Sexual Anatomy, Reproduction and the Menstrual Cycle

Sexual Anatomy, Reproduction and the Menstrual Cycle

Where are the ovaries? What is the function of the fallopian tubes? This chapter gives a guided and thorough tour of the internal aspect of the sexual and reproductive organs and helps to introduce us to the organ terminology, their function and their place in our body. After the tour, we deal with the menstrual cycle – including ovulation and bleeding.

The chapter also touches upon the cultural aspects of menstruation and its influence on women’s moods and mood swings which may occur at various stages of the cycle, as well as the range of ways to combat the pain which can accompany the monthly bleeding, and more. The last part of the chapter is dedicated to religious women writing about Nida and Jewish/Muslim religious requirements relating to menstruation.

Introduction

In the following section we will review the sexual, reproductive and menstrual system. When referring to the female sexual organ, we find ourselves lacking a name we feel comfortable using. The lack of a name, free of negative connotations, reveals in a way the social and cultural approach to our bodies and the feminine sexual organs. There are a wide variety of names that refer to our vulva – childish ones, medical ones (vagina, vulva), biblical ones, American ones (cunt, bush, pussy), and the curse words. The issue of a proper name for our sexual organ is discussed in different chapters of this book. Upon examination we find out that not only do we lack a name we can relate to, but that most of us don’t even know or like our sexual system, which is important for a variety of reasons, the most obvious being health, birth and of course pleasure.

The female sexual system: self-guided tour

The purpose of the self-guided tour is to provide an introduction and knowledge of our bodies. You are invited to join our six-point sexual system guided tour. At each point you can read more detailed information by clicking on the link:

Entrances and Exits

Introitus [1. Introitus

The introitus leads to the vagina and through it the menstrual blood is secreted. The vagina is the birth canal through which babies are born in a natural delivery. Women sometimes insert a tampon, a finger, a penis or a vibrator into the vagina.] Urinary opening [2. Urinary opening

An opening leading to the urinary canal that drains the urinary bladder, in which urine is collected in the body.] Anus [3.

Anus

An exit opening through which feces leaves the digestive system. Women sometimes insert a finger, a penis, a vibrator, or suppositories into the anus.]

The external area

The vulva [4. Vulva

A general name for all the parts specified below. The vulva protects the genitals, which are the parts that react to sexual arousal.

Pubic hair

Protects from abrasions during sexual intercourse.

Mound

Skin and fat that cover the pubic bone and protect it during sexual intercourse.

Pubis symphysisPubic bone

The joining of the pubic bones. To feel this part of your body, put your hands on your waist and follow the bones forming a V down to the vagina.

Labia majora

Protect the Labia minora.

Labia minora

Become swollen as a reaction to sexual arousal.

Perineum

Located between the anus and the vagina, stretches during childbirth.

Vestibule

The area between the Labia minora, which contains the vagina and the urethra.]is comprised of a number of organs and is located at the external part of the feminine sexual system.

Shaving and Piercing

If you choose to shave your pubic hair, to have it waxed or to have your genitals pierced, be very careful and maintain your hygiene. This is a very delicate part of our body. Only use clean appliances and carefully choose the professionals you go to and their work environment, checking the degree of sterility and professionalism.

The orgasm spot

The clitoris[6. Clitoris

Its role is to cause the orgasm, sexual arousal. The clitoris is a general name for many organs including:

Hood of clitoris

Its role is to protect the shaft of the clitoris

Shaft of clitoris

Looks like a string made of blood vessels that fill with blood during sexual arousal. We cannot see it, but we can feel it.

Crura

Protruding tissue that connects the pubic bone to the clitoris; cannot be seen.

Bulbs of the vestibule

Fill with blood during sexual arousal; cannot be seen.

Vestibular glands, Bartholin’s glandsvulvovaginal glands

These glands produce drops of fluid during sexual arousal that provide immune protection. We cannot see them, but we can feel them.] is a complex organ with many parts: Hood of clitoris, Shaft of clitoris, Suspensory ligament, Crura, Bulbs of the vestibule. The tip of the clitoris should be distinguished from the clitoris as a whole. The tip of the clitoris is only a single part of the whole clitoris, though its role in our pleasure is very significant. The clitoris and the Bartholin’s glands are the only organs in the human body of which the sole purpose is sexual pleasure. The clitoris contains more than 8,000 nerve ends (more than in the male sexual organ). During sexual arousal, the blood vessels become wider, the sexual organs are filled with blood, the pelvic muscles contract, and the tip of the clitoris (Hood of clitoris) which is built of elongating tissue, becomes swollen and even more sensitive (further information on the subject is available in the chapter on Sexuality). The clitoris is the most sensitive spot among the sexual organs, and most women (70%) experience a clitoridean orgasm.

The way in

This important part of the female reproductive system is a hidden one, located inside the body. From the vagina[7. VaginaBirth canal

The vagina is a flexible canal surrounded by muscles about 10 cm long, into which the penis, fingers or vibrator are inserted during sexual intercourse and through which the sperm make its way into the uterus. The vagina also drains the menstrual blood from the uterus, and is also a part of the birth canal.

Hymen

A membrane that partly covers the vagina.

Urethral sponge / perineal spongeG-spot

An aroused tissue in the front side of the vagina; a place of pleasure and orgasm.

Fornix (part of vagina)

The circumferential joint between the cervix and the vagina.

Cervix

The cervix is a canal leading from the vagina to the uterine cavity. The cervix allows the sperm to enter the uterus in the right timing of ovulation and protects from infections. The cervix broadens during childbirth.

Os (part of cervix)

The opening to the cervix which opens only during childbirth; protects the uterus from penetration of foreign objects (such as tampons, etc.)

Pubococcygeus (PC) muscle

A system of muscles that support the pelvis and other organs.] and its surroundings (Pelvic floor[8.

The pelvic floor

The pelvic floor is the area located at the bottom of the pelvis, and is made up of two flexible tissues: muscle tissue and connective tissue and of blood vessels and nerves. The pelvic floor has 3 openings: the urethra, the frontal ostium, that leads to the urinary canal; the introitus (located in an inner part of the pelvic floor); and the anus, the dorsal ostium. The pelvic organs are situated above the pelvic floor: the urinary bladder, the uterus and the rectum. It is important to have a healthy pelvic floor, because it helps the normal function of the urinary, sexual and birth systems and of the openings:

– closing and controlling openings

– stabilization of the pelvis and the lower back and maintaining the right position of the pelvic organs

– normal sexual function (penetration, orgasm)

– Easier passage of the newborn through the birth canal

When the pelvic floor is weak or highly contracted, its function might be disturbed. When it is weak, it does not properly support the pelvic organs, and its weakness affects the normal activity of the openings. In these cases, and especially when there is an increase in the intra-abdominal pressure (which may be caused by coughing, sneezing, laughing, picking up a child, sport, etc.), a prolapse of the pelvic organs and/or urine, gas or feces leakage may occur. When the pelvic floor muscles are highly contracted this may cause constipation, difficulties in giving urine and pain. Additional deficiencies in the pelvic floor muscle system may cause a frequent need to give urine or feces. In many cases a combination of these events occurs.

