Person at the foot of a mountain with the upside down image of the "female" reproductive system. Flare up, hiking

Provisions and Period Panties: Hikers With Endometriosis Get Creative When They're On the Trail

During the Covid-19 pandemic, many people embraced outdoor activities as an escape from quarantine. Being in nature can have positive effects on your mind and your body since the great outdoors can promote relaxation and exercise.

However, an outdoor stroll or weekend camping trip can quickly turn painful if you have endometriosis.

May brings sunny days and herds of grazing deer to Yellowstone National Park. But May 2021 also brought a surge of tourists into the park.

Yellowstone reported that their summer tourism in 2021 had gone up 11% when compared to the number of people who visited the park in 2019.

Many other sites, like Grand Teton, also hosted record-shattering numbers of hikers and campers.

The Outdoor Federation backs up these stats. According to the organization's 2021 Outdoor Participation Trends Report, 53% of Americans engaged in recreational outdoor activities during the pandemic: the highest number on record.

However, women statistically spend less time participating in hiking and camping than men.1

Menstruation may contribute to this gender disparity. Being on your period can pose challenges when a woman is stuck outdoors.

Hiking challanges with endometriosis

If you have endometriosis, these challenges (and the mountain you're hiking) may feel insurmountable. Common symptoms of endometriosis include heavy bleeding, irregular periods, digestive problems, and severe pain.

Each of these symptoms can make camping or hiking difficult, if not dangerous.

Imagine that you're in the middle of a hike, or you've just made camp when you start to feel the telltale signs of an endometriosis flare.

If you're far away from the nearest restroom, you may not have an easy way to clean yourself with your precious supply of drinking water. Wearing wet, soiled undergarments can cause a woman hiker to feel embarrassed and uncomfortable.

But if a woman is forced to stay in her bloody underwear for hours on end, she may also develop skin irritation, rashes, or a yeast infection.2

Some women who struggle with extreme cramps may be unable to walk back to their vehicle, so they may have to endure more time outdoors even if they're not prepared.

Unfortunately, I don't have to imagine the above situation. I've lived it.

Last summer, I joined the other Americans who spent more time outdoors. Here in Florida, hikers are rewarded with crystal blue springs, birds, and lizards.

A small group of my friends and I planned to meet up at a nearby trail to spot alligators. My bag included all of the stereotypical "essentials" for a short hike: a water bottle, sunscreen, my camera, and some basic first aid supplies.

Unfortunately, most outdoor blogs don't include endometriosis essentials on their packing list. When I got to the trail, I began bleeding and cramping.

With no restroom in sight, I made a swift retreat back home.

Later that day, my friends sent me pictures from their hike. They saw several alligators and were excited to have spotted some elusive wild ponies.

Over the last year, I have visited that same park several times. I have yet to see the ponies.

I am not the only woman with endometriosis who has dealt with FOMO because of my symptoms. Groups like Disabled Hikers are empowering people with chronic illnesses to reclaim outdoor adventure.

Their website states, "The physical, mental, and emotional benefits of access to nature are widely known, yet communities that need these benefits the most are often excluded from outdoor spaces. What does accessibility in the outdoors actually mean, and how can it be improved for all people with disabilities?"

Hikers with chronic illnesses like endometriosis can visit the Disabled Hikers website to find suggestions for accessible trails and campsites.

It's a cruel irony that, while it may be difficult for us to get outside, women with endometriosis can also greatly benefit from being in nature. People who have chronic illnesses may spend more time indoors, which can lead to Vitamin D deficiencies, anxiety, and seasonal depression.3

Several medical studies suggest that people may feel less stress (and even less physical pain) after they spend time in nature.4

If you're planning an outdoor trip, it's important to prepare for the unexpected. Having an endometriosis-friendly backup plan can give you a more peaceful trek and more peace of mind.

Preparing to go outdoors while having a possible flare up

Here are some questions and suggestions that I consider before I spend extended time outdoors.

  1. Does this location have a nearby bathroom? Can I plan my hike so I can remain in close walking distance to the toilet?
  2. If I experience a medical emergency like debilitating cramps, will I have phone access to contact a friend or park rangers for assistance? Should I invite a loved one to hike with me, just in case?
  3. If I begin bleeding, do I have enough water to drink and wash? Do I have some wet wipes that can help me stay clean? Do I have an extra pair of underwear and a waterproof bag to store the dirty clothing?
  4. Did I pack my menstrual cup or other menstrual products that I might need?
  5. Is my first aid kit stocked with some pain meds or other medical tools I need to manage my pain?
  6. If I am camping or hiking on an extended trip, I might need more supplies if I have an endometriosis flare. Have I packed an emergency blanket, lamp, battery pack, some extra protein bars, a hammock or seat, and other tools that can keep me as safe and as comfortable as possible?

These questions can help me determine which hiking trails could be safe options for my body and my needs.

When I stuffed my backpack to go on that ill-fated hike last summer, I did not know that I would need some extra supplies. Now, I make sure to include some emergency items in my pack so I'm always ready to visit nature, even when Mother Nature decides to spontaneously visit me.

What to bring with you when hiking

Your supply list may be different. Consider consulting your local park rangers, your doctor, and other hikers or campers with endometriosis as you prepare your own kit.

  • Pain medication
  • A blanket to use if I need to sit and rest
  • Tissues for emergency toilet paper
  • A rechargeable TENS unit
  • My menstrual cup and a pair of period panties
  • A pack of wet wipes
  • A battery pack to charge my phone just in case I need to call someone for help

Other options you might consider

For some people with endometriosis, hiking and camping may not be safe even if they do pack some extra hygiene and medical products. You don't always have to be physically in a natural setting to reap some of the mental and physical benefits.

Psychologists at Canada's University of Waterloo conducted an experiment where participants spent time roaming in a virtual simulation of a forest. These researchers found that virtual nature scenes can also reduce a person's stress and physical pain.5

Some video games like Skyrim, Walden: A Game, and The Witcher: Wild Hunt transport players to highly detailed landscapes. The forest scenes and mountain peaks in these games are quite realistic, so a gamer may almost feel as though they are walking through an actual National Park even if they're sitting in front of a computer screen.

Adventurous people can use digital technologies to explore nature. If you'd like to incorporate more physical exercise into your virtual hike, consider using a VR headset and handheld controllers.

These virtual realities can help you feel a little closer to the great outdoors. Just don't try to climb up on your furniture as you try to scale a VR boulder.

You don't want to start an avalanche by knocking over a pile of laundry.

The nature tourism industry still has a long way to go before every trail and national park is accessible to people with endometriosis. As we advocate for parks to make these changes, we can help keep ourselves safe by packing extra supplies and trying out virtual nature therapy.

Women deserve to be safe as we go outdoors. Endometriosis doesn't have to keep us hiding in the shadows. Next week, I'm going to visit the hiking trail again.

And I have a good feeling that this time, I'll finally see the ponies.

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