Transforming whispers into powerful conversations

Why breaking the silence and stigma around menstruation is crucial


by Ntindah Luembe, IMI Director, RHSC

As we mark the 10th anniversary of Menstrual Hygiene Day, it’s fitting that we shine a light on the pervasive challenges menstruators face worldwide. While we have made strides in some areas, many still grapple with barriers such as affordability, availability, and quality of menstrual products, along with a significant lack of information. But arguably the most insidious barrier is the stigma and taboo surrounding menstruation that manifest in numerous ways — from hushed conversations to concealed sanitary products. This secrecy often leaves many feeling isolated and ashamed. The stigma fosters ignorance and discomfort, preventing open discussions about menstrual health and management options, and ultimately restricting access to essential information and supplies.

Historically, menstruation has been cloaked in taboo. In many cultures, menstruating women were isolated and considered unclean or impure. While these views may be more subtle today, menstrual stigma persists. Girls and women often face ridicule or fear when they first start menstruating, lacking the necessary support and understanding. I asked friends and acquaintances in Zambia, where I live, about their experiences of menstruation. Their responses were sobering. One woman reflected on her family’s response: “My young sister was ridiculed by myself and other family members for not revealing that she had started menstruating. Most girls are afraid to tell their parents when their periods start because they don’t know how to provide proper support and counselling.” This underscores the crucial role of education and family support in combating menstrual stigma.

In recent years, there has been progress in improving access to menstrual management options, including pads, tampons, menstrual cups, and period underwear. However, access remains a significant issue in low-income countries, especially in rural areas where affordable products are often of poor quality. Ngosa from Zambia shared her experience: “My first-period experience was horrible. I had to inform my grandmother, who then provided me with a cloth since it was nighttime and there was nowhere to access pads. I developed low self-esteem because everyone knew what was happening, and I considered it personal and private.” It’s important to recognize that many menstruators in low- and middle-income countries, between 38% and 61%, do not have access to purpose-made menstrual products. This highlights the urgent need for improved access to these products and emphasizes the significance of preserving their privacy and dignity.

Interestingly, while condoms are widely available in public bathrooms, menstrual products are often nowhere to be found. Even where supplies are available, menstruators often experience fear and embarrassment.

One woman said, “ Women have to hide reusable pads when drying them, as men might laugh or make demeaning comments.” But another woman remembered a more positive experience: “When my period started, my mom was very supportive, having taught me exactly what to do.” In different ways, both these stories highlight the critical role that support and education play in mitigating the negative impacts of menstrual stigma.

The impact of menstrual stigma extends beyond social discomfort and can lead to serious health risks. The lack of access to purpose-made menstrual products and adequate sanitation can result in infections and other health complications. For example, one woman shared, “I started using disposable pads from my second menstrual cycle. The experience was positive, but I encountered problems with rashes and irritation.” Smriti Shukla in Lucknow, India, a PhD researcher, and a member of our RHSC Menstrual Health Supplies workstream, observes: “There is still significant hesitance to discuss menstrual issues openly, especially in low- and middle-income countries. A gynaecologist, also in Lucknow, mentions that many menstruators delay seeking medical advice on menstrual health concerns until they escalate into serious problems.” This reluctance to seek medical help is not just a healthcare issue but a societal failure. And misconceptions and ignorance can lead to significant health disparities. The consequences of such neglect are far-reaching, affecting not only individual health but also educational opportunities and economic participation.

To address these systemic issues, we need comprehensive education and awareness programs that demystify menstruation and promote it as a normal biological process, inextricably linked to broader sexual and reproductive health.

Educational initiatives must target all genders and age groups to foster a supportive environment that encourages open dialogue and reduces stigma.

We have powerful tools at our disposal like the “Managing Menstruation: Know Your Options” tool which provides a comprehensive guide on safe self-care options for managing menstrual bleeding and pain. It includes information on how contraception and menstruation interact, offering evidence-based, unbiased advice to help users make fully informed choices tailored to their needs and preferences.

On this Menstrual Hygiene Day, let’s reaffirm our commitment to menstrual equity. We must harness the collective power of communities, organizations, and governments to challenge and change the harmful narratives surrounding menstruation, coming together to create a #PeriodFriendlyWorld. By promoting inclusive and sustainable practices, we can ensure that every menstruator has the resources and support they need to manage their menstrual health with dignity and without discrimination.

As we look ahead to 2030, with an estimated 1.81 billion menstruators in low- and middle-income countries, we must ask ourselves: can we afford to maintain this taboo and stigma? How can we transform their experience of menstruation? The answers lie in our collective action, in elevating the conversation on menstrual health. Let’s take action today, transforming whispers into powerful conversations for a future where menstrual equity is a reality for all.

Top photo: Jonathan Torgovnik/Getty Images/Images of Empowerment