Practicing continence can help us identify the pelvic floor muscles. It is advisable to exercise these muscles every day in order to maintain our health:

  • Straighten your back
  • Contract the pelvic floor muscles (close and pull upwards) with a long slow exhalation of air
  • Stay in this position, the muscles contracted, up to 10 seconds, and then relax the muscles for 10 seconds
  • Repeat the exercise a few times
  • You can also practice fast contractions: contract the pelvic floor muscles and hold them for 2-3 seconds, afterwards relax them for a second. Repeat the exercise a few times.

During the exercise it is important to notice the following:

– Keep a long back, allowing a free passage of air through the breathing muscles and the diaphragm

– Accompany the exercise with a soft long exhalation. You can also count aloud

– Make sure that during the contraction you are not pushing outwards ]), we can partly see the uterus[9. The uterus

The uterus is an internal organ in the abdominal cavity; it is hollow, shaped as a pear and has thick muscular walls. During the fertile years, our uterus is 8 cm long. The inner side of the uterus is lined with a mucus lining which allows implantation of the fetus.

The uterine mucus regenerates every month, from the end of menstruation until the end of ovulation. During this period of time, induced by the Estrogen hormone, the mucus develops and thickens. Progesterone, a hormone secreted after ovulation, causes more changes and the mucus is ready for the intake of a pregnancy. If pregnancy does not occur, the uterine mucus is shed; this process is the bleeding we call menstruation.] (especially using a speculum), which is located deep in the pelvis and to which the fallopian tubes[10. The fallopian tubes

The fallopian tubes are two gentle tubes, 10 cm long, that branch from the upper sides of the uterus to a point close to the ovaries. The fallopian tubes have a crucial role transferring the egg and the sperm, and in them the insemination occurs. In the part of the tube close to the ovary, a fringy tissue forms the fimbria, a part to which the egg is released from the ovary during ovulation. Since the egg cannot move on its own, the transference of the egg from the ovary to the uterine cavity depends on the fallopian tube’s function.] and ovaries[11. The ovaries

The ovaries are our egg inventory and they contain approximately 300,000-400,000 eggs that mature (one by one) in the ovaries until ovulation. The number of eggs in the ovaries does not renew, and it is in a constant drop from the moment we are born (as apposed to the constant production of sperm in the testicles). The female sex hormones are secreted from the ovaries] are connected.

The Breasts

In western popular culture the female breasts[12. The breast organs:

Areola

Surrounds the nipple and contains contractive muscles that cause it to become erect in response to cold, sexual arousal and breastfeeding (this is the stimulus for lactation). At this spot the infant’s mouth closes on the breast while breastfeeding. The areola also has an important part in pleasure. The circle of skin, which varies in color, is located at the center of the breast, surrounding the nipple. The areola’s color may be different from other parts of the breast, it may have small bulges, and hair might stem from it. In many cases, the areola becomes darker during pregnancy.

Nipple

The mammary ducts open at the nipple to allow passage of milk. The nipple also has a part in sexual arousal, and it can become erect as a response to sexual arousal, cold or heat. The nipple is located at the center if the breast, and may be flat, bulging or sunken.

Sebaceous glands

Secrete an oily matter protecting the nipple during breastfeeding. Appear as bulges on the areola.

Fatty tissue

Surrounding and protecting the glands and the connective tissue and is spread throughout the inside of the whole breast.

Connective tissue

The connective tissue provides support and structure to the breast. It holds the mammary ducts and glands in place and is spread throughout the inside of the whole breast.

Mammary glands

The mammary glands infuse milk to the nipple for breastfeeding and may also produce a clear fluid when we are not breastfeeding. The mammary glands are made of lobules that produce milk and ducts.] receive much attention and are related above all to sexuality and fertility. Each of us has unique breasts, just like our fingerprints, and there is no perfect or ideal pair of breasts. A preference to large breasts or small breasts not only differs from one person to the next, it is also a matter of fashion. Our social surroundings are busy with our breasts as objects, separate from our bodies, and consequentially we sometimes are too.

During puberty, due to the great increase of sexual hormones, mammary glands start to develop in each breast. The amount of lactating tissue is more or less equal among women. The breast is built mostly of adipose (fat) and connective tissues which surround the mammary glands. The amount of fatty tissue in the breast is partly determined by our genes and affects the size of the breast. There is no correlation between breast size and its sexual arousal threshold, breastfeeding difficulties or the amount of breast milk produced after childbirth. Your breasts may have firm and soft areas, various textures, and areas more or less sensitive. A regular check can help us learn our unique patterns. It is advisable to check your breasts regularly and see a doctor if a change to texture is noticed or if a lump appears.

The menstrual cycle
The menstrual cycle is a cyclic process, which will be described below, and includes the bleeding days which we usually refer as the Period.
The fertility cycle – menstruation and reproduction
Getting your first period is a pivotal moment in your path of femininity, of changing from girl to woman, along with the growth of breasts and the appearance of pubic and axillary (underarm) hair. Women talk about the period in various ways; but it is surprising to notice how we refrain from using the words “bleeding” and “blood”. A very large number of expressions and words are used as code words to describe the menstruation and the menstrual cycle.

What mom never told me / Jamar Ben Moshe

“At home, having to do with bodily secretions was not to be mentioned. I used to think that grownups only pee… we had to flush during peeing so that – god forbid – no one heard the peeing sounds outside the room.”

We had a meeting about menstruation and sexuality. Naomi, 43, said that at 12 she had very little knowledge on the issue, knowledge that she acquired in school enrichment lessons. When she got her period at summer camp, during the summer break, she wasn’t sure “that was it.” She draped her underwear with toilet paper and felt very lonely. “When I go back from the trip I threw away all my underwear. I started using cotton-wool and at some point, independently, I bought tampons and started using them. I don’t remember anyone in my family ever asking me what’s new on the subject. I remember that there was talk about tampons that might rip the hymen, but I read up on my own and decided it was ok.”

Conversations with grown women show that most of us grew up in complete ignorance with regards to the body and sexuality. Menstruation was a physically inherited secret, but didn’t necessarily come with the right preparation and support from mother to daughter. For some women, the secret became an open wound in an already complex relationship with their mothers. This wound feeds on lack of trust and helplessness.

The attitude towards these issues and the awareness of young women and girls has been changing over the decades. This change can be also seen in the attitudes of the media, the internet, literature, the curricula, and of other information resources that public is exposed to, young and old, to issues of sexuality and puberty.

