By Bethan Davies, Newcastle University and Becky McCerery, Northumbria University
This article is republished from AntarcticGlaciers.org. Read the original post.
Menstruation is still sometimes seen as a taboo topic but it is something a menstruating person will have to consider when planning or undergoing fieldwork in remote environments. We need to stop shying away from these conversations and in fact incorporate briefings outlining facilities and disposal of waste menstrual products into the standard pre-departure rundowns for all field-staff and students.
This article is aimed at both people who menstruate, and also fieldwork leaders who wish to better support their team. Note that neither of us are medical practitioners, and we recommend speaking with your healthcare provider or gynaecologist as early as possible in the first instance.
In this article, two women seek to share their experiences of menstruation whilst undertaking fieldwork and share some recommendations. We hope these thoughts and some of our suggestions and recommendations may be useful to people who may either be menstruating themselves, or acting as fieldwork leaders and considering how to best support their colleagues and students. Furthermore, menstruation products are constantly evolving, meaning that there are some new products available that not everyone may be aware of or have experience of. A chat with your healthcare provider well in advance of any planned fieldwork is advisable.
Some of these recommendations for menstruation in the field rely on the ability to accurately predict the onset of menstruation which will vary person to person. If you have a regular cycle, it may be worth trying a free period tracker app for a few months prior to fieldwork (however, one should note the privacy policies of these carefully, especially re. abortion rights or selling of data in countries where abortion is illegal) . If you have an irregular cycle and period tracking is unreliable, we hope some of the tips in this post will still apply to you but recommend some extra planning with your healthcare provider well in advance of your fieldwork.
Make the facilities available for the day clear
If you are a fieldwork leader, you can resolve a lot of anxiety in your team or students if you are very clear in advance about what facilities are going to be available each day. Ideally you would plan on three comfort breaks (mid-morning, lunch and mid-afternoon) per day, as well as before and after the day’s activities. Knowing what explicitly to expect each day will alleviate a lot of problems.
Don’t forget that many students may not have experience of protracted fieldwork, and may have limited tools or knowledge about how to manage in the absence of toilet facilities. These people need support in order to feel less anxious in the field.
Facilities aren’t always available
Sometimes it is just not possible to arrange a bathroom. Glaciers and glacial landforms, for example, are typically located at the head of a valley, and require a full day out to visit. So, what are your options?
Medication prescribed by a healthcare provider or licensed pharmacy (Superdrug, Boots, etc) can be used to stop or delay menstruation as well as help with period, PMS, and PMDD symptoms. The following website is a helpful tool primarily used for contraceptive purposes but also provides useful information on medication brands, active ingredients, possible side effects and user experience which you may want to take with you to an appointment with your healthcare provider – The Lowdown.
It is worth noting that if you do opt to start a new hormonal medication it can take 3-6 months for side effects such as breakthrough bleeding, period frequency, or amenorrhea (absence of menstruation) to settle.
Fieldtrip leaders should note that not everyone is able to take hormonal contraceptives or medication to stop or control their periods, for a wide variety of reasons. Further, hormonal contraceptives do not always stop bleeding.
Hormonal medications with the primary use as a contraceptive are a popular choice for managing menstruation. This may be the most appealing choice if you are already taking a hormonal contraceptive.
Speak with your healthcare provider or sexual health clinic about what options you have that may control menstruation. The website Sexwise has a lot of useful information, and is supported by the FSRH.
Your choice of hormonal medication will be very individual and subject to personal preference, but some people may find that menstruation stops entirely with some hormonal medications, such as the coil, implant, or progesterone-based pills (although this is not guaranteed!). You may also find that if you are on the combined contraceptive pill (estrogen and progesterone-based) you can skip your pill free days or run packs together, but check with your healthcare provider beforehand. There will be a lot of individual variation depending on preference and co-morbidity.
People may find that they need to try several options to find one that works for them, so this process should begin several months ahead of any anticipated fieldwork.
Even if people on hormonal menstrual control do not usually or frequently have periods, it’s worth taking some hygiene products and ziploc bags in case of breakthrough bleeds.
Period delay medications
A second option is a period-delay medications. Certain medications can be prescribed by a doctor or a pharmacist that can, if taken at the right time, delay menstruation by a few days to weeks. The advantage is that this is a short-term measure meant to delay a particular period, so may be useful for people who don’t normally want to take hormonal medications, and would not affect fertility. Again, this is typically a progesterone-based medication. Some family doctors are now also prescribing a shorter course of contraceptives for period delay.
You will typically take the medication a 2-3 days before the onset of menstruation and keep taking it until you’re ready for your period to start. Your period should then start 2-3 days after stopping the medication and will mark the first day of your new cycle. We recently used this method before 2 weeks of remote fieldwork and it worked a charm! In this case, I tracked my cycle and took the medication 3 months in advance to alter my cycle so that I did not have to rely on taking medication regularly in the field. However, you can take this medication when needed but bear in mind that there can be side effects which vary by the individual.
This technique is only really appropriate for shorter trips of up to two weeks. This is because the medications can be a higher dose, and so one should not take them for a prolonged period of time. If your expedition is longer than 2 weeks, then we recommend discussing alternatives, such as a hormonal contraception, with your healthcare provider.
It should be noted that this is not a contraceptive. We recommend speaking with your healthcare practitioner well in advance of any fieldwork, so that you can experiment or practice a few cycles ahead.
Many people who we have spoken with highly recommend reusable menstrual cups. Menstrual cups are an intravaginal device (worn inside the vagina much like a tampon) and are made from medical grade silicone. The advantage over disposable hygiene products is that these can comfortably be worn for up to 12 hours, meaning most field days can easily be achieved without having to change products. The length of time you can wear your cup without having to change will also depend on how heavy your menstrual flow is. Different brands will have different capacities but can typically hold up to 30ml liquid.
If your cup gets full it may leak, so some people with particularly heavy flows may also opt to wear liners or period underwear as a back-up! Some people with heavy flows find that the menstrual cup doesn’t last the full day, but may last longer than a tampon.
Upon return to base, menstrual cups can be rinsed in a basin or sink and reused. After each cycle they can be sterilised using boiling water for 7-10mins (brand dependent). This means that they can be used even when camping deep-field, do not generate waste, and will last you years if taken care of properly! A fieldcamp leader can make life much easier for people who menstruate by clearly providing and labelling a pan that can be exclusively used to wash and sterilise menstrual cups, and ensuring that people have space and privacy do to so.
Some people may find menstrual cups uncomfortable, and we recommend trying a few different sizes and brands if this is the case. Again, the key is preparation, and experimenting ahead of time to get to know your body. Put A Cup In It is a menstrual cup comparison chart that can help you find the right cup for you based on; cervix height, cup capacity, and firmness etc.
It is worth noting that although using menstrual cups is less likely to cause TSS (toxic shock syndrome) than using tampons as there is no absorbency component to their use, any intravaginal device does carry risk. TSS is a rare condition and so long as you follow the guidelines issued by the manufacturer they are extremely safe to use but it is still important that you familiarise yourself with the symptoms of TSS. If you have concerns, Healthline have a handy post on how to safely use menstrual cups.
Many people swear by reusable and washable menstruation underwear. The advantage again is that they can be used all day without being changed and don’t contribute to any waste. Multiple pairs can be used and washed over a menstrual cycle but once full they will need to be washed before they can be used again. They therefore may not be ideal in the deep-field without washing facilities or if privacy whilst washing them is desired. However, they could also be used as a backup for other tools such as menstrual cups or tampons.
Preparation is key, and we recommend carrying in your rucksack a ziploc bag, some wet wipes and a spare pair of underwear that can be easily changed into, if desired. This should be achievable hiding in a river cutting or behind a large rock. Fieldcamp leaders can help by making washing facilities available.
Some people find these tight and uncomfortable to wear, so experiment to find if they are right for you. We’ve seen a few recommendations to try going up a dress size if the underwear is too tight but they should fit snugly to prevent leaks. Modibodi have a great ‘How it Works’ page to help you find the best underwear for your flow, the occasion (hot days, heavy exercise etc), and fit. They also supply ranges with extra protection for bladder leaks and incontinence.
Disposable hygiene products
If you prefer disposable hygiene products then there is no reason to change whilst on fieldwork. We recommend bringing wet wipes, hand sanitiser and tissues or a pee rag along with a few ziploc bags to facilitate changing pads and tampons whilst crouched behind a rock. Don’t forget to put all your trash into a ziploc bag or similar to dispose of appropriately upon return to base. You can cover the bag in marker pen or electrical tape for more privacy of the contents if required. Dog poo, nappy or specific menstrual waste bags can be useful as they’re opaque and scented, and some are available in biodegradable materials.
