Blog of the Society for Menstrual Cycle Research

Menstrual Hygiene Day: What’s in a name? Why Menstrual Hygiene Day is called Menstrual Hygiene Day

May 27th, 2014 by Saniya Lee Ghanoui

Guest post by Danielle Keiser

Summary: Menstrual Hygiene Day is not only about the biological process of growing up into a woman, but also about addressing the challenges that exist in many developing countries with regards to managing menstruation safely and hygienically. Such challenges include potential vaginal infections caused by poor access to soap and water and toilets, inadequate or unhygienic sanitary protection materials, or infrequent cleaning or changing of these materials. In many cases, this results in adolescent girls missing school and women missing work. Moreover, the continued silence around menstruation paired with limited access to factual guidance at home and in schools results in millions of women and girls having very little knowledge about what is happening to their bodies when they menstruate and how to deal with it.

Is ‘hygiene’ a negative word?

Menstrual Hygiene Day, oh, be some other name! As Juliet famously said about a rose with regards to Romeo being a Montague, what is in a name? That which we call hygiene by any other name would still be (according to the Oxford Dictionary) “the conditions or practices conducive to maintaining health and preventing disease, especially through cleanliness”, would it not?

Since we launched the initiative to make the 28th of May Menstrual Hygiene Day, we at WASH United have undoubtedly started the conversation about menstruation, with social media buzzing as to why #MenstruationMattersand worldwide events and activities set to take place by many of our 135 partner organizations. One recurring conversation has revolved around disagreement with the term ‘hygiene’, a term that has been criticized for not being ‘period positive’ and doing little to ‘honor the menstrual process’.

I’d like to take the time to explain why we chose the word hygiene, focusing on how optimal Water, Sanitation & Hygiene (WASH) conditions, or more specifically, access to clean water and soap, toilets, sanitary protection materials and factual guidance are prerequisites to enabling women and girls to embrace their periods and feel positive about the whole experience. When menstruation is managed in privacy, with safety and dignity, women and girls are much more likely to develop the comfort and confidence needed to participate in daily activities. And since all human rights stem from the fundamental right to human dignity, when women and girls are forced into seclusion, taunted and teased, or fear leaking due to inadequate menstrual hygiene management (MHM), dignity is difficult to maintain.

 

4 reinforcing thoughts: It’s about hygiene.

1. Imagine that while menstruating, you are either not allowed to bathe or you simply don’t have a shower to rinse your body.

In parts of Kashmir, India, some menstruating women are prohibited from using water sources and advised to stay away from flowing water in general. Also, they are not allowed to look at their reflections in the water.

2. Imagine unexpectedly starting your period in the middle of an important math lesson. Is your first thought, I need to go to the toilet? Do you go to the one dirty latrine that is shared with 65 other boys and girls, without a lock? And what will you do with your stained panties? There’s no hand-washing facility and not even a wastebasket to throw them away in.

There are still 2.5 billion people who do not have access to adequate sanitation. If roughly half of the world’s population is female, that’s 1.25 billion girls and women who cannot simply ‘go to the ladies’ room’ to check on themselves and change their pad, tampon or cup in privacy.

3. Imagine having no idea, or a very faint one, about what a period is, why it happens, or how to take care of it when it happens.

Worldwide, many girls feel a ‘culture of silence’ around menstruation, including in their families. Often, male family members are clueless about menstruation, treating it as something negative or a curse. Girls do not feel comfortable even talking to their mothers about the subject, and many teachers only skim the surface on lessons about puberty and reproduction because it makes them uncomfortable.

How do girls learn about periods?

May 1st, 2013 by Laura Wershler

How do girls learn about menstruation today? Who talks to them? Who do they talk to? Or do most girls rely on the Internet for information about periods?

