The period is finally having its moment.
In the last decade, the difficulties women and girls across the globe face during menstruation have inspired a raft of grass-roots campaigns. “Period poverty” activists seek to make menstrual products more affordable and available. International agencies like Plan International, Water Aid, U.N. Women and Unicef are supporting menstrual hygiene programs in dozens of countries. Access to safe, accessible bathrooms and materials to manage menstruation is now recognized as a human rights issue that involves many other areas of development, like clean water, education and gender equality.
These shifts are certainly heartening. For centuries, around the world, menstruation has been treated as a source of shame, rather than as a normal, healthy part of women’s lives. Initiatives to “make menstruation matter” are both welcome and overdue.
Why, then, after years studying these efforts, do I feel ambivalent? Because too many of them have opted to focus on providing women with new products, failing to substantively fight the core problem surrounding menstruation: cultural stigma.
Consider the humble piece of cloth. Many Westerners are horrified to learn that repurposed cloth is commonly used by women in poor countries to manage their periods. Yet cloth is absorbent, readily available, cheap and sustainable. Folded or cut to size, changed as necessary and properly washed and dried, it can be sanitary and effective.
Still, many programs are hustling to replace this traditional method with commercial products. In addition to the nongovernmental organizations that make products their priority, start-ups are seeding microbusinesses in which, say, Rwandan, Indian and Ugandan women make and sell pads. Such an approach falls under the category of a “technological fix”: a seemingly simple solution to what is, in reality, a complex problem.
Such interventions can be helpful, and in some circumstances even necessary, but they fail to address the root issues. No menstrual product is effective for a schoolgirl who lacks access to a clean, secure toilet, as is the case in many poor countries. Stigma about menstruation often undermines proper use, and a woman’s fear of inadvertently revealing she is menstruating remains a distraction and a burden.
These fears and stigmas are prevalent in the rich world, too. As the historian Joan Jacobs Brumberg has shown, in the United States at the turn of the century, menstruation became increasingly medicalized: Doctors, who were mostly men, and increasingly viewed as experts, coached mothers to socialize their daughters to keep tidy and discreet. Menarche, the first menstrual period, was effectively reduced from a sign of womanhood to a “hygienic crisis.”
Even now, American girls are socialized to see menstruation, and more generally, their bodies, as problems to be solved through use of the “right” products. Today, we are exporting this view around the world.
The outsize attention paid to products reduces menstruation to a hygiene issue when it should be much more. The monthly shedding of the uterine lining is part of a cycle that lasts, on average, for 40 years. It is a vital marker of health and a pivotal developmental milestone for half the world’s population.
Menarche should be a prime opportunity to begin a girl’s lifelong authentic engagement with her body. Instead, we hand her a pad and teach her to put it up her sleeve when she goes to the bathroom.
Many of the people doing work on menstrual health initiatives know that distributing products is not a silver bullet. Indeed, some pair distribution with education. A few also push for infrastructure improvements and policy change. But as people working in the field have told me, the reality is that providing pads is easier than trying to change ingrained cultural habits. It’s also readily measurable: It’s easy to note the number of pads that have been handed out in a month. It’s much harder to provide similar metrics for improved knowledge and education levels.
We must resist the well-meaning impulse to improve the lives of menstruating girls through consumption. The greater need is for people to understand that periods aren’t something shameful and best kept hidden. When menstruation is treated as normal, it becomes more than a nuisance, a punch line or a weapon wielded to keep women in their place.
Our aim must be to transform the revulsion into respect, to shift from “eww” to “oh.” We need to redirect resources toward promoting innovative, inclusive and culturally sensitive community-based education about the menstrual cycle. And the audience must be not only girls, but also everyone surrounding them — boys, parents, teachers, religious leaders and health professionals.
To be clear, I am not denying that women need something to bleed on. Of course we do. Nor I am suggesting that women should be denied access to new methods of handling menstruation better suited to their needs.
But menstrual activism won’t be meaningful if it is reduced to Western-style “better living through more consumption.” After all, periods remain taboo in high-income countries where commercial products have been the norm for decades. Challenging the social stigma and disgust directed at the female body must be our main mission — in the developing world and everywhere else.
If this moment is going to grow into a movement, it must do more than move products. It must move minds.