Handling feminine hygiene on multiple-month treks?

Question

How can I handle multiple months of menstrual cycles on a long trek like the Appalachian Trail? I am asking about how to handle the mess. Here are my personal considerations:

1. Using hormonal birth control to skip five months of periods is not an option for me.
2. I'm concerned about the amount of space pads or tampons would take up in my pack, not to mention the amount of trash that would accumulate.
3. I'm of the opinion that 27 is a bit young to be having a hysterectomy (though I have considered it).

Are there any other options out there?

EDIT: May, 2016 (four years later): This video by Emily Graslie of The Field Museum in Chicago explains in great detail and from years of experience how women handle menstruation on field expeditions, including information she has gathered from other women in the field about what worked and did not work for them in practice.

Answer 1

Try a menstrual cup. The advantage being that you only need one (maybe having two is a good idea) and that it can be washed.

Answer 2

This question really made me curious as my wife has asked me the same thing. If you end up finding a better solution than anyone on this site can provide, I ask that you would please share it.

I searched the web for a bit and found this website.

Allow me to quote the part I found most important.

Sponges Isabelle Gauthier of Blood Sisters, an organization of women in Montreal, created a publication called Hot Pants which describes the use of sea sponges for menstruation. Often sold as cosmetic sponges in pharmacies sea sponges can be inserted into the vagina and can be left inside until saturated. The sponges should be soaked overnight in water with white vinegar before and after each period. It is necessary to dispose of the sponge in the garbage once it begins to fall apart.

Pros: This option is environmentally friendly and chemical free.

Cons: Being aware of the saturation level of your sea sponge may be the last thing on your mind as you portage across a rushing creek. Although Gauthier insists that the sponge will not get lost "up there" it may be difficult for some to get used to reaching up to extract the sponge. There may not always be fresh water available to rinse your sponge.

Cost: Pharma Plus sells a bag of 3 natural sea sponges for $6.49. Gauthier approximates that a single sponge could last "six months if you take good care of it." A lifetime of menstruation could be yours for just over $100.00

Site: http://www.logy.org/~alana/blood.htm

Article: How to Handle your Period while you Enjoy the Great Outdoors

Author: Beth Clarkson

Upon further investigation, you should take care to thoroughly clean the sponge before first use and subsequent uses (obviously). This site notes they are no longer sold as hygiene...things... (not sure what to call them) as they have been known to contain bacteria.

Here's the relevant stuff:

Your concern about ocean pollution making sea sponges potentially dangerous is justified. In fact, this is the reason sea sponges are technically no longer allowed to be sold as menstrual products. In late 1980, menstrual sponges sold commercially were examined by a University of Iowa laboratory and found to contain sand, grit, bacteria, and various other contaminants. Other studies have found chemical pollutants and fungi in sponges sold for menstrual use. The Centers for Disease Control have documented a least one case of toxic shock syndrome associated with the use of a sea sponge.

Site: http://www.foodrevolution.org/askjohn/49.htm

Article: Menstrual cycles and sea sponges

Author: John Robbins

EDIT

The more I research about this issue (which I should probably stop now) the more I see that most women vastly prefer a menstrual cup, particularly the Diva Cup

EDIT 2 Just ran across this article about bears and menstruation. It is hypothesized that the odors from used tampons and pads attract bears. If bears are attracted to them, my very uninformed opinion is that other carnivorous animals may be attracted also. So I hope that immediately eliminates the use of pads and tampons for you.

Site: http://www.yellowstone-bearman.com/menstruation_data.html

Article: Bears and Menstruating Women

Author: Kerry A. Gunther

Answer 3

I would highly recommend a menstrual cup. That's what I use while camping and hiking as they're light easy to carry and generate little-to-no trash. You can simply pour out and bury the blood rather than packing out a load of dirty tampons.

However keep in mind that there is a learning curve associated with each type of cup, and there are a LOT of different cups. Some may not work for you at all depending upon your shape. While a lot of women swear by the divacup, it doesn't work for me at all, but I've had amazingly good luck with the instead softcup (they sadly discontinued their reusable cup though).

I'd recommend trying as many cups as you can out in the months leading up to your trip so you can make sure you have some thing reliable when the time comes. Don't leave it to the last minute!

The silicone ones (like divacup) are easy to clean, especially if you're packing a small propane stove or you're planning to build fires along the way. Give it a rinse in water to get the blood off and then boil it for a few minutes to sterilize it daily and you should be fine. Be careful to rinse it a lot if you decide to clean it with soaps, as soaps can be very irritating to your privates.

Another option to consider in conjunction with the cups is using hormonal birth control -- not to stop periods, but to reduce them. I know this wouldn't work for me as it gives me nasty side effects, but when I was on it my flow was significantly reduced and much more manageable in conjunction with the cups (I'd only have to empty them the minimum recommended amount which was once every 12 hours), vs now when I have to empty them every 6 hours or so, depending on the cup. Each woman is different and this won't work for everyone, but it might help if you have a heavy flow.

edit: I'd highly recommend buying a second cup once you find the type that works for you -- that way you don't have to free bleed while you're washing the other one, and have a backup in case one breaks/tears/gets dropped into a river