Take this article by Elizabeth (bylines are first names only) – What I Wish I Knew About My Period – posted last week at Rookie, an online magazine for teenage girls. Not a teenager but definitely a young woman, Elizabeth (Spiridakus) shares the wisdom she’s gained through her menstrual experience. Here’s her sum-up:

These are all the things I wish someone had told me before I got my first period, and in the couple of years that followed. Most of all, I wish I had FOUND SOMEONE TO TALK TO! I had so many questions and fears about the whole business, and I think I would have been so much less self-conscious, and so much HAPPIER, if I had only had access to some friendly advice. So, talk to your friends! Talk to your cool older cousin or aunt or sister or your best friend’s cool mom or your OWN cool mom. Leave your questions—and your good advice—in the comments, because I certainly haven’t been able to cover all the bases here.

Read this again: “Most of all, I wish I had FOUND SOMEONE TO TALK TO!”

Photo courtesy of Laura Wershler

Elizabeth urges readers to talk to their friends, cool older relatives, or their own – or somebody else’s – “cool mom.” Great advice, but I have to ask:  Why aren’t cool moms and older relatives already talking to the girls in their lives about menstruation? Sharing friendly advice? Passing on wisdom from mother to daughter, woman to woman?

Suzan Hutchinson, menstrual activist, educator and founder of periodwise.com, a project dedicated to empowering girls and women to embrace the taboo subject of menstruation, has a few ideas about this. She thinks many moms don’t know when to begin “the period talk” or what to say, so they remain silent until their daughters start their periods, or they wait thinking their daughters will initiate period talk. She warns against this.

“We should all remember that when moms offer too little information or start providing information too late, girls often question their credibility and hesitate to return as new questions arise.”

Although Suzan’s mother talked to her about menstruation, she didn’t start early enough, before Suzan heard things from other girls that she didn’t understand. Her early menstrual experience included lying to her friends about getting her period long before she did at age 15. By then she was “too embarrassed to ask my much more experienced friends” and “too proud to turn to Mom.” She tried to deal with things on her own.

“I needed a period coach – someone to walk through things with me and instruct me…help me figure out what to do, when to do, how to do.”

A period coach. This is exactly what Elizabeth is for the girls at RookieRead the comments. Readers loved it.

She’s not the only one using the Internet to connect with girls about menstruation. Despite my reservations about a website operated by the company that sells Always and Tampax, the content of which deserves serious critique, I must acknowledge that thousands of girls are turning to beinggirl.com for period coaching, including tips on how to talk to their moms!

Moms shouldn’t be waiting for their daughters to talk to them. They need to find their own period coaches. Other mothers like Suzan Hutchinson and the mom who started bepreparedperiod.com.

The more information girls have the better. Brava to Elizabeth for What I Wish I Knew About My Period. But moms and cool older relatives have got to get in the game. Now. Don’t wait until the girls in your life come to you.

What I told the girl in my life about menstruation

December 22nd, 2011 by Alexandra Jacoby

Last month I wrote about what I would tell the ten-year-old girl in my life about menstruation. This would be my first conversation about it with her.

I really appreciated the supportive responses that I received in the comments and offline! 
I was nervous about it. Your participation helped me to move forward.

Some of you asked me to tell you how it went…

I’m not going to.

Maybe it went well. Maybe it didn’t. Maybe it was a long talk, and kind of delicious to get that time with her, or maybe it ended abruptly. Maybe we hugged, suffered long silences, or laughed each other silly. Maybe I drew diagrams and she was the art director. Maybe she’s avoiding me now.

It doesn’t matter.

Because the point is – even more than to start talking – to keep talking. Not to look for done. Not to hope for done.

Just to say what you have to say; ask questions, reveal what matters to you, and stay.

Knowing that it’s not over. If it didn’t go “well”, that’s just a moment in time.

Remember why you wanted to have this talk – why you wanted her to have this information – why you wanted her to trust you with her questions and opinions.

If it went well, that’s just a moment in time. You don’t know what will happen next.

Her body-experiences, social experiences, ideas, needs and wants are going to change change change.

Done doesn’t exist in our world of human bodies.

Maybe I gave a really “good” talk and it still sucked for her. Maybe my girl’s poised reception of my seriously-delivered speech is not a possibility for either of you. Don’t worry about that.

I’m not telling you how it went because I don’t want our story leading to dos and don’ts, cues to take, and pitfalls to avoid. All that is useful, but I want to stay general for a moment, and, in the absence of specifics, to appreciate on the ongoing, evolving nature of

talking about, 
and being, 
a human body.

what to tell the girl in my life about menstruation?

