By Katie Dominy
Time of the month. Having the painters and decorators in. Riding the crimson wave. The Red Army. Aunt Flo. Lady time. In 2020, a supposed era of body acceptance and positivity, the very topic of menstruation is still shrouded in euphemism and innuendo.
Even when periods aren’t being referred to in crude or derogatory tones, there is a tangible sense of taboo and embarrassment. This phenomenon is almost universal; from hushed teenagers secretively distributing sanitary products to friends ‘caught short’ in school; to women hiding more severe menstrual symptoms out of embarrassment; to general reactions of discomfort – and even revulsion – amongst the wider population when periods are talked about openly. It is undeniable that, globally, we have a long way to go before periods are free from shame.
But where does this sense of shame come from? And what effect is it having on health and wellbeing around the world? This month, The International addresses these often-overlooked questions.
A Bleeding Shame
“When you start getting periods… our mothers take us to a separate room and start advising you that you have to keep it a secret and no one should know that you are in menstrual periods. So when a drop [of blood] passes through, they say ‘Ah, she is namagwatala,’ meaning a very dirty person… So it is shameful.”
A woman from Uganda
According to the UN, there are nearly 2 billion people around the world who menstruate – around a quarter of the global population. For these individuals, research shows that the average lifetime will consist of 450 menstrual cycles across some 38 years – in total, the equivalent of some 6.25 years of menstrual bleeding. In fact, every day around the world, there are approximately 800 million people menstruating.
Given how widely and frequently periods are experienced on a global scale, it seems logical that menstruation should be viewed as a healthy, natural bodily function. However, the taboo surrounding periods is not new.
Of the world’s major religions, the only one that does not carry behavioural regulations around menstruation is Sikhism. The others enforce rules; for example, Coptic Orthodox Christians, Hindus, and some Buddhists (having been influenced by Hindu practices) are barred from entering places of worship when they are menstruating; and in Islam, those who are menstruating cannot touch the Quran, with some being advised to stop participating in certain religious practises. Orthodox Judaism carries particularly detailed regulations; all physical contact between men and women during menstruation and the following week is strictly prohibited, couples should not sleep in the same bed, and women are expected to bathe extensively during the Niddah period (or the ‘ritually unclean’ timescale). Clearly, human beings have had a complicated relationship with periods for hundreds (if not thousands) of years.
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It would be all too easy to dismiss these attitudes, stating that they bear little resemblance to how people actually perceive periods in the twenty-first century. However, it is clear to see how these ideas (of ‘impurity’ and social exclusion) have permeated modern-day culture – and on an international scale.
‘Menstruation huts’ (isolated places where women and girls quarantine for the duration of their period) are still used by certain Russian Orthodox groups, as well as some communities in Venezuela, western Nepal, Mali, and Indonesia. This practice does not only ensure social isolation: according to UN experts, it also makes individuals vulnerable to poor hygiene, disease, and psychological harm. Social exclusion is not exclusive to home settings; in rural India, 20% of girls stop going to school after they have their first period. In Sub-Saharan Africa, 10% of school girls do not attend lessons when they are menstruating, meaning that they are absent for as much as 20% of a school year. A 2018 US poll found that 42% of American respondents had personally experienced ‘period shaming’ from male counterparts, and 60% felt embarrassed during menstruation due to societal taboos. In the UK, 48% of girls between the ages of 14 and 21 feel ashamed about their periods.
Menstrual shame is present across the globe. However, it is not the only obstacle on the path to effective period management.
Period Poverty
“I didn’t know what was happening… or what to do to manage menstruation. I used cotton wool, pages from an exercise book, leaves from trees. I suffered much embarrassment at school because I leaked and stained my uniform.”
A Tanzanian woman with a physical disability
The term ‘period poverty’ has garnered increased media attention in recent years. But what does this alliterative catchphrase actually mean? According to the Royal College of Nursing, period poverty is, “the lack of access to sanitary products due to financial constraints”. The global statistics on this issue are eye-watering: internationally, there are as many as 500 million people each month living in period poverty.
Trends of period poverty can be seen all over the world. In many European countries, a so-called ‘tampon tax’ exists, whereby menstrual hygiene products are taxed as ‘luxury’ items. In fact, in around half of EU member states, sanitary towels and tampons are in the same tax category as tobacco, wine, and jewellery. The worst offenders are Hungary (where sanitary products are taxed at 27%), as well as Denmark and Croatia (which tax at 25%).
This is a puzzling trend for products that are, without doubt, essential for good hygiene and sanitation. Statistics from 2015 suggest that, in the UK, the average lifetime cost of sanitary products amounts to around £18 000. As we know far too well, there are many members of society who simply cannot afford such an expense.
Unfortunately, the result of not being able to access adequate sanitary products is often to improvise pads out of cloth, toilet paper, items of clothing, etc. Some people even resort to prolonged use of the few sanitary products they can afford, which carries the risk of infection.
Inadequate sanitary products aside, some analysts extend the definition of period poverty further, to incorporate, “the lack of access to sanitary products, menstrual hygiene education, toilets, hand washing facilities… [and/or] waste management.” When figures suggest that approximately 4.2 billion people around the world do not have access to safe sanitation services, the sheer scale of period poverty becomes even more apparent.
The Solution?
Clearly, the combination of stigma and poverty is a global barrier to menstrual health and hygiene. UNICEF states that “without considering needs for safe and dignified menstruation, the world cannot achieve the vision for sanitation and hygiene” espoused by the UN Sustainable Development Goals. Many international organisations (including the World Bank, ActionAid, WaterAid, Femme International, to name a few) have created outreach programmes to improve menstrual health and education. In Zambia, Japan, South Korea, Taiwan, and Indonesia, women are legally entitled to ‘menstrual leave’ from work, allowing them to handle more severe physical pain from home. In recent years, Italian leaders have debated whether to introduce similar legislation. To improve inclusivity, UNICEF has also stressed the importance of including transgender and non-binary menstruators in discussions surrounding menstrual health.
Progress is being made. However, perhaps it is only through increased conversation that harmful narratives can be broken down, and access to sufficient period management can become the norm for all.
Katie Dominy is The International’s Middle East correspondent.