zebee

This is knowledge I've gained over years of having to figure this stuff out myself, now shared in a handy format for you and anyone who needs it. 
All my life I've had very heavy periods. So heavy that I'd fill a menstrual cup (25-30ml capacity) in an hour. So I bleed around 250-300ml on my "heavy days" which number four out of seven days of my period... that said, my most recent period lasted 15 days, around half of which were heavy days. 

Products that can hold heavy flow:

A menstrual disc, worn with backup like period underwear. A disc has got a much higher capacity than a cup, often as much as 60-70ml, and it's much gentler to take in and out if you need frequent changes. It also sits differently in the body and is suctionless, so I find it more comfortable. If you don't want frequent changes even though it's filled up, it can autodump once it's full and tuck back in place. It also, in my experience, holds more than its capacity (it sort of plugs the blood up). I love the autodump feature, and this feature is also why I recommend wearing backup with it. Here's how to insert a menstrual disc. And here's the autodumping feature explained. There are also discs with removal stems depending on whether you have a high or low cervix. I have a high cervix, but I couldn't stand menstrual cup stems, so I chose a disc with a ring to pull: the Elskbar menstrual disc. Occasionally if I can't find the ring to pull, I just bear down the way you would while peeing, and my muscles push the disc far enough in front for me to grab the rim and pull it out.

Oh, side note, here's how to measure your cervix. Your cervix can change in height during your period so it's best to check then!

Cloth pads. They absorb much better than the disposable variety and I have fewer leaks with them because often even their wings are absorbent (unlike disposables which have flimsy wings). My flow is gushy and it doesn't float in a puddle on top of the cloth pad the way it used to with disposables. While I love my menstrual disc and it has changed my life, on some heavy days I don't want to plug the flow, I'm more comfortable letting it flow out.

This section is going to be comprehensive because there's a lot to say about what sort of cloth pad to choose, and other considerations.

Choose the right absorbency.

Gusher pads are a good bet. These are pads with channels ripped into the topper, and they usually have multiple layers of a really absorbent core like zorb or bamboo terry. These are mostly available in the Western world, not where I live, so I haven't tried them. But I've seen them talked of online, and Etsy has a lot of options. According to heavy bleeders in the West, they work well for a tap-like flow. If you can sew your own pads or get them custom made, here's a video about the best fabrics to use for heavy flow pads. And here's what a gusher pad looks like.

Since gusher pads aren't available to me, what do I use? I'm so glad you asked.

These are the most absorbent pads I've ever worn: Saukhyam reusable pads. They have saved my literal life along with the menstrual disc. They are cotton topped, with banana fibre for absorbency. They come with base pads plus inserts, and while the base pad can be used on its own, I use the inserts for the extra absorbency. The base pad has a waterproof PUL beneath the banana fibre, and cotton backing so that it stays put in underwear. These pads are thin, because the banana fibre is a single absorbent layer, but it's astonishingly absorbent. They've performed better for me than other cloth pads with multiple layers of zorb or polyester in the absorbent core. And they're available internationally, at least in the UK. The UK store doesn't seem to have as many shopping options as the India store (for instance, in the India store you can choose an entire pack of just "night pads" which are the pads I go for, since they're the longest, and the size of the pads in the India store varies slightly based on your age and weight. The UK store pads seem to be one size.) It's important to wear well-fitting underwear with these, so that there's no gap between them and your body. I recommend wearing them on top of period underwear for the snugness and extra protection.

Isn't washing a huge pile of cloth pads exhausting? It doesn't have to be. The best way is to pop them in the washing machine with bioenzyme detergent splashed on top of them (plus an oxy stain remover type thing if you want), and put them for a rinse + spin cycle, with the highest spin setting. Take them out and sun dry them or put them on the radiator. I wash them every day of my period by basically popping them in the machine before I go have my bath, so by the time I'm washed they're washed too. Leaving them for days at a time without washing them is more likely to make the stains set in.

Period panties. These are great for backup, and for nights. My favourite brand is Nushu because they use skin-friendly cotton and modal (I can't stand polyester being the first layer my skin touches). Their absorbent layers are zorb, and they ship internationally. I recommend the Seamless Hip Hugger because the bonded seams prevent side leaks, making them great to wear on their own, too, not just as backup.

What do I do about feeling drained all the time? Until we get universal menstrual leave, I don't know what to tell you besides the things you probably already know. Nor do I know how to replenish myself quickly enough to replace what I've lost. But doing something is better than nothing, so. Take blackstrap molasses for iron and magnesium. Coconut water or other drinks with electrolytes. Rest as much as the world allows you.

And that's all I've got. May the menstruation go easy on you. If you've any questions for me, ask away, and I'd love it if you shared your own tips.

Crossposted from my journal.