November 24th, 2011 by Alexandra Jacoby

Ever since I saw this uterus pillow, I have been thinking about what to tell the girl in my life about menstruation. She’s ten years old. This pillow is exactly something I would give her! It’s handmade, using strong colors of the kind I like, and about a subject most people don’t want to talk about. [I like to annoy her!] Also, it’s pretty.

I’ve had it since the summer, and I still haven’t given it to her — because I want to say something with it.

uterus pillow - ovulating

uterus pillow by Wendy Caesar.

But – what?

I have no idea what she knows or thinks or feels about her body in general, or about menstruation in particular.

Where do I start?

[translate that to several months of procrastination]

Telling myself that it was research and preparation for a good talk, I started asking people what they think I should say to a ten-year old girl in my life. Most asked me if it wasn’t too early to start this topic? I mean if she isn’t menstruating yet…

why bring it up?

Her school will know when to start the conversation. Or maybe leave it up to her, to whenever she asks you…

She’ll ask her mother then probably. Or maybe her mother has already started this conversation….

Wait! None of that matters —

I am totally ducking. I am afraid to get it wrong.

How will she know that conversations are not tests, or competitions, if I keep acting like there’s a right way to do this— like I need training, expertise or approval to talk to the girl in my life about something that I have experienced myself for several of her lifetimes?

I want her to know that it’s ok to not-know EVERYTHING about your body and what comes next, and that it’s ok to ask questions from a place of not-knowing.

Right. Decision made. I will not become an expert before talking with her.

I’ll make this about her and about me.

Here’s what I’ll do:

I’ll ask her what she’s heard so far:

  • What do you know about menstruation?
  • What did your mother tell you?
  • School?
  • Friends?
  • Female relatives?
  • Your father?

I’ll check in with her:

  • What does it feel like? – What people told you —
  • Is it: scary, embarrassing, no big deal, exciting…

I’ll tell her why I brought this up:

The menstrual cycle is not just about bleeding and whether you can get pregnant today — though, those two situations are reason enough to learn as much as you can about your cycle. You want to be prepared for, and satisfied with, both experiences.

uterus pillow - menstruating

the same uterus pillow, by Wendy Caesar.

The menstrual cycle is one of your body’s vital signs.

Its hormones and processes affect and interact with how you feel, how your bones grow, how your skin looks, your body temperature… From the inside out, of your body-your home, your cycle determines your quality of life in many ways.

Most of us know little about how our bodies work. And, unless we feel pain, have difficulty doing something we want to do, or are incapacitated, we don’t necessarily need to know any more than the little we know.

But — and this is why I bring it up — the more you do know about how it works, the more power you have over the quality of your body-life, which in turn feeds your mental-spiritual-emotional life. And back around again.

I bring up the menstrual cycle because its integral to the workings of a woman’s body and while there are ranges of normal — day to day, it’s a unique experience for each of us.

I want her to be aware of that, and to begin paying attention to her body because it’s her body. Not just when it raised an issue that needs a response, like what to do about the blood.

I’ll end with:

“It means there’s blood flowing out of my uterus!”

November 4th, 2011 by Elizabeth Kissling

So says 15-year-old Judy to her boyfriend Johnny on the occasion of her first period, in this vintage film about menstruation, Linda’s Film About Menstruation. This 18-minute treasure was produced in 1974 by the Creative Artists Public Service Program of the New York State Council of the Arts (CAPS), a program that ran from 1970 to 1981.

Would that cities and states still had arts budgets for these kinds of projects!

World Menopause Day

October 25th, 2009 by Elizabeth Kissling

We’re a week late in commemorating World Menopause Day here at re:Cycling. Sounds like a holiday right up there with Menstrual Monday, but it doesn’t sound very celebratory, from what I can discern.

I discovered World Menopause Day, observed annually on October 18, when a press release for GEM Keep it cool™, “the first ever, ready to drink wellness supplement for menopause relief made with natural and nature-identical ingredients free of the risks associated with hormones” showed up in my inbox yesterday. Cynic that I am, I wondered if this holiday was simply about selling products to middle-aged women, so I began poking around on the internetz.

