Young Menaka (name changed) from Chennai remembers the shame she felt the day she stained her white school uniform with menstrual blood, even today. “I stained my pure white uniform at school and the chair I was sitting on. I was so scared and ashamed that I sat there till every boy left the class. I hugged my (girl) friend and cried, and we wiped the chair clean before anyone could see us,” she recounts. Every woman has one such ‘horror’ story of an embarrassing situation because of a stain. It is not the staining itself that is so horrifying, but the embarrassment over it.
In India and around the world, menstruation is heavily stigmatised, resulting in a wall of silence that contributes to the inability to resolve other related problems. The list of taboos is endless and confining, and menstruating individuals face a litany of dos and don’ts that govern their lives during those few days every month – do not enter temples, do not perform any religious rituals at home, do not cook or enter the kitchen…The list drags on, including everything from salt to husbands. In extreme cases, women are banished from their homes and confined to an outer room or a hut where they menstruate in isolation. In our work with women, particularly within vulnerable communities, we have heard countless experiences of such stigma impacting their lives. But let us also not lull ourselves into believing that this issue is restricted to the marginalised or the rural areas. It is alive and thriving everywhere, albeit in different ways.
But not only do we not want to talk about this biological function, we also do not wish to see any evidence of it. During my travels, I have been asked to dispose of sanitary pads across walls into adjoining drains, water bodies, or garbage lots. In one house, I was asked to walk down a few flights of stairs, go out of the house, and dump it across the road. Women who use cloth or rags as adsorbents dry them in secrecy under other clothes, leading to potential infection. (Remember Akshay Kumar’s Pad Man?) Most homes do not even have dustbins in toilets, the most logical place for disposing of menstrual products.
Many women from our focus group discussions in various towns in Tamil Nadu report that they wash their used pads, tear them into pieces and flush them down the toilet, or dispose of them with household waste, to do away with the ‘theetu’ (a superstition positioning period blood as impure). Some of this may be due to the non-existing solid waste management systems for medical waste in many towns, but some of it is simply our desire not to see (and god forbid smell) ‘these things’ in our homes. How many hotels have we visited that don’t have dustbins in their bathrooms?
The burden of bleeding
For something that we want to pretend does not exist, periods enter a girl’s life dramatically, leaving a visible impact. It signifies a step towards adulthood, but it also comes with a price: pain and discomfort that girls must bear.
As menstruation begins, girls often find their lives turned upside down. Depending on their culture, they are expected to wear their hair up or down, skirt hemlines go down or are replaced by trousers, the chest is tamed into what can only be described as a cloth cage, and night curfews are imposed.
Young girls — who are barely catching their breath from the concreteness of the bleeding — are told that menstruation means they can get pregnant. While it is important to educate girls about sexual health, this fact often comes with veiled threats and restrictions — you could get pregnant out of wedlock, and if you do, your life is ruined. Periods, then, mark not what could possibly be a celebration of femininity, but a lifetime of restrictions and cages.
During discussions with transgender men in Trichy, it became evident that they faced different challenges. “We depend on community toilets and use the men’s section. There is no way to dispose of a pad in the toilet. There are no incinerators or dustbins,” says one of them. Another trans man says, “I now have a partner, a woman. I did not want to bleed anymore, so I underwent treatment to stop my periods. But the mental and emotional journey was arduous.”
Most women also leave menstruation in the same silence and stigma as they enter it. They enter menopause with little knowledge about it, with their bodies (especially of the underprivileged) already wracked with deficiencies because of poor nutrition, and sometimes with hysterectomy presented as their only option.
What can we do to free ourselves from this?
The price of secrecy
The secrecy and lack of information about menstruation come at a huge cost. Adolescent girls often experience their first period with little to no awareness of menstruation, or worse, half-baked information heard from didis or friends. A study shows that nearly half of the girls in India lack knowledge about the process when they first begin menstruating, and this misinformation may persist throughout their lives. A 21-year-old girl from Trichy recounts the fear she felt when she discovered blood staining her clothes. Afraid and puzzled, she ran to her mother and aunt, who then unveiled the mystery of menstruation to her.
We have witnessed this unfortunate reality firsthand in our work at the Tamil Nadu Urban Sanitation Support Programme (TNUSSP), where we worked on Menstrual Health Management (MHM) and allied initiatives, engaging with a wide range of citizen groups including urban poor residents, schoolchildren, government officers, sanitation workers, and business owners. Even middle-aged women, who one might assume would have picked up knowledge over their lifetime, exhibit a lack of understanding about basic health principles. While periods are not only about biology, medicalising this issue (and forgetting cultural aspects) has its own danger, and if nothing else, we need to impart health information.
