Dearest guys, I know a lot of you get squeamish hearing about women’s reproductive health, especially periods. I want to encourage you to read this anyway. If you have women in your life, they are going to be dealing with this stuff and you can’t just stick your head in the sand and pretend they won’t. Plus, a little knowledge (and empathy) will go a long way towards keeping the women in your life healthy and happy, especially in trying circumstances. So man up and read about women’s reproductive issues! (There are several items in the below essay that apply to all genders, anyway.)
I have been thinking a lot about my period lately. I don’t actually enjoy thinking about it, but my body didn’t give me a choice. My periods were getting obscenely heavy and the cramps were enough to double me over and cause me to cry. In public. I finally went to the doctor when it got to be too much to bear and, after a thankfully brief time while I waited to find out if it was cancer, it turns out I had a fibroid. Around 80% of women will have a fibroid at some point in their life. Some barely notice it, some are severely affected. Aside from heavy bleeding and excruciating pain, they can also affect your fertility.
I’m really lucky that my doctor got me in for surgery quickly. As with most things in my life, it started me thinking about what I’d have done if the same thing occurred after the SHTF. I wondered how I’d handle just a normal period, or menopause when the time comes. (Which is closer than I like to think about – am I really turning 40 this year? Eep!)
For the purposes of this post, I’m going to go with the premise that everything has broken down – international trade, cross-country shipping, etc. and that we wouldn’t have access to regular medical care, either medicines or surgeries. However, I’m not a doctor, nor do I play one on tv, so please consult a medical professional if you have issues or in-depth questions. None of the below is intended to diagnose or treat you – it’s just a blog post. If you’re having trouble go see a doctor. Not to mention that I’ve only brushed the tippy-top-tip of the iceberg on all these subjects.
Ah, the one time of the month when I could actually believe in some old God who was pissed at women and cursed us with a period. But, no matter what I feel about the thing, I still have to deal with my menstrual cycle. The typical woman uses either a sanitary napkin (aka “pad”) or a tampon. The good news is that reusable pads and tampons can be made pretty easily. There’s also the menstrual cup if you’re up for using something like that.
Women have used rags for millenia, but thankfully our technology has improved. There are tons of patterns online to help you make your own with only a little sewing skill needed. I especially like Precious Star Pads‘ YouTube channel for information on how to use and clean reusable pads. Now, I will be honest. I haven’t had the courage to try them myself. I have a bit of mental squick factor on the subject. I’d like to get over that and move over to something more sustainable. I do have the materials and pattern squirreled away just in case I ever need/am able to change over.
You may find that your period changes during a SHTF. Extreme stress can affect your period by either bringing it early or keeping it away. Lack of nutrition can also make you amenorrheic (cause you to not have a period). In the short term you probably won’t have any ill effects from not having your period, but over the long term it can cause infertility, osteoporosis, and hormonal imbalances.
Regular exercise, eating healthy, the occasional beer, and limiting your salt intake will help regulate your periods. More regular periods will help you plan for and work around any days with severe cramps or excessive flow. As miserable as it sounds, exercising while cramping will actually help deal with the pain.
Fibroids, PCOS, and other reproductive health issues
There are many issues that can affect women’s reproductive systems, and unfortunately a lot of them cause a lot of pain. PCOS, fibroids, endometriosis, PID – the list goes on. The other problem is that most treatments rely on medication or surgery to mitigate the symptoms. It’s tough because most of them affect fertility, so not only can you experience excruciating periods, you can also have trouble conceiving.
How do you manage the pain while still getting your daily chores done? There are some things that will help mitigate the symptoms, at least. Most of the tools are the same you can use to deal with painful periods. Eat lots of leafy vegetables, limit your sodium and sugar intakes, and exercise regularly. I know that doesn’t sound terribly practical, especially in a SHTF scenario, but it’s actually shown to be effective in pain management. You can also have a beer – hops are shown to help with hormone regulation. Dandelion tea can also help regulate your hormones and ease discomfort.
Simple things like yeast infections can be hard to manage after an apocalypse. Hygiene becomes especially important as continued high stress can actually change your body chemistry. If you aren’t able to bathe for long stretches things can go from unpleasant to unbearable pretty quickly. Keeping your sugar intake low can help prevent yeast infections. Once you have one, if you can’t find Monistat, try yogurt. Yeah, sounds weird, but the active cultures combat the candida fungus.
Until the 1950s (yes, you read that right, the fricking nineteen-FIFTIES!) childbirth was the leading cause of death of women*. It still is one of the main causes in the developing world – something like 90%+ of maternal deaths happen there. It’s even still the 6th leading cause of death for women in the United States. That is pretty scary when you think about it. A lot can go wrong with pregnancy, from start to finish.