I found that World Menopause Day has a venerable history: it was started in 1984 by the International Menopause Society (IMS) and the World Health Organization (WHO). Both are reputable, credible organizations with admirable goals, so I was easily persuaded that World Menopause Day isn’t all about marketing. IMS marks World Menopause Day by doing its best to spread the word about potential health consequences of menopause:

In observation of the day, the IMS, through its organ the Council of Affiliated Menopause Societies, distributes sample press materials to inform women about menopause, its management and the impact of estrogen loss. World Menopause Day can also be a call to implement policies that support research and treatment in the area of menopausal health.

As the world’s population ages, there will be increasing numbers of women entering menopause and living beyond postmenopause. The potential symptoms of menopause may have a negative impact on the quality of daily life. Moreover, the consequences of menopause can lead to a host of age-related diseases including heart disease and osteoporosis. Nations around the world should continue to educate women about menopause and the benefits of preventive health care.

The North American Menopause Society (NAMS) offers similar party plans:

The North American Menopause Society (NAMS), in conjunction with The International Menopause Society, recognizes October 18 as World Menopause Day. This important day is acknowledged by the organization as the day when all nations should take active steps to educate women about the health-related implications of menopause.

I grok that many women, probably even a statistical majority, experience some unpleasant symptoms during the menopausal transition. And I know that the Baby Boom generation thinks no one ever experienced menopause before (just like they were the first to experience adolescence, sex, parenthood, and other milestones), but why does all of the acknowledgment of menopause and education about it have to be so clinical? Not to mention so sad. Menopause is not a disease. It’s a natural phase of adult women’s lives, and I’m really hoping it comes with some benefits. (For instance, I’m looking forward to being a wise old crone, esteemed by my community. Being a smart-assed young woman and now, middle-aged woman, hasn’t won me as much esteem as you might think.)

7dwarves_menopI’m tired of seeing menopause represented as abject misery. I was especially distressed to see one blog marking World Menopause Day with this illustration of the Seven Dwarves of Menopause. It’s another pathetic example of propagating the idea that women are ruled by their hormones, which are always destructive. There’s clearly a lot of education to be done about menopause, hence the need for World Menopause Day, but also a need to find ways to celebrate aging.

To learn about official Society for Menstrual Cycle Research views of menopause, read our Testimony to Office of Research on Women’s Health at NIH [2009] and our Position Statement on the Women’s Health Initiative & Estrogen Therapy [2007].

“Happy It’s Here”

October 16th, 2009 by Elizabeth Kissling

P&G_WhisperProctor and Gamble has just launched a new internet campaign in Singapore for their menstrual pads. The flash-heavy website tells why girls are Happy It’s Here :

Happy, confident, and loving life. You know what you want and where you want to go next. You feel wonderful about being a girl!

This is not a new product, but a new campaign for the pads known as “Always” in the U.S. Guess what they’re called in Asian markets.

Wait for it.

Whisper“.

That’s right. P&G’s ad promotion “to instill a positive attitude in young Singaporean women about their menstrual periods, seeking to dispel some of the squeamishness toward the subject that persists in much of Asia” is for a product called Whisper, with all the connotations of menstrual silence that carries.

In fairness to P&G, the name change from the U.S. product pre-dates the new internet campaign by ten years. And I wanted to give them a break after reading this quote in the Wall Street Journal article about the new campaign:

“We see our role as being over and beyond just selling the products,” says Sujay Wasan, associate marketing director for P&G’s feminine-care division in Asia. “Periods are not a necessary evil, or a curse, or a problem to be solved. It’s an absolutely natural part of being a woman, and it needs to be appreciated and celebrated,” he said.

But then I finally figured out how to turn off the site’s annoying music (yeah, I’m not really their target audience) and started poking around. I saw the links for “about your period” and “28-day cycle” and assumed P&G was serious about trying to do a little menstrual education here. So I clicked on the 28-day cycle link from the menu, and pretended today was the first day of my cycle so that I could check it out. I read, “Day 1: During your period you may feel thinner. That’s because your body may burn carbs better. Tip: Show off your figure at the gym, beach or by the pool!”

