Written by Ellen McCammon
Managing menstruation in India can be difficult. May be characterized by challenges with obtaining, cleaning, storing and disposing of period supplies and inadequately private, safe and clean bathrooms [1]. Apart from the logistical and resource-based difficulties in managing the physical experience of menstruation, there are also emotional and psychological challenges associated with menstruation in India, where periods are highly stigmatized. [1, 2].
A study published in SRHM in 2001 on menstruating women in the slums of Delhi, India, found that many women knew nothing about menstruation before it began and received little information about it afterward, reflecting a widespread “cultural silence” about menstruation. [3]. Women were often told that menstrual blood was dirty or impure and could not participate in some of their regular activities during their period.
Although it has been nearly two decades since these findings were reported, a number of similar challenges were reported by participants in a recent study conducted by researchers from the University of Chicago’s Center for Interdisciplinary Research and Innovation in Sexual and Reproductive Health (Ci3). Interviews were conducted with girls and young women aged between 15 and 24 living in the slums of Lucknow, Uttar Pradesh to explore their experiences of menstruation [4]. Most participants learned about menstruation for the first time after it started and often had limited information or misconceptions about menstruation as a biological process. Socially, women and girls were given messages that they were unclean during menstruation and instructed to limit activities such as worship and going out into the community. There were few opportunities to discuss period-related issues openly, as participants were advised not to talk about it to younger girls, boys and men or to members of the community. While most participants reported attending school while menstruating, managing bleeding at school was difficult due to poorly maintained bathrooms without adequate privacy, teasing by male students, and shaming by teachers.
It is striking to consider how so many of the challenges participants face are created or exacerbated by how menstruation is or is not talked about. When no one talks to girls about menstruation before they get their period, their first menstrual experiences are often embarrassing and disorienting. By strictly limiting the circumstances under which menstruation is discussed to certain family members, there are few opportunities to share information or correct misconceptions. How can mothers, older sisters, and cousins provide information that they themselves never received?
When they talked about menstruation, it was often in a negative context. Participants received messages that they were embarrassing to other people know they were menstruating, and that menstruation is dirty. They were subjected to malicious teasing when others perceived that they were menstruating. It is therefore not surprising that the primary emotions described in relation to menstruation were fear, embarrassment, frustration and shame.
Instead, participants were reassured by conversations that communicated that menstruation was a normal phenomenon and not something bad. These findings highlight the importance of open discussions about all aspects of the menstrual experience, including the negative psychosocial aspects of menstrual stigma and taboo, to shift the culture around menstruation.
Proponents of a menstrual hygiene management approach sometimes suggest that providing comprehensive biological and health information and adequate menstrual management resources is enough to facilitate healthy, safe, and comfortable menstruation. While these strategies are important, they are not enough. The human rights perspective on menstruation makes it clear that reducing the stigma of menstruation is a prerequisite for effectively and sustainably addressing the material and informational needs of menstruation [5]. After all, if periods are a dirty secret, who will ensure that accessibility to these resources remains a policy priority?
Facilitating open discussions about menstruation will not only reduce stigma against menstruating people, but help promote participation in the menstrual justice movement. Menstrual hygiene management is often framed as a ‘women’s issue’, and yet, not all women menstruate and not all menstruates are women. While the stigmatization of menstruation is part of a wider system of marginalization of women [6]it is important to resist the essentialization of menstruation as a universal experience of womanhood. Everyone should have the opportunity to share how their period has affected their life, regardless of whether they have their period or not.
It is encouraging to see the new approaches taken by Indian activists and organizations in recent years to open up discussions about menstruation. In urban areas, young Indians are using TikTok to share poetry and thoughts about menstruation. In rural Jharkhand, artist and activist Srilekha Chakraborty organized youthart students and community organizations at painting beautiful menstruation themed murals with the aim of sparking debate. Photographer Poulomi Basu created the transmedia campaign Blood speaks in the hope of ending the Hindu practice of Nepal chaudurior seclusion in period huts during period. And of course, the award-winning short documentary “Period: End of Penalty” follows several women as they start a sanitary pad manufacturing business in a village outside Delhi.
The importance of developing and sharing stories to create empathy and reduce stigma cannot be overstated [7-9]. Narratives and stories help facilitate understanding of young people’s lived experiences and encourage honest dialogue about sensitive issues. Storytelling has always been central to our work Jay Kahanithe parent study from which our menstrual data were drawn. For more than two years, a team of interdisciplinary experts from Ci3 discovered the perspectives of a group of young people in India by eliciting their stories, concerns and desires about issues related to gender and sexual and reproductive health using innovative narrative-based research methods. These collected stories have been turned into short videos, graphic novels and games that are part of an intervention for young teenagers in India to be implemented later this year. In the meantime, let’s keep talking about our experiences with menstruation — let’s fill the silence.
- Chandra-Mouli, V. and SV Patel, Mapping knowledge and understanding of menstruation, menstrual hygiene and menstrual health among adolescent girls in low- and middle-income countries. Reproductive Health, 2017. 14(1).
- Mahon, T. and M. Fernandes, Menstrual hygiene in South Asia: A neglected issue for WASH (water, sanitation and hygiene) programmes. Gender and Development, 2010. 18(1): pp. 99-113.
- Garg, S., N. Sharma and R. Sahay, Socio-cultural aspects of menstruation in an urban slum in Delhi, India. Reproductive Health Issues, 2001. 9(17): pp. 16-25.
- McCammon, E., et al., Exploring the menstruation-related challenges of young women in Uttar Pradesh, India, using the socio-ecological framework. Sexual and reproductive health issues, 2020. 28(1): pp. 1749342.
- Winkler, IT and V. Roaf, Taking the bloody linen out of the closet: menstrual hygiene as a priority for achieving gender equality. Cardozo JL & Gender, 2014. 21: p. 1.
- Arora, N., Menstruation in India: Ideology, Politics and Capitalism. Asian Journal of Women’s Studies, 2017. 23(4): pp. 528-537.
- Muralidharan, S. and E. Kim, Can empathy compensate for low bystander efficacy? Effectiveness of domestic violence prevention narratives in India. Health Communication, 2019: pp. 1-10.
- Batson, CD and NY Ahmad, Using empathy to improve intergroup attitudes and relationships. Social Issues and Policy Review, 2009. 3(1): pp. 141-177.
9 Barroso, J., et al., A randomized controlled trial of the effectiveness of a stigma reduction intervention for HIV-infected women in the Deep South. Care of patients with AIDS and STDs, 2014. 28(9): pp. 489-498.
Please note that blog posts are not peer-reviewed and do not necessarily reflect the views of SRHM as an organization.
