From Puberty to Period Positivity: A Journey of Empowerment
When you’re a planner like I am and you’re ready to have a baby, you plan for it. So I went to a presentation at a nearby hospital where a panel of OBGYNs were offering conception advice. One of the tips was to buy some ovulation predictor strips to figure out when you were ovulating. I ordered some online and got to work testing, but for several months they never picked up that I was ovulating. I finally called my OBGYN’s office and spoke with the nurse to tell her my dilemma. “I’m looking at your chart, Mrs. Koziol, and it says here you are taking the birth control pill.” “Yes, that’s correct,” I answered. Pause (longer than usual). “OK,” she said, “well the purpose of the birth control pill is to prevent you from ovulating, so……”. I felt like an idiot. While I hadn’t decided to specialize in women’s health yet, I had been a woman on this planet for over 25 years and wasn’t able to connect the dots. Where was this lesson in school?!
Fast forward a few years and 2 kids later, and I was knee deep in my work as a Women’s Health Physical Therapist. One particular patient was struggling with a pelvic organ prolapse (where your bladder, uterus, rectum or vagina descends towards or beyond the vaginal opening or the rectum from the anal opening). I got out a mirror so I could explain to her what was happening down there and when I looked up, her eyes were forcefully closed. She told me she had never looked down there and didn’t plan to anytime soon. There were countless other stories like this along the way, and it saddened me how truly uneducated most women were about their bodies. And listen, I’m not blaming them. The design of our modern medical system encourages putting out fires vs learning how to prevent them in the first place.
About the time I started teaching my Prenatal and Postnatal Pilates classes, someone gave me a copy of the book Taking Charge of Your Fertility. Now I already was a Women’s Health specialist who had attended HOURS of continuing education classes and extra study, yet I found myself underlining every other sentence in this book. How did I not know some of this???!
It was about this time that I decided to leave the clinic to enter the community and my primary driver was to meet women earlier on in their pregnancy journey to capture their attention when they were most motivated to learn about their changing bodies. I focused on my Prenatal Pilates classes and while I loved what I was doing, I still felt there was this gap in knowledge that I wasn’t quite addressing.
The 5th Grade Puberty Day (more like 30 minutes)
I never would have thought that my 10 year daughter would be the one to light the way to my true calling, but she’s always surprising me! It was the spring of her 5th grade year and she was scheduled to get the puberty talk in school that day. I had asked the school to send me the recording they would be sharing with the students. It was about 30 minutes long and apparently they each would be listening with headphones while a teacher supervised. Don’t get me wrong, the video was OK. It talked about normal puberty changes (many of which most girls were already experiencing but better late than never I guess). But knowing what I didn’t know then and what my patients didn’t know now, I knew these girls deserved MORE.
I was lamenting the state of puberty education in this country when out with some girlfriends one night (listen, I’m a real blast to have around, people) when all my friends started suggesting that I should be the one to teach our girls about puberty. Maybe it was the wine talking, but I was listening and decided right then and there that I would accept their offer. I hired a puberty coach who gave me recommended reading lists and homework assignments. I dragged my daughter across the country to attend a Great Conversations workshop in Seattle. I fell in love with the mastermind behind that series, Julie Metzer, and she agreed to a mentoring phone call. And the rest is history.
My Menstruation Workshop was Born
I taught my first ever Mom and Me Menstruation class from my home on Monday, June 24th, 2018 from 6-9 PM. Not a single one of my friends showed up for my debut, but that’s OK. A fire was lit inside me that night, and I’ve been fanning the flame ever since. I’ve hosted this workshop dozens of times since that first class. While I expected to find it rewarding to educate young menstruators about their period, what I didn’t expect was the absolute magic that would happen when I realized that many of the moms were learning about their periods for the first time right alongside their daughters.
Within the last year or two, I have made the workshop available in an online format for several reasons. Women would always say things like, “My sister and her daughter would love this workshop but they live in Florida (or New York or Montana).” Some single dads even reached out to me to say they wanted to learn more or attend with their daughters but didn’t feel comfortable coming to a group workshop. Here’s what makes the Magic of Menstruation online program so valuable. I want girls to feel normal and beautiful and proud of their bodies after learning how their parts work. And I want parents to feel better prepared to have important conversations with their daughters and be an askable adult for future questions they may have.
Puberty Popcorn
I heard puberty once compared to popping popcorn in one of those old fashioned popcorn poppers. You know, the kind where you add oil and then the kernels and you can watch as the kernels pop into fluffy pieces of popcorn. There’s always one kernel that has to pop first, and then a whole big bunch pop in the middle, and then there’s always one kernel that pops last. Which is why in puberty there is NO sense in comparing yourself to anyone else. Some people experience puberty changes first, and a whole big bunch experience puberty in the middle, and then a few are the last to go through puberty. You don’t know if someone is gaining their height first or their weight first or both at the same time. All bodies are beautiful and worthy of love. The changes you are experiencing on the outside have absolutely nothing to do with the person you are becoming on the inside. Plus, how boring would it be if we all looked exactly alike?
