Debunking Menstruation Myths

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The myths and taboos about menstruation are universal. They affect women in differing ways, but it is always at a cost. The most marginalized group is adolescent girls. In a study conducted in 1990, the World Health Organization stated that in many developing countries, girls know less about menstruation than they do about pregnancy. They know it is coming, but they do not know what it is, and are shocked and frightened by the sight and process when it first occurs. Because no one will discuss the issue, there is an automatic assumption that it is shameful and should be kept secret. This affects the girl’s self-esteem, for it is a natural process, without which she would not even exist. The taboo makes it so that she is not even able to discuss the topic with her male peers, resulting in further alienation. These conditions can make girls feel dirty and different and in some cases can even lead to their dropping out of school.

Importance of debunking myths

Rag and tampon manufacturers and the pharmaceutical industry perpetuate myths and stigmas about menstruation to maintain or increase profits. They both promote the idea that menstruation is a disease state with the sole purpose of selling their products. By slandering menstruation with myths and negative attitudes, they create a market for “feminine hygiene” products. This is evident by their statements, advertisements, and product labeling. For example, there are several different ads and articles promoting “menstruation suppression” using birth control pills or other hormonal methods. This is not a new idea but merely a repackaging of an old idea that has been perpetuated by drug companies. Coco de Mer has a gallery of advertisements with period-related myths and stigmas that have been used to promote menstruation-related pharmaceuticals.

Menstruation myths and stigmas have a broad reach and impact. Previous work by Chris Bobel and others has shown that myths about menstruation can have several negative consequences. They can lead to poor self-esteem in menstruating individuals and a negative attitude towards their bodies. This is thought to be especially important for adolescents who experience the onset of menstruation. They can lead to bullying and embarrassment by peers, both boys and girls, and result in school absenteeism. In some parts of Nepal, girls are still sent to live in “menstrual huts” away from the family home during menstruation because they are believed to be unclean. This can leave them open to greater psychological and physical danger and does not reinforce a sense of pride in the passage of womanhood.

Impact of myths on menstruating individuals

The lived experience of menstruation is, for many, a contradictory process: natural, yet shameful; necessary, yet repulsive; ordinary, yet extraordinary. The attitudes we carry towards our own menstruation are frequently ambivalent and, whatever we profess to believe, the concrete experience of our monthly bleeding can carry different meanings at different times. Menstruation myths exacerbate this ambivalence. Myth and secrecy about menstruation have historically had a significant impact on women’s and adolescent girls’ experiences of menstruation – all over the world. Myths serve to confuse and demean females, while alleviating boys from the potential anxiety provoking information about the process. They contribute to a shroud of secrecy and, frequently, a general cultural attitude of repulsion towards what is a normal and natural process. The public silence surrounding menstruation reflects a division between men and women, and a historical unease about the “proper” place of women in society. Women’s monthly bleeding has rendered them “impure” in the eyes of various religions, and in certain Hindu traditions a menstruating woman is not permitted to enter a temple or even to cook. Egede has pointed out that cultural taboos about menstruation often reflect a fear of female sexuality, and a desire to control women.

Common Menstruation Myths

Myth 2: Menstruating individuals are more emotional or irrational. This myth can be particularly damaging as it is used to undermine women’s abilities in fields such as politics, or high-stress professions such as medicine and law. Women are prone to believe this myth and therefore evoke it, attempting to find excuses for moments where they have acted emotionally or irrationally. Partners of menstruating women can use the ‘premenstrual tension’ PMS theory to account for any arguments or tension occurring within the relationship. Women have more than enough labels when it comes to being emotional or irrational; it is unfair to blame hormones as the cause of their behavior. Premenstrual mood changes affect not all menstruating women and symptoms can vary from mild to severe.

Myth 1: Menstruation is dirty or unclean. This myth has been perpetuated through religious beliefs, patriarchal societies, and general misogynist attitudes towards women’s bodies. However, menstruation is a natural, healthy function of the female body in response to hormonal changes, and not a sign of disease or a health problem. Women need to know that they are not “dirty” while experiencing menses. There is no medical reason to believe that menstruating women are ‘dirty’ or ‘unclean’, and therefore women should not feel dirty or unclean as a result of menstruating. If women feel the need to bathe more frequently while menstruating, there is nothing wrong with this; it is simply a personal preference and not an indication of poor hygiene.

Myth 1: Menstruation is dirty or unclean

Although over time rituals and customs to help women manage their menstrual periods and the negative symptoms associated with them have given women the idea that menstruation is a difficult, unclean, and impure process that must be “put up with.” Despite what some may think, the idea is a social construction and not a truth! Menstruation is a natural process and essential to the human life cycle. In a study of attitudes toward menstruation, it was found that women who held more traditional religious beliefs and who endorsed the idea of menstrual etiquette were more likely to experience negative attitudes and emotions towards menstruation itself. This means that women who view menstruation as unclean or impure are doing so as a result of cultural conditioning and it is this attitude that will lead them to have a negative experience with their periods.

First mentioned by ancient Hebrews and perpetuated in 19th and early 20th century writings, the belief that menstruation was a curse or punishment is still upheld in many cultures throughout the world. Even in modern western society, menstruation is looked upon unfavorably. In a recent study by the maker of the drug Aleve, 52 percent of the women and 44% of the men agreed with the statement that “women’s periods and premenstrual syndrome are socially unacceptable topics of conversation.” A general agreement was also in place that women’s periods are not fully under their control. Seemingly small comments such as “I must be PMSing” as an excuse for bad emotions or to rationalize exaggerated actions are clear demonstrations that negative behavioral expectations still exist for menstruating women. These expectations are important to consider when looking at the ways in which women’s lives are affected by their menstrual cycle.

Myth 2: Menstruating individuals are more emotional or irrational

Biological studies examining hormone-behavior interaction do not support the view that the premenstrual phase is a time of negative mood (Ussher 2006). A recent, comprehensive review of the literature concluded that the menstrual cycle phase does not have a significant impact on mood (Eisenlohr-Moul et al. 2016). Effect sizes are negligible, and less than 10% of the mood variation in the general population is accounted for by premenstrual phase hormone changes. Hormonal contraceptives, which suppress ovarian hormone cyclicity, do not prevent PMDD. This suggests that hormone withdrawal, rather than change in hormone levels, is the determinant of mood change in the premenstrum.

The belief that women become more emotional or irrational during the premenstrual phase is deeply ingrained in Western culture and perpetuates the stereotype that women are not fit to hold responsible positions in society. There is much cultural support for the notion that the premenstrual phase is a time of negative mood, decreased efficiency, and irrationality. Lord and Taylor (2003) found that many people, including health professionals, view premenstrual mood changes as a negative and unsolvable problem and ascribe these changes to hormonal factors. Premenstrual dysphoric disorder (PMDD) was included in the DSM-IV, the diagnostic and statistical manual for mental disorders, despite debate in the psychiatric community. While some argue that mood changes in the premenstrum are caused by hormonal imbalance, others contend that the etiology is stress-induced and that categorizing a natural phase of the reproductive cycle as a mental disorder is pathologizing normalcy (Ussher 2006).

Myth 3: Menstruation affects athletic performance

Many sports people believe that their performance will be affected if they take the hormone regimen of the combined oral contraceptive pill (COCP) and manipulate their menstruation by taking the placebos every 12 weeks instead of every 4 weeks. One further concern was if they experienced irregular bleeding and spotting. These concerns were raised because they thought that menstrual cycle irregularity and COCP use would lower their estrogen levels and therefore impact their bone health and athletic performance. However, there is limited scientific evidence to really verify these concerns. Tripp et al showed that manipulation of the menstrual status via the COCP did not affect bone turnover in trained females. Meanwhile, others have shown that COCP use is associated with higher bone mineral density in different populations of females. More research has recently been done to investigate the effect of the oral contraceptive pill on athletic performance. A recent study by Lebrun et al found that cycle control has no effect on exercise performance. There is even less evidence to suggest that irregular bleeding and spotting impairs athletic performance. A study conducted by Brown et al showed that menstrual cycle irregularity of over 1 week disturbed neither training response nor physical adaptations to exercise training in previously sedentary adults. Also, temporal changes in estrogen levels do not appear to affect athletic performance. In fact, estrogen has been said to enhance the contractile function of muscle which may result in improved muscle strength and performance. An interesting point is that studies have shown that some females believe that they should avoid vigorous exercise during menstruation. This is more of a psychological barrier rather than a physiological one and it has been reported that strenuous exercise can actually alleviate menstrual discomfort in some women.

