Menstrual stigma

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This photo shows unused and used tampons, while the advertisement employs euphemistic colors, such as blue instead of red Used and unused tampon.jpg
This photo shows unused and used tampons, while the advertisement employs euphemistic colors, such as blue instead of red

Menstrual stigma refers to the negative social and cultural perceptions, beliefs, taboos, and practices surrounding menstruation. [1] It encompasses the perception of menstruation as impure or shameful and often leads to secrecy and emotional distress. The manifestation of menstrual stigma varies across cultures and may have profound effects on mental health, social participation, and opportunities. Strategies aimed at addressing menstrual stigma typically involve educational and awareness initiatives.

Contents

Stigmatization

Cultural variations

Menstruation, deeply intertwined with intricate cultural beliefs, is often accompanied by taboos, myths, stigmatization, negative emotions, and feelings of shame. [1] [2] [3] The associated beliefs and practices exhibit variations influenced by factors like country, religion, and social status. [4] [5] Cultural norms play a pivotal role in determining whether menstruation is a source of social stigma that is concealed or observable. For instance, in the United States, menstruation is predominantly concealed owing to societal norms of secrecy. In certain societies like Nepal, the onset of menstruation is commemorated through public rituals, and women undergoing menstruation may be secluded. [4] [6]

The notion that menstruation is a cause of impurity and danger has persisted into the contemporary era. According to a survey conducted by the World Health Organization involving women from 10 different countries, certain cultures still view menstruating women as impure, leading to restrictions in their religious or social activities. The WHO survey not only recorded both negative and positive attitudes toward menstruation but also highlighted culturally enforced sanctions (such as being prohibited from cooking) and self-imposed restrictions (such as refraining from washing one's hair). [4] [7] [8]

Euphemisms

People often use euphemisms like "time of the month," "Aunt Flow," and "on the rag" to refer to menstruation, highlighting the discomfort and stigma associated with it. [9] This stigma is a global phenomenon, with menstruation often seen as something impure that should be kept private. Many individuals, from a young age, are taught that menstruation is something to be concealed or hidden for women to lead their everyday lives. [2] [10] The media plays a role in perpetuating this stigma through advertisements that stress secrecy, avoidance of embarrassment, and freshness. They also use euphemistic images and colors (like blue instead of red) to describe menstruation. [11] [12] [13] Menstrual stigma can be passed on through educational materials, communication (or lack thereof), and the language used to discuss it (e.g., euphemisms). [1] [12]

Activism

Feminists and various activists have countered negative depictions of menstruation by advocating for positive perspectives. They do so primarily through educational and media campaigns, consciousness-raising efforts, and by challenging conventional representations of menstruation. These actions aim to promote more affirming views of menstruation within various institutions like education, healthcare, families, and media. [14] [15] While feminist scholars and activists have endeavored to encourage the celebration of menarche and menstruation, their positive messages may be eclipsed or obscured by the prevailing stigmatizing narratives. [12]

Consequences

The menstrual stigma can have detrimental effects on various aspects of women's lives, including their overall well-being, somatic and mental health, social status, and sexual activity. [1] [16] [12] [2] Women who internalize these negative attitudes often take active measures to hide their menstrual status, such as wearing loose clothing and avoiding certain activities to prevent any signs. [2] This constant effort to conceal their menstruation leads to increased self-awareness, heightened vigilance, and a sense of shame related to their periods. [12] [16] Failing to hide it can make them feel as though they've fallen short of societal expectations of proper menstrual etiquette. [2] The stigma can have adverse effects on women's sexual lives since engaging in sexual activity during menstruation is often viewed as socially unacceptable. [1] [3] [17] Both men and women may use derogatory terms like "disgusting," "smelly," "awkward," "dirty," and "messy" when referring to menstruation and sex during this time. [17] Younger, single individuals with less sexual experience are more likely to avoid intercourse during menstruation and use negative language to describe it. [1] [17] In contrast, older, more experienced couples are more inclined to see sexual activity during menstruation as acceptable and enjoyable. [1]