So in a SHTF situation you want to give you and your baby the best chance of, you know, not dying. Someone will need to ensure the survival of the species, right? The good news is that preparation here is worth 10 pounds of cure. Keep your weight in check, keep active leading up to the birth, and eat as healthy as possible to have your body in top condition for its coming challenge. The healthier and stronger you are pre-labor, the better you’ll be on the day you pop out the little one.
Make sure that anyone assisting washes their hands first. I know that’s a simple thing, but you’ve basically got a pipeline to your internals between your legs. Bacteria can travel on the hands of someone helping to deliver a baby and cause terrible infection. Wash your own hands and vaginal area pre-delivery, too.
Note that you probably will not even realize you’re pregnant for a lot longer than before a collapse. How do you know if you’ve skipped your period because you’re pregnant as opposed to because you’ve been under constant stress for the past three months as you try to escape a major city?
* true – a lot of that had to do with doctors not understanding germ theory. Maternal death rates actually increased around the turn of the 20th century as women started going to hospitals to have their babies, then in the 40s and 50s rates started to drop again.
Birth control and STD prevention
If you plan to have sex after the SHTF, you need to think about birth control and STD prevention. Shelf life for condoms is about five years, so having some included in your preps is a good idea, but not the only thing on which to rely. True, no method is 100% certain, but the Pill and condoms are 98% effective when used properly. So going to other methods is definitely a concern once your little pink packet of pills or your black box of condoms runs out. Diaphragms last up to 10 years so they may be a good alternative to keep on hand.
Family planning isn’t truly as new as it feels. The condom as we know it was invented in the 1830s, though variations go back to the 15th century (maybe even back to ancient Egypt or Rome, though the jury’s out on it). But there are other methods, too. None are as effective or safe as condoms or hormonal birth control. There’s rhythm/counting your cycle, pulling out, even cervical mucus examination. I certainly wouldn’t feel qualified to do that last one, but it’s the most effective option. And of course, nothing is as certain as abstinence, but we’re assuming that you don’t want to be abstinent for the rest of your life just because the world fell apart.
Then there’s the touchy and challenging subject of abortion. This is a decision you and your partner have to make in connection with your ethics, morals, and religious views, and if any law enforcement survives, the laws of your location. I highly recommend the book “Contraception and Abortion from the Ancient World to the Renaissance” by John Riddle. The book discusses how this was managed prior to modern medicine, and how we lost that information when modern medicine took over. It’s fascinating.
With regards to STDs/STIs, there’s no way to prevent them without condoms (and even condoms aren’t 100%). But there are ways to mitigate the risks. Monogomy is the first and most powerful. Whether that’s monogomy between two people or five, keeping your sexual partners limited to each other you limit the likelihood of picking up an infection. Far less effective is a quarantine period. This is particularly ineffective for asymptomatic carriers or carriers that are in the incubation period.
I don’t know about you, but menopause scares me. Stories of hot flashes, memory loss, irritability, and all the other fun that comes with it make me want to run screaming. But I know that I don’t get to pick if or when I go through menopause. Many of the things that help mitigate menstrual issues are the same things that will help deal with menopause. Yes, the old “eat healthy, exercise, and limit sodium” refrain. Some herbal teas may help, but none have been shown to do anything in clinical trials. Other than the benefit of a break for a cuppa, of course. Do avoid alcohol and caffeine, as they will exacerbate symptoms.
Consent, sex work, and rape post-SHTF
This is a really, really broad category and I feel like this heading could be the subject of three or four months of essays, but for this post I’m going to broad brush these subjects like crazy. First of all, the SHTF does NOT mean that consent goes away. It doesn’t mean that you no longer have the right to chose who you want as a sexual partner. You still get to decide what happens with your body and with whom you share it and how far you go.
That said, some people will use society’s collapse as an excuse to ignore the rules. Rape is a thing (and yes, rape can happen to men, too) that a lot of us are going to have to deal with in a post-SHTF world. I’m not a counselor, but I do know that rape is never the fault of the victim – NEVER. I also know that you can build a healthy, happy life after a rape, even if it takes some time. You may need help, and it’s ok to ask for it.
This next topic is one that a lot of people may find raises their eyebrows. If you choose sex work as a profession, that’s ok! As long as you make the choice and you can set your terms, go for it. There is no shame in it. The unfortunate thing about most sex work – today or in a total collapse – is people are forced into it instead of choosing to work in the industry. So, if after an apocalypse you choose to trade sex work for food, money, what have you, that’s ok. Just be aware of the risks, including STIs/STDs, unwanted pregnancy, or sexual violence by people who don’t respect sex workers.
Luckily, you can manage most daily reproductive issues like your period without modern medicine. There are ways to manage and mitigate other issues. Don’t get me wrong – I’m not knocking modern medicine. I am so grateful for the easy surgery in a nice little hospital. I’m grateful I can purchase the supplies or medicines I need to make life easier. But, should those not be available I know that there are backups and other ways of dealing with this. I mean, modern medicine is barely 300 years old and women have been dealing with this for millenia. I think we’d manage.
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