A woman that grew up without the proper knowledge, tells us about how she tried to make her daughter’s first menstruation a meaningful event: “Of course I tried to atone for my experience. I started to sneak conversations with my daughter when she was in fifth grade, and she asked more and more questions. The girls used to talk to each other, and I even talked to her friends. I also bought an adequate book that was at home. The day she got her period, about a year ago, she called me at work crying. I calmed her down and guided her. I left work early and I bought her a nice small basket and put two kinds of sanitary napkins in it, a new set of underwear and a training bra, and new pajamas. When I came home we talked about it a little, and since then, if she has trouble deciding about trips or visits to the swimming pool she confides in me. She tried to use tampons and couldn’t, and she asked me if I could demonstrate. I did!”

Each woman chooses her own way for her and her daughter. Getting the first period occurs during puberty and the monthly ritual is an important part of the feminine identity. It is fitting that we, as mothers, think about the issue in advance and try to give our daughters a reliable and useful amount of information – each woman and the degree of involvement, guidance and demonstration that suits her. Not all of us are able to get over the past barriers and demonstrate inserting a tampon. However we can prepare ourselves for the conversation, sneak in daily references that will signal to our daughters that we are there to listen. If we have a hard time talking to our daughters ourselves, we can also expose them to existing information resources (give them a book, direct them to a certain website).

They need the information, but more than that they need us as guides in this information-flooded world.

The menstrual cycle, what happens to us and our bodies?

Understanding the basic biological principals of the menstrual cycle can help us deal with decisions regarding menstruation, such as what can we do if we suffer from severe cramps or from excess / irregular bleeding.

What is ovulation?

Every month, during our fertile years, ten to twenty follicles begin to mature, induced by hormones. In most cases only one follicle (“the leading follicle”) completes its development and our body absorbs the others before completing their development. The leading follicle contains a number of cells that produce the estrogen hormone that allows the development of the follicle to continue. The follicle and the egg maturing inside it move towards the surface of the ovary. During ovulation, the follicle and the ovary’s membrane open and allow the tiny egg to leave the ovary. Some women feel, around that time, a cramp or pain in the lower abdomen or back (ovulation pain). This pain is usually accompanied by a fluid secreted from the cervix, sometimes containing blood. In rare cases women experience headaches, abdominal pain or fatigue. Other women feel especially well during the ovulation period.

A short while before menstruation, the estrogen producing cells in the follicle begin to also produce the progesterone hormone. After the egg leaves the ovary, the corpus luteum is created from the cells that surrounded the egg. This corpuscle is named after the yellow fat inside it, and it produces hormones that assist the keeping of the pregnancy. If insemination occurs, the cycle is discontinued and the pregnancy begins. If a pregnancy does not occur, the corpus luteum is re-absorbed. After ovulation, the egg that left the ovary sweeps away to the funnel side of one of the fallopian tubes which opens into the abdominal cavity, and begins a few days journey to the uterus. In this journey the egg is lead by wave-like cramps of the muscles in the fallopian tubes. When sperm enters the vagina, it passes through the cervix and makes its way through the uterus to the fallopian tubes. Each fallopian tube is covered with microscopic fibers that constantly move forwards and backwards, pushing the semen towards the ovary and carrying it towards the egg.

If insemination occurs (a unification of a sperm and an egg, also called conception), it usually occurs in the external third part of the fallopian tube (the part close to the ovary). The journey of an inseminated egg to the uterus lasts up to six days. If the egg is not inseminated, it dissolves or flows out together with the vaginal secretions, usually before menstruation, without our notice.

When we are born, our two ovaries[15. The ovaries
When we are born, the two ovaries contain approximately two million follicles. The follicles are saccules in the center of which lies an immature egg. During our childhood years, the ovaries absorb about half of these follicles. Out of the follicles that exist in the ovaries when the menses start, only about 300 to 500 mature eggs will develop. For many years, fertility researchers believed that women are born with a lifelong fixed supply of follicles that produce eggs, and cannot produce more eggs after birth. Today this belief is being challenged.] located at each side of the uterus, contain approximately two milion follicles. In the center of each lies an ovarian follicle. Each month one ovarian follicle ruptures and discharges an oocyty which then travels to the uterus through the fallopian tube. The departure of an oocyte from the ovary is called ovulation. Estrogen, produced by the maturing follicle, induces the uterine glands to grow and thicken. This thickening of the uterus lining is called the Proliferative phase[16. The menstrual stages

Estrogen, produced by the maturing follicle, causes the glands that line the uterus (endometrium) to grow and thicken and increases the blood supply to these glands. This thickening of the endometrium is called the proliferative stage of the menstrual cycle and it may last between six and twenty days. Progesterone, produced by the fractured follicle after the egg has been released, induces the endometrium glands to secrete nurturing factors for the embryo (this stage is called the secretion stage). An inseminated egg cannot be received in the uterus during the proliferative stage, but only in the secretion stage.

After ovulation, if there was no conception, the follicle produces estrogen and progesterone for approximately twenty days; in the last few days the amount of hormones decreases. The drop in estrogen and progesterone levels causes the tiny arteries and veins in the uterus to close. The secretion of nurturing factors in the endometrium is discontinued, and the endometrium leaves the uterus (this is called “menstruation”). Menstruation is not only a sign that we have not conceived in the past month, it is a sign of good health, of the existence of periodicity in our bodies, which also plays a cleansing role.] of the menstrual cycle and may last 6 to 10 days. In the cervix [17. The cervix

The type of moisture or fluid produced by the cervix changes throughout the menstrual cycle, as a response to hormones. There are common patterns of these fluid secretions, but each of us is advised to follow her own menstrual cycle and find out her unique pattern. It is possible to follow the moistness or dryness in the vagina by feeling the introitus with your finger and by observing and touching the secretions. Try writing down daily these changes for a number of cycles in order to have a feel of the changes in the fluid during your menstrual cycle. During the fertile period, sperm can survive up to five days in the cervix fluid. After ovulation, when the effect of progesterone contradicts the estrogen activity, the cervix fluid thickens and we can feel the vagina drying up gradually.], a cervical mucus is produced, a liquid which changes during the menstural cycle as a reaction to hormone levels.

During menstruation [18. Menstruation

During menstruation most of the endometrium leaves the uterus, apart from the bottom third that is left in order to create a new endometrium. When the new follicle begins to grow and secrete estrogen, the endometrium thickens and a new cycle begins. Sometimes we experience a menstrual-like bleeding with no ovulation – even when our cycles are regular; menstruation without ovulation becomes common as we approach menopause. Your menstrual fluid includes, in addition to blood (and sometimes coagulated blood), the cervix fluid, vaginal secretions, cells and tissues from the endometrium. The content of the fluid is not observable as the blood colors the fluid red or brown.], the uterus sheds most of the uterine lining, leaving the lower third in place in order to create a new lining. When the new follicle starts growing and secretes estrogen, the uterine lining thickens once more and a new cycle begins.

Length of menstrual cycles

As women differ from each other, women’s menstrual cycles differ too. We often think about menstruations as occurring once a month, but while some women experience menstruation exactly once a month, others’ menstrual cycles may be longer or shorter. In most cases menstrual cycles recur every twenty to twenty six days. Some of us have regular cycles (the bleeding appears, for instance, every 28 days or every 40 days), while others have interchanging longer and shorter cycles. Sometimes small spontaneous changes may occur, and other times the changes are great, especially if you are under a lot of stress or losing a significant amount of your body fat. Significant changes to the length of the menstrual cycle occur more often as we get older, and especially after giving birth or when approaching menopause.

