What we mean when we talk about menstrual health

Story: Noa Gortworst

Menstrual Health is an integral part of gender equality and global health. Approximately 1.8 billion people in the world menstruate, a quarter of the world population. However, the topic of menstrual health encompasses more than only periods. Menstrual health is closely linked to other important aspects of global health and human rights. Let us explain. 

What is menstrual health?

Simavi uses the term menstrual health, instead of menstrual hygiene, when referring to menstruation as this term includes both menstrual practices and the broader elements that link menstruation to health, wellbeing, gender, education, equality, empowerment and rights. In this term ‘health’ does not only imply the absence of illness, but also refers to social and mental wellbeing.

In order to achieve menstrual health, menstruators need to have access to appropriate physical care to manage their menstruation, such as hygiene products, water and soap. They should also be able to experience menstruation without stigma, discrimination or stress, and access treatment for cycle-related discomforts and disorders. Furthermore, it is important that menstruators have accurate information about the menstrual cycle, menstruation, and hygiene practices.

What is period poverty?

Worldwide, millions of people who menstruate do not have access to the menstrual products, hygiene facilities, water or sanitation that are required to safely and comfortably manage their menstruation. Period poverty refers to the inability to afford the necessary tools to manage menstruation, as well as the education and awareness to safely navigate their menstrual health. Period poverty causes menstruators to miss school and work, it can lead to insecurity, bullying and discrimination, and it can negatively affect their health.

Period poverty is caused by high prices for menstrual products, but also by a lack of water and sanitation. 2 out of 5 people in the world live without a safely managed sanitation facility, and a quarter of the world’s population does not have access to clean water near their home. These are massive obstacles for people who menstruate to safely manage their periods. Furthermore, a lack of information and education around menstruation can perpetuate period poverty. Many young girls do not know about menstruation before they have their first period. Because of this they do not know how to take care of their periods and might experience distress because they do not know what is happening to their bodies.

The Oky Period Tracker App was co-created with girls, for girls, to facilitate age- and culture-appropriate information about menstrual health.

What are menstrual health taboos?

In many parts of the world, taboos and stigmas about menstruation persist. Menstruating people might be seen as dirty or untouchable. They are sometimes prohibited from staying in the home during their period or from touching food or crops, because of beliefs that this will bring bad luck.

Even in places where such taboos do not exist, people who menstruate are often taught to hide their menstrual blood or menstrual products. The need to hide menstruation is often based on the idea that blood is dirty and people who menstruate are less clean, attractive and competent. As a result, menstruators can internalize such views and think of their menstruation as unclean and inconvenient, unintentionally resulting in negative body views and shame.

Menstrual health and WASH

Menstrual health and WASH (water and sanitation) are closely related. Not only do people who menstruate have different needs, but they face different barriers in accessing WASH services. Without access to clean water and sanitation, they are not able to manage their periods safely. Good menstrual hygiene is important for preventing infections. When menstruators are not able to wash their hands and bodies, or change their sanitary products, this can lead to urinary tract infections or bacterial vaginosis.

Furthermore, it can be very uncomfortable when people who menstruate are not able to change their sanitary products or wash themselves, potentially leading to shame or psychological stress. This can bar them from participating in society; they might have to stay home from school or work, or they might be discriminated against.

Girls from Khagrachori, Bangladesh who participate in girls club organised by Simavi's Our Lives, Our Health, Our Future programme. In the girls clubs they learn about their menstrual health as well as their reproductive and sexual rights.

Menstrual health and sexual and reproductive rights

As menstruation is a part of the reproductive system, menstrual health cannot be achieved without sexual and reproductive rights. As important as having access to WASH services, is having access to appropriate birth control and sexual and reproductive health services. It is crucial that people have the full authority and ability to decide over their own bodies, health and sexuality. This also includes the right to live free from (sexual) violence, and to be able to choose whether and with whom to engage in sexual activity, and whether or not they want to become pregnant. For this, having access to birth control and sexual education is crucial.

Some people who menstruate also need hormonal birth control to help them manage their periods, for example if they suffer from menstrual health disorders such as polycystic ovary syndrome (PCOS) or endometrioses. In these cases, hormonal birth control can help them regulate their cycle and manage symptoms. People who suffer from menstruation-related disorders should have access to birth control or other medication that can help relieve their symptoms, without fear of stigmatization. Furthermore, pregnancy can pose risks for some people, whether those be physical, mental or sociological. People should be able to safely use their preferred method of preventing pregnancy without any obstacles.

Menstrual health and female empowerment

Achieving menstrual health contributes to female empowerment. While stigmas, taboos, and period poverty all have negative effect on the position of women and girls in society, being free from them gives them opportunities to pursue their rights and wellbeing to the fullest. When women and girls have access to sanitary products, WASH services and birth control, they are able to pursue education or careers without these barriers and live a healthy and dignified life.

In a society where menstrual health awareness is widespread, people who menstruate will be free from the taboos and discrimination that can be associated with periods. They are treated with dignity, and able to live as they do when they are not on their periods. Therefore, it is equally important that people who do not menstruate have the same awareness about menstrual health and help facilitate environments in which people can manage their periods accordingly.

The Perfect Fit is a start-up from Indonesia, supported by Simavi, that creates sustainable and reusable period pads.

Menstrual health and climate change

Climate change has a severe impact on menstruators access to menstrual health. Climate change is causing water sources to dry up or become salinized. This affects people's ability to take care of their personal, and thus also menstrual, hygiene. Most climate disasters are also water related, including floods or hurricanes. These can destroy water infrastructure as well as toilets. Impacting menstrual health management.

Menstrual health and climate change are also linked in other ways. In areas where there is a lack of waste management systems, menstrual hygiene products can be a big source of pollution. In Indonesia for example, where menstruators sometimes have to resort to burning or burying their menstrual products as there is no proper waste collection. A solution to this is using sustainable and reusable menstrual pads. In Indonesia, Simavi supports the Perfect Fit, a start-up that makes reusable pads as well as provide education about menstrual health and hygiene.

What does Simavi do?

As a WASH organisation that holds feminist values in the highest regards, facilitating menstrual health is an important part of Simavi’s work. We acknowledge that due to their needs to manage menstruation, women and girls are affected differently and more severely by water scarcity and a lack of sanitation services. Therefore, we put women and girls at the center of our programmes.

For example, in Uganda, where girls regularly miss schools due to a lack of water and sanitation. Here, our WASH, Learn and Share programme works in schools to ensure sustainable access to clean water, safe sanitation and hygiene education. Or in Bangladesh, where we set up girls clubs as part of the Our Lives, Our Health, Our Future programme. Here, young women and adolescent girls from indigenous groups were provided a safe space to learn about their own menstrual health and sexual and reproductive rights.

Whether we work in schools, with girls clubs or community groups, Simavi is committed to ensuring that women and girls have access to safe water, a toilet, and their human rights.

Esther Oeganda

Everybody has the human right to safe water and sanitation.

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