, and many more. Of course, there was always the option of alcohol to dull the pain. I don’t recommend that, especially when dealing with PMS. 

Later during the Victorian era, pills and potions became popular. They included everything from herbs to cocaine. During the 18th and 19th centuries, alcohol and herbs infused together became popular. Now we have modern-day painkillers. 

Another way to deal with cramps is with heat. Modern-day women take long hot baths or use a heating pad. There are now even rechargeable portable heating pads worn like a belt, and you can take them to work or wherever you are going if you need to. Keep in mind, a lot of modern-day, off the grid homes, have some type of solar, wind, steam, propane, or other way to produce electricity to recharge things. There are also the options of warming up cloth beside a fire, steaming fabric, or using a water bottle, not the kind you use to drink out of today. In fact, this kind looked more like a bag of water. It was first used with animal bladders and later with rubber before plastic and silicon became popular. Women would fill these with warm water and place them on the affected area. If you are writing modern with electricity, there is the standard heating pad or a cloth bag filled with rice and warmed for a minute or two in the microwave. Not too long, or you will burn the character! A heating method my grandmother told me of was having a small dog or cat sleep on your belly while you were sewing or doing other work that would allow this. 

Fun fact: To decrease the risk of toxic shock syndrome, you should always change tampons every four to eight hours, although read the instructions on the box. Not all tampons are the same, and this is a general rule of thumb. For the same reason, menstrual cups should be emptied every ten to twelve hours. Some smaller ones, like the Lily Cup Compact, say the max time is eight hours. Again, read the instructions. 

What could possibly go wrong? 

Likely to go wrong: Your character shifts, or her pad shifts, and there is leaking. It happens to every woman. 

Likely to go wrong: A period starts in the middle of the night, and things get messy. This is especially embarrassing for newlyweds. 

Likely to go wrong: Cramps make whatever work your character is doing much harder. 

Possible to go wrong: While on their period, your character goes swimming or maybe just gets wet, and the blood leaks out of the pad and onto their clothing. 

Possible to go wrong: Your character is still learning to use a menstrual cup and didn’t place it correctly, and things get messy.

Unlikely to go wrong: Nothing helps the pain of disabling cramps for your character. Maybe they try something that does not work, or perhaps they have nothing to try. 

Unlikely to go wrong: Your character gets toxic shock syndrome and dies. Depending on when and where the character develops it and how early they get help, there is as little as a 30% chance of death. However, there is as high as a 70% chance also. Those are both today’s numbers. Historically these chances would have been much higher. 

Improbable but technically still in the realm of possibilities: Your character never gets a period. It is rare, but a few cases have been reported of women who never have a period. These women are also unable to have children. Still haven’t figured out where the sign-up for no periods is. 

Improbable but technically still in the realm of possibilities: Your character has naturally conceived in her 60s. I know, that sounds insane!! However, it is believed that a Chinese woman, Xinju Tian, is the oldest woman to give birth after naturally conceiving at age 67. The Bible even has records of women conceiving at older ages. I know how exhausting it was to be pregnant in my 20s. No, thank you to pregnancy at that age for me! 

Helpful Links to Learn More:

History of Periods:,treated%20with%20respect%20by%20society

History of Tampons:

History of Menstrual Cups:

History of Sea Sponges:

History of Menstrual cramps:

Oldest Natural Pregnancies: