A group of women in Meru, Kenya, are taught about how to use a menstrual cup. Menstruation is a sign of a woman’s health and fertility, yet it is still beset by shame, secrecy, humiliation, fear, taboo, stigma and embarrassment. Photo by: SuSanA Secretariat / CC BY

May 28 is Menstrual Hygiene Day. It is a day to shout about a natural process that millions only dare whisper about.

Menstruation is a sign of a woman’s health and fertility, yet it is still beset by shame, secrecy, humiliation, fear, taboo, stigma and embarrassment. Women and girls who do not have access to the water, toilets, disposal facilities, privacy and information they need to manage their menstruation safely and with dignity suffer most.

This situation is completely unacceptable in 2015. A growing number of people are demanding an end to both physical barriers and stigma — in communities, and as high as the United Nations.

In September, U.N. member states will finalize the sustainable development goals. This is a once-in-a-generation opportunity to deliver the ability to manage periods hygienically to all girls and women. WaterAid is calling for an indicator that measures the presence of hygienic, safe and private places for women and girls to manage their periods — including toilets, washbasins, water and soap — in homes, schools and health care facilities.

A global indicator will help hold governments to account and ensure that menstrual hygiene management for all is not just an empty promise, but a reality.

Why do we think that this is such an important issue?

Menstruation and the onset of puberty in girls should not raise an eyebrow. It should be recognized as just a normal part of growing up. Instead, for millions it can lead to huge disadvantage and prejudice.

A colleague who told me of her experience growing up in Uganda has illustrated this vividly. She remembers that when she started her periods, any hint of a conversation about it brought such an air of embarrassment that she soon learned to keep it to herself.

With no sanitary pads, she used toilet paper to stop the flow of blood — a painful endeavor during her 10-kilometer walk to school. The hard paper caused bruising and open wounds on her thighs that were very painful. Her school did have toilets, but they were dirty and without water so she couldn’t clean herself.

Because of the stigma, it was difficult even to find out what was happening to her body. Eventually she was taught about puberty in biology lessons, but there was no discussion about what this meant in society, and nobody challenged the negative beliefs associated with menstruation.

“It was too embarrassing. Boys bullied us and made fun of us. They would write sticky notes on my back — ‘I am dirty’ or ‘I am stinking’ and the teachers refused to intervene,” she told me.

Boys and girls then went to separate sessions on puberty, she recalled. Boys emerged from their sessions feeling proud of the changes in their bodies, while girls were embarrassed and ashamed.

A recent paper by academics Inga Winkler and Virginia Roaf, “Taking the Bloody Linen Out of the Closet,” provides a detailed analysis of the human rights framework in respect to menstrual hygiene management. It shows that without proper facilities and information, the human rights of women and girls, and true, substantive gender equality cannot be guaranteed.

The stigma associated with menstruation is still a major driver of gender inequality in many countries. Many of the cultural and religious norms, often grounded in patriarchal assumptions, seek to prevent contact with menstruating women and girls in order to “avoid contamination” or “becoming impure.” These practices reinforce the process of keeping women subjugated and discriminated against, rather than treating periods as a natural biological process and a mark of fertility.

Menstruation should not be a matter of shame or impurity. Rather, it should be associated with pride and dignity.

The stigma and disadvantage starts right at the onset. Girls who are menstruating at school need sanitary towels, latrines, places to change and safe water. They also need nonjudgmental, factual information. Without these, the school environment is unhealthy, discriminatory and dangerous to the extent that menstruation is one of the leading causes of girls leaving education in the developing world.

How do we address this? In keeping with an analysis by Sandra Fredman from the University of Oxford, by:

● Redressing disadvantage, promoting girls’ education and the construction of toilets at school.
● Addressing stigma and stereotyping, educating not only girls but also men and boys on the intricacies of menstruation, to provide opportunities for discussions to shed light where there is currently shame and confusion.
● Embracing difference and achieving structural change, addressing menstrual hygiene management at all levels, from legislation and policies, to financing and tax reforms, to institutions, down to the very practical necessity of disposal units for menstrual towels.
● Enhancing voice and participation, because substantive equality means enabling women and girls to take these decisions in an informed way and not to be judged for them.

Including menstrual hygiene as an indicator for the SDGs is an opportunity we must not miss. It will address a huge and pressing practical problem for billions of women and girls, while also taking a big step toward gender equality.

Don’t whisper it. We have the chance to advance gender equality in one giant leap. We must not fail.

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About the author

  • Louisa Gosling

    Louisa Gosling is a program manager for principles at WaterAid U.K. She is responsible for mainstreaming WaterAid’s principles on equity, inclusion and rights into its WASH programs. She has worked in international development for over 20 years, and joined WaterAid in 2008. Her work promotes awareness of access to WASH in realizing the rights of marginalized people. She works with practitioners to develop inclusive and rights-based approaches to overcome discrimination and exclusion.