Dear all,

About evidence on culture of hiding menstruation (in England at least): Norma O'Flynn (2006)
'Menstrual symptoms: the importance of social factors in women's experiences'
www.ncbi.nlm.nih.gov/pmc/articles/PMC1934056/

My experience is England, and I'm older (61): I am coming to realise that attitudes vary widely and quite locally, also that young people, (thanks to campaigning educators), are much less hung-up about talking about their periods. However only last week I overheard two young but experienced secondary school science teachers admitting that they feel embarrassed to teach the menstrual cycle, even to girls, and will gloss over it or hope that someone else has covered it so they don't have to. As a science teacher myself in special schools for children with emotional and behavioural difficulties (many become pregnant at 13-16) I found that many students had missed 'sex education' lessons. I was anxiously reprimanded by a fifteen-year old for teaching him the subject, even though it is on the curriculum (I responded that his reaction showed me that it was exactly what I should be teaching him!).

Harder to assess what parents say to their children without serious study, but a teaching colleague with Dutch roots told me young people are told much less in England than in Holland.

Men I know in England tend to express embarrassment when the subject is brought up - but again those are mostly older men. A 40-year-old father had no idea what I was talking about! I have never heard of a father talking about menstruation to his daughter - but then I have never asked, and the subject has never come up.

On the other hand, I have met several African and Indian women and men who have dumbfounded Westerners with their apparent lack of inhibition in talking about menstruation. They might not have been a representative sample... I have also read of men and women in the Middle and Far East openly citing menstruation as a reason for absence from work (in a man's case, in order to do the cooking as his wife was menstruating). This would never be admitted in England, as O'Flynn confirms.

I probably overstated it, but my point is that we should be very cautious when making assumptions about cultures we don't really know.

Thanks for your comments, Elisabeth! Much appreciated,

Susannah

This is very exciting - to see so many initiatives to study and improve menstrual management. I notice that most mentioned here are based in India.
I'm English, and I believe we in the West have a lot to learn from India, Africa, in fact many other cultures.

In England, at least, we are notoriously inhibited about anything to do with sex - yes, it's still true! This has led to an orthodoxy that menstruation is "not to be mentioned", and everything related is dirty and embarrassing. We are struggling to change that, but our culture is by no means "over it".

I think it is important in all these studies and "interventions" to look first, very critically, at one's own assumptions and definitions.
First: "hygiene": who is being "protected" and from what "contaminant"? When studies ask "how hygienic is this woman?" they often purport to be concerned with the woman's health - in which case you might expect them to discourage the collection and holding of menses in or near the body (eg in pads or tampons), because that could possibly lead to bacterial build-up. Examples of practices that avoid this include the Lao women in Liyen Chin's study (2014, on the SuSanA forum) who simply wear double-thick skirts, and wash frequently. However, the implied message is "yuck, this menstruating woman is dirty, don't let her/it near me!" ie the person being protected is the non-menstruator.

Then: "protection" - from what? I applaud those (again, all, so far, in India!) who affirm that "[fresh] menstrual blood is not dirty or toxic". Please spread that message to the West!

Thirdly: "sanitary": let us be clear, if there is anything insanitary about menstruation it is used disposable pads with nowhere to go, when they cause toilets to block and faeces to overflow. The term somehow overflows itself, so that menses itself becomes regarded as "unsanitary", and any spot of blood from a vagina gives people the horrors.

I fully admit to having had to face and hopefully overcome a lot of these irrational fears myself in the past year of studying the subject. For that, I am grateful to this forum, and to many mainly non-Western women (and some marvellous men) for talking face-to-face and online about the ways they view menstruation. I've had to face up to the fact that claiming I am "respecting" others, eg by using euphemisms and skirting round the subject, has often been a get-out for not challenging taboos. When they are acknowledged and not challenged, taboos are reinforced.

Now, I look forward to learning from more of the World about better ways we can manage menstruation, to overcome the big problems we have in the West, not only our attitudes (which, for instance, prevent English users of reusable pads from hanging them out to dry in the sun - despite telling everyone else to do so!), but also the waste-disposal and pain-management and working-pattern difficulties.

Susannah

Interesting to read this "other side of the argument" - also interesting to read the reader comments below the blog post.

That thing about not necessarily promoting disposable pads because it creates a solid waste problem I would also agree with.

The argument might fall apart though if you take menstrual cups. This is a product that women from developed and developing countries enjoy using alike (and it's a minority in both societies so far who uses that). Mind you one difference is that issue about "unmarried women" not meant to use something that is inserted (i.e. no tampons either). Here, I like though how Penny Phillips-Howard has challenged us by saying:

The general view when talking to professionals here is that menstrual cups would not be used by girls [saying they can only be used by 'married' women], but there is no evidence to show this either way. maybe they are right, but it would be good to validate. One paper in Nepalese schoolgirls (Oster and Thornton) suggests girls will use, I attach the file.

(see her post here: forum.susana.org/forum/categories/24-men...g-environments#14163)

Anyway, the opinion piece by Sinu Joseph does leave me wondering if some issues are sometimes "hyped up" to get more funding and attention (getting attention for menstrual hygiene issues is at the moment in general a good thing, to pull it out of the taboo corner).
Susannah, can you elaborate on:

Added to this, the West has MORE of a problem with hiding away menstruation and its paraphernalia than some other cultures

It's hard to compare it exactly and yes, taboos exist also in Western societies around menstruation but I would argue they are indeed quite a bit less severe and serious than what I have read about for some other cultures. Take the example of mothers not talking to their daughters about menstruation, I would say that's pretty rare in the West, isn't it? Girls not knowing what happens when they start bleeding? Very rare. School curriculums not teaching kids about menstruation? Also rare. Girls too embarrassed to ask their father for money to buy menstrual hygiene products? Rare, I would have thought?

swarajyamag.com/culture/why-india-doesnt...y-napkin-revolution/

I find this perspective from Sinu Joseph whom I met at the SMCR conference, very interesting.

My own studies of the current literature on global menstrual management practices show that long-standing, tried-and-tested local practices tend to be referred to as deficit. When replaced by 'Western' methods eg disposable pads, these import the same problems as they already cause the West - ie disposal, toxic fumes from incineration, etc. Added to this, the West has MORE of a problem with hiding away menstruation and its paraphernalia than some other cultures (vide Nikki Dunnavant's experiences in Nepal, where 'everybody knew' when she was menstruating).

Perhaps we should look to learn more from 'developing' nations, and bring some of this knowledge back to the West.

Susannah