The number of bleeding days changes too: most of us have a bleeding period of two to eight days, when the average is 4-6 days. The flow starts and stops, though it is not always noticeable. Normal secretion during menstruation is about 4-6 tablespoons (approximately 1quater of a cup), or 50-90 grams. Many of us are surprised to hear that number, as it very often seems much more than that.

Fertility Awareness Method – FAM

Familiarizing ourselves with our menstrual cycle can be a useful measure for our health and fertility. Knowing and following the periodicity of our menstruation enables us to become aware of changes: to interruptions in the bleeding, to a delay in bleeding or to excess bleeding. Changes to the familiar periodicity might be a sign of a number of changes in the body, such as weight changes, mental stress, pregnancy, age-related cessation of menstruation, and various diseases such as thyroid gland problems and cancer. A follow up of the menstrual periodicity can be carried out in different ways: recording the different phases in a diary, a computer or a notebook – for instance, when we are bleeding, when do we have a vaginal secretion or when we experience a physical or emotional change (including changes in our energy, moods, pain, cramps, secretion amount, sexual desire, or general health). In addition to developing a general awareness to changes in the menstrual bleeding, we can learn the Fertility Awareness Method as a scientifically valid method to naturally controlled conception and contraception. The method is based on close observations and recordings of various signs which reflect when and if we are fertile. The menstrual cycle can be divided into three phases: an infertile phase that begins after the menstrual bleeding; the fertile phase (of which the ovulation is a part); and the infertile phase that begins after ovulation. Each of us can learn to recognize the phase she is in using three initial fertility signs: basal body temperature, cervical fluid and cervical position. However, please note that the limited information given here is insufficient and that effective reliable use of the method requires a careful learning. It is recommended to take a short course with a certified guide (for more information go to: http://www.poriutivit.com).

How we collect the menstrual blood?

Around the world, women use various products to hold or absorb the menstrual blood. The choice is usually made according to convenience, availability or familiarity, and depending on our financial circumstances. If we regularly monitor our secretions we can get to know their color and texture and recognize anything out of the ordinary or which does not seem ok, thus learning our bodies.

Many of us use commercial products in order to absorb the menstrual blood. Some of us use “external” products, such as menstrual pads or cloth strips, and others prefer “internal” products inserted into the body, such as the menstrual cup or tampon. These products are highly accessible and advertised on TV and in magazines, in stores, supermarkets and pharmacies. We will further discuss the alternatives for commercial products below, alternatives which many of us no nothing about.

Those of us who use tampons and menstrual pads should be aware of a health problems caused due to our exposure to Dioxins[20. Dioxins

Commercial tampons and sanitary napkins are made of cotton, rayon, or a combination of both. Rayon is an artificial substance made of wood chips, bleached with chlorine in order to give it a clear pure look similar to cotton. A by-product of the bleaching process is dioxin which has a tendency to be absorbed in the fatty tissue of the body and accumulate. Though dioxin is also found in sanitary napkins, they are less dangerous than tampons as they do not directly touch the vulva and the toxins do no penetrate our bodies directly.

The tampon companies, trying to avoid this health risk, say they bleach the rayon using chlorine dioxide (any oxide with a ratio of two oxygen atoms per molecule) instead of the chlorine gas, stating that the process is safer. However, the process still uses chlorine, and therefore still has dioxin residues.], which are known cancer causing chemicals with toxic effects on the immune and reproductive systems.

Alternatives for tampons and menstrual pads[21. Alternatives for tampons and sanitary napkins

Worldwide, women use alternative products for tampons and sanitary napkins, for environmental-ecological reasons, economical reasons, because of the desire to avoid the risk of TSS, or for reasons of comfort. Among the alternatives you might find unbleached tampons, chlorine free tampons, tampons made of undyed cotton, disposable cotton napkins, cloth napkins for multiple use, and devices that contain (not absorb) the menstrual fluid. These products are usually costly in the short run and are less available on the market, but if you can purchase them in the long run you can save money and protect the environment. It may take us some time to get used to the multiple-use tampon, and like any other alternative suggested above, it may not be suitable for everyone.]

Alternative absorbents

100% cotton tampons are available at natural health stores. These tampons are more expensive than the commercial ones, but they have their health benefits. If we chose to use these tampons, the ones made of organic cotton are preferable as cotton grown inorganically contain many toxins due to use of pesticides.

Disposable un-bleached cotton napkins are available at natural health stores.

Cloth (cotton) sanitary napkins for multiple-use are economic and environmentally friendly, and are also more comfortable and soft than nylon sanitary napkins. You can recycle the napkins by washing them. The napkin should be replaced every few hours, according to the flow. After use the napkins should be rinsed and immersed in cold water for thirty minutes and afterwards they are washable in a washing machine or by hand wash. You can also rinse them and keep in a bag if you are outside your home. A few women in Israel produce multiple-use sanitary napkins, and they are available on the web and in a number of stores; we can even make them ourselves.

Some of us prefer using products than collect the menstrual fluid instead of absorbing it. During menstruation these devices should be taken out, emptied, rinsed, and returned every few hours. At the end of menstruation, they should be sanitized in boiling water and kept until the next menstruation.

Multiple-use tampon (mooncup, keeper) or “menstrual cup” – cups made of flexible soft rubber or silicone that are inserted to the vulva and collect the menstrual blood.

The Keeper is a rubber (latex) elongated cup that is placed in the lower part if the vulva by vacuum (suction of air) in order to collect the menstrual blood. You can use a keeper when swimming or exercising but not while having sexual intercourse that includes penetration. The keeper can be used for 10 years.

A Mooncup is a bell-shaped cup, 5 cm long, made of soft medical silicone, and is especially suitable for women who are allergic to rubber. The mooncup is inserted like a tampon, so that the cup walls end together with the vulva walls, and the blood flows and accumulates inside the cup without leakage of fluids or odors. The device should be taken out and emptied every 4-8 hours, depending on the flow; afterwards is can be inserted once more.

Sea sponges is another absorbing multiple-use product. It is made of a natural sea sponge that has an activity similar to a tampon. The sponges are recyclable and are relatively inexpensive. Their disadvantage is the contamination that they might absorb from the sea. A possible solution for the problem is boiling the sponge in water for 5-10 minutes before the first use and between uses.

FAQ regarding commercial tampons

  1. Will the tampon get lost inside me? No, certainly not. Our body is wise, and the cervix (the gatekeeper of the uterus) will not allow it to go anywhere it’s not supposed to.
  2. Will tampons make me sick? No, most likely not, if we use them correctly and change them frequently, about every 4-6 hours. It is not recommended to use a tampon for long periods of time (such as through the night), and you should not use tampons with higher absorption capacities than you need since this kind of use might increase the risk of TSS (Toxic Shock Syndrome). Many of the tampon manufacturers state the risks of TSS and the risks of chemical traces and active substances that might cause irritation on the tampon packaging.
  3. If I use tampons, will it affect my virginity? No. The use of tampons might cause an expansion of the hymen.

