Open and inclusive communication is key to managing menstrual health

Abstract

We are based in India, a country that has progressed considerably in managing menstruation in the past decade. According to a recent national survey¹, about 90% of Indian women with 12 or more years of schooling used safe period products, such as locally prepared napkins, sanitary napkins, tampons and menstrual cups, in 17 states and union territories. Compared to four years previously², there has been a 20% increase in the use of safe methods by women aged 15–24 during menstruation. Yet, despite substantial progress in use of period products, concentrating solely on physical management will not effectively improve menstrual health.

In many parts of India (as in other countries), menstruation remains deeply rooted in stigma and taboos that perpetuate gender discrimination and reinforce negative stereotypes. The way that people manage menstruation is just one visible manifestation of the social norms and stigma that become ingrained from menarche (the beginning of menstruation) and even earlier. In some cultures, menstruating individuals are considered impure, which can lead to social exclusion and discrimination. Menstruation affects daily life, including schooling, employment, social relationships and mental health^3,4,5 — and not only because of the physical aspects but also because of how stigma and social norms shape its management. In some cultures, menarche signifies sexual availability, and families can face pressure to arrange marriage for girls soon after its onset to control their sexuality and protect family honour⁶. Those who menstruate may go to great lengths to hide the fact that they are experiencing normal biological and bodily functions. As a result, they may invest a lot of time and effort in managing menstruation owing to stigma and societal norms, which can be compounded by a lack of resources.