Bleeding men are revered. Blood spilled in war is heroic and earns men respect; blood brothers show their deep, abiding loyalty with a slash of crimson between palms. That reverence comes to a screeching halt the moment the blood is pouring from between a woman’s legs.
Historically, in many cultures — even in the Bible—menstruating women were seen as unclean, dirty, evil. In one ridiculous extreme of the attitude, 1920s doctor Béla Schick went so far as to try and prove there were poisonous “menotoxins” in women’s menstrual blood that could infect anyone who came in contact with it.
While those attitudes may seem egregious today, menstrual squeamishness still exists as a source of comedy and disdain in popular culture. How many times have you heard the joke “what bleeds for seven days and doesn’t die” as a source of male laughter? Even in a time of period activism and the free-bleeding movement, menstrual products are still marketed with an emphasis on discreet packaging, and women’s reproductive health is still undertreated by the medical establishment.
These long-held and slow-to-disappear stigmas are based on uneducated and oppressive patriarchal attitudes that still make their way into modern medicine and are dangerous to girls’ and women’s health. In extreme cases, such taboos prevent women from getting diagnoses, treatment, or education about more serious health conditions.
Part of the problem is that women’s health has not been studied in the kind of depth that is needed, with researchers often citing the variability of women’s menstrual cycles as reason to exclude them from clinical trials, most notably those on coronary heart disease (the number one killer of women in the United States) and drug efficacy and safety.
Meghan Cleary, a writer, speaker, and advocate specializing in clinical gender bias and founder of the website Bad Periods, a repository of research based on personal experience, finds the lack of knowledge frustrating and insulting. “The NIH [National Institutes for Health] didn’t require that women be included in medical studies until 1991, and that’s only government studies,” she points out. “It was only in 2011 that they figured out women present with heart attacks differently. There is very little clinical information [about women’s bodies].”
Marni Sommers, associate professor of sociomedical sciences at Columbia University who focuses on gender, health, and education in sub-Saharan Africa and Southeast Asia, writes in a 2017 paper published in BMJ Global Health, “In many societies, cultural taboos frequently hinder open discussion around vaginal bleeding, restricting information and early access to healthcare.”
Sommers and her co-authors are calling for greater attention to non-menstrual-bleeding episodes, including those related to pregnancy, childbirth and postpartum, miscarriage, cancers, and endometriosis.
There is still a long way to go toward education around women’s bleeding in less developed countries. Religious norms, cultural taboos, poverty (which leads to harder access to supplies), and lack of education create a climate of poor health for women and girls, many of whom drop out of school or can’t work due to issues related to stigmas, access, and privacy around their periods.
Another of Sommer’s studies, published in the journal Conflict and Health, describes a condition most of us world never even have to think about: refugee girls and women, who may spend weeks in transit fleeing conflicts or long periods of time in refugee camps where aid workers may not be fully educated about how to talk to them about their needs.
“If a girl or woman is walking three to five days across countries or borders to get someplace safe, the last thing she may have thought about when fleeing her home is ‘Did I bring cloths to manage my period?’” Sommer told me by phone. “Whenever I see pictures of women and girls coming across in boats, I think, ‘How are they managing [their periods]?’”