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How do women pee and manage periods while climbing?


This post was written by Andrea Nicole.


You Or Us Or Uterus

Having a uterus is a lot of work, but it’s even more work on a big wall. Although I’ve climbed long multipitches in the past, I was always on the ground by the end of the day to take care of business. However, managing your period on a big wall - when you’re on the wall for several days at a time - is a completely different ballgame.


My first big wall was Leaning Tower for the Dano jump, and I ended up bleeding onto one of my only two pairs of pants on the very first day. Thus, I ended up wearing my one unbloodied pair the rest of the time. Not a huge deal, but I also learned on that project that hauling sucks, so consequently I now only take one pair of pants up a wall, making the stakes for managing my period effectively higher.


In the video, I discussed pads, tampons, and reusable period underwear. Several comments mentioned menstrual cups, and I think this is worth discussing. I didn’t address them in the video because the thought of using one on a big wall didn’t even occur to me - the logistics of emptying and cleaning one at belays seemed a lot more cumbersome than just swapping a tampon or pad. However, if you have experience with a menstrual cup on a big wall or a setting that simulates the challenges that are relevant to a big wall, please don’t be afraid to share your thoughts. A community of experience is more valuable than that of one gal who has two big wall periods under her belt. Plus, I’m always on the lookout for period solutions that create less waste, so if I could make menstrual cups work on a big wall, I’m super down.


As an aside, this content is obviously geared toward people who have periods. There are a variety of options that minimize or avoid periods altogether (usually hormonal contraception that either regulates or alters the frequency with which menstruation occurs) that are beyond the scope of this. These are all either prescription medications or medical devices/procedures that need to be performed by a professional. If you are interested in any of these, please consult your healthcare provider.


Pads

These are absorptive liners with adhesive backsides that stick to the crotch of underwear and absorb blood. They are probably the easiest menstrual product to use and also the one that allows you to see clearly how much of the absorptive capacity you have used at any point in time. They come in numerous different capacities, ranging from 10 to 15 mL of blood.


Tampons

This is an insertable product that is most commonly made of cotton. It is inserted into the vagina and absorbs blood. The only clear indicator that the product is full is if you start to see blood on the string, your underwear, or if your pee begins to turn pink. The maximum recommended time a tampon should be left in is 8 hours, though with a heavier flow, many people will find that they need to change them much more frequently than that. They also have different absorptive capacities, usually ranging from 3 to 12 mL of blood.


Reusable Underwear

Period underwear, of which the two best known brands in the US are Thinx and Knix, are reusable underwear that have additional inserts in the crotch designed to absorb blood. They come in an overwhelming number of styles, cuts and absorptive capacities, generally ranging from 15 to 60 mL, depending on brand and absorbency. They are a replacement for pads and one of two reusable products on this list. The main downside for these is that when they are full, you have to completely change your underwear (PITA if you’re wearing a harness). This could present problems for someone with a very heavy menstrual flow, though that can be mitigated to a large degree by pairing these up with one of the insertable menstrual products. An additional downside is that the absorptive insert is black (likely for discreteness), making it a little more difficult to tell how “full” it is.


Menstrual Cups

A menstrual cup is a little cup that is inserted into the vagina and catches menstrual blood. When full, it must be emptied and sanitized before reuse. The maximum recommended time it should be left in is 12 hours, though with a heavier flow, it will need to be changed more often than this. The capacity is generally around 25 to 27 mL. This is the second of the two reusable products on this list.


I have not used a menstrual cup on a big wall, because of what I have perceived to be possible challenges in doing so. If you have used one on a big wall, I’d love to hear your experience and tips for using.


I think one of the biggest limitations to menstrual cup use on the wall is arguably the cleaning aspect. Remember that you must carry all of your water for the entire climb with you from bottom to top and still have enough water to get back down. If you are using a menstrual cup that needs to be cleaned, you need water to do that, and that means you are using some of your very finite (and very heavy) water supply to clean up.


