Menstrual Cycles & Mental Health
Yoppie • October 27, 2021 • 5 min read
Yoppie looks at the myths, misconceptions, truths and realities of the relationship between mental health and your menstrual cycle. *Originally posted on Yoppie.com.
Premenstrual syndrome (PMS) is something that most people who have periods will experience. Hormones are powerful, and when they’re fluctuating (as they do before your period) they can make us feel pretty physically and emotionally out of kilter. Sometimes, the symptoms of PMS can go beyond just discomfort, manifesting as premenstrual dysphoric disorder (PMDD) – a severe form of PMS.
Unfortunately, PMS is common. From bloating and headaches to bad skin and sensitive moods, a whopping 90% of us will experience at least one PMS symptom before our period.
If that wasn’t enough, before our period, hormones can also amplify things like anxiety, depression and other mental health conditions we may already be trying to manage. Thanks, hormones!
In this guide, Yoppie explores PMS, PMDD, uncovering the unique relationship between your period and your mental health to help you get on top of PMS for good!
Why understanding mental health & menstrual cycles is important
Because hormones have a hand in almost everything going on in our bodies, they also affect our brains and therefore, emotions. This is why hormones can directly influence our mental health, even if that change is just periodic and linked to our monthly cycle.
Learning about what your hormones are up to during your cycle can help you understand why you might be feeling a certain way. And although it won’t give you the power to suddenly control how you’re feeling all of the time, it can help you make sense of it.
It also acts as a reminder to stop our inner voice giving us such a hard time, and to be kind to ourselves instead. With the right knowledge and self-care, we can turn meltdowns and angst into understanding and compassion.
Many people will also experience a mental health condition at some point in our lives, whether that’s just briefly or something that has to be managed long term. Understanding how our hormones interplay with existing mental health conditions can help to avoid misdiagnosing PMS or PMDD. We’ll go into more detail about this a bit later in the guide.
Hormonal changes and how they affect your mood
What may look like on the surface to be uncontrolled anger, destruction and rage may actually be truth, justice and love. – Layla Saad
In the days leading up to your period, you might notice a subtle emotional shift, or it could feel more like dropping off the side of a cliff.
As well as physical symptoms like cramps and headaches, PMS can include emotional symptoms like:
- Tiredness and fatigue
- Teariness and emotional vulnerability
- Heightened anxiety
- Feeling generally unsettled
All this can mean that we’re:
- Not feeling very sexy (our libido and lubrication goes AWOL)
- More sensitive to criticism (from ourselves and others)
- Reacting more strongly to triggers
- Wanting to withdraw and spend some time alone
We’ve all heard PMS being dismissed with shallow quips when emotional reactions are judged to be out of place (usually by people who don’t have periods). The mindless comment “are you on your period or something?” is poised to instil rage rather than bestow any gems of insight.
We’re not immune to occasionally having a good laugh at ourselves when we do indulge in a bit of PMS fuelled behaviour, but generally, PMS just makes us more sensitive to things that would probably already bother us. The rose-tinted spectacles we wore during ovulation have come off and tolerance levels can drop.
What causes PMS?
As with many issues around women’s health, due to a lack of scientific research, it’s not known for sure exactly what causes PMS. But, there is a strong theory.
During ovulation, the female sex hormones oestrogen and progesterone peak. During the luteal phase (the phase in your cycle after ovulation) both these hormones begin to fall. Then there’s a second smaller peak as progesterone rises, peaks then drops again.The rapid rise and fall of these hormones can affect chemicals called neurotransmitters in our brains, namely:
- Serotonin
- Dopamine
Both of these neurotransmitters influence mood, sleep and energy levels, with low levels sometimes causing:
- Sadness
- Sleep problems
- Irritability
- Anxiety
- Food cravings
All symptoms of PMS and PMDD
But it seems not everyone is affected in the same way. Some experts believe genetic differences mean some people are more sensitive than others to changing hormones and the influence these have on the brain. This is because research suggests that women who develop PMS or PMDD actually have similar levels of progesterone and oestrogen to those who don’t.
What are “normal” PMS symptoms?
Everyone is different, so putting a label on what’s normal isn’t really possible. The best thing to do is to work out what’s normal for you, and if your normal is ok with you!
Generally, PMS symptoms last for a few days to a week before the start of a period and – although pretty dang unpleasant – shouldn’t have a significant impact on your overall well being. But, this isn’t the case for everyone.
