Feminine hygiene on a trek in Nepal, the essential guide for every woman

Feminine hygiene on a trek in Nepal is easily the question I get asked most often in private messages, way more than “which jacket should I pick” or “how much elevation gain should I expect.” And I get why: spending three weeks on the trails of the Annapurna or Manaslu circuits without running water, without guaranteed privacy, and sometimes in sub-zero temperatures takes real preparation. The good news is that with the right gear and a few habits picked up on the trail, it’s actually very manageable. I’ll share what I’ve tested myself over several treks in Nepal, what actually works at altitude, and what I wish I’d known before my first departure.

Why this topic still isn’t talked about enough

There are dozens of guides out there on choosing boots or dealing with acute mountain sickness, but very few that dare to talk openly about periods while trekking. That’s a real gap, because the female body reacts differently to altitude, cold, and prolonged exertion. The cycle can shift, come early, come late, or become heavier because of physiological stress. I’ve seen trekkers panic in the middle of the Khumbu simply because they hadn’t planned for this at all.
This silence around the subject also comes from a certain cultural modesty, reinforced by the Nepali context, where traditions around menstruation are still marked by local taboos in places, including some remote valleys where the practice of chhaupadi still exists, a custom that isolates women during their periods. As a foreign trekker, you’ll never be confronted with this practice directly, but it’s worth knowing it exists so you can understand certain local sensitivities and show respectful discretion in traditional villages.

Choosing the right gear before you leave

Packing the right supplies is probably the single most important step. On the trail, you won’t have a pharmacy at every stop, nor guaranteed privacy in the lodges. So you need to arrive with a kit built for complete self-sufficiency.
A menstrual cup remains, in my view, the best solution for a multi-week trek. It cuts down on waste, lasts up to twelve hours, and avoids running out of supplies, which can quickly become a real problem once you’re past Namche Bazaar, where shops become scarce. I switched to this system four years ago and I wouldn’t go back to disposable products on a trek for anything.
Period underwear is also an excellent option, especially as a backup to the cup, for nights or lighter-flow days. It washes easily in cold water at a lodge, dries fast thanks to the technical fabric, and prevents the nighttime leaks that are a real source of stress in a shared dorm.
For anyone who prefers disposable products, I’d recommend going for biodegradable or compostable versions, which are kinder to a mountain environment already under strain from mass tourism.
Here’s the essential kit to pack before you go:

• a menstrual cup suited to your body, tested at home beforehand
• two to three pairs of period underwear for nights and backup days
• a small bottle of mild, unscented, biodegradable soap
• reusable waterproof bags for dirty laundry or waste
• alcohol-free intimate wipes for days with no water source
• a water bottle or bladder used exclusively for intimate hygiene
• water purification tablets, also useful for washing safely

Managing your period at altitude and in harsh conditions

Altitude has a real effect on the menstrual cycle. Lower atmospheric pressure, intense physical effort, and the stress of acclimatizing can cause a delay, an early onset, or a heavier flow than usual. It’s not guaranteed to happen, but it’s common enough that I’d advise packing supplies for a full cycle even if your period isn’t due during the trek.
Cold weather also complicates the logistics. Changing at minus ten degrees in a tent or an unheated lodge on the Manaslu circuit takes some organizing. My trick, tested in the field: I get my evening supplies ready in a waterproof bag that I keep at the bottom of my sleeping bag overnight, so nothing’s frozen when I wake up. A small detail, but it genuinely makes a difference to daily comfort.
Hydration matters a lot here too, and it’s often overlooked. At altitude, you urinate more because of altitude-induced diuresis, and you tend to drink less simply because you lose track. Good hydration helps limit cramps and regulate flow. I personally aim for at least three liters of water a day above 3,000 meters.

Washing and managing privacy in the lodges

In the teahouses of the Solu-Khumbu or Annapurna regions, hot water is scarce and often costs extra. So you learn to make do with basic squat toilets, sometimes just simple pits, and limited privacy in shared dorms.
My technique is to always ask the kitchen for a bowl of hot water, usually for a few rupees, rather than waiting for a hot shower that might never come. That hot water is enough for a quick, effective intimate wash, even in the bitter cold. I follow up with biodegradable wipes to finish the job, especially at higher-altitude lodges where water becomes a genuine luxury.
For washing clothes, aim for the quieter hours in late afternoon, when other trekkers are still on the trail or at dinner. Laundry rarely dries overnight above 3,500 meters, so I hang my period underwear on the outside of my backpack while walking the next day, tucked into a mesh pouch out of sight.

Handling waste responsibly

This is a point I think is essential and too often overlooked by trekkers in a hurry. Nepal already suffers from visible pollution on the busiest trails, especially around Everest Base Camp. Any waste left in nature takes years to break down at altitude, where the cold slows decomposition dramatically.
The rule I always follow, and one I recommend to every woman I trek with: any disposable menstrual waste has to be carried out in a sealed, opaque bag until you reach a proper trash facility in a town. Never count on local incineration in mountain villages, the infrastructure simply isn’t there for it.
That’s one more argument in favor of a menstrual cup or reusable underwear, which drastically cut down this logistical headache. Over a three-week trek, the difference in waste volume is huge.

Preventing urinary and vaginal infections

Urinary infections are a common reality on treks, caused by cold, dehydration, and staying in damp clothes after sweating. I had a brutal bout of cystitis myself around Dingboche, above 4,000 meters, and I can tell you that’s not the kind of experience you want three days’ walk from base camp.
To lower the risk, I’d recommend changing underwear as soon as possible after heavy sweating, avoiding non-breathable synthetic fabrics in favor of merino wool, and never holding it in just because you don’t want to undress in the cold. It’s also worth packing a preventive treatment like cranberry tablets, which are light and easy to slip into a first-aid kit.
If symptoms get more serious, like persistent burning or fever, never wait it out: heading back down and seeing a doctor is the only sensible option, since prolonged self-medication at altitude can mask a bigger problem.

My own experience on the trail

I still remember my first trek on the Manaslu circuit, when my period started two weeks early, right in the middle of the stage between Samagaon and base camp. I’d only packed the bare minimum, thinking I’d be fine for the whole trek. The result was total improvisation with whatever I had on hand, and a lot of needless stress that weighed down two days of walking.
Since then, I always pack a full kit regardless of the calendar, and I consider this subject just as important as choosing boots or a down jacket. That experience is exactly what pushed me to talk about it openly with the women I meet on the trail, because I know just how much this information is still missing out there.

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