Interconnected stigmas

Menstrual stigma is a significant element of the broader issue of endometriosis stigma. [18] [19] The negative attitudes toward menstruation play a pivotal role in perpetuating the stigma surrounding endometriosis. While much of the existing research on endometriosis stigma has primarily focused on menstrual pain and the associated stigma, it's crucial to recognize that chronic pain, in general, carries its own societal stigma. [18] Considering that endometriosis involves persistent pain during menstruation, sexual activity, and pelvic symptoms, this pain-related stigma can exacerbate the overall stigma associated with endometriosis, leading to adverse mental health outcomes. [18] Furthermore, infertility stigma is another factor contributing to the overall stigma surrounding endometriosis. [18] Many individuals with endometriosis experience infertility issues, and this aspect of the condition can lead to feelings of depression and anxiety. [18] [20]

It's important to note that stigma operates on multiple levels, including self-stigma (internalized negative attitudes), perceived stigma (how individuals believe society views them), and experienced stigma (actual instances of discrimination). These various forms of stigma have been observed to have a significant impact on the well-being of individuals living with various chronic illnesses, including endometriosis. [18]

Related Research Articles

In psychology, libido is psychic drive or energy, usually conceived as sexual in nature, but sometimes conceived as including other forms of desire. The term libido was originally used by the neurologist and pioneering psychoanalyst Sigmund Freud who began by employing it simply to denote sexual desire. Over time it came to signify the psychic energy of the sexual drive, and became a vital concept in psychoanalytic theory. Freud's later conception was broadened to include the fundamental energy of all expressions of love, pleasure, and self-preservation.

<span class="mw-page-title-main">Menstruation</span> Shedding of the uterine lining

Menstruation is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. The menstrual cycle is characterized by the rise and fall of hormones. Menstruation is triggered by falling progesterone levels and is a sign that pregnancy has not occurred.

<span class="mw-page-title-main">Endometriosis</span> Disease of the female reproductive system

Endometriosis is a disease of the female reproductive system. It occurs in women and a limited number of female mammals. In endometriosis, cells like those in the endometrium, the layer of tissue that normally covers the inside of the uterus, grow outside the uterus. Lesions can be found on ovaries, fallopian tubes, tissue around the uterus and ovaries (peritoneum), intestines, bladder, and diaphragm; and may also occur in other parts of the body. Symptoms include pelvic pain, heavy and painful periods, pain with bowel movements, painful urination, pain during sexual intercourse and infertility. Nearly half of those affected have chronic pelvic pain, while 70% feel pain during menstruation. Up to half of affected individuals are infertile. About 25% of individuals have no symptoms and 85% of those seen with infertility in a tertiary center have no pain. Endometriosis can have both social and psychological effects.

<span class="mw-page-title-main">Ovulation</span> Release of egg cells from the ovaries

Ovulation is the release of eggs from the ovaries. In women, this event occurs when the ovarian follicles rupture and release the secondary oocyte ovarian cells. After ovulation, during the luteal phase, the egg will be available to be fertilized by sperm. In addition, the uterine lining (endometrium) is thickened to be able to receive a fertilized egg. If no conception occurs, the uterine lining as well as the egg will be shed during menstruation.

<span class="mw-page-title-main">Sexual attraction</span> Attraction on the basis of sexual desire

Sexual attraction is attraction on the basis of sexual desire or the quality of arousing such interest. Sexual attractiveness or sex appeal is an individual's ability to attract other people sexually, and is a factor in sexual selection or mate choice. The attraction can be to the physical or other qualities or traits of a person, or to such qualities in the context where they appear. The attraction may be to a person's aesthetics, movements, voice, or smell, among other things. The attraction may be enhanced by a person's adornments, clothing, perfume or hair style. It can be influenced by individual genetic, psychological, or cultural factors, or to other, more amorphous qualities. Sexual attraction is also a response to another person that depends on a combination of the person possessing the traits and on the criteria of the person who is attracted.

Premenstrual syndrome (PMS) is a disruptive set of emotional and physical symptoms that regularly occur in the one to two weeks before the start of each menstrual period. Symptoms resolve around the time menstrual bleeding begins. Different women experience different symptoms. Premenstrual syndrome commonly produces one or more physical, emotional, or behavioral symptoms, that resolve with menses. The range of symptoms is wide, and most commonly are breast tenderness, bloating, headache, mood swings, depression, anxiety, anger, and irritability. To be diagnosed as PMS, rather than a normal discomfort of the menstrual cycle, these symptoms must interfere with daily living, during two menstrual cycles of prospective recording. These symptoms are nonspecific and are seen in women without PMS. Often PMS-related symptoms are present for about six days. An individual's pattern of symptoms may change over time. PMS does not produce symptoms during pregnancy or following menopause.