Fieldtrip leaders could consider having an emergency supply of materials available, and making it clear that these are easily available from a designated person.
Those of us with painful periods have the added bonus of pain management to contend with in the field! The most important thing to note here is to try and replicate whatever you do at home – be that the use of anti-inflammatory medication such as ibuprofen or heat treatments. If you’re an avid hot water bottle user then discrete heating pads made specifically for period pain relief are a great option if hot water is limited in the deep-field. They are typically single disposable pads but can last for up to 12 hours! You can find them relatively cheaply in the pharmacy such as these Cura-Heat patches from Boots.
If you are on any particular prescription medications for painful periods and/or conditions such as endometriosis or polycystic ovary syndrome for example, it is important you bring enough medication for your full field campaign. Fieldcamp leaders should familiarise themselves with these conditions so they are in a comfortable position to provide support to field party members should they need to.
Going to the toilet
It would be appropriate here to add a comment on how to do what we term a ‘wild wee’, otherwise known as a ‘wee with a view’! Fieldwork leaders should bear in mind that some of their female students may be very anxious about this, and inexperienced.
If you usually crouch or sit to urinate, then a ‘wild wee’ is very easy. Look for somewhere a little hidden, such as behind a rock or tree or in a gully. Whip down your trousers and underwear all the way to your ankles, crouch low, and urinate. You can use some hand sanitizer if required. Ensure any trash is packed into a ziplock bag and returned to base for appropriate disposal.
You can consider using a ‘pee rag‘ for a sustainable, waste-free alternative to tissues and toilet paper. Carrying a small bottle of hand santiser is important to stay hygienic.
For a solid deposit, we recommend digging a hole, far from any sources of drinking water. Bury the waste. Used tissue paper should be burned with matches and the ashes buried, or put the used tissue paper in a ziploc bag to dispose of later. Ensure you wash your hands with water or hand sanitiser. Local areas may have more specific local guidelines and fieldworkers should appraise this before fieldwork.
If you can see people, and there aren’t many opportunities to hide, then if you face them, all they can see is your clothing. For added privacy you can place your rucksack in front of you. If need be, you can let people know that you’ll catch them up in a few minutes.
Some people swear by a ‘she-wee’, which allows them to stand whilst urinating, without removing all their lower clothes. We recommend a lot of practice before using these in anger, as otherwise they are messy!
Culture and attitude
Fieldwork leaders, it is important that you culture an atmosphere in your team where people feel supported to urinate or go to the toilet. Many people have anxiety about this, and some will even avoid drinking to prevent having to urinate in the field. This can put their health at risk. In our opinion, a matter of fact attitude and a statement at the start of the fieldwork is best to encourage people to feel supported. Don’t assume that women and people who menstruate have it all figured out and that it will all work out. Your team needs your support here.
Fieldwork leaders can support their team by ensuring that facilities for the day are explicitly made clear, and should aim to include regular comfort breaks where possible. They should provide washing or other facilities, and should discuss this with the group in advance of fieldwork. Ideally they should keep a stock of emergency supplies, and brief themselves and fieldworkers on how to obtain access to medical care, including pregnancy tests.
About the authors: Bethan Davies is a Senior Lecturer in Physical Geography at Newcastle University. Becky McCerey is a Physical Geography Postdoctoral Research Fellow at Northumbria University.
Suggested Further Reading
Bastia, T., Hope, J., Jenkins, K., Lemanski, C., Meth, P. & Moeller, N. et al. (2022) Navigating the challenges of fieldwork and childcare: Revisiting ‘muddy glee’. Area. https://doi.org/10.1111/area.12834
Bracken (née Bull), L. and Mawdsley, E. (2004), ‘Muddy glee’: rounding out the picture of women and physical geography fieldwork. Area. https://doi.org/10.1111/j.0004-0894.2004.00225.x
Leyland, J., Geoghegan, H., Hall, S.M., Latham, A. & Souch, C. (2022) Classics Revisited: ‘Muddy glee’ – What geography fieldwork means in the current moment. Area. https://doi.org/10.1111/area.12838