By now, you’ve probably heard about Kiran Gandhi, whose blog about running her debut marathon during her period without a pad or tampon The Best Yoga Routine to Address Menstrual Cramps.
Reactions to the piece have run the gamut, from “you go, girl” to “yikes” to “hope she didn’t like those tights because that stain’s never coming out.”
The philosophical debate has dominated the comments sections, but the post also raises some practical questions. So we went to the experts for tips to help any woman run with the flow.
Q: Medically, is there any reason a woman shouldn’t “free-bleed” during a marathon?
Three out of three doctors we asked agree: Nope, no health hazard here. After all, women both ran and had periods long before you could pick up a pack of Kotex at the corner store.
As for other runners around you, sure, you might expose them to a bit of blood, but it’s not like anyone makes it to mile 24 squeaky clean and perfectly hygienic. “Many runners lose control of bowel and bladder during races and have to deal with bodily fluids,” says Holly J. Benjamin, M.D., director of primary care sports medicine at the University of Chicago.
The biggest downside will probably sound familiar to any runner—female or otherwise. “If menstrual blood flow were to cause excess moistness in your shorts or running tights, it could increase the chances for chafing during the run,” says Elizabeth Stevenson-Gargiulo, D.O., an obstetrician/gynecologist on the medical staff of Baylor University Medical Center at Dallas (and a blogger at www.runningthroughpregnancy.com). “As any marathoner knows, significant chafing could ruin a race.”
Q: So if you choose protection, what’s the best option—a) tampons, b) pads, c) other?
Well, each has its pros and cons. Many find tampons more comfortable and convenient. But if you’re running for three hours or longer, you do face a small risk of toxic shock syndrome if you don’t swap them out, says Jocelyn Szeto, M.D., a primary care sports medicine specialist at The University of Texas Health Science Center at Houston. Cases of this potentially deadly infection have declined in recent years, but in part that’s because more women have heeded warnings about it.
Could Women Be Hardwired for Endurance Events really hurts, Stevenson-Gargiulo says. So follow the tried-and-true rule of the marathon: Nothing new on race day. Experiment with pads on your long training runs so you know what works best for you.
Q: Medically, is there any reason a woman shouldnt free-bleed during a marathon the menstrual cup, a reusable silicon device you can insert to collect your flow. No evidence has linked it to toxic shock syndrome and you can leave it in up to three times longer than a tampon, Benjamin says. Though not everyone loves the process of inserting or cleaning it up, the device has a significant fan base. “Many women who’ve tried it swear they will never go back to pads or tampons,” Stevenson-Gargiulo says.
Q: Almost every lady runner seems to have a “my-period-showed-up-just-before-or-during-my-race” horror story. But really, what are the chances?
You could crunch the numbers and figure it out, statistically speaking. But bodies don’t run like calculators, and many issues can alter an athlete’s hypothalamus-pituitary-adrenal gland axis—scientifically speaking, the complex system of glands and hormones that governs your cycle.
“The training in and of itself—the pure physical component—has a big impact on that hormonal axis. That’s a big reason why periods in my female athletes are so unpredictable, especially around the time of training for those events,” Szeto says. And feelings, too, affect your physiology. “If it’s your first marathon or you’re really trying to PR, there’s an additional kind of emotional stress—and the hormonal axis is exceptionally sensitive to that.”
Pads eliminate your risk of TSS but can often feel bulky, bunch up, and rub you raw where it?
Obviously, tracking your cycle reduces—if not eliminates—the chances of being caught off guard. Eating enough calories to support your running and ramping up your training slowly reduce the stress on your body, keeping your hormones steadier and regulating your cycle, Szeto says. (Bonus: This protects muscles and bones, too.)
Women on contraceptive pills tend to menstruate more like clockwork, making things easier to plan—and adjust. “If you are due to get your period around the time of your race, you can skip over the placebo pills and continue to take the hormone pills, effectively ‘skipping’ your period that month,” Stevenson-Gargiulo says. You should probably clear this with your doctor first, Szeto adds.
Regardless, you’ll probably want to stash a few extra tampons or pads in your race gear, just in case. (Hey, hats off to races like Women Rock in Chicago, which stocks them in the porta-potties). Even if you have your rhythm locked down, you might make a new friend who’s not so lucky.
Q: Seriously, though: Can a stain like that ever come out, and if so, how? Asking just in case. Running clothes ain’t cheap!
Probably, provided you act swiftly. That’s according to laundry pro Mona Weiss, cofounder of organic soap company Eco Nuts. Start by soaking your bottoms in cold water the first chance you get, and don’t put them in the dryer until you’re sure you’ve banished the last bit of blood. Heat—from warm water or the dryer—sets in protein-rich stains like blood, making them near-impossible to remove, Weiss says. And skip the vinegar—though it can remove some stains, it creates odor problems in synthetic fabrics.
From there, the best solution depends on which of the hundreds of types of technical fabric you’re working with, and it’s hard to know in advance. So choose from this menu of stain-removal methods, hang-dry, and check your progress. If some blood remains, repeat or try another. “Don’t give up and don’t be afraid to try different things until you see success,” Weiss says.
- Add a tablespoon of salt to cold water and let the garment soak for a few hours. Then hand-rinse to scrub out the stain, working from the outer edges in to avoid spreading.
- Make a paste of salt or baking soda and water to draw the blood out. Apply, let it dry, scrape off, and repeat as needed.
- Apply mild bar soap or dish detergent, then rub the fabric together to work the stain out. Or, let the soap—or a stain-removal product that contains enzymes—sit on the stain for 10 to 15 minutes before rinsing with cold water.
- Weirdest, but good for large stains: Postsoak, sprinkle on some meat tenderizer, which also contains protein-busting enzymes. Rinse after 15 to 30 minutes.
Cindy is a freelance health and fitness writer, author, and podcaster who’s contributed regularly to Runner’s World since 2013. She’s the coauthor of both Breakthrough Women’s Running: Dream Big and Train Smart and Rebound: Train Your Mind to Bounce Back Stronger from Sports Injuries, a book about the psychology of sports injury from Bloomsbury Sport. Cindy specializes in covering injury prevention and recovery, everyday athletes accomplishing extraordinary things, and the active community in her beloved Chicago, where winter forges deep bonds between those brave enough to train through it.