Sexual desire is an emotion and motivational state characterized by an interest in sexual objects or activities, or by a drive to seek out sexual objects or to engage in sexual activities. It is an aspect of sexuality, which varies significantly from one person to another and also fluctuates depending on circumstances.

<span class="mw-page-title-main">Sex work</span> Offer of sexual services in exchange for money or other types of exchange

Sex work is "the exchange of sexual services, performances, or products for material compensation. It includes activities of direct physical contact between buyers and sellers as well as indirect sexual stimulation". Sex work only refers to voluntary sexual transactions; thus, the term does not refer to human trafficking and other coerced or nonconsensual sexual transactions such as child prostitution. The transaction must take place between consenting adults of the legal age and mental capacity to consent and must take place without any methods of coercion, other than payment. The term emphasizes the labor and economic implications of this type of work. Furthermore, some prefer the use of the term because it grants more agency to the sellers of these services.

<span class="mw-page-title-main">Premarital sex</span> Sexual activity before marriage

Premarital sex is sexual activity which is practiced by people before they are married. Premarital sex is considered a sin by a number of religions and also considered a moral issue which is taboo in many cultures. Since the Sexual Revolution of the 1960s, it has become accepted by certain liberal movements, especially in Western countries. A 2014 Pew study on global morality found that premarital sex was considered particularly unacceptable in "Muslim Majority Countries", such as Malaysia, Jordan and Pakistan, each having over 90% disapproval, while people in Western European countries were the most accepting, with Spain, Germany, and France expressing less than 10% disapproval.

<span class="mw-page-title-main">Menstrual disorder</span> Medical condition affecting menstrual cycle

A menstrual disorder is characterized as any abnormal condition with regards to a woman's menstrual cycle. There are many different types of menstrual disorders that vary with signs and symptoms, including pain during menstruation, heavy bleeding, or absence of menstruation. Normal variations can occur in menstrual patterns but generally menstrual disorders can also include periods that come sooner than 21 days apart, more than 3 months apart, or last more than 10 days in duration. Variations of the menstrual cycle are mainly caused by the immaturity of the hypothalamic-pituitary-ovarian (HPO) axis, and early detection and management is required in order to minimize the possibility of complications regarding future reproductive ability.

<span class="mw-page-title-main">Culture and menstruation</span>

There are many cultural aspects surrounding how societies view menstruation. Different cultures view menstruation in different ways. The basis of many conduct norms and communication about menstruation in western industrial societies is the belief that menstruation should remain hidden. By contrast, in some hunter-gatherer societies, menstrual observances are viewed in a positive light, without any connotation of uncleanness.

Adolescent sexuality is a stage of human development in which adolescents experience and explore sexual feelings. Interest in sexuality intensifies during the onset of puberty, and sexuality is often a vital aspect of teenagers' lives. Sexual interest may be expressed in a number of ways, such as flirting, kissing, masturbation, or having sex with a partner. Sexual interest among adolescents, as among adults, can vary greatly, and is influenced by cultural norms and mores, sex education, as well as comprehensive sexuality education provided, sexual orientation, and social controls such as age-of-consent laws.

Menstrual leave is a type of leave where a person may have the option to take paid or unpaid leave from their employment if they are menstruating and are unable to go to work because of this. Throughout its history, menstrual leave has been associated with controversy and discrimination against men, with very few countries enacting policies. In these countries, menstrual leave is still associated with low uptake. It is seen by some as a criticism of women's work efficiency or as sexism against men. Supporters of menstrual leave policies compare its function to that of maternity leave and view it as a promoter of gender equality.

Self-concealment is a psychological construct defined as "a predisposition to actively conceal from others personal information that one perceives as distressing or negative". Its opposite is self-disclosure.

Education is recognized as a social determinant of health. Education has also been identified as a social vaccine against contracting HIV. Research suggests a negative linear relationship between educational attainment and HIV infection rate, especially the educational attainment of women and girls.