Myth 4: Menstruation is always painful

The belief that “menstruation is always painful” is a myth which may lead women to view their periods as a time of suffering. In reality, although it is natural to experience a certain amount of discomfort due to the shedding of the uterine lining, pain is not always a global experience. Approximately 10% of young women with severe and incapacitating menstrual pain suffer from a condition called dysmenorrhoea. There is a primary dysmenorrhoea, which is menstrual pain without any pathology, and secondary dysmenorrhoea which is painful periods associated with a pelvic pathology. Common menstrual cramps are not an indicator of an abnormality as there is no evidence of a pelvic disease in most cases. A recent study stated that women with dysmenorrhoea missed 2.2 days of school per year compared to menorrhagia sufferers who missed 4.6 days of school per year. This demonstrates that while painful periods are a burden, a more common menstrual problem of heavy bleeding may affect women even more.

Debunking Menstruation Myths

Clears away, since Greco-Roman period, menstruation myths and gods related to feminine menstruation rite. Dealt with in the three myth sections above, the Shekhinah is related to the partitioning of the sacred and profane. Menstrual blood is the most powerful unclean substance. By touching a niddah a person becomes unclean and must immerse in a mikvah. Men are sources of ritual impurity but unlike niddah, this status is continuous. A menstruating woman is a niddah. The laws of niddah are rooted in the biblical custom of the laying a bar or a wadi between Israel and its enemies before going out to battle. Cross-dressing by any participant is a rabbinically decreed extension. Ritual immersion in a mikvah following menstruation and after childbirth is a Biblically ordained measure of ritual purity.

Fact 1: Menstruation is a natural bodily process

At one time in my life, I had thought that menstruation was a “curse” or some unnatural happening, a notion I am positive is commonplace amongst many people, both male and female. Like any other naturalistic process, menstruation might come with unpleasant symptoms or consequences, however the result of declaring menstruation “abnormal” or “unclean” creates a social and cultural disempowerment of women. By framing menstruation as a health issue and period products as medical necessities, it becomes easier and more justifiable to argue for their increased taxation and their inaccessibility to low-income women. In 2015, the average retail price of a 36 count box of tampons was $7.47 – and that’s a basic necessity over a span of 30-40 years of a woman’s life. Considering that nearly 25% of women in the US live below the poverty line, this treats a population-wide issue as an issue only for those who suffer from it due to some medical anomaly. In order to set the foundations for an empowered view of menstruation and to better recognize when there are abnormalities truly in need of medical attention, it is crucial to unlearn the view that menstruation is abnormal and instead recognize it as the natural process that it is.

Fact 2: Hormonal changes during menstruation can impact emotions, but not necessarily negatively

During menstruation, hormonal changes are thought to cause moodiness and increased irritability. However, despite experiencing a wider range of emotions than normal, not all of these emotions are negative. An author of this claims that emotional changes for some women can be dramatic, occurring suddenly and inexplicably. Women’s experiences with premenstrual and menstrual mood changes and the role of changing hormone levels remain an area of controversy. But not all women experience negative emotions. Over half of menstruating women report having positive emotions both premenstrually and during menses. Changes in hormone levels can affect many different neurotransmitters and their receptors in the brain, and these effects are thought to result in mood changes. Hormone changes affect the production of endorphins, which are the brain’s feel-good neurotransmitters. Beta-endorphins are lower in women with premenstrual mood changes compared to women with no mood changes. Although there is some evidence that poor nutrition and altered metabolism in some women with PMS can lead to changes in production of certain neurotransmitters in the brain, there is no evidence that the effects of hormonal changes on mood are related to a deficiency in any specific nutrient. Women who have had depression premenstrually or postpartum (after childbirth) are more likely to have severe mood changes with normal hormone fluctuations. This may indicate an underlying vulnerability to certain hormone-related mood disorders. But more research needs to be done to understand the effects of hormones on mood changes and the wide variability in women’s experiences.