Common PMS symptoms
Not everyone experiences all PMS symptoms, but some of the most common are:
- Withdrawing and detachment
It’s not unusual to start feeling a little detached in the days before your period. Social gatherings and parties suddenly seem less than appealing and your motivation is at a monthly low. - Low sex drive
Oestrogen takes a nosedive in this part of the cycle and takes vaginal lubrication along with it. Although you might be feeling a little needier and happy to give and receive physical affection, sex is probably not high on your priority list. - Change in appetite
You could be craving more of certain foods around this time, or, your appetite could disappear. It’s common to feel like eating sweet, carb heavy ‘comfort food’ – but that doesn’t mean it’s good for your PMS. - Feeling anxious, irritable or sensitive
You might find yourself getting teary, feeling extra stressed or just unwilling to let go of an injustice you’d normally gloss over. Feelings of anxiety can also bubble up around now and you might find yourself feeling insecure or questioning your job or relationships. You may also find that you’re being self critical about your choices and feelings. - Feeling tired but finding it hard to sleep
Despite feeling fatigued and lethargic, you might find it hard to fall asleep at night. Experts believe it’s not uncommon to experience weird nightmares or daydreams.
The NHS outlines some more symptoms here.
If you believe PMS symptoms are having a recurring, lasting and significant negative effect on your wellbeing, it may be worth exploring the possibility of PMDD, and/or your overall emotional and mental health.
Around 20 and 40% of women experience moderate to severe premenstrual symptoms (PMS). But between 3 and 8% of women experience symptoms that prevent them from functioning in normal daily life. This is premenstrual dysphoric disorder (PMDD).
PMDD: What to look out for:
- If your relationships at home and work are suffering – for example, do you find yourself breaking up with your boyfriend at the same time every month, or feel like quitting your job despite enjoying it most of the time?
- If your inner critic becomes overwhelming and starts tipping into self loathing.
- If you find yourself having suicidal thoughts or urges to self harm.
- If you feel unable to cope with everyday events or responsibilities like working, cooking, going to appointments or even leaving the house.
- If you’re finding it impossible to concentrate or constantly forgetting things.
- If you’re experiencing heart palpitations or anxiety attacks.
There can often be a relationship between PMDD and other mental health conditions. In fact, PMDD and PMS can mimic the symptoms of other conditions and vice versa, leading to misdiagnosis. This is why if you think you may have PMDD, it’s important to speak to an understanding GP.
What can get misdiagnosed as PMDD or PMS?
To make things even more confusing, there are several conditions that can imitate or overlap with PMS and PMDD symptoms. Things like:
- Depression
- Anxiety
- Perimenopause
- Chronic fatigue syndrome
- Irritable bowel syndrome (IBS)
- Thyroid disease
The emotional symptoms of depression and anxiety can be really similar to PMS. It’s thought that around half of women seeking treatment for PMS also have one of these conditions. Depression and anxiety can be around for the entire month – but still, unfortunately, get worse before or during periods.
Handling and adapting to your cycles and mood
One of the best ways to make the most of your cycles and mood is to start tracking your cycle. Once you start figuring out a pattern, not only will you be able to predict more accurately when you’re about to start your period, but you may start noticing a significant pattern to your emotions each month.
There are loads of apps around that can help you track your cycle, but it may take some trial and error to find one you like best. You could even just use a notebook or paper diary.
Harnessing hormonal ebbs and flows
We can’t all feel at our best all of the time. A bit of self reflection and down time can be the perfect antidote to a hectic month. If you’re naturally a little introverted, having a great excuse to slow things down can be a welcome relief. It can be the perfect time to give yourself some much-needed space for self-reflection and a little extra TLC.
Understanding your own personal cycle gives you the opportunity to make plans knowing in advance how you might feel. PMS week may not be the best to try out that new dancing spot, instead, schedule some one-on-one time with a close friend, a night in with some good food or even just a bath or hitting the sack early.
If you’re feeling emotional or teary, it can be exhausting trying to bottle your emotions up. Allow yourself to cry if that’s how you feel. Finding an outlet like watching a weepy film or listening to music in a space of your own, on your own terms, can be cathartic.
Coping with PMS
As well as tracking your cycle and slowing things down just before your period, here’s some general self care and coping tips to help kick PMS to the curb.