Now, on the one hand, I’m glad to see some recognition that bleeding isn’t the only thing happening during menstruation and acknowledgment that the menstrual cycle is not a bodily process isolated in the uterus and vagina. But advice to young women to practice being a sex object really grates my cheese. And it only continues: on Day 2, I’m told that since I’m burning up those carbs and feeling so thin, I should put on some hip-hugging jeans. Day 5, I’m told that I’m unlikely to feel jealous, so I should let my boyfriend have a guy’s night out. Heterosexist, much?

It goes on and on, with descriptions of the cycle in terms of emotional experience rather than physiological processes, and even though there’s a caveat at the beginning of the calendar that every girl is different, it offers mighty presumptive advice for dealing with these emotional changes. Happy It’s Here assumes that all girls are heterosexual and aspire to be paragons of femininity, as defined by the beauty product industry and other handmaidens of the patriarchy (yes, I’m using the p-word).

It also overemphasizes emotional element of the menstrual cycle, at the expense of knowledge about the physiology and anatomy of menstruation.The only mention of hormones comes on Day 15: “Estrogen is low and that nasty progesterone kicks in. Brace yourself for mood swings, irritability and bloating.” Oh, that nasty progesterone! If only it weren’t essential for fertility, a functional uterus, and bone health.

Sorry, P&G. I know you’ve been working on normalizing menstruation in your marketing campaigns, but this isn’t helping.

[H/T GladRags]

Girls, Periods, and Missing School, or More Hazards of Menstrual Silence

September 21st, 2009 by Chris Bobel

Moon CupEver-alert Liz Kissling drew my attention to this post on Nicholas Kristof’s blog (he’s the co-author of Half the Sky - check it out)

Kristof picked up on the does-menstruation-keep-girls-out-of-school buzz that researchers and on-the-ground development workers have been asking for some time. This is the same link that opportunistic P&G picked up in 2007 with the launch of their cause marketing campaign “Protecting Futures.” The campaign involved Always-brand pad distribution, school bathroom construction and health education, yet, as far I can tell, “Protecting Futures” has ended with a whimper…I can’t find a thing about it on the web, save dated references.

Maybe the campaign has slipped into obscurity because the girls lack commercial products–girls miss school causal connection is being weakened by research like the study cited by Kristof.

Researchers Emily Oster and Rebecca Thorton supplied girls with menstrual cups (note: not single use pads) and measured whether their use of cups had an effect on school attendance and grades. Nope, they found, makes no difference; the girls with and without cups missed about the same number of days and performed about the same in school.

In a way, their findings didn’t surprise me.

Girls have been managing their flow since, well, there were girls, and I bristle at the implication that their lack of access to single use commercial products was high on the global south wish list. It always seemed like a version of those ignorant primitives will never join the 21st century until they consume more stuff line of thinking that motivates (ethnocentric) global north “do-gooders” (and multinational corporations)

But, from my living room in the US, steps away from a washing machine/dryer and a reliable bathroom, I didn’t dismiss the possibility too quickly. The menstrual taboo, after all, does complicate period management when you spend the day with boys, boys who must not know what your body is up to–this takes time and energy

But here’s the thing.

Oster and Thorton DID find a menstruation-school attendance link. Menstruation DOES indeed impact school attendance, they found, in one particular way.

CRAMPS, reported the girls, keeps them home. Get this: nearly 44% of the girls cited cramping as the reason they couldn’t make it to school while they were menstruating.

CRAMPS. Sound familiar to anyone?

So that seems an invitation to find out more.

  • What kind of cramps?
  • What do the girls know about cramp prevention and management?
  • What kind of information and support do the girls need to deal with their contracting uteri so that they can get to school and stay there without sitting in at their desks doubled over in pain?

But addressing the cramp problem aint gonna be easy.

The very same pernicious menstrual taboo that mandates that girls manage (read: hide) their periods, also makes it difficult for girls to get informed and take effective action when the cramps hit.

We just don’t talk about this stuff–and that’s a silence heard around the world.