Hormones
In Module 1 of my Magic of Menstruation program I talk all about hormones and how they are responsible for the changes that help change you from someone in a kid body to someone in an adult body. Hormones can be hard to wrap your mind around but I like to think of them like mail delivery trucks. They deliver messages from your brain to other parts of your body, helping them to do their jobs. The changes that every body can experience in puberty include changes in height, weight, acne, body hair, and body odor. While boys experience more voice changes than girls, girls can have some changes there too. And while girls develop breast buds, boys do make small amounts of estrogen and may notice an enlargement of one breast or the other, mostly felt as a small pea-sized ball under one or both nipples. The same hormones that are responsible for all these changes in girl bodies are also responsible for menstruation. I like to explain that menstruation is a fancy word for period and that every month your hormones signal your uterus to start building a “home” made out of blood and tissues for a possible pregnancy one day. Because we want that “home” to stay fresh, each month you will shed out the old blood and tissues (this is your period) and get ready to build a fresh new one.
I’ll never forget giving the above spiel at a fairly packed workshop, and one courageous girl raised her hand and asked why there were “tissues” inside her body. She was picturing a box of Kleenex in there!!! Kids always keep me honest and remind me that at that age, they take what I say very literally!
While I don’t go into great detail about the slang terms for body parts or for getting your period in my program, this is a good time to mention the importance of period positive language. While terms like Aunt Flo, the Red Bird, and Shark Week might get a chuckle, we shouldn’t perpetuate the negative stigma by hiding behind the slang. Using words like period and menstruation help us have more open dialogue with medical professionals and show our children we feel comfortable talking about natural biological processes.
A Tour of the Vulva
Module 2 of my Magic on Menstruation program is a tour of your parts. If you own the part you deserve to know what it’s called and what its job is in your body. I explain that when you're a baby or toddler, there is often a parent changing your diaper or helping you use the toilet so we can keep an eye on your parts and make sure everything looks normal down there. But, as you get older, it's time for you to take over!!! And that starts by knowing the proper terms for the parts you own, how they are supposed to work, and when to know if something isn't quite right.
Sometimes it can make us uncomfortable to talk about parts that are most often covered by clothing and considered "private" but this is an important conversation, and it can be helpful to look at REALISTIC images of REAL body parts. I show a collage of breasts and vulvas so girls can see that all parts come in different shapes and sizes and colors but that all bodies are beautiful and worthy of love.
Sidenote: Adults need this reminder too. I often ask my adult clients this question: “If I put a collage of 50 vulvas on the wall behind me, could you pick out yours? Could you say, that’s me, 4th row, 3rd one in?” I would say about 95% of women say they could not identify their vulvas. And I know this is true because as a Women’s Health Physical Therapist, I would often use a mirror to point out what I was observing in my external vulvar assessment and women would often say, “I don’t know how long it’s been like that; I never look down there.”
At this point in my live workshops, many girls giggle or look embarrassed when we discuss parts like the labia and vagina. Laughing is a natural coping mechanism for topics that are uncomfortable, and I never make anyone feel bad for giggling or feeling awkward. In fact, I’ll talk about it a little. I’ll put up a slide of the ear and say, “Does anyone feel weird talking about the ear?” Of course no one does. Then I’ll switch over to the vulva and the girls shift around uncomfortably. So I’ll switch back to the ear and say, “We feel more comfortable talking about this part, right, because we can see everyone’s ears. It’s normal to feel a little awkward talking about body parts that are usually covered by clothing, but by the time you’re done with the workshop, I want you to feel as comfortable talking about the vulva as you are about the ear.”
Menstrual Cycle Awareness
The first time I heard this term was in a book about Menopause called Wild Power. “It allows you to get to know your unique rhythm of power and learn how to live in sync with it, heal your menstrual symptoms, and awaken your personal Wild Power revolution.” And that starts with understanding the 4 phases of your menstrual cycle and learning how your hormones will often rise and fall in a predictable pattern that correlates with your mood, energy, appetite for movement, and desire to be social. Charting your cycle using a paper chart or digital app can give you great insights that allow you to work WITH your body. In Module 3 of the Magic of Menstruation program, the 4 phases of your cycle are illustrated plus I teach some really fun facts about your eggs. For example, did you know that by 20 weeks gestation you have all the eggs you’ll ever have which means we all spent a brief moment of time in our grandmother’s bodies. How cool is that?!
In order to become a Menstrual Cycle Awareness Expert, you need to start tracking your cycles. A quick internet search will show you the most popular period tracking apps or you can even print out a paper tracker to help your young menstruator become familiar with the predictable moods and energy levels they may expect at various points in their cycle.
Manage your Moods
Once girls understand the natural rise and fall of hormones throughout their monthly cycle, they can better understand the “why” behind their moods and energy levels. Stress is going to be a part of everyone’s lives, and in puberty, stress levels might increase. It’s important to understand the difference between positive and negative stress, and to find some tools to help you complete the stress cycle. Unfortunately this is a common age to not be getting as much sleep as you need, so we’ll talk about how to improve sleep hygiene routines to support all the hard work your body is doing.