Diet
The food we eat helps us regulate our bodily functions, and one of those functions is the transport of certain hormones. Eating well throughout the month is one of the best and healthiest ways to curb PMS symptoms.
Deficiencies in certain vitamins and minerals such as B vitamins like Vitamin B6, Iron, Magnesium can affect hormones and make symptoms associated with PMS, worse. Likewise, although you might find yourself craving those sweet, carby meals and snacks – but overloading on sugar can also worsen PMS symptoms.
Exercise
Exercise can help alleviate PMS symptoms. Especially aerobic exercise. If you’re not an avid exerciser, don’t be put off – you don’t have to join a gym or take up running. Exercise should be available in some form to everyone. Experiment to find one that works for you.
From walking, jogging, skipping (jump rope) and swimming to local classes like yoga, pilates and spinning – there’s lots to choose from. Even just switching up your route to work to incorporate 30 minutes walking each day could make a noticeable difference.
Rest
PMS can affect our body clocks, making it more difficult to sleep even if we’re feeling lethargic. To try and counter this, tune out for as long as possible before bedtime. Try putting your phone away (staring at your phone before bed can make it harder to fall asleep), dimming the lights and doing something you find relaxing before shutting your eyes for the night.
Ensure the room you’re sleeping in is ventilated (opening the window for a short period of time each day can help to increase oxygen levels in the room) and make your bed as comfortable as possible.
Essential oils like lavender can also help aid sleep, so popping a few drops on your pillowcase might help you drift off.
Stress management
Stress has a habit of making any symptom worse, including those of PMS. Some people find that massage, yoga and meditation really help.
Don’t feel guilty about saying “no”. Although it’s a good time to take stock, It might help to try and avoid having any big or important discussions around this time.
Stop smoking
Studies have shown smoking can make PMS symptoms worse, so, apart from the fact it can cause cancer – another pretty good reason to stop!
Treatment options
If your PMS really has you at the end of your tether, you might want to speak to a healthcare professional to see if specific treatments are worth looking into. As well as lifestyle and habit changes your doctor can suggest things such as hormonal medicines, cognitive behavioural therapy or antidepressants to help beat those monthly blues.
For more in depth info on tackling PMS, PMDD and mental health – stay tuned. We’re on a mission to arm you with the facts you need to feel on top of your menstrual health for your whole cycle, every cycle.
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A Beginner’s Guide to Menstrual Cups: A Sustainable and Practical Alternative
Menstrual cups have gained popularity in recent years as a sustainable and cost-effective alternative to traditional menstrual products. Made of medical-grade silicone or latex, these reusable cups collect menstrual fluid rather than absorbing it, offering numerous benefits for those who choose to use them. If you’re new to menstrual cups and considering making the switch, this beginner’s guide will provide you with essential information to help you get started. #### What is a menstrual cup? A menstrual cup is a bell-shaped device designed to collect menstrual fluid. It is inserted into the [vagina](https://nabtahealth.com/glossary/vagina/), where it forms a seal and collects the flow, holding much more liquid than a tampon or pad. The cup is reusable, offering a more sustainable option compared to disposable products. #### Advantages of menstrual cups: **Eco-friendly:** Menstrual cups reduce waste as they can last for several years with proper care. By using a cup, you can significantly decrease the number of disposable pads and tampons that end up in landfills. **Cost-effective:** Although menstrual cups have a higher upfront cost than disposable products, they are a long-term investment. Over time, using a menstrual cup can save you money since you won’t need to regularly purchase [pads or tampons](https://nabtahealth.com/articles/what-type-of-sanitary-product-is-right-for-me/). **Extended wear time:** Unlike pads and tampons, which typically require changing every few hours, menstrual cups can be worn for up to 12 hours, depending on your flow. This makes them convenient for overnight use and allows for uninterrupted activities during the day. **Lower risk of leaks and odor:** When inserted correctly, menstrual cups create a secure seal that reduces the risk of leaks. Additionally, since the fluid is collected rather than absorbed, menstrual cups do not cause the same odor issues that can arise with other products. **Health benefits:** Menstrual cups are made of hypoallergenic materials, making them suitable for people with sensitive skin or allergies. They also do not disrupt the natural pH balance of the [vagina](https://nabtahealth.com/glossary/vagina/), reducing the risk of infections. #### How to use a menstrual cup: **Choosing the right cup:** Menstrual cups come in different sizes and shapes. Consider factors such as your age, flow, [cervix](https://nabtahealth.com/glossary/cervix/) position, and whether you’ve given birth when selecting the appropriate cup. It may take some trial and error to find the perfect fit. **Sterilize the cup:** Before using a menstrual cup for the first time, sterilize it by boiling it in water for a few minutes. Ensure the cup is clean and dry before