Fact 3: Menstruation does not hinder athletic performance

There is also no hard evidence that menstruation does in fact hinder an athlete’s performance. According to certain studies, bronze medalist marathoner Kathrine Switzer has been quoted saying, “I ran my fastest time ever on the day after I finished my period. I believe the energy loss theory is a myth.” Also, Switzer, who is known as the first woman to run in the Boston Marathon, has had experience running both while on her period and while not. She was asked to detect any differences in her performance and said that she herself could not detect any variations. Many experts say the effects are individual and depend on specifics of the athlete’s cycle, and that it should not be assumed that performance is hindered. “I think that it’s a myth that women’s performance goes down premenstrually,” said Dr. J.D. Adams, an exercise physiologist and an expert on women athletes at Springfield College in Massachusetts. “I think there are too many women who have demonstrated otherwise.” Dr. Mark Hargreaves, an exercise physiologist at the University of Melbourne in Australia, says, “It’s very varied among individuals, and most of the negative feedback is psychological. From a metabolic or a cardiovascular or respiratory perspective, there is no compelling data that I know of to suggest that exercise performance is limited in the premenstrual phase” (see Globe and Mail article). The energy loss and cognitive function theories both seem very vague and invalid, considering there is no research that has proven either. With the evidence currently available, it is unfair and illogical to assume that women athletes cannot achieve optimal performance during their menstrual cycle.

Fact 4: Menstrual pain can vary and is not always severe

Prostaglandins are the cause of pain, but the levels of these chemicals do not necessarily correlate with the severity of the pain. Prostaglandins are produced in the lining of the uterus. When the lining breaks down during menstruation, these chemicals are released into the muscle of the uterine wall and cause it to contract. When the muscle contracts strongly, it can cut off the oxygen supply to the uterus muscle, a situation which is very painful but does not cause damage to the muscle itself. This sometimes results in pain being referred to the inner thighs and/or the lower back. High levels of prostaglandins can also cause symptoms such as nausea, diarrhea, headaches, and dizziness. Women who experience these severe symptoms should not assume that they are normal. They should seek advice from a medical practitioner to rule out any other conditions that may be causing a high level of prostaglandin release.

Not all women experience menstrual pain severe enough that it disrupts their daily routine. Up to 20% of women only experience low abdominal pain and 32% of women report no menstrual pain at all. It has been suggested that women who exercise regularly may be at lower risk of developing menstrual pain. Women who lead an active lifestyle or are athletes often find that their level of fitness is associated with a milder perception of menstrual pain. There are many conditions that are associated with more severe menstrual pain, and it is important that women who experience very painful periods discuss this with their healthcare provider so that the possibility of an underlying problem can be assessed. Some women experience chronic pelvic pain unrelated to their menstrual cycle, and others can have a painful period for a day or a few days, and then the pain goes away. Women should understand that menstrual pain is not ‘all in the mind’, and further research is needed into understanding how to best manage and alleviate menstrual pain.

Fact 5: Menstruation is not dirty or unclean

The truth is, menarche is a beautiful process. Menstruation signals to a girl and her family that she is entering womanhood and is a time for celebration. It represents the ability to conceive children and is the outward sign of an inward process – ovulation. Ovulation is the best indication of gynecological health. A regular cycle and normal flow indicate that a girl is ovulating and that her body is working well. On the other hand, irregular menses or a lack of menses might indicate a hormone imbalance and can affect fertility. Thus, abnormal menstrual cycles can have an impact on a woman’s fertility, even though she’s not trying to conceive. Though it sounds strange, a lack of menstruation can sometimes be seen as a health problem since the body has to have a certain amount of fat and a certain level of stress hormones to ovulate. Overall, menstruation is a vital sign of women’s good overall health, and inability to menstruate can sometimes be seen as a health problem for women who are not necessarily trying to conceive.

The belief that menstruation is dirty and women who are menstruating are unclean largely stems from traditional and religious beliefs, being perpetuated over generations. During menses, women have often been forbidden to enter sacred places or practice religious rituals. Even today, in many parts of the world, this belief is psychologically and socially damaging for young girls who are struggling to adapt to the menstrual process. Understandably, the general attitude towards menstruation is negative because it has been passed down from generation to generation. But to youthful girls just learning about it, this can be devastating.

Educating and Empowering

To achieve genuine gender equality, misinformation and menstrual myths that perpetuate inequality need to be debunked. Menstrual information and education that is inaccurate can have far-reaching implications. One of the greatest needs for tribal women when they receive some kind of formal education is the ability for them to understand the changes that occur in their bodies. Usually in the past, girls were given the impression that menstruation is something that is dirty and impure, something that needs to be hidden. This has led to feelings of shame, combined with entirely preventing girls from schooling during their periods. Even nowadays, anything related to menstruation is a taboo topic for girls in many developing countries. They severely lack an understanding about what is happening to their bodies and may think they are sick or dying the first time they menstruate. It is important to dispel the myths with simple and accurate explanations while assuring girls in providing assistance with managing their sanitary needs, so that girls do not feel that they need to drop out of school.

Promoting accurate information about menstruation

Before we tackle the myths, let’s first remind ourselves what menstruation actually is. According to Always, menstruation is the part of the menstrual cycle in which the unfertilized egg and the inner lining of the uterus pass out of the body, signifying the end of a fertility cycle. This is controlled by the ebb and flow of female hormones and usually takes place in fertile years; it ceases when pregnancy starts or in menopause. Syl Laidlaw took the point to mention the myth that menstruation is unnatural, saying “menstruation is presumably about as natural a reproductive phenomenon as a woman can have.” The fact that a third of the women recently polled did not even know when they were fertile questions the understanding of natural female body processes. This lack of understanding has likely contributed to some of the myths and misunderstandings. Bradin Cormack cited that in studying early modern English writings about menstruation, men get all their information on the subject from women but are greatly misinformed by it or are unsure as to whether the knowledge women possess is identical to their own.

Introducing the topic of Period Mythbusters, Jennifer Weiss-Wolf commented that promoting puberty education lies at the heart of all menstrual advocacy. She encouraged readers to get information, check the facts, and to “serve it up to boys and young men, too, so they don’t grow up with the same supernaturally strange and offensive attitudes about menstruation.” Stephanie mentioned that ladies only recently stopped coming up with some of these questions, whereas boys in her class had been using them as ammunition against the opposite sex for as long as they can remember. Sexual Health teacher and researcher, Chris Hayter, said the main issue in educating children is exploring the misinformation outside formality with an “I wonder if that is true” attitude.

Encouraging open conversations and destigmatizing menstruation

While improvements in education and gathering accurate information are important steps to this end, a critical mass of change can only be reached by women and girls refusing to hide or disparage that which is as natural as breathing and that which connects them to the essence of life. Openness about menstruation facilitates the process of accepting the cyclical nature of fertility and draws the curiosity and support of male allies. Menstruation can only stop being a taboo topic if girls today are encouraged to be proud of their future roles in perpetuity of the human race. Though it may seem worlds away, grassroots changes in attitudes about menstruation will undoubtedly be reflected in policy shifts that benefit women. These efforts will then guarantee a future in which our granddaughters will no longer be stymied by the limitations set upon them by a period.

Long-standing cultural attitudes about menstruation’s defiling and devaluing nature have a negative impact on women’s and girls’ emotions, self-perception, and behaviors. Subjects in military training have reported that embarrassment of bleeding through or catching their menses wafts has called into question their preparedness for the undertaking. Athletes may reduce their beneficial training due to the fact that they theologize their poor performance was due to menses rather than merely an off day. Countless women and girls miss opportunities for education, social, and religious involvement, as well as potentially lifetime-cultivating experiences in the great outdoors for fear of compromising factors involved with their menses. Women in the workplace and girls in classrooms face an often subtle but incredibly powerful form of discrimination when it comes to menses and menstruation. To reduce this discrimination, it is necessary to engage in open conversations about the issue, bring the topic of menstruation to fully supportive light, and eradicate the belief that menses can hold a person back from a full and satisfying life.

Providing support and resources for menstruating individuals

Several studies have shown that many girls miss school when they are menstruating, often because they feel too uncomfortable due to pain or fear others may notice they are menstruating. If systems are in place to support these girls to feel more comfortable and manage their symptoms, they are more likely to continue attending school. If they miss less school each month, this has clear positive impacts on their education. For example, an analysis based on available data from 73 low and middle-income countries estimated that 1 in 10 African girls miss school during menstruation and eventually dropout due to menstruation-related issues, thus providing support for menstruating girls has the potential to reduce gender disparity in education. This represents a critical step in enabling girls to reach their full potential, considering the strong links between education and improved health, poverty reduction, increased empowerment of women, and economic growth. This, in turn, has positive flow-on effects to the local, regional, and even global communities.

Providing support and resources for menstruating individuals is critical in enabling individuals to manage menstruation effectively so they can continue to study, attend work, and participate in social activities. This can involve a range of strategies from policies allowing individuals time to rest if needed, accessible sanitary facilities, pain management (i.e. provision of painkillers), to education about healthy menstrual practices.