If you have a relatively light flow and can get away with a full 12 hours between changes/cleanings, then this might make sense for you, as long as the weight and volume of that water you will need to clean and maintain the cup is not more than the weight and volume of the equivalent amount of other menstrual products. If you’ve never been on a big wall before, weight, volume and water are VERY important considerations.


Disposal of the blood is also something to consider. Usually, I dispose of used menstrual products in ziplock bags, which keeps them out of the way until I can transfer them to my poop tube. However, ziplocks might not be water-tight enough to keep liquid blood from leaking out and then you’ve potentially got blood leaking onto your gear. It would be tempting to empty the cup onto the rock. But keep in mind that parties climbing below you might be a little worried if they see blood running down the C2 they’re about to jump on. It’s bad enough that everyone pisses all over the rock, making it even more important to dispose of the blood in a responsible and respectful manner to others climbing.

Side note:

After we got down from El Cap, I was talking to a woman in El Cap Meadow who swears by menstrual cups. She said her flow was very light and that she could get away with leaving her menstrual cup in for a full five days without emptying or cleaning it. Although the risk of staph toxic shock syndrome is low with use of insertable menstrual products (more on that below), this does increase the risk and is not a safe practice.


Toxic Shock Syndrome (TSS)

TSS became a household term in the 1980s when a rash of people (no pun intended) were diagnosed with the life-threatening disease after leaving insertable menstrual products in for a prolonged period of time. While the risk of TSS is relatively low, it gets brought up a lot in relation to insertable menstrual products, and I think it’s helpful to understand what it is and what causes it.


Normal vaginal flora (bacteria) contains staphylococcus aureus that produces a toxin called TSST-1 (toxic shock syndrome toxin 1). This toxin causes massive activation of the T cell branch of the immune system and leads to a life-threatening distributive shock (distributive shock is where all of your blood vessels relax and are unable to effectively circulate blood to your vital organs).


The levels of these bacteria in the vaginal flora are usually pretty low. They are aerobic bacteria, meaning they need oxygen to reproduce, and the vagina is not a very oxygen-rich environment. However, when you insert a menstrual product, either a tampon or a cup, this increases oxygen levels in the vagina, allowing the bacteria to proliferate. Left in too long, the bacteria can proliferate to levels where the amount of TSST-1 they are producing becomes dangerous.


Risk of illness from TSST-1 is highest in younger people. The reason is that by the age of 40 years, about 80% of females have developed antibodies against TSST-1, rendering them far less susceptible to illness. But that still means that 1 in 5 do not have antibodies against the toxin and are at elevated risk.


Signs of illness are fever, fatigue, flu-like symptoms, and a characteristic rash that is like a peeling sunburn. Your best protection is following the guidelines surrounding the use of insertable menstrual products, which are designed to limit TSST-1 producing staph aureus growth in the vagina and minimize risk.



Pee Funnel University

Even if you manage to dodge your period on a big wall, you can’t dodge peeing. If you didn’t come equipped with a handy hose to water the rock, you’re going to have a few more steps and a little more hassle involved in taking a piss, but it’s a fundamental skill you need to master if you’re going to climb anything big.


Fortunately, peeing is not much more cumbersome than changing a menstrual product. If you’re just peeing at a belay without the use of a pee funnel, you simply unclip the straps that connect your leg loops in the back, lower your pants a little and either squat if you’re on a ledge, or dangle your backside out enough to not pee on yourself if you’re at a hanging belay.


There will be times, however, when you would be best served to pee in a bottle (parties climbing below you, at night when you don’t want to fully get off the portaledge and dangle in a swami belt over the side, etc.), and in these situations, it can be helpful to have a pee funnel.


There are more pee funnels on the market than I can count, with different designs, materials, etc. I’ve used the SheWee in the past, and it worked fine. More recently, I bought a Freshette, which I have yet to use.


If you are going to go the pee funnel route, you should definitely try using it at home before doing so in the wild, so you know how it works and can be certain you’re not going to pee all over yourself. Another thing to consider is that these do need to be rinsed with water after each use, so keep that in mind when thinking about how frequently you’re going to use it and the amount of water required to rinse after each use.


What's Next

See all the ways to poop on a big wall


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