Written by: Prisha Khanna, Moitrayee Das
Menstruation isn’t just a monthly occurrence; it’s a rhythm, a cycle that governs bodies, moods, and lives. And we still don’t fully grasp it. For about 1.8 billion individuals globally, menstruation doesn’t just mark a few days on the calendar. It is, rather, a continuous and often disruptive rhythm that impacts the body, mind, and overall life course (UNICEF, 2020).
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Despite its known regularity and inevitability, the phenomenon remains widely misunderstood, not just biologically but also culturally. The hormonal fluctuations that occur over the course of 28-30 days significantly affect energy, mood, and cognition. Additionally, irregular cycles, conditions like PCOS, PCOD, Endometriosis, and early onset menopause aren’t rare anomalies anymore. They are, in fact, common realities often brushed under the carpet of unawareness and ignorance.
The perception surrounding menstruation doesn’t exist in a vacuum. Cultural stigmas, lack of appropriate education, and systemic neglect tend to exacerbate the burden on menstruators. This is felt particularly harshly by young individuals who are forced into premature adulthood due to early onset menstruation, and those balancing navigating their cycles and careers.
It is crucial to reframe the narrative. Menstruation is not a “once a month” phenomenon, but rather a lifelong, identity-molding experience. It is crucial to adopt this lens of perception to better understand the experience of menstruators around the world.
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The Ongoing Biological Experience
The biological influence of menstruation extends far beyond the few days of bleeding. Hormonal fluctuations throughout the month, involving estrogen and progesterone, have profound effects on physical and emotional health, often presenting as fatigue, pain, mood swings, disturbed sleep, reduced appetite, etc. (Farage et al., 2009). These shifts play a prominent role in people’s day-to-day lives.
Despite this, the physiological impact of these alterations is heavily normalized in present-day society. Menstrual pain, dysmenorrhea, is known to be severe enough to even impair individuals’ everyday activities. Its prevalence is known to vary between 16% to 91% among individuals of reproductive age (H et al., 2014).
Additionally, recent studies have shown that the age of menarche (menstruation onset) in individuals has seen a global decline. This has major physiological, psychological, and social repercussions, which are often overlooked in society. It is known to be linked with increased exposure to estrogen, which can have biological effects like metabolic syndrome, obesity, and an increased risk of breast cancer and cardiovascular diseases (Lee et al., 2019). Individuals experiencing early menarche may find themselves unprepared and often confused when dealing with the anxiety, mood swings, and low self-esteem accompanying rapid physical changes. This period of transition can be overwhelming for some, impacting social interactions and mental health (Christine Gries, 2025).
Without adequate awareness and education, the spread of misinformation is rampant. This is often the root cause of the stigma and shame frequently associated with menstruation today, and it requires our prompt attention.
The societal understanding of menstruation, in its limited form, is clouded by cultural perceptions and even taboos. Many societies still view menstruation as “impure” or “shameful,” rather than for what it truly is—a natural biological process. The stigma, passed down over generations, spreads its roots further in the absence of accurate education. This manifests as social exclusion, prohibitive practices, and muted voices of menstruators around the world. The lack of open communication further adds to the spread of misinformation while disregarding vital health concerns, which can have long-term physical and mental impacts.
Culture Builds Experience
Menstruation is clouded by several taboos across cultures worldwide, often labeling the process as “impure,” “unclean,” or even “polluted.” This perception is believed to have roots in ancient religious and cultural beliefs, which have manifested as present-day stereotypes. Few ancient scriptures describe menstruation as a ritually unclean period, requiring women to practice separation and purification rituals before they can resume regular social and religious activities (BibleAsk, 2018).
While rituals are known to instill a sense of identity and community in societies, such ritualistic activities may add to feelings of isolation and low self-esteem. It may become a prohibiting factor for individuals to adopt healthy menstrual hygiene practices due to the subsequent shame and lack of adequate access to sanitary products.
The fear of societal judgment holds individuals back from being forthcoming with any menstrual problems they may be experiencing, which leads to a delayed diagnosis and treatment of various menstrual health disorders (Chandra-Mouli & Patel, 2017).
The culturally rooted stigma and taboo surrounding menstruation have long been responsible for holding back open discussions in social and educational settings, which presents itself as a severe lack of menstrual health education today. This has resulted in educational disadvantages and increasing dropout rates among girls and a lack of sensitivity and training among healthcare workers to address issues surrounding menstrual health, further leaving menstruating individuals feeling helpless in navigating this continuous cycle (Chandra-Mouli & Patel, 2017).
It is imperative to re-evaluate our conversations surrounding menstruation and evolve the narrative. The scope of menstrual literacy needs to expand beyond simply hygiene factors and biological processes to also accommodate the larger emotional and cultural perspective, which is the need of the hour.
Reshaping Menstrual Literacy
There is a dire need for a radical overhaul in the realm of menstrual literacy. It is crucial to encompass a more holistic understanding of the body and emotions in the larger cultural context. Conversations cannot remain limited to biological processes and sanitary napkins alone. There needs to be space to address issues like hormonal imbalances, menstrual pain, mood swings, and the socio-cultural narrative in which individual menstruation experiences are shaped today.
Early exposure to menstrual health education needs to be a healthy blend of body literacy with emotional awareness—a space where students across genders and sexual orientations are encouraged to understand menstruation without shame or judgment. Educational institutions have a pivotal role to play in normalizing these conversations at an early age. Workplaces and corporate wellness programs need to create holistic and inclusive spaces that expand acknowledgment and support for menstruation beyond medical leaves alone.
Opening the floor to such stigma-free dialogue and sustained efforts to break the silence of hushed conversations surrounding menstruation is the first step to dismantle the structural load of stigma and taboo that surrounds the phenomenon today.
Menstruation needs to be perceived not just as a solitary monthly occurrence, but as a lifelong experience that is an amalgamation of physical health, mental health, and socio-cultural dynamics. We can no longer ignore the profound impact it has on the day-to-day lives of a significant percentage of the global population. Menstruation cannot be dismissed as a minor inconvenience. It deserves appropriate seriousness, support, and empathy from the right stakeholders, ensuring the well-being and dignity of menstruating individuals globally.
References
BibleAsk. (2018, March 19). Why were menstruating women considered unclean? – BibleAsk. https://bibleask.org/why-were-menstruating-women-considered-unclean/
Chandra-Mouli, V., & Patel, S. V. (2017). Mapping the knowledge and understanding of menarche, menstrual hygiene and menstrual health among adolescent girls in low- and middle-income countries. Reproductive Health, 14(1). https://doi.org/10.1186/s12978-017-0293-6
Christine Gries, M. (2025, June 12). TABOOS AND IGNORANCE: MENSTRUATION – Soroptimist International. Soroptimist International. https://www.soroptimistinternational.org/taboos-and-ignorance-menstruation/
Farage, M. A., Neill, S., & MacLean, A. B. (2009). Physiological changes associated with the menstrual cycle: a review. Obstetrical & Gynecological Survey, 64(1), 58–72. https://doi.org/10.1097/OGX.0b013e3181932a37
H, J., M, J., & G, M. (2014). The Prevalence and Risk Factors of Dysmenorrhea. Epidemiologic Reviews. https://pubmed.ncbi.nlm.nih.gov/24284871/
Lee, J. J., Cook?Wiens, G., Johnson, B. D., Braunstein, G. D., Berga, S. L., Stanczyk, F. Z., Pepine, C. J., Bairey Merz, C. N., & Shufelt, C. L. (2019). Age at Menarche and Risk of Cardiovascular Disease Outcomes: Findings From the National Heart Lung and Blood Institute?Sponsored Women’s Ischemia Syndrome Evaluation. Journal of the American Heart Association, 8(12). https://doi.org/10.1161/jaha.119.012406
UNICEF. (2020). Menstrual hygiene. UNICEF. https://www.unicef.org/wash/menstrual-hygiene
Prisha Khanna, an undergraduate psychology student, and Moitrayee Das, an Assistant Professor of Psychology, are both at FLAME University, Pune.