insertion. **Insertion:** Wash your hands thoroughly. Fold the cup using one of the various folding techniques available. Insert the cup into your [vagina](https://nabtahealth.com/glossary/vagina/), aiming towards the base of the spine. The cup will unfold and create a seal against the vaginal walls. **Removal:** To remove the cup, wash your hands and find a comfortable position. Gently pinch the base of the cup to break the seal, then carefully pull it out. Empty the contents into the toilet, rinse the cup with water, and reinsert if desired. #### Caring for your menstrual cup: **Empty and clean the cup:** Depending on your flow, you may need to empty the cup every 4 to 12 hours. Rinse it with water or wipe it with unscented, mild soap. Sterilize the cup between cycles by boiling it for a few minutes. **Store properly:** Keep your menstrual cup in a breathable bag or container when not in use. Avoid storing it in an airtight or plastic container to prevent odor and bacterial growth. Menstrual cups offer a sustainable, [cost-effective](https://www.lizzom.com/collections/lizzom-products), and convenient alternative to traditional menstrual products. While there may be a learning curve when initially using them, many people find them comfortable and reliable once they get accustomed to the process. By following the tips and techniques outlined in this beginner’s guide, you’ll be well on your way to a more sustainable and hassle-free period experience.
What are Sanitary Pads?
Sanitary pads are recognised worldwide. They are a [menstrual hygiene product](https://nabtahealth.com/what-type-of-sanitary-product-is-right-for-me/), designed for use by women during their monthly periods and also known as sanitary napkins or sanitary towels. #### **From simple beginnings…..** Sanitary pad designs in the 1960s incorporated flexible, thin, leak-proof polyethylene as the back sheet. Over time, sticky, elastic plastics were used, allowing the sanitary pads to be attached to a woman’s underwear directly, rather than hanging off a belt-type device. Later in the 1970s, designers grasped the idea of making plastic “wings” to be used to wrap around panties and place the pad exactly where it is required. #### **……to widespread use in the 21st century** Which brings us, more or less, to the present day, where sanitary pads are still very widely used globally by women during their monthly periods. They can also be used after childbirth when it is normal to have vaginal bleeding for a week or two. In fact, any flow of blood from the [vagina](https://nabtahealth.com/glossary/vagina/) can be easily absorbed and contained within a sanitary pad. Many young women choose to use sanitary pads when they initially start their periods, as it can take time to develop the confidence to use a [tampon](https://nabtahealth.com/what-are-tampons/). Today’s sanitary pads are produced from various materials, based on the brand, country of origin, and even style of pad. #### **How to use sanitary pads** Sanitary pads are worn externally, unlike menstrual cups and tampons that are worn internally. Sanitary pads should be changed regularly, depending on the period flow, i.e. how light or heavy the bleeding is. Provided the right absorbency of the pad is selected, leakage should not occur, meaning menstrual blood does not reach clothing and furnishing Sanitary pads are wrapped individually for easier usage and can be easily carried in your purse. #### **A pad for every flow type** Some of the most common types of pad are: • Regular: it is a middle-range sponginess pad. • Maxi/Super: A spongy bumper pad routinely used by women with heavy periods. • Overnight pads: Longer than regular pads, allowing more protection while lying down.Suitable for use during the night. • Maternity pads; Longer and thicker than maxi/super pads. Designed for women to use after childbirth, can also absorb urine. • Ultra-thin: A thin pad that may be as spongy as a Maxi/Super or Regular pad, but with a reduced amount of bulkiness. It is important to remember that, regardless of type, sanitary pads cannot be flushed down the toilet as they might cause a blockage. #### **The environmental impact of disposable sanitary pads** Establishing exactly how much plastic waste comes from sanitary pads is tough, as it is labeled as medical refuse. The plastic used in sanitary pads is not eco-friendly and can [lead](https://nabtahealth.com/glossary/lead/) to environmental and health hazards as one pad takes hundreds of years to decompose. An increased environmental awareness is one reason why, recently, women have been looking for alternative, more eco-friendly sanitary products. [Reusable pads](https://nabtahealth.com/the-use-of-reusable-sanitary-pads-in-sub-saharan-africa/) and washable [menstrual cups](https://nabtahealth.com/what-are-menstrual-cups-and-why-are-they-growing-in-popularity/) are both becoming more widely used. Both have actually been in existence for a long time, but improved designs make them a viable alternative for the modern woman. Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#1960787575785977787b6d78717c78756d71377a7674) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * “How Tampons and Pads Became so Unsustainable.” _National Geographic_, 18 Oct. 2019, [www.nationalgeographic.com/environment/2019/09/how-tampons-pads-became-unsustainable-story-of-plastic/](http://www.nationalgeographic.com/environment/2019/09/how-tampons-pads-became-unsustainable-story-of-plastic/). * “What Is a Sanitary Pad?” _Menstrupedia_, [www.menstrupedia.com/articles/girls/sanitary-pad](http://www.menstrupedia.com/articles/girls/sanitary-pad).
