In 2009, a UNICEF
report showed that “in countries where menstrual hygiene is considered a taboo, girls going through puberty are typically absent for 20 percent of the school year”*. Societies across the world still treat menstruation as an unmentionable topic. With so few people willing to breach this issue, most of the information being passed on is based on myths, superstitions and false beliefs. Girls are taught to stay a little afar, especially from religious practices or partaking in public/social events if one is menstruating. Dealing with menstruation is challenging enough, especially for young girls who are still dealing with the turbulence that is puberty. With limited to no space to talk about menstruation openly, these myths and half-truths are constantly perpetuated which leads to many women feeling isolated and baffled by what's happening to their bodies. Not to mention continuation of unhygienic practices leading to severe health problems perpetuated by these myths and half truths among adolescent girls and women.**
At a social level, increasingly, girls are expected to compete with their male counterparts. Whether its in education, sports or career - women and girls are breaking down barriers and showing that whatever boys can do, they can do equally well, if not better. This is all being done with period cramps and other discomforts that are well hidden from the public eye. Women and girls attend school, college and the workplace often without usable toilet facilities; not to mention the non-existent sanitation options for women while travelling long distance or in public transportations such as trains and launches.
With health and social issues directly and indirectly connected to issues of menstruation, we still do not talk about it, address it, educate our daughters about it. If every girl gets it and every girl knows about it, why not talk about it?
Why is it important to talk about periods?
Looking at it from a medical perspective, there are hundreds of health conditions and diseases related to menstruation (the period) and menstrual cycle (the time from the beginning of one period to the next), so dealing with periods in a clean and smart manner is imperative.
It is very important for a woman to have regular periods, especially if she is trying to conceive. During each menstrual cycle, levels of the hormone oestrogen rise, resulting in an egg developing and being released by the ovary (ovulation). The womb lining thickens in preparation for a possible pregnancy. The egg travels down the fallopian tube and if it meets a sperm and is fertilised, a pregnancy can occur. The egg lives for about 24 hours and if it isn't fertilised, it will be absorbed into the body. The lining of the womb will come away and leave the body through the vagina mixed with blood. This is a period. So by now you should be able to understand that if there are no regular periods, there won’t be regular ovulation and no pregnancy.
If the period doesn’t start by 16 years of age its called delayed menarche and needs medical attention. If the period starts and then stops it may be due to stress, extreme weight loss, medications or even conditions such as polycystic ovarian syndrome (PCOS). If the period starts on time, but is too heavy or happens too often, it may cause too much blood loss which can eventually lead to anaemia if supplements or adequate nutrition is not given. Periods may be irregular in the beginning which is normal but it can also be caused by unsuspected pregnancy, PCOS or thyroid problems. Periods can often be painful (the pain can range from mild to severe), due to the uterine muscles contracting to remove the blood, but in few cases this may indicate an underlying disease such as endometriosis, fibroids, pelvic inflammatory disease etc.
These are few examples of the diseases related to periods. Maintaining proper hygiene alone can get rid of many complications and infections.
What are the dangers associated with poor hygiene?
It is extremely important that the girls are taught about the importance of hygiene and the potential risks if its not maintained. The risk of infection is higher than normal during menstruation. A plug of mucus normally found at the mouth of the cervix is dislodged and the cervix opens to allow blood to pass out of the body. This creates a passage for bacteria to travel back into the uterus and pelvic cavity. In addition, the pH of the vagina is less acidic at this time which can increase the chances of gaining yeast infections such as Thrush (Candidiasis).
Here are few examples of poor hygienic practices and their associated risks:
unclean sanitary pads/ napkins/cloth- bacteria may grow, cause local infection, travel up to the uterus or the urethra.
changing pads/ cloth infrequently- causes local skin irritation and rashes leading to infection if the skin is broken.
wiping from back to front- bacteria from the bowel is moved to vagina (or urethra) causing infection.
Teaching our daughters, helping the future
“I was 11 when I got my period. I remember going to the bathroom with serious stomach pains and finding spots of blood in my underwear. My parents were out that night. I changed my clothes and for some reason, as if by some instinct, I wore a pair of jeans. I don’t even remember when I fell asleep. The jeans had soaked up the blood overnight and there was none on my bed. Relief. But hold on, there was blood all over my pants. Horrified, I told my mom that maybe I cut myself. My mom and I were never close, so I was scared and hesitant to tell her. She took me to the bathroom, checked, had an exasperated look, instructed me to take off my clothes, wash myself and to just wait there. So, I waited in the bathroom while she gave instructions to someone to get something. I overheard Amma telling Nanu, “atoh taratari hobe bujhinai. Jhamela.” A box appeared with “Senora” and a picture of a woman smiling on it. I always wondered what those boxes were at the pharmacies, a little hidden from the main counter, and now I knew. She brought out two white thick cotton rectangulars with loops extended from each side. Amma gave me instructions on how to loop the extensions with the additional elastic band around my legs and to wear my underwear over it. She briefly stated that this will soak up the blood. Naively I asked will it end today? A little amused, she said, no, you will have it all your life, till you grow very old. I remember my entire world at that very moment fell apart. 7 days a week, every month, I will have this for the rest of my life? What does that mean? What is the reason behind this strange phenomenon? Why won’t my brothers get it? I had so many questions but was too scared to ask. I was instructed not to move around too much and to not go out to the playground with my brothers. The only thing I was happy about this gruesome experience was to get excused from Arabic classes! When asked why, all I received was a word “napak” - dirty. I would be dirty for 7 days a week each month, for the rest of my life. Again, why am I dirty? I didn’t know how to ask. Suddenly I grew up. No one explained anything else to me. There was a strange silence around it, almost as if somehow it was my fault. Whatever I learnt, I learnt from friends with older sisters. By then, I had already faced embarrassing moments with leaks and pad disposal. Sometimes I think it is a miracle that I had no infection or health problems given how little I knew and how many mistakes I made.”
-Maya user, age 32
Parents, guardians, older siblings, especially sisters play a crucial role in teaching girls about their bodies particularly on this important rite of passage. Girls who were taught about their bodies, menstruation cycles and how to hygienically manage their periods, are found to be more confident, able to participate in school and other social events.
Different girls become women at different ages and the first period can start anytime and anywhere, so it is good to start preparing yourself early on. Once she starts her period explain to her what is happening and slowly answer her whys and hows. Most parents avoid talking about periods because of the uncomfortable topic of sex and reproduction, but these topics can be better handled in a culturally sensitive way if you start preparing yourself to have the “talk”. Given cultural barriers, sometimes it is easier for an aunt or an older sister/cousin to talk to your daughter. Reaching out to close female confidants will show your daughter that she has a community, a support system. Teach her how to manage her first period, and whom she can go for help with how to use a pad, how often to change it and the importance of maintaining hygiene. Show her how to dispose used pads or, if using cloth, how to clean it. Help her to be prepared for leaks, unexpected irregular period dates and stomach cramps.
Take her shopping. Let her decide what kind of sanitary napkins she wants, and what form of undergarments she might be comfortable using. If she's uncomfortable shopping with you, give her some space. Instead of giving her a list of dos and don’ts, take her out and celebrate the day. Boost her confidence with some compliments. Let her know that what shes going through doesn’t have to be scary and that she always has someone to talk to.
If you think you still have questions of your own, remember, as a parent, there is nothing wrong in admitting that you don’t have answers to everything. Remember moms, realities of today’s girl children are far different from what you had experienced during your adolescence. If you are unsure about any topic related to menstruation (irregularity, cramps, sanitary napkins and feminine products, etc.), you can find important and culturally relevant information on the web on sites like Maya. If you are still unsure, make an appointment with a health professional to have a candid conversation that will be beneficial to both you and your child.
If mom isn’t around, your daughter should be comfortable asking you - the dads - to get her a packet of sanitary napkin instead of wearing the same dirty one. Braving an uncomfortable moment now can help your daughter from avoiding major medical complications in the future. For her health and happiness, be as supportive as you can, be as open as you can. You will raise a more confident and self assured woman if you acknowledge her new womanhood in a positive manner.
