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A campaign around menstrual hygiene management cannot be limited to only the provision of products. It should also look at menstruation as a socio-political issue and focus on fighting stigma.

Chennai: Chums. Monthly visitor. Code red. Stomach pain. Woh din (those days). Olagilla (not inside), Purathu aayi, (I am outside) Dooram or doora (far away). Code words for periods are common in many Indian languages. In case we assumed that the scenario was different outside of India, the International Women’s Health Coalition says that there are 5,000 different slang terms for the word ‘periods’ across 190 countries. These endless euphemisms are a simple outcome of the silence around a phenomenon that millions of women undergo every day, but about which they remain mostly silent.

Priya, a young working woman in Chennai, remembers not only what class she was in when she had her first period, but is also able to recall the exact clothes she was wearing then, and the ensuing pain and shivers. As she shared her experiences with a room full of women – some strangers and some colleagues – the intense shame and embarrassment of the day was still vivid in her mind. “I had to sit in a separate room for 11 days. I cried constantly. I was also given all sorts of food restrictions,” she recalled.

Priya was one of the 40 women in their mid-twenties to mid-forties in Chennai who shared their experiences as part of a community menstrual hygiene awareness event – ‘Red Thiruvizha: Period Talk Fest’ – organised across four cities by the Tamil Nadu Urban Sanitation Support Programme (TNUSSP) and the Indian Institute for Human Settlements (IIHS) on the occasion of Menstrual Hygiene Day on May 28.

As more experiences were shared, it became evident that much was common across ages, educational backgrounds or socio-economic class: a sense of embarrassment, an intense fear of staining, lack of open conversation at offices and some degree of dos and don’ts and rituals practiced in most homes.

The narratives around menstruation are often predictable: young girls in rural areas are unaware about menstruation until their first period; rural women do not have access to pads and follow superstitious practices and more recently, about the plastic waste generated by pads, and the push to switch to sustainable menstruation products. Presently, the framing of ‘what’s wrong’ is usually centred around girls and women rather than society at large.

Red Thiruvizha focused on five themes: (i) breaking the silence, (ii) moving beyond taboos, (iii) menstrual health, (iv) safe disposal and (v) making an informed choice about products. The idea was that campaigns around menstrual hygiene management must look at menstruation as a socio-political issue, and focus on fighting stigma to ensure structural and societal change, rather than only on the provision of products.

Have we really broken the silence around menstruation?

Are urban working women able to talk about periods to their families, in their workplaces, or to the men in their lives? Are they aware of products in the market to be able to make an informed choice? How do women cope with practical issues like staining, changing and disposal of pads?

Padmavati, a social activist who facilitated the event through a game, explained that breaking this silence through sharing can be a form of therapy for most women. For many, it may be the first time they are talking about periods publicly. “If I am taking a day off because of menstrual cramps, I never tell my boss I have ‘stomach pain’ as everyone knows this means ‘ladies problem’. So I say headache or backache or make up any other reason, but I don’t want him to know it is periods,” shared Pallavi.

Kala, who recently had a baby, faces mood swings during her periods, but puts up a show of being cheerful, both with her superiors at work and with her family. “I may be craving to eat something sweet, but I can’t talk about it and have to take care of my baby,” she said. Several women still don’t enter the kitchen or religious spaces during their period, and while some tactically use this to their advantage by getting some rest from cooking, health still often takes a backseat.

Fears about staining

One of the biggest fears and pressures that most women shared were about staining, as this would often attract not just embarrassment but rebuke. “When I got my first period during my Math exam, I stained my uniform. I was embarrassed and shocked. Even today, if my bed gets stained, my mom gets furious. She mops the whole house after that,” shared Lalita.

Fears about staining

Radhika, now in her mid-20s, recalled how when she stained a chair at school, she was so embarrassed that she sat at the spot for around an hour, waiting for all the boys in the room to leave so that she could clean it. For several women, these sorts of experiences were scarring, leaving them feeling cautious and uncomfortable at their workplaces, constantly visiting the toilet, or subtly asking other female colleagues to check for staining.