What Type of Sanitary Products is Right for me?
From the time that a female starts her periods when she enters [](https://nabtahealth.com/what-is-puberty/)[puberty](https://nabtahealth.com/glossary/puberty/) until she reaches [](https://nabtahealth.com/about-the-three-stages-of-menopause/)[menopause](https://nabtahealth.com/glossary/menopause/) and stops having periods, menstrual hygiene will become something that she has to carefully consider. Most women menstruate for about 40 years and regular periods are a good indicator that a female is reproductively healthy. Although, unfortunately there are exceptions to this, for example women with [](https://nabtahealth.com/what-is-endometriosis/)[endometriosis](https://nabtahealth.com/glossary/endometriosis/) often have periods that appear normal. As menstruation is such a fundamental part of being a woman of reproductive age, taking the time to explore and sample the available sanitary products can help make periods more manageable. Deciding on which sanitary products to use can be influenced by a range of factors, including: * Cost * Environmental impact * How often the product will need changing throughout the day * Local availability * Heaviness of flow * Personal preference and/or recommendations by friends and family. The range of sanitary products available today means that the majority of women are able to manage their periods safely, comfortably and with dignity; in contrast to days gone by when old rags and sheep wool were commonly used to soak up menstrual blood. **Sanitary pads** ------------------- A common choice for girls who have only just started their periods. [Sanitary pads](https://nabtahealth.com/what-are-sanitary-pads/) are also known as sanitary napkins and sanitary towels. They are narrow pieces of absorbent material that fit directly into the underwear. Easy to use and change, they are available in different absorbencies to suit differing flow rates and times of the day. Some have wings attached to help secure them in place and reduce the risk of stains or leaks. Disposable sanitary pads were first used in the early 1920s, they gave women the opportunity to manage their periods discreetly, as there was no longer the need to wash and dry the bulky homemade versions publicly. Now, with advancements in manufacturing and material availability and a general public who are becoming increasingly environmentally driven, there is renewed demand for reusable sanitary pads, to avoid the high plastic wastage that comes from most disposable variants. [Reusable sanitary pads](https://nabtahealth.com/the-use-of-reusable-sanitary-pads-in-sub-saharan-africa/) are made from new or old materials such as sheets, pillow cases, and towels. They are made from pure cotton, as it is the best material for absorbing and also the most comfortable to wear. **Tampons** ----------- Often preferred over sanitary pads by dancers, athletes and swimmers, [tampons](https://nabtahealth.com/what-are-tampons/) are worn internally. A simple concept, they are devised of a wad of cotton attached to a string. Some come with a plastic applicator for ease of insertion. Once inserted into the [vagina](https://nabtahealth.com/glossary/vagina/), they expand slightly to absorb menstrual blood. They will typically need changing every 4 to 6 hours and, as such, are not ideal for wearing overnight. In the 1980s, an association between tampon use and Toxic Shock Syndrome (TSS) was reported. Whilst the overall risk of developing TSS remained very low, the link between it and tampon use was enough to put some women off using them for prolonged periods of time. Like disposable pads, tampons incur significant plastic waste and many women today strive for alternatives that are more environmentally friendly. **Menstrual cups and disks** ------------------------------ A [menstrual cup](https://nabtahealth.com/what-are-menstrual-cups-and-why-are-they-growing-in-popularity/) is a reusable hygiene product. The cup is made from medical-grade rubber or silicone, it is small and funnel-shaped and is inserted into the [vagina](https://nabtahealth.com/glossary/vagina/), where it forms a seal and collects menstrual blood. There are disposable menstrual cups, but it is the reusable ones that have really been growing in popularity in recent years. The menstrual cup