"You’re the reason I get up in the morning. That, and I need to pee."
Darynda Jones, "Seventh Grave and No Body."
If you are a woman who spends a lot of time in the wilderness, you know firsthand how annoying it is to be in the backcountry on your period. If you haven’t experienced this quite yet…just wait…it will happen. From menstrual cramps and mood swings to dealing with tampons and bloating, sometimes being female is rough. But let’s be honest, gals; guys could never do this on a monthly basis. We are so much stronger than we allow ourselves to believe. I personally have the most excruciating cramps; sometimes I vomit from pain, literally cry, and curl up in a ball. I have tried every natural remedy on the market, but I still stick to the tried and true ibuprofen, which is sold under the brand name Advil or Motrin. Ibuprofen is a pain reliever with anti-inflammatory properties that specifically target prostaglandins. Prostaglandins trigger symptoms of pain associated with inflammation, and they are produced in high concentrations by your uterine tissue during menstruation. They are primarily responsible for menstrual cramps. Ibuprofen works by preventing your body from making prostaglandins, thereby reducing your menstrual cramps. It is recommended by physicians to take 800 milligrams of ibuprofen two to three times a day for pain and to begin two days before your cycle in order to prevent cramping. This is the recommended dose to treat any sort of pain caused by inflammation. I'm a family medicine doctor, and I strongly recommend and prescribe this dose to all of my patients who do not have gastritis or ulcers.
I personally do not have a problem using tampons while I am backpacking or hiking; however, you must follow the Leave No Trace guidelines and remember to change your tampon every four to six hours. Contrary to popular belief, altitude alone should not really affect your period flow. Some people do notice changes when they travel to higher or lower altitude areas, but this is more likely due to the stress of travel, crossing time zones, change in sleep cycles, etc.
Menstrual cups are an an alternative to tampons and pads. They’re usually made of silicone or natural rubber, and you can use for one for your entire trip and beyond. Some popular brands are DivaCup, Softcup, Lily Cup, The Keepers and Moon Cup. This reusable cup captures your menstrual flow, which means you need to insert it and later remove it to empty out its contents. You can usually wear a cup for up to 12 hours straight without emptying it, though this depends on how heavy your flow is; many women say they do empty it every four hours for heavy cycles. These cups come in different sizes, so it is recommended you try this product for a couple of cycles at home so you can get used to the fit and used to inserting and emptying the cup before you go out into the wild.
Before inserting or removing the cup, be sure to wash your hands with hand sanitizer or soap and water. Empty the contents of the cup and bury it in a cat hole just like you would any other human waste. Cat holes should be 6 to 8 inches deep and 200 feet away from any water sources. If you are on a glacier or in a sensitive area where you need to use bags for human waste instead of digging a cat hole, empty the contents of the cup into the waste bag. Then re-insert the cup and wash your hands again.
To clean your cup during the trip, wash it with warm water and oil-free soap if you can. You can also sterilize it in boiling hot water for 5 to 10 minutes. Be sure to avoid using vinegar, tea tree oil, scented/fragrance soap, castile/peppermint soap or any other oil based soap, rubbing alcohol, antibacterial soap, hand sanitizer, pre-moistened wipes, baking soda, hydrogen peroxide, dishwashing soap, or bleach or harsh chemicals; these ingredients can slowly degrade the silicone, and just imagine inserting hand sanitizer or rubbing alcohol up into your girl parts…no, thank you. The cup needs to be stored in something breathable, so once your cycle is over, you can keep it in the cotton pouch that comes with many cups or use another cotton or paper bag.
Disposing of tampons and pads in the backcountry means that you must pack out all of your waste. Yes, that means used pads and tampons. Bring the kind of tampons without applicators for less waste to pack out. Make sure to have one bag for clean tampons and another well-marked waste bag for used ones. Store used pads or tampons inside a separate duct-taped waste bag, and add dry tea bags or crumbled aspirin to control the scent. If you are in the bear country or in another area with wildlife issues, you will need to place this bag in a bear proof container so that you don't have odors drawing wildlife toward your tent.
If you’re on a slope, pee facing downhill so it flows away from you and not back down onto your feet. If it’s windy, try to pee so it flows in the same direction as the wind so it does not get blown back at you. Squat low to the ground with your heels in front of your bum, so you do not risk peeing on your hiking boots. Always wipe. Drip-drying over time can lead to urinary tract infections or yeast infections, and wiping after going pee makes a huge difference in preventing these illnesses. If you use toilet paper or baby wipes, please pack these out using a Ziplock bag (I double these baggies)
You can also use a “pee handkerchief," also known as a bandana, and tie it on the outside of your pack to dry in the sun. To those who may question whether a pee rag is sanitary, consider that ultra-violet rays from the sun are one of the earth’s most powerful disinfectants. A pee rag on the outside of a backpack is probably cleaner than the toilet paper rolls in many public bathrooms. You can also use a high-flow squeeze bottle to clean yourself after you are done by squeezing water into your girl parts (the high flow is really important). Note: These high flow bottles also work great for flushing out any wounds or lacerations you may get while on the trails. If you do not want to mess with squatting on the trail, the Freshette feminine urinary director is also an option. To be honest, I have never used this device, nor does it interest me, but I know lots of gal pals who swear by it.
Finally, if you’re pinned down in a snowstorm, the last thing you want to do is go out into blinding wind and snow at night to drop your pants and pee. This is where the pee bottle comes in, and there are some special tricks for this one. First of all, make sure you get the largest pee bottle possible so that you don’t have to get out and empty it any more than necessary. I like using an extra-large collapsible Nalgene Cantene. Use a permanent marker to label the bottle (I typically mark a skull and crossbones on it) so it doesn’t get mixed up with your regular water bottles. No matter what, make sure it’s collapsible and has a wide mouth.
Remember to always pack out what you pack in and do your business 200 feet from the trail and/or any water source.