Talking to men about periods

Men play a meaningful part in the conversation around periods – in order to de-stigmatise the issue and help women cope with practical period issues. Information about periods is also given to men in very haphazard, indirect ways. For instance, a male employee at TNUSSP revealed that in the government school where he studied, girls would wear a long skirt and blouse before puberty, and would mandatorily be made to wear a ‘davani’ (pallu) over their blouses soon after menarche. So the whole school would know which girls have ‘grown up’, but without any proper knowledge on what this actually meant.

Puberty rituals practised in many families give boys vague knowledge about periods, but often it is much later that they find out about the medical and health aspects of menstruation. If approached correctly, puberty can instead be a window of opportunity to not only teach young adolescent girls and boys about the changes occurring in their bodies but also about fertility, contraception and other aspects of sexual and reproductive health.

While some women are now comfortable to talk about periods, at least with their husbands or partners, there is still some awkwardness when talking about it to other family members, colleagues or supervisors. “I often ask my husband to buy pads, but I’ve never asked my father, ” shared Lata.

Informed use of products

Talking about periods is also important to bring about conversations on practical issues of product use and disposal. With the recent push to sustainable menstruation, there is some conversation around eco-friendly products such as menstrual cups and reusable cloth pads, although often restricted to small circles. For many women, the switch to pads itself was recent and came after several years of using cloth or seeing their mothers struggle with using cloth.

“I have heard about eco-friendly products, but I don’t know if they will be viable. We know that pads are not good for the environment, but we can’t help using them,” stated Maya. Some others were unaware of alternative products, or had some hearsay knowledge but were worried about using them.

While talking about the range of products available for menstrual hygiene, it also becomes important to not transfer the burden of pollution only on women with a trend of ‘pad shaming’, but also talk about affordability and comfort. There is a pressing need to educate everyone about the need for safe disposal, as dropping pads in toilets, burning or dumping in water bodies have severe environmental consequences.

However, it is usually a lack of options that lead to unsafe disposal, or to unhygienic practices such as prolonged pad use, as women who don’t find dustbins may be too conscious to even bring this up. While awareness about eco-friendly sanitary products is essential, infrastructure and processes to handle non-biodegradable waste should also be developed, as the onus for this lies not just on women, but on all stakeholders.

So right from being prepared for the first period to the everyday problems of menstrual management, it is essential that the continued silence around menstruation be broken by enabling a supportive environment for girls on body literacy. Taboos around menstruation that have a detrimental impact on the emotional state of girls and women, as well as a negative bearing on their lifestyle and health, need to be discussed.

Without this structural change, the stigma around this natural biological process can be seen as a human rights violation. As gynaecologist Dr Amuda Hari, who participated in the event said, most Indian women end up prioritising everything but themselves, especially after they have children, ignoring menstrual health issues.

But periods are more than just about ‘bleeding’. Knowledge of menstrual health is crucial to understand sexual and reproductive health. However, for many women, practical preoccupations around periods such as family taboos of not being allowed to sleep on the bed, or carrying a pad to the office toilet without men noticing, take precedence.

Red Thiruvizha was also held at Trichy and Coimbatore for different groups of women and girls, in colleges and urban poor settlements, along with radio broadcasting on the topic by various stations including Big FM, Radio City and Radio Mirchi.

Note: Names have been changed to protect privacy.

N. Abhilaasha is an architect-planner who works with the TNUSSP team at the Indian Institute for Human Settlements. Archita S. is an external consultant at the Indian Institute for Human Settlements and writes on cities and urban issues.

With inputs from Kavita Wankhade, M. Ganesh Kumar, Reeba Devaraj, Sugantha Priscilla, Parameshwar, Niladri Chakraborti and Asma, TNUSSP team.