holds up to 38 ml fluid, meaning it requires changing less often than a sanitary pad or tampon; it also has fewer of the negative associations with TSS that tampons have. Whilst it can take a few attempts to master the [art](https://nabtahealth.com/glossary/art/) of insertion, leakage rates are low once the cup is in position. Reusable menstrual cups should be washed and wiped clean before each use and sterilised at the end of your period. Modern menstrual cups are very durable and can last for up to 10 years with proper care. Menstrual disks and cups are similar as both are inserted into the [vagina](https://nabtahealth.com/glossary/vagina/) and both collect blood rather than absorbing it. Disks typically sit higher up, where the [vagina](https://nabtahealth.com/glossary/vagina/) meets the [cervix](https://nabtahealth.com/glossary/cervix/) (the [vagina](https://nabtahealth.com/glossary/vagina/) fornix). Unlike cups, disks are usually not reusable and will need to be discarded after use. They can also be slightly messier to remove than cups. ### **_Advantages of menstrual cups and disks_** * They are affordable. * Potentially safer than tampons * Hold more blood than other sanitary products, meaning you can go longer without changing them or emptying them. * The reusable varieties are more eco-friendly than disposable pads or tampons. ### **_Disadvantages of menstrual cups and disks_** * Emptying them can be messy. * In very rare cases, may cause an allergic reaction. However, most modern varieties are made from hypoallergenic materials. * Vaginal irritation, particularly if not accurately inserted. * Hard to remove or insert. **Period pants** ---------------- Period underwear ([period pants](https://nabtahealth.com/what-are-period-pants/)) are a relatively new addition to the portfolio of sanitary products. These are more like normal underwear, except that they have additional layers of material built in to absorb any period blood. There are different types of pants available for light, medium, and heavy flow days. They can be worn alone, or as a back-up alongside tampons or menstrual cups. Fully reusable, they are another of the more environmentally-friendly options and, because there is no need for any internal insertion, they are a good option for those who are hesitant to use tampons, cups or disks. These special pants can also provide welcome relief for those who experience urinary incontinence. In conclusion, there are now a large selection of products that allow you to go about your normal life whilst on your period each month. Selecting the right product will minimise the risk of leaking, discomfort, embarrassment and inconvenience. Consider a women health test to learn more on your health. Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#146d75787875547a757660757c717578607c3a777b79) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * Eijk, Anna Maria Van, et al. “Menstrual Cup Use, Leakage, Acceptability, Safety, and Availability: a Systematic Review and Meta-Analysis.” _The Lancet Public Health_, vol. 4, no. 8, 1 Aug. 2019, pp. E376–E393., doi:10.1016/s2468-2667(19)30111-2. * Hajjeh, Rana A., et al. “Toxic Shock Syndrome in the United States: Surveillance Update, 1979–19961.” _Emerging Infectious Diseases_, vol. 5, no. 6, 1999, pp. 807–810., doi:10.3201/eid0506.990611. * “How Tampons and Pads Became so Unsustainable.” _National Geographic_, 18 Oct. 2019, [www.nationalgeographic.com/environment/2019/09/how-tampons-pads-became-unsustainable-story-of-plastic/](http://www.nationalgeographic.com/environment/2019/09/how-tampons-pads-became-unsustainable-story-of-plastic/). * “Menstrual Cups vs. Tampons: Things You Might Not Know.” _Mayo Clinic_, Mayo Foundation for Medical Education and Research, [newsnetwork.mayoclinic.org/discussion/menstrual-cups-vs-tampons-things-you-might-not-know-about-the-cup/](https://newsnetwork.mayoclinic.org/discussion/menstrual-cups-vs-tampons-things-you-might-not-know-about-the-cup/). * “Tired of Tampons? Here Are Pros and Cons of Menstrual Cups.” _Health Essentials from Cleveland Clinic_, Health Essentials from Cleveland Clinic, 15 Nov. 2019, [health.clevelandclinic.org/tired-of-tampons-here-are-pros-and-cons-of-menstrual-cups/](https://health.clevelandclinic.org/tired-of-tampons-here-are-pros-and-cons-of-menstrual-cups/).