Toxic Shock Syndrome (TSS) [24. Toxic Shock Syndrome

Toxic shock syndrome (TSS) is a very rare but potentially fatal illness caused by a bacterial toxin. It is believed that approximately half the cases of TSS reported today are associated with tampon use during menstruation. Research suggested that use of some high-absorbency tampons increased the risk of TSS in menstruating women. ]

Dirt?

Our bodies’ secretions and scents are a natural part of us and our vagina has a natural cleansing process. Without an explicit instruction from a medical expert, the interior part of the vagina should not be washed. Using a bidet and vaginal deodorants, even rarely, may change the balance between acids and bases in the vagina and cause infections. Vaginal deodorants contain perfumes which can cause allergies. In order to keep our bodies clean it is advised to wash the vagina daily in lukewarm water.

The fertility cycle, a cultural anatomic view

Our menstrual cycle, during our lifecycle as women, plays an important part role, both culturally and in our day-to-day.

The following discussion focuses on the social and cultural aspect and on varying points of view regarding Niddah customs, and also focuses on an alternative medicine perspective, offering a more positive approach towards our femininity and its signs on our bodies.

It is your menstruation – what makes it yours?

Many factors can affect the way we feel towards our menstruation and the menstrual cycle in general. Regrettably, the religious and/or cultural ceremonies, prayers and traditions express at times a negative approach to menstruation. The initial experience of menstruation may affect our perception of it many years later. We should remember that it is our menstruation and our bodies, and so we can decide how to treat it; whether we love it, hate it, or are indifferent to it. Our approach can significantly affect our daughters’ approach to their menstruation.
This section offers all of us new thoughts and perspectives on the topic, in search of the positive aspects of menstruation and of a change in our approach, and therefore a change in our daughters’ approach.

From the beginning of menstruation to its cessation

The Israeli social discourse of the 80s did not include an explicit attitude towards the monthly bleeding. A plethora of terms/code words existed in order to allow women to refrain from saying the “dirty” word, examples for this are: “red flag”, “the witch”, and “the aunt came for a visit”. Today, code words for menstruation are less common, though it seems that the idea of them has evolved. In the Israeli affluent society of the new millennium, marketing attitudes shape our lives. The media and the world of advertising are accomplices to the concealment of the truth. Bleeding and menstruation are not mentioned in commercials; the only word you might hear is “period”. Most of the blood absorption products are shown in blue/purple colors, and commercials rarely show any red colors. The message that these commercials send to women is that they need to display a feeling of “business as usual”, like in the tampon advertisements that say: “you can run with it, jump with it”. The secret was “upgraded” and became a “stowaway”, an integral part of our lives.

Changing our attitudes and approaches towards menstruation is an important part of other broad social processes which can further girls and women towards awareness and self and social acceptance. All of us – mothers, sisters, friends and professionals – can and should be partners in this process through open conversation, listening and taking actions.

Anatomic view, how does it affect us?

During the fertile years, the hormone cycle rhythm determines the ovulation and menstruation timing. Menstruation causes menstrual changes and PMS [25. Menstrual changes and PMS

The menstrual cycle is controlled by hormone levels that increase and decrease in a cyclic pattern. These hormones cause physical and emotional changes that some of us experience during our monthly cycle. Different women experience these changes in different ways and levels: some of us notice few differences, others experience extreme changes; some of us experience periods of excess energy and creativity, while others experience mood swings and physical changes. Some women experience menstruation in a very negative way, that includes mood swings, fatigue, depression (often moderate, but sometimes severe), swelling, sensitive breasts, and headaches. Such menstrual changes may sometimes significantly disrupt our lives. The symptoms and hormonal affects may vary in women from one month to another and throughout life.

The term PMS (Premenstrual Syndrome) is based on the premise that premenstrual changes are a disease. Truly, some women experience menstruation as inconvenience, fatigue, cramps, or pain, but the term labels this as an all embracing problem and does not reflect the true and meaningful variety of this feminine experience.] in many women. Some women experience these changes in greater severity, in the form of dysmenorrhea[26. Dysmenorrhea

Women experience different levels of pre-menstrual cramps (convulsion). The symptoms that accompany the cramps often include nausea and diarrhea that are caused by an excess production of prostaglandins (chemicals that cause contraction of the uterus and the bowel muscles). An excess level of prostaglandins leads to rhythmic contractions of the uterus that can be accompanied by pain.

Science distinguishes between two types of dysmenorrhea: primary dysmenorrhea, which is a bleeding related problem (and not pain related to pelvic problems); and secondary dysmenorrhea that occurs due to pelvic pathologies such as pelvic inflammation or endometriosis. Your treating physician can help you determine if you suffer from primary or secondary dysmenorrhea.] (painful menstruation) with nausea and diarrhea or in the form of Pre-Menstrual Depression [27. Premenstrual depression – when is it too much?

Mood changes, bad moods and depression prior menstruation can occur on a variety of levels. Sometimes we have more extreme expressions of emotions or even an expression of emotions that we weren’t able to express earlier. If, along with the feeling of depression, you feel extremely tired and are pale, you might be suffering from anemia and you should check your blood iron level.

If you notice that the premenstrual depression is more than just moodiness and that it significantly disrupts your daily life (you can’t get out of bed, you miss workdays, or you have suicidal thoughts) you should seek professional assistance. In recent years there has been much discussion regarding the definition and treatment of PMDD (Premenstrual Dysphonic Disorder), characterized by a combination of physical and behavioral symptoms such as excessive rage and anger, aggravation and stress. Some prefer not to label premenstrual changes in women as a specific disorder, as this may lead to a stigma of menstruation as a disorder. This supports the stigma that women “loose their minds” once a month, meaning that women are under a hormonal attack, they are irrational and therefore cannot hold authoritative, high or pressuring positions. Others feels that overlooking this syndrome, which some of us live with regularly, to be an even more disturbing phenomenon. Many women experience extreme premenstrual changes and depression, and the lack of social recognition of the phenomenon might cause them even more harm.]. Menopausal women can suffer from menorrhagia (excessive menstrual bleeding) and/or irregular bleeding[28. Menorrhagia (excessive menstrual bleeding) and/or irregular bleeding

If there was no ovulation during the menstrual cycle, heavier menstrual bleeding might occur. This is more common in middle aged women. Lack of ovulation and excessive menstrual bleeding can occur for many reasons, especially if we are very stressed, if we use an intrauterine device as contraception, after discontinuation of pregnancy, or if there is a myoma (benign tumor) or a tumor in the uterus.

Irregular bleeding – menstrual bleeding not according to schedule – can be a result of an aberrant pregnancy, the beginning of the middle-age years, a recent tubal ligation, or a different health condition. You might also experience irregular bleeding if you have a hereditary bleeding disorder.