While silence impacts women across the spectrum, they have a disproportionate impact on menstruators from marginalised locations, who often do not have access to hygienic, safe sanitary materials, a private space to take care of personal hygiene with dignity, or medical care when needed. The National Family Health Survey (NFHS)-5 data shows that 22% of young women still lack access to menstrual products, a number that is likely even higher among older women. The SBM-U gender guidelines recommend access to MHM facilities in community toilets. Stories abound of women missing their daily wages because there is no restroom facility at their workplace or because they have to walk kilometres to find a place to change napkins, or because they live in a crowded slum. “We use community toilets during periods so that we can dispose of the pad or cloth easily. At home, with men around, it can get uncomfortable,” reveals Uma (33) of Trichy, her voice resonating with countless others.
Women from marginalised communities are also forced to undergo hysterectomies in exploitative labour practices, or simply as a money-making endeavour for some medical practitioners. A part of the reason that women undergo this is the silence around menstruation, and inadequate avenues to discuss options.
In a small town in Coimbatore district, one woman in her early forties shares her reason for removing her uterus. “I have two boys. If I touch them during my period, they will fall ill. Doing household work on my period days was so uncomfortable, so I decided to remove my uterus.” For another 40-year-old, her daily bus commute to work was a source of humiliation and discomfort. Fearful that the odour of soiled pads would draw disdainful gazes from others, she felt that the only way to escape this shame was to remove her uterus.
In the face of such circumstances, government and non-profit programmes aim to address these gaps, often including awareness initiatives in their efforts. However, the unwillingness to speak about the issue hampers these initiatives.
Breaking the silence
In many ways, women do talk about menstruation within their own circles. I read somewhere that most women connect with complete strangers over motherhood, but I have seen women connect with complete strangers across generations and locations over menstruation — in trains, in hotels, at field sites, as we scramble to find absorbents or a place to change, or a painkiller so that we can grit our way through an important meeting. We meet one another, in knowing glances, nodding our heads in commiseration, and often with empathy.
Yet, we also remain strangely silent. I am not talking about celebrating periods – they have never been more than an inconvenience – or a celebration of bodies. I also respect the fact that this is a private issue for many of us. But that should not prevent us from talking about this when necessary. We need to be able to seek medical attention when needed, we need to be able to tell our friends, teachers, and bosses when we want time to ourselves. Most importantly, we need to speak out against the antiquated myths that surround us.
Speaking about taboos does not necessarily break taboos, but we might find the strength, the strategy, and wherewithal to find solutions. Perhaps, menstruating girls will find solutions if they are freed from the trauma of silence. This is not to put the burden on girls and women, but rather, to explore how they can be, and often are, active change agents.
I remember a childhood game we played, which involved completing a ditty about what "good girls" from respectable families should never do. We gathered wisdom from teachers, relatives, and strangers who imposed rules on us: don't sit with legs apart, speak loudly, wear short skirts, or fall in love. Our game aimed to break every line, reminding us that these were false beliefs and that we owned our lives and shouldn't bear shame or burdens.
Working with a diverse team, I have shared many moments of pride, solidarity, and connection. One such memorable event was on Menstrual Hygiene Management Day when we came together as a team to share our stories and trysts with menstruation. It was not surprising to hear that each woman had more than one tale to tell, but what was heartening was that even men had stories of their mothers, sisters, and partners, and empathised with their pain. There are other examples where boys and men have been involved in bringing about change in menstrual practices. Perhaps, the time for change is truly here.
In our own work, we have developed an educational module called ‘Ungal Thozhi’ (meaning ‘your friend’ in Tamil) that encourages discussions among young girls on menstruation. We have launched it in 50 schools and multiple urban poor communities. Earlier, our awareness programmes were held in closed rooms to ensure participation. Now, after three years, we are able to conduct these sessions in open community spaces, like temples, which are open for all to attend. Through our annual campaign called Red Thiruvizha (Festival) on Menstrual Health Day, we also reached out to thousands through Radio FM, social media, in-person consultations, and street plays.
A 27-year-old woman who is part of the ‘Ungal thozhi’ programme says, “I used to feel shy to even utter the word ‘periods’ before. Now I can discuss it with anyone, and we have understood how it is linked to reproductive health.”
In this hope, and with this spirit, let us work together to end the silence around menstruation.