Adolescents turn to pornography for learning amplified by insufficient sex education, arousal, mating motivations, coping mechanisms, alleviating boredom, entertainment, and to explore their sexual and gender identities. However, they may also encounter content that disturbs them. Without adequate support, they learn to navigate disconcerting material, developing the skills to seek out content that affirms their sexuality while avoiding that which causes discomfort. Without alternative narratives, they think it leads to harmful attitudes about women, sex, LGBTQ people, and people of color, and unrealistic expectations. The use of pornography by adolescents is associated with certain sexual attitudes and behaviors, but causal relationships remain unclear. It can be assumed that adolescents are not passive "fools" or "victims". The typical adolescent consumer of pornography is male, in advanced stages of puberty, sensation-seeking, and often grapples with weak or disrupted family relationships.

<span class="mw-page-title-main">Menstrual hygiene management</span> Access to menstrual hygiene products and disposal of used products

Menstrual hygiene management (MHM) or menstrual health and hygiene (MHH) refers to access to menstrual hygiene products to absorb or collect the flow of blood during menstruation, privacy to change the materials, and access to facilities to dispose of used menstrual management materials. It can also include the "broader systemic factors that link menstruation with health, well-being, gender equality, education, equity, empowerment, and rights". Menstrual hygiene management can be particularly challenging for girls and women in developing countries, where clean water and toilet facilities are often inadequate. Menstrual waste is largely ignored in schools in developing countries, despite it being a significant problem. Menstruation can be a barrier to education for many girls, as a lack of effective sanitary products restricts girls' involvement in educational and social activities.

Menstrual suppression refers to the practice of using hormonal management to stop or reduce menstrual bleeding. In contrast to surgical options for this purpose, such as hysterectomy or endometrial ablation, hormonal methods to manipulate menstruation are reversible.

<span class="mw-page-title-main">Period poverty</span> Economic justice issue related to female periods

Period poverty is a term used to describe a lack of access to proper menstrual products and the education needed to use them effectively. In total, there are around 500 million menstruators that cannot manage their periods safely due to lack of menstrual products and for fear of shame. The American Medical Women's Association defines period poverty as "the inadequate access to menstrual hygiene tools and educations, including but not limited to sanitary products, washing facilities, and waste management".

Menstruation can have a notable impact on mental health, with some individuals experiencing mood disturbances and psychopathological symptoms during their menstrual cycle. Menstruation involves hormonal fluctuations and physiological changes in the body, which can affect a person's mood and psychological state. Many individuals report experiencing mood swings, irritability, anxiety, and even depression in the days leading up to their menstrual period. This cluster of symptoms is often referred to as premenstrual syndrome (PMS). For some individuals, the psychopathological symptoms associated with menstruation can be severe and debilitating, leading to a condition known as premenstrual dysphoric disorder (PMDD). PMDD is characterized by intense mood disturbances, cognitive, and somatic symptoms, which occur in a cyclical pattern linked to the menstrual cycle. In addition to PMDD, menstruation can exacerbate existing mental health conditions. The complex relationship between menstruation and mental well-being has garnered increased attention in both scientific research and public discourse.