Excessive menstrual bleeding and irregular bleeding can each be a sign of serious health problems, and therefore it is advisable to see a doctor in these cases. Managing a cyclic table with menstrual recordings can help us learn about “normal” or “typical” flow and help in the follow up of the menstruation and menstrual cycle length.] or from amenorrhea[29. Amenorrhea

Some women experience amenorrhea, absence of menstruation. Primary amenorrhea is a condition in which menstruation hasn’t appeared until the age of 16 (if secondary sexual signs have developed or 14 if no secondary sexual signs have started to develop). Secondary amenorrhea is the discontinuation of menstruation after at least one menstruation has occurred. Amenorrhea may occur for different reasons (other than pregnancy), that include: lack of ovulation, menopause, breastfeeding, intensive physical activity, emotional factors, pressure situations, previous use of birth control pills, use of certain drugs, a congenital anomaly in the birth canal, hormonal imbalance, cysts or tumors, chronic diseases, and chromosome anomaly. Amenorrhea is often caused by a combination of a few of these reasons. If you experience amenorrhea you should see your treating physician.] (absence of menstruation). Menstrual pain can be treated by using painkillers (Acamol, Optalgin, and prescription medications). Alternative medicine also offers various treatments to these symptoms/syndromes.

Menstruation suppression[30. Menstruation suppression

In recent years a common trend of initiated menstrual suppression has developed – using hormones or other drugs to decrease the number of menstruations or to stop the bleeding altogether. Women suppress menstruation by using different contraceptives; Depo-Provera, for instance, is an injected hormonal contraceptive that prevents ovulation, and is usually accompanied by adverse events as amenorrhea. Additionally, some birth control pills provide hormones for a long period of three consecutive months, what only leaves four times a year without hormones during which menstrual bleeding will appear.

For years doctors have been using initiated menstruation suppression to treat women with painful menstruations or other problems. In recent years a different discussion is developing which suggests that healthy women take medications to ease their coping with the monthly menstruation. Investigators are at the start of a data collection process regarding the health implications of initiated menstruation suppression, but for now there is insufficient data from a large enough number of women over long periods of time.

The wish to stop menstruation warrants thorough inquiry. Some of us believe that our monthly cycles are a sign for our health, while others experience them as painful and disturbing. Menstruating each month is a natural phenomenon; it’s the body’s way to healthily cope with not conceiving. It is advisable to refrain from treatment if we are not ill.

Adapted from the third English edition of Our Bodies Ourselves, 2005.]

Sex during menstruation

Based on personal experience, sex during menstruation is a liberating, relaxing, accepting, loving and an arousing experience. It was not easy to free myself and allow myself to feel this way. The bleeding is considered such a dirty thing, something that makes us clumsy, smells bad, and in general it is probably advisable to stay away from the vaginal area for the two to seven days of monthly bleeding. How did all these things turn into something that not only is not a problem, but is also really sexy?

One of the things that make it so sexy is the thought of it. Sex during menstruation is swimming against the current, literally. Everything we are told about menstruation, and therefore by implication about our bodies, that it’s too dirty, too smelly, too hairy, not smooth, not tight, not always understandable, not always “user friendly”: how does the vagina work, our mysterious cave? – All of these things are embodied in the menstrual blood and therefore we should keep away from it as much as possible. And if we rebel against this and say “especially now I will touch myself and have sex”, pleasure awaits us. The feeling of freedom that accompanies this step is huge, especially because it feels as if all boundaries have been broken, however far from reality is it.

The menstrual cycle, Niddah, and I

The Jewish laws of Niddah originate from the bible. Later on they were developed by Chazal and in the Halakha. Today the custom is that religious married couples who follow the laws of Niddah, refrain from having sexual intercourse from the beginning of menstruation and until a week with no bleeding has passed. At the end of the Niddah period, the woman immerses herself in the Mikvah, and after that intercourse is allowed. These laws have evolved throughout history. In different times and in different places the laws were kept differently, and even today women of various Jewish communities keep this mitzvah (not only women who define themselves as religious).

The Mikvaot in Israel are supervised by religious councils, and as such are under the supervision of the Chief Rabbinate and its representatives. This fact can become a problem for secular women who are required to immerse themselves in the Mikvah before their wedding.

Keeping the laws of Niddah has had its ups and downs in the course of time. In certain periods it was perceived as a unifying symbol of Jewish people, living amongst other peoples. In some cases the rabbis and the women argued about the right way to keep the mitzvah, which is wholly in the hands of women. Many couples did not keep it, inter alia because of the difficulty of finding a safe place to immerse in water. As academia and secularism evolved in Jewish communities during the 19th and 20th centuries, keeping the laws of Niddah was abandoned by many Jewish women. Even today, the debate regarding the laws of Niddah is complex and ever-changing.

Different questions that arise in the modern context are: to which degrees should women keep these/some all of the customs surrounding Niddah? Should couples be completely separated throughout the entire period, prohibited to have any contact during the Niddah? How can the connection between the impurity stigma in relation with menstruation and the personal feminine experience be broken? Another issue that has recently become central in public debates is the question of the duration of the waiting period before going to the mikvah and having sexual intercourse. Doctors have asserted that women miss their ovulation due to postponing sexual intercourse until after the visit to the mikvah (Religious barrenness). This discussion has lead to a new discourse regarding the laws of Niddah. Gynecologists today are aware of the religious problems stemming from the Niddah system, in relation to fertility and to irregular bleeding. Another change that has occurred in recent years is a higher female involvement in connection with guidance and teaching the law of Niddah: for hundreds of years the rabbis had the supreme authority in these matters, and today there are many women’s groups called Halakha consultants, who have be taught by the best rabbis and are now an alternative address for other women seeking guidance.

Niddah and impurity / Haviva Ner David*

The rules and rituals regarding impurity and menstruation are kept today by most religious women. The preservation of these laws is intriguing because of the disappearance of other rituals of impurity and purity after the destruction of the second temple. Women who keep the laws of “family purity” conduct, for instance, internal vaginal checks on a regular basis and a monthly immersion in the Mikvah in order to purify, whereby allowing sexual contacts with their spouses. Why do we do that? Where does this custom stem from and what are the perceptions that lie within this custom? Can we untie the negative bonds between impurity and femininity, and how?

The Niddah blood is a unique case within a general system of the Jewish impurity and purity rules, since the rest of the rules and rituals are relevant only to rituals performed in the temple. Moreover, the Niddah impurity determines if the woman can have sexual relations or not, meaning it is the only type of impurity that has practical implications today.

The fact that only the Niddah impurity is relevant for our time has made the discourse on impurity, including its negative connotations, focus solely on women’s bodies and their bleeding womb. Many religious Jews think that only women’s bodies are a source of impurity, and that the Torah does not define other cases as impurity. This is, of course, a falsehood. Since the destruction of the second temple the Torah defines all Jewish people as impure. In a sense, we are constantly impure.

