Periods, Altitude and Aching Legs – The Questions Women Actually Ask About Trekking in Nepal

Nobody tells you the questions you really want answered before a big trek are the unglamorous ones. Not “will I see incredible mountains” (you will), but “what happens if I get my period at 3,700 metres with no bin in sight” and “am I fit enough for this, honestly.”

I trekked to Annapurna Base Camp in 2005, chronically underprepared (hello young person who thinks they can take on the world!), with a water-resistant jacket that turned out not to be and I can tell you from experience that the physical and practical stuff matters just as much as the scenery. So let’s talk about it properly.

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“Am I fit enough?”

You don’t need to be an athlete. You need reasonable, consistent fitness and the willingness to keep putting one foot in front of the other on tired legs, which is a different thing entirely. On my trek, some of the toughest days were seven hours of walking, much of it steep stone steps, at altitude. I was, by my own admission, not in great shape going in. I got through it because I kept moving, took the flatter sections (we called them “Nepali flat”) as recovery and leaned on my guide’s pacing rather than my own pride.

What actually helps in the months before – regular walking with a loaded day pack, stairs and time on your feet rather than short bursts in the gym. If you can comfortably walk for several hours on consecutive days, you can do this trek.

“What about altitude sickness?”

This is the one that catches people out regardless of fitness level, because altitude sickness doesn’t discriminate between marathon runners and everyday walkers. It can affect anyone above about 2,500 metres. The standard, sensible precautions are – ascend gradually, drink far more water than feels necessary and take rest days built into your itinerary rather than pushing through a headache. Garlic soup is a genuine local remedy you’ll be offered constantly (I lived on potato and garlic soup for a week and became rather fond of it). Some trekkers use the medication Diamox as a preventative, which is worth discussing with your GP or a travel doctor before you go.

Know the early symptoms and be attentive to them – headache, nausea, dizziness, disturbed sleep. Mention them to your guide immediately rather than pushing on, this is exactly why a licensed guide is now mandatory on these routes, they’re trained to manage this.

“How do I deal with my period on the trek?”

This is the question I get asked most and the one most guides skip over entirely. Here’s the honest version.

There are no bins on the trail or in most teahouses, so the rule is simple – pack it out. A few small ziplock bags in your daypack for used products, sealed and carried until you can dispose of them properly, is the standard approach. Some women swap to a menstrual cup for trips like this specifically because it means far less to carry and manage, though it’s worth practising with one at home first if you haven’t used one before, water for cleaning it can be limited on the mountain.

A few things that make a real difference:

• Loose, dark-coloured trekking pants
• A small “period kit” packed separately so you’re not digging through your whole bag at a rest stop
• Pain relief packed in your daypack, not buried in your main bag
• Wet wipes or biodegradable tissue for cleaning up when a proper wash isn’t an option

Altitude and physical exertion can also throw your cycle off entirely, lighter, heavier, early, or late are all normal responses to the stress of trekking, so don’t be alarmed if things don’t run to schedule.

Don’t let this be the reason you don’t go. Plenty of women have trekked through their period at altitude and come home saying it was a non-issue once they had a system.

“What if I need the toilet and there’s nowhere to go?”

Most teahouses have a squat toilet in a separate, often cold, outbuilding. As you climb higher, facilities get more basic. During the day, you’ll simply step off the trail when needed, your guide will know the etiquette and give you space. It sounds daunting before you go and becomes completely unremarkable by day three. I promise.

If you haven’t yet discovered the She Wee (or, She Pee), you might want to check it out! A game changer for those mid trail need-for-a-wee moments when your knees are saying otherwise.

“Will I actually enjoy it, or will I just be suffering?”

Both, honestly and that’s part of what makes it worth doing. I cried on that trek. I also laughed until I couldn’t breathe, had a Nepali massage that neither of us could keep a straight face through and watched a sunset turn an entire mountain gold. The hard days make the good ones land harder. If you go in expecting a mix of genuine physical challenge and genuine wonder, rather than an easy holiday, you’ll have the right mindset for it.

The one thing I’d tell my 2005 self

Prepare your body more than I did and prepare your period kit better than I did (mine amounted to hope and a packet of panadol). Everything else, the fear, the uncertainty, the “can I actually do this” voice in your head, sorts itself out somewhere around day three, when you realise you’re still walking and you’re doing just fine.

If you want the full rundown on what to actually pack for a trip like this, have a look at the Ultimate Women’s Travel Packing Guide..

If a small-group women’s trip to Nepal is something you’d love to see me run, register your interest here, it’s what tells me there’s a group ready to go.