Menstruation is a physiological phenomenon that women and girls experience every month. Yet, it remains taboo in many cultures worldwide. In most countries, it is a delicate and rather uncomfortable topic, which explains the silence that surrounds it. As a result, women and men lack awareness and knowledge when it comes to menstruation, which encourages detrimental menstrual hygiene management and practices. It also explains how deep-rooted beliefs can still exist in some countries, such as that women are impure when they menstruate and should therefore be denied basic human rights, which includes a lack of access to food, water or proper sanitation facilities. In addition, women and girls suffer from serious psychological side-effects: embarrassment, shame, and loss of dignity are undeniable consequences of stigmatizations surrounding menstruation. Therefore, considering menstrual hygiene management as an urgent issue is not only a matter of gender equality but also of human rights, education, health and other impacted fields.
For example, 32.5% of schoolgirls from South Asia had not heard about menstruation prior to their first menstrual period while 97.5% did not know that menstrual blood came from the uterus. Meanwhile, 48% of girls in Iran believe that menstruation is a disease. In Africa, according to UNESCO, one in ten girls miss school during menstruation, which eventually leads to a higher drop-out rate. These common experiences among women from lower and middle-income countries around the globe highlight the importance of menstrual hygiene management to the promotion of women’s rights to reproductive health, sanitation, education and human dignity.
Menstrual Hygiene Management (MHM) encompasses the necessary practices to handle monthly menses with self-respect and ease, as well as broader issues and behaviors that need to be acknowledged:
• Access to affordable, sustainable, and sanitary materials to collect the blood; soap and water to clean with; private facilities to change and dispose of material as often as necessary, according to WHO and UNICEF’s joint definition.
• Gender-specific, correct, and timely knowledge. Gender-specific sexual and reproductive health education in schools is linked to lower rates of HIV and STIs, with a higher general health outcome in society. This emphasizes the need for education on menstruation to question gender norms and power-dynamics within intimate relationships, inform youth on their rights, and skills needed for healthy sexual management.
• Informed and comfortable professionals. Teachers and adults can learn how to discuss MHM with children and young adults, in a way that is informative, direct, and comfortable for both parties. It is also important for professionals dealing with construction and access to water/sanitary facilities to be informed about needs that should be met. This is not only in reference to MHM practice awareness, but also to consider resource scarcity in a region and building sustainable methods accordingly.
• Addressing social norms through education, advocacy, and policy. The silence and stigma surrounding menstruation is present in many developing countries throughout the world. Women often face cultural attitudes that view menstruating females as “contaminated” and consequently are forced into isolation, suffer physical and dietary restrictions and exclusion from daily societal activities. As long as menstruation is considered a taboo, and as long as it is poorly understood ¬– by both men and women– it will impede the development of good public policy and the necessary practices to be established.
• A shocking 70% of all reproductive diseases in India are caused by poor menstrual hygiene, which could be addressed with the proper materials and education. MHM needs to be addressed globally by focusing on changing attitudes and reducing stigma around menstruation and sanitary practices through advocacy, education, and action.