References

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  2. 1 2 3 4 5 Barrington, Dani Jennifer; Robinson, Hannah Jayne; Wilson, Emily; Hennegan, Julie (2021-07-21). "Experiences of menstruation in high income countries: A systematic review, qualitative evidence synthesis and comparison to low- and middle-income countries". PLOS ONE. Public Library of Science (PLoS). 16 (7): e0255001. doi: 10.1371/journal.pone.0255001 . ISSN   1932-6203. PMC   8294489 . PMID   34288971.
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  5. ↑ Severy, Lawrence J.; Thapa, S.; Askew, I.; Glor, J. (1993-06-28). "Menstrual Experiences and Beliefs". Women & Health. Informa UK Limited. 20 (2): 1–20. doi:10.1300/j013v20n02_01. ISSN   0363-0242. PMID   8372476.
  6. ↑ Buckley, Thomas C. T.; Gottlieb, Alma (1988). "A Critical Appraisal of Theories of Menstrual Symbolism". Blood Magic: The Anthropology of Menstruation. Berkeley, Calif.: University of California Press. pp. 1–50. ISBN   0-520-06085-7.
  7. ↑ Snowden, Robert; Christian, Barbara, eds. (1983). Patterns and perceptions of menstruation: a World Health Organization international collaborative study in Egypt, India, Indonesia, Jamaica, Mexico, Pakistan, Philippines, Republic of Korea, United Kingdom and Yugoslavia. London: Croom Helm. ISBN   978-0-312-59809-9.
  8. ↑ "A cross-cultural study of menstruation: implications for contraceptive development and use. World Health Organization Task Force on Psychosocial Research in Family Planning, Special Programme of Research, Development and Research, Training in Human Reproduction". Studies in Family Planning. Stud Fam Plann. 12 (1): 3–16. 1981. ISSN   0039-3665. PMID   7466889.
  9. ↑ Newton, Victoria Louise (2016). "'Auntie's Come to Tea': Menstrual Euphemism". Everyday Discourses of Menstruation. London: Palgrave Macmillan UK. pp. 133–145. doi:10.1057/978-1-137-48775-9_8. ISBN   978-1-137-48774-2.
  10. ↑ Peranovic, Tamara; Bentley, Brenda (2016-11-16). "Men and Menstruation: A Qualitative Exploration of Beliefs, Attitudes and Experiences". Sex Roles. Springer Science and Business Media LLC. 77 (1–2): 113–124. doi:10.1007/s11199-016-0701-3. ISSN   0360-0025. S2CID   151698754.
  11. ↑ Fahs, Breanne (2020). "Sex During Menstruation: Race, Sexual Identity, and Women's Accounts of Pleasure and Disgust". The Palgrave Handbook of Critical Menstruation Studies. Singapore: Springer Singapore. pp. 961–984. doi:10.1007/978-981-15-0614-7_69. ISBN   978-981-15-0613-0. PMID   33347212.
  12. 1 2 3 4 5 Johnston-Robledo, Ingrid; Chrisler, Joan C. (2020). "The Menstrual Mark: Menstruation as Social Stigma". The Palgrave Handbook of Critical Menstruation Studies. Singapore: Springer Singapore. pp. 181–199. doi:10.1007/978-981-15-0614-7_17. ISBN   978-981-15-0613-0. PMID   33347160.
  13. ↑ Sveen, Hanna (2016). "LavaorCode Red: A Linguistic Study of Menstrual Expressions in English and Swedish". Women's Reproductive Health. Informa UK Limited. 3 (3): 145–159. doi:10.1080/23293691.2016.1237712. ISSN   2329-3691.
  14. ↑ Fahs, Breanne (2011-01-19). "Sex during menstruation: Race, sexual identity, and women's accounts of pleasure and disgust". Feminism & Psychology. SAGE Publications. 21 (2): 155–178. doi:10.1177/0959353510396674. ISSN   0959-3535. S2CID   55169009.
  15. ↑ Kissling, Elizabeth Arveda (2006). Capitalizing on the Curse. Boulder, Colo: L. Rienner. ISBN   978-1-58826-310-0.
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  18. 1 2 3 4 5 6 Kocas, H. Deniz; Rubin, Lisa R.; Lobel, Marci (2023). "Stigma and mental health in endometriosis". European Journal of Obstetrics & Gynecology and Reproductive Biology: X. Elsevier BV. 19: 100228. doi: 10.1016/j.eurox.2023.100228 . ISSN   2590-1613. PMC   10465859 . PMID   37654520.
  19. ↑ Reinhardt, Anne; Eitze, Sarah (2023-11-03). "Breaking the endometriosis silence: a social norm approach to reducing menstrual stigma and policy resistance among young adults". Psychology & Health. Informa UK Limited: 1–23. doi: 10.1080/08870446.2023.2277838 . ISSN   0887-0446. PMID   37921431. S2CID   264972887.
  20. ↑ Greil, Arthur L.; Slauson-Blevins, Kathleen; McQuillan, Julia (2010). "The experience of infertility: a review of recent literature". Sociology of Health & Illness. Wiley. 32 (1): 140–162. doi:10.1111/j.1467-9566.2009.01213.x. ISSN   0141-9889. PMC   3383794 . PMID   20003036. S2CID   2083730.
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