The irony is that religious and traditional women purify themselves each month at the Mikvah while immersing in the Mikvah, while men stay impure all the time. Most men do not immerse themselves in the Mikvah at all, and some chose to immerse only before the Sabbath or before Yom Kippur. Therefore, we could assume that women who immerse regularly in the Mikvah would be considered “less impure” that men, however this assumption is far from the truth.

The concept of impurity, with relation to the set of rules and rituals accompanying feminine menstrual blood, needs a positive interpretation; it needs to be interpreted and defined in a manner that suits our modern and feministic sensitivities. But an ideological interpretation is not enough: if we continue carrying out rituals that perpetuate negative attitudes towards women, the phenomenon live on. We can create positive rituals regarding the menstrual blood, the monthly menstruation – its beginning and its cessation – and the bleeding that follows labors or pregnancy discontinuations. Women are perceived, in our social subconscious, as a source of impurity. Once a girl gets her first period and until she begins to immerse in the Mikvah as a married woman, she is constantly considered impure. Therefore, a young girl’s first menstruation is not a cause of celebration in the Jewish world.

This attitude is emphasized by the fact that there is no traditional ceremony that symbolizes the first period of a Jewish girl. We can see this as ignorance in a turning point of women’s lives, but in most case it is considered, at least sub-consciously, as a moment when a woman goes from purity to impurity.

It is important that we, as mothers to our daughters, make sure that our daughters’ first menstruation is a positive experience that will act as a counter-balance to the negative association between impurity and femininity. There are many creative possibilities to make that experience an enjoyable, meaningful event which they can share with their daughters. We can, for instance, have a “mother-daughter” evening, or celebrate the event with close friends. Ceremonies that mark miscarriages or menopause can be empowering and consoling, and they can even help erase the taboo concerning central events in our life.

Creating new rituals is not the only way to cope with the negative perceptions of impurity related to the menstrual blood. Another way is reinventing existing ceremonies. Maintaining “family purity” has caused damage with regards to women’s perceptions of themselves and their bodies, but this is a feminine ceremony focusing on women and their bodies, and as such it can potentially be a source of positive empowering spiritual expression.

We are responsible for this renewal. If we continue keeping the practices of “family purity” exactly as it has been passed on from generation to generation, and kept since the Talmud times, we will perpetuate the negative perception of impurity related to it. For example, though impurity is not a relevant term in the time after the destruction of the second temple, Rabbis and ordinates have emphasized traditions related to refraining from impurity. In the Talmud we find “distancing”, meant to prevent sexual arousal of the spouse by refraining from gestures of closeness and intimacy (i.e. making the bed, washing the spouse’s feet, etc.). Other practices have been added over the years, like the prohibition of eating from the Niddah’s dishes, or sitting on her bed. These acts of distancing are ancient remnants of the purity and impurity system that was followed before the destruction of the temple, creating the feeling that the distancing from the woman stems from a fear of “contamination”, rather than from mutual agreement to avoid sexually arousing contact. Instead of accepting this system of rules as is, we can differentiate with our spouses, between avoiding “foreplay” or other sexual practices, and other acts of distancing which are no longer relevant in this day and age.

Moreover, though there is no basis for this in the Halakha, women are distanced during Niddah not only from their spouses, but from holy objects; for example, they are not allowed to touch the Torah, and in some communities they are to refrain from entering the synagogue. These traditions, and others, have been strengthened by Rabbis and ordinates such as Moses Isserles who wrote an obligating interpretation of the Shulchan Aruch. Surprisingly, this trend is still very much alive. Rabbis of modern religious communities claim that women during Niddah are not allowed to dance with the Torah during Simchat Torah.

The Torah clearly distinguishes between Niddah – regular menstrual blood, and Hazava – irregular uterine bleeding. According to the Talmudic Halakha, the Niddahis impure for seven days as of the beginning of the bleeding, as long as the bleeding lasts seven days or less. If the bleeding lasts eight days or more or if the woman experiences bleeding form more than three days not within the period of menstruation, the woman is defined in a state of Hazava (i.e. “problematic” bleeding). The woman should wait until the bleeding is over, and wait seven more days until she can immerse in the Mikvah and purify.

During the Talmudic period, the laws of Niddah and the laws of Hazava were united. According to the Talmudic Halakha, every woman experiencing uterine bleeding, during menstruation or not, and regardless of the length of the bleeding, must wait at least five days (in order to ensure that the sperm in her body has lost its power and cannot pass impurity to others), and after that she can conduct “Hefsek Tahara” – an internal check to confirm that the bleeding has ceased. After that the woman must wait seven days before immersing in the Mikvah and having sexual intercourse. In other words, the Talmudic Halakha turned the woman’s normal healthy menstruation into a disease, equal to irregular bleeding.

Women can take action with regards to “family purity”. We can for example choose to keep the Halakha as written in the Torah, instead of keeping the Talmudic Halakha.

The Rabbis have created in practice a new category of feminine barrenness that exists only in women who keep Niddah laws: “religious barrenness”. Women in this category ovulate before the seven days have ended and before they can go to the Mikvah and have sexual intercourse. Therefore, though they are healthy and fertile, they cannot get pregnant. This “problem” is “solved” by doctors who prescribe pills that postpone ovulation. Thus, instead of creating a solution to the “problem” from the side of the Halakha, modern rabbinical authorities have forwarded the problem to doctors who prescribe medications to completely healthy women.

Women do not have to accept this reality passively. It is important to note that we can go back to biblical “family purity”, according to which the woman immerses seven days after the beginning of the bleeding, and only a woman with irregular bleeding waits seven more “clean” days. In addition, instead of bearing the burden of these rituals alone, we can ask that our spouses take part in the ceremony and immerse with us. There are many natural Mikvaot where men and women can immerse together – the sea, lakes, rivers, and natural springs. If we insist that men immerse too before reuniting the couple, the immersion in the Mikvah will become a cleansing of the partners one for the other, within the renewal of the sexual relation between them, instead of the purification of the women’s impure bodies.

Instead of throwing the Niddah laws out with the Mikvah water, women who want to reconnect to religious ceremonies can look for new ways to reclaim the Niddah and Mikvah mitzvoth. Interpretation and practice can make these ceremonies a source of spiritual empowerment and enrichment, instead of being a source of spiritual humiliation and depletion.

My body’s Judaism – Niddah and immersion in sanctity / Esther Yedgar*

I am a traditional, Sephardic woman and I keep the laws of Niddah. As such, my experience in the Mikvah is different from the negative experience many secular brides talk about. I love going to the Mikvah for many reasons. I know the claim that it’s an unpleasant place. In many Mikvaot this may be true. They are not clean enough and secular women do not always feel wanted there. I can only say that there are lovely Mikvaot and friendly bath attendants, you just have to find them.

