Menstruation needs to be put higher on the health agendas

Dr. Venkatraman Chandra-Mouli works with Adolescent Sexual and Reproductive Health in the World Health Organization’s Department of Reproductive Health and Research. Over the last 20 years of his work on adolescent health, he has seen menstruation move from a non-issue to the fringes of the global health and development agendas. He believes that to bring out the institutional and social norm changes needed, menstruation has to be higher on both the global and national agendas.

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Chandra-Mouli regrets that a perfectly normal stage of development – menarche – and a perfectly normal human function – menstruation – have been clouded by taboo and stigma.

– In different social and cultural contexts, menstruation evokes discomfort because of its association to sexuality and reproduction, shame because of girls’ inability to manage it effectively, and exclusion because of its association with impurity. This hinders girls’ abilities to carry out everyday activities, weakens their self-esteem and self-confidence, and sets a foundation for poor healthcare seeking behavior.

According to Chandra-Mouli’s research and experience, many adolescent girls in low and middle-income countries are uninformed and unprepared for menarche. They are excluded and ashamed of their periods. Lack of access to menstrual products and to water and sanitation, hinders them from taking care of themselves, and taking charge of their lives. And when they do need care at home or in a clinic, they do not get it.

– It is essential for girls, as well as boys, to be informed about puberty and menstruation from an early age. Both girls and boys need to know that puberty and menarche are normal life stages. As their bodies and minds mature, they need and have the right to understand the changes they will experience and how to manage them effectively. Ideally, information should not only be provided at homes and schools, but also from other adults, such as sports coaches, who play an influential role in adolescent lives.

Adult teaches children (photo)

Ideally, information should not only be provided at homes and schools, but also from other adults, such as sports coaches, who play an influential role in adolescent lives.

WHO advocates for girls to grow up in a context where menstruation is considered healthy and normal; where all girls are well-informed, have access to sanitary products, and receive the support they need.

– This is happening in some places through the efforts of certain individuals and organizations. In order for this to happen on a larger scale, long-term programs, thorough leadership, management and investment are needed. Parliamentarians and government leaders are crucial for making this happen. Ultimately, menstruation needs to be high on their agendas for real change to occur.