Period Problems And How To Manage Them...



Posted by Jeremy Windsor on Jan 22, 2021

Over the last year Dr Hannah Lock has been writing about a wide range of mountain medicine topics on her blog. With no shortage of experience, her posts offer real life, practical solutions to a host of medical problems that face those who are heading into the mountains. We can't recommend it enough! Here's an excerpt below to get you started...


"We can’t escape them, but you don’t need to let a period get in the way of enjoying your expedition or making it more challenging than it needs to be. Hopefully this information will empower you to make the decision that is right for you, by informing you of the many options that are out there. Every woman is different so what works for some may not work for others, but luckily there are lots of choices.   


Things worth considering...


-Expeditions may impact upon your regular cycle - in general, physical and emotional stress can influence menstruation, as can the physiological stress imposed by ascent to high altitude. Although changes in menstrual cycle hormone profiles have been documented, this is not an exact science and is different for every woman.

-What sort of activity and environment will your expedition involve and how may this impact upon your ability to manage your period? For example, six to eight hours of trekking daily with no "formal toilet facility" and little place for privacy means that as a woman, emptying your bladder isn't always straightforward (don't even get me started on a "she wee" - they work for some but not me) let alone managing a period!


Washing facilities can often be cramped and inhospitable!


-What level of hygiene can you realistically expect to achieve on your trip? For example, will you get a shower every day or are you trekking for ten days with only a bowl of warm water to wash with each morning?

-Do you normally have associated symptoms on or around the time of your period like breast tenderness or abdominal cramping – if so, will these be manageable on expedition?

-Will you be able to responsibly dispose of any sanitary products you use or is it best to consider reusable items such as a "mooncup"?

-Do you also need to consider contraception?


Toilet facilities at Barafu Camp (4645m) on Kilimanjaro


If you feel that managing your period on your expedition won’t be too challenging, that’s great, just remember to pack plenty of sanitary products (more than normal) with you and store them in dry bags or similar to keep them clean and dry.

For some women however, the thought of having a period during their expedition is not an option they want to consider. So here are some medical options available in the UK, after consultation with a medical professional, that can help you have more control by delaying or stopping your period:


Option 1 - Norethisterone

Quick Facts - A synthetic progesterone tablet that delays the onset of your period.

Advantages - Start three days before your period, it can delay it for up to 20 days. Contains progesterone and therefore does not increase the risk of clot formation.

Disadvantages - Needs to be taken three times a day. It is not an effective contraceptive. It can lose it's effect if you develop a GI upset.

Examples - Primolut, Utovlan


Option 2 - Combined Oral Contraceptive

Quick Facts - An oestrogen based oral contraceptive that is usually taken on a daily basis for 21 days. This is followed by a 7 day break (or the taking of inactive tablets) when ‘breakthrough’ bleeding occurs.

Advantages - Bleeding is generally lighter and less painful. It is an effective contraceptive. Packets can be taken "back to back" for up to 3 months to prevent symptoms.

Disadvantages - Needs to be taken daily. Oestrogen increases the risk of clot formation. It can lose it's effect if you develop a GI upset.

Examples - Marelon, Microgynon, Yasmin


Option 3 - Progesterone Only Pill 

Quick Facts - A progesterone based oral contraceptive "Mini Pill" that is taken daily.

Advantages - Contains progesterone and therefore does not increase the risk of clot formation.

Disadvantages - A tablet has to be taken at the same time every day. Bleeding occurs in the majority of women. This can often be irregular and unpredictable. It can lose it's effect if you develop a GI upset.

Examples - Cerazette, Cerelle, Micronor


Option 4 - Depot Injection 

Quick Facts - A contraceptive injection that is administered every 3 months.

Advantages - Contains progesterone and therefore does not increase the risk of clot formation.

Disadvantages - Bleeding can occur in the first few months

Example - Nexplanon


Option 5 - Implant

Quick Facts - A small plastic rod is implanted under skin that provides effective contraception for up to 3 years.

Advantages - Contains progesterone and therefore does not increase the risk of clot formation.

Disadvantages - Bleeding can occur in the first few months

Example - Nexplanon


Option 6 - Intra Uterine Device

Quick Facts - A small plastic hormone containing device that is inserted through the cervix and into the uterus. It can provide effective contraception for up to 5 years depending upon the type. It is often effective in reducing heavy menstrual bleeding and may eliminate bleeding completely.

Advantages - Contains progesterone and therefore does not increase the risk of clot formation.

Disadvantages - A limited amount of bleeding can occur in the first few months.

Examples - Jaydess, Kyleena, Levosert, Mirena


But, as with any drug, all of these options have the potential for side effects which affect people in different ways so it’s well worth trying them out before you’re due to leave on an expedition. Many of these options also take a few months to ‘settle into’ so again, trying things early is the key..."


Thanks Hannah! 

Hannah's blog can be found here.

Thanks also to Dr Debbie Miller for her advice in preparing this post.

If you have anything related to mountain medicine that you wish to publicise please get in touch!

If you would like to find out more about mountain medicine why not join the British Mountain Medicine Society? See this link for details.


1 thought on “Period Problems And How To Manage Them...

David Hillebrandt commented 1 month, 1 week ago
Great, simple advice. easily understood by a layperson. the mark of a GP experienced in communication! Thanks Hannah

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