Your Period and a Show and Tell of Products
Even though your actual period is only 2-7 days out of the entire monthly cycle, it deserves a module all to itself! Here we answer ALL the questions you’ve ever wanted to know about your period. We’ll talk about how much blood you will lose on average and the normal colors of blood you may see. And of course we’ll spend a lot of time talking about the products that can help us manage that period blood. These products can be divided into products that go on the outside of your body to catch menstrual blood which include disposable pads, non-disposable pads, and period underwear. And then of course there are products that go inside the vagina to collect period blood which include tampons, and menstrual cups and discs. Girls have a LOT of questions about putting in tampons. Which hole does it go in? Will it hurt? Can I go to the bathroom with a tampon in? I make it my job to answer all the questions they have and even ones they may not have known they have. I’ll demonstrate how to put in a tampon using a plastic model. And I’ll answer the most common questions I get asked about this topic: Can a tampon ever get lost in there?!
Arming your young menstruator with all these facts is invaluable. Knowledge is power. But if we don’t tackle the practical and actionable solutions to their commonly experienced period problems, we’ve done them a disservice. Knowledge plus action is empowering. I think it’s essential to walk them through a scenario where they get their period away from home, and how they can navigate this potential conundrum. A common fear girls have is getting their first period at school. So we problem solve how they can exit the classroom, where to go from there, and all the practical tips from borrowing a friend’s sweatshirt to tie around your waist, to making a pad out of toilet paper until they can find a better product to use. Some moms will say, “I had to figure it out on my own.” But why should we make them reinvent the wheel. Helping them figure out practical solutions to the problems that overwhelm them poses you as an askable adult that they can come to with other questions in the future.
What’s normal?
If you had an earache and then started noticing brown goop dripping out of your ear, you would probably know something was wrong and you might need to see a doctor. How would you know this? Well, you know what your earwax normally looks like plus you know your ear normally doesn’t give you pain. This is why it’s important to know what normal vaginal discharge looks like and when to seek medical attention for vulvar issues that don’t seem “normal.”
Fuel Your Body
After discussing normal vs abnormal periods, I like to remind young menstruators that getting your period is HARD work and so you need to do your part to support healthy cycles by fueling your body with necessary nutrients like protein, gentle carbs, and yes, even fat. Fat is not a four letter word and in fact, fueling fats are the building blocks of hormones. Just like you can’t fill your car gas tank with lemonade refreshers and sour patch kids, your body needs quality fuels to run its best. And doing sports and other activities are kind of like taking your body on a cross country road trip…you need to refuel often. If you don’t get enough fuel, your body will prioritize its functions and may halt your period. If you miss more than a couple periods, you are at risk for developing RED-S, relative energy deficiency in sport which can have drastic effects on your bone, reproductive, cardiovascular, and psychological health. This is also a good time to remind girls about the importance of maintaining a healthy body image, unfollowing social media accounts that glorify diet culture, and that puberty is a time when all bodies are changing. Some people are growing in height first, some people are gaining their weight first, and some are doing both at the same time. All bodies are beautiful, all bodies are worthy of love, and the way you look on the outside has absolutely nothing to do with the person you are on the inside. Plus, how boring would it be if we all looked exactly alike?!
BONUS Adults-Only Content
While that wraps up my child-centered learning for this workshop, there is a bonus parent-only containing content for mature audiences only. After teaching this workshop for many years, parents often reached out afterwards to say that their child had follow up questions they didn’t feel qualified to answer. Or they would say that this workshop inspired additional conversations (my hope and prayer!) they weren’t sure how to tackle. In this bonus ADULTS ONLY section I address topics like consent, masturbation, and pornography. If you are clutching your pearls reading some of those topics, it’s not your fault. In our culture, these topics aren’t mainstream discussion points and are often considered “taboo.” They’re certainly not something that most people feel comfortable discussing with minors. And as someone who has taught sex education to grades 5th-12th, I can tell you the research does not support the claim that comprehensive sex education that addresses these issues leads kids to experiment in risky sexual behaviors. In fact, it’s quite the opposite. Kids exposed to quality, age-appropriate, anatomically correct sexual education engage in less risky sexual behaviors and delay first experience with sex.
But I do understand that this is a charged topic with strong opinions surrounding it. If this isn’t your cup of tea, no hard feelings, simply skip this module.
What I’ve Learned
Here’s what I’ve learned in over 5 years of teaching menstruation workshops. Our young girls are curious about how their bodies work. They’ve perhaps been exposed to conflicting messages from social media or friends or other resources. They WANT to learn about this sort of information (despite eye rolls, and heavy sighs, and words of resistance), and they want to learn it from a trusted adult. It’s an honor and a privilege to help you get the conversations going. And perhaps the most inspiring part of this work is not just educating young menstruators, but watching their trusted adult learning about periods for the first time right alongside them. I take my responsibility very seriously, appreciate the value of well-placed humor in a program like this, and thank you from the bottom of my heart for trusting me with this topic.