On the day of immersion in the Mikvah I devote time for myself, wax my legs, shape my eyebrows, have a facial treatment. I nurture my body, but also my mind. Immersion is an opportunity to look inside. I stand naked in front of God and pray – accept me as I am, help me to accept myself as I am. In the Mikvah a woman voices her most secret wishes in prayer, asking for her husband, for herself, for her home. Unlike men in the synagogue, I do not hide behind a Tallit or a Sabbath suit. As he created me I stand in front of him, and this allows me to find loving acceptance of all of my bodily flaws. In the Mikvah’s mirror I measure myself differently than in front of any other mirror. It is not my youth, skinniness, or beauty that I seek. I seek my femininity, tenderness, motherhood, Judaism of my body. I don’t judge myself as much at the Mikvah, I am less enslaved by the “secular” beauty ideal.

Coming home is accompanied with great expectation. At home my loving husband awaits me with a romantic dinner. The phone is disconnected and no one except us exists. Even after thirty years of marriage with God’s help this is a night in which I am a young bride, coming home from the Mikvah.

My husband does not await the sexual promise hidden in the immersion. He awaits my love, the sanctity I bring along with me, our intimacy that had disappeared (especially due to my nerves during menstruation), and to our long-unconsummated love. Tonight we love, know and discover each other, confirming our bond. True, you don’t have to keep Niddah in order to experience romantic moments in a marriage, but how many of us really know how to do this? Sometimes you need to be away from each other to rediscover how fun it is to be so close.

I do not feel impure during menstruation. Since the destruction of the second temple, all Jewish people are impure. I do feel sacred when I immerse in the Mikvah. As a woman I am responsible for the sanctity of the home, of the Sabbath, of Kashrut, of anything that brings magic into my family. I realize this magic every month.

In North Africa, women went nowhere alone, except to the Mikvah. My grandmother, Mama of blessed memory, would take her girls and immerse in the Mikvah. A multiple-participant event that was very intimate. The Mikvah, like the kitchen, was a private place for women. It was the place where the community notices that a girl is ready for marriage, barren women immersed to brake the “curse” of their barrenness, and everyone offered them medicines and spells. Women who suffered from their husbands got a night off, and women who loved their husbands were excited for what was to happen that night. The Mikvah was not just keeping a Mitzvah, it was also a night of intimacy, of company. Today I immerse alone, but feel that I am accompanied by all those women, singing and laughing, telling secrets.

In a society in which the religious-secular polarity is increasing, it is easy to find a middle road if you can see its beginning. As many Sephardic people, my husband and I built a traditional home, we choose every Mitzvah we keep, and keep it in the most equal way. Niddah is one of these Mitzvoth. The man has responsibilities during Niddah, no less than the woman. During Niddah the man needs to soften and support his wife, count the days with her, support her in her pain; to me it is like childbirth preparation. My husband and I chose not to keep the customs of separation between man and woman – keeping physical distance, separate beds, dining on the same table with a barrier between us, etc. This choice stems from the fact that our equal relationship does not cause me to seek separation during Niddah. Unlike Mitzvoth, customs are rules that a person is not obligated to keep, if they weren’t kept in his parents’ home. In Algeria, women during Niddah did not cook at all. In those far away days, when the man was king for half a month, during the other half he was at the mercy of his sister to cook for her. At least that was my grandfather’s situation. My husband does not have to suffer this, as we cook every meal together.

There are many customs of Niddah. The Ashkenazi Jews are as usual more strict than the Sephardic. My friend does not immerse in the Mikvah; only in the Sea of Galilee. The Mitzvah is to immerse in pure water. In Jewish communities where there was no Mikvah, the women used to immerse themselves in the river or lake even during the European or Iranian cold winter. Thus, my friend keeps a custom that she relates to (a bond to nature, and the bonus of staying away from the unpleasant Mikvah where she lives). There are many diverse ways to keep Niddah, and through this, preserve the way women created a closed feminine circle inside the communities from which their families came.

Diary of a Halakha consultant / Tova Genzel*

Since I got married I have been keeping the laws of family purity, known as ‘Laws of Niddah’. I grew up in a home where the Halakha was strictly followed, but like many of my friends I new nothing of the issue directly related to the relationship between husband and wife. When we decided to get married, between preparing the house and planning the wedding, I asked a friend to teach what should be kept and how. Smilingly and seriously, she became my “bridal counselor”. She taught me that our joint life is divided into different periods. Beginning with menstruation, and throughout the whole bleeding period, physical contact between the spouses is forbidden. After the bleeding days are over, in order to purify, we count seven clean days. ‘Clean’ means clear of visible blood. In order to make sure that the bleeding has stopped; we should carry out a daily check using a white cloth (sold especially for this purpose at Mikvaot and pharmacies. The check is similar to inserting a tampon). The first check is conducted before we begin to count seven days. This way we make sure the bleeding has begun (‘Hefsek Tahara’) and afterwards we check on each of the seven days. Finally, at the end of the seventh day, the final preparations are made before going to the Mikvah, including a full body treatment (in time of favor, this is a time to halt the flow of life and think of the spiritual meanings of the Tahara, of the renewal of the old-new contact between the spouses, and more); and after that, to the Mikvah. A last shower, to make sure nothing separates me and the water. Immersion in the Mikvah. After the immersion a new period begins, during which the relation between the spouses can be expressed through physical closeness; this period begins upon coming home from the Mikvah and ends the next time I get my period.

In addition to teaching me these laws, my friend also explained to me the practical elements of keeping the laws. It was like the difference between reading how to keep the Sabbath in a book, and talking to someone who keeps the Sabbath and hearing how her Sabbath actually looks and feels.

I am grateful to this friend of mine.

Since then I have learned more – time and experience take their course. I have learned that keeping these laws depends on the power to ask when the situation is unclear: I’m pregnant. I’m after childbirth. I’m breastfeeding. I’m using contraceptives. The bleeding that is usually foreseeable and understood is suddenly confusing. When should I start counting the seven clean days? What should I do if I see an unexpected bleeding during these days? Should I start over? And what happens when the couple is having trouble getting pregnant, and they are afraid to miss the ovulation while waiting for the Mikvah immersion? And what about the time when the menstrual cycle begins to shorten during the middle-age years?

We should go to the rabbi. The rabbi?! It has been so from time immemorial.

But we live in a new generation now. Talking to a rabbi about the duration of my bleeding? It’s possible, and many rabbis are aware of the difficulty the situation might pose.

However, today there is an alternative.

I belong to a group of women called “Halakha consultants”. We learned the Niddahlaws for two intensive years, with the guidance of great rabbis, and today we are an alternative address for women seeking guidance. Women from all social sectors come to us, without the need to identify themselves, and ask questions. Many times the women come to us for a short question regarding the Halakha, but at times the conversation with a female Halakha consultant, who understands the issue and is sensitive to the difficulties and the conflicts that stem from the questions of Halakha in this area, can allow listening, talking, crying and many sighs, some of relief. We can be contacted on the phone, or you could ask a question using email. If necessary we can also meet face to face.

We are guided by rabbis, and we consult with then when necessary.

Our website: http://www.yoatzot.org

* Dr. Tova Genzel, Halakha Consultant