In rural Nepal and Soweto and suburban Boston and, yes, in your neighborhood, too.

Opening up the conversation about our bodies and how their work–in all their messy, often inconvenient, often mystifying complexity– gives us a chance to take control of our health and our lives.

In other words, the key to keeping girls in school may NOT be “more efficient” menstrual management, but rather, breaking the silence surrounding the body.

But we can’t expect only vulnerable girls to breach the taboo and begin asking the questions. Adult women and men, teachers, policy makers, government officials, health care workers, moms, dads, bloggers, all of us, need to get talking. In other words, those of us with some measure of privilege need to model that it is okay, even GOOD, to speak about the menstrual cycle.

That talk , of course, will sound different in different places and in different cultures. So we need to develop culturally-sensitive menstrual literacies and we need to start now.

What’s that?

Sorry. I can’t hear you.

Could you please speak up?

What It Feels Like for a Girl

September 17th, 2009 by Elizabeth Kissling

Nearly 20(!) years ago, I conducted research for my doctoral dissertation about how and what girls learn about menstruation. I researched the literature and interviewed girls ages 11-16 about what kinds of information about menstruation they received and the sources of their menstrual knowledge. Among my findings, I learned that even girls who had received adequate menstrual education from school and parents did not consider themselves prepared for their first periods. They wanted to know more about what menstruation would feel like – not more about ovaries and hormones (although research and anecdotal evidence suggests their knowledge in that area is not as well-developed as they believe). They had serious questions about whether it would hurt, how often they would need to change their menstrual pads, and other phenomenological questions about the experience of menstruation. This kind of information is seldom part of formal menstrual education, but the girls in my study found ways to seek out this information, often through girlfriends and sometimes through popular culture sources, such as teen magazines.

These issues are even more important to girls with autism or other special developmental needs. This morning I stumbled upon this discussion at change.org about how communication with one’s daughter about what to expect at menarche is even more critical for autistic girls:

[w]hile I knew full well what menstruation “was,” my lack of expressive communication created a pretty major problem. And that wasn’t the only major problem. There was also the issue of the cramps, low blood pressure, and other ill effects which completely confused me on every level. My internal body sense is very poor, so I would mistake cramps for needing to use the toilet, or (much worse) needing to use the toilet for cramps. Self care issues with cleanliness were a big problem. On top of that sensory issues with pads were so bad that menstruation was truly a nightmare event. As I’ve aged, I’ve found ways to cope with all of these things, but it would have been much better had I found those ways to cope as a pre-teen rather than as an adult.

As someone who came of menstrual age in the 1970s when disposable menstrual pads were the approximate size and thickness of an entire box of Kleenex, I chuckled to myself when adolescent girls of the early 1990s complained to me that their paper-thin, modern pads felt like diapers. Knowing little about autism or its variants at the time, it didn’t occur to me how different the sensory experience of wearing pads could be. I’m glad I kept my amusement to myself, and I second the recommendations for instructing girls about menarche from Dora, the writer quoted above, whether they are autistic or not.

1. Communication–communicating about it when it happens, self-advocating for needs related to it

2. Sensory and motor issues with feminine products–tampons or pads, cloth or paper, consideration both of what feels (from a sensory angle) least irritating and is within the person’s motor capacity for managing

3. Internal body sense–managing pain or any other “sickness” associated with menstruation, the distinction between menstruation-related sensations and other body sensations

4. Schedule and hygiene–routines and schedules for managing feminine products, motor and executive function skills for maintaining hygiene, getting assistance if necessary

“Go With the Flow” with Tyra

September 13th, 2009 by Elizabeth Kissling

Did anyone happen to see the recent episode of the Tyra Banks show about menstruation? I was traveling when it aired and unable to watch or record it, so I’m curious. Reports are that the invited guests were three photogenic lady doctors who explained the physiology of menstruation and PMS. As Jessica Wakeman at The Frisky said, “It’s a ghastly state of affairs for sex ed if grown women are learning why they get their periods on The Tyra Show.”

Readers should note that statements published in re: Cycling are those of individual authors and do not necessarily reflect the positions of the Society as a whole.