Let’s Talk. Period.

By Annie Tourette, Associate Manager, Advocacy and Communications

One in two people across the world has menstruated, will menstruate or currently menstruates.

That’s half of the world’s population.

But socio-cultural barriers and entrenched misperceptions make it difficult for menstruators to access the trusted and accurate information to make and own their menstrual health decisions.

To break down these barriers, we need to normalize the period conversation, both on and off-line.

PSI network members in Angola, Côte d’Ivoire, Haiti and Central America launched dedicated Facebook channels between 2016 and 2018 to connect young people aged 15-24 to safe spaces where they can chat with their peers about topics that matter to them. PSI content managers curate interactive material in partnership with PSI-trained midwives and most importantly, page users themselves. These materials engage young people on topics like makeup and fashion, but also their health, including contraception and periods.

The goal?  Make talking about the latest eyeshadow as normal as questioning if cramps are a normal part of the monthly cycle.

But the health-related material didn’t originally intend to focus on menstruation.

Young people asked for it.

PSI’s social media content managers gauge the content their users gravitate to by tracking engagement in real-time. And from private messaging with midwives to Facebook posts, each social media interaction shows that women and girls feel increasingly comfortable sharing their questions and concerns about menstrual health and everything that comes with it.

These posts have given the PSI teams rich insights about how women and girls understand their menstrual health and how social media can connect them to the information they need.

Here’s what PSI’s teams have gleaned, so far:

  1. Menstruators are hungry to dig into their cycle, with a keen focus on fertility.

“How can I track my monthly cycle? How long should my period normally last? Which days am I fertile? Can I have sex during my period?”

There remains persistent confusion around the most fundamental part of menstruation: the cycle. Users frequently send in questions (that are then published anonymously) about cycle length and menstrual phases; many girls and women shared concerns that their cycle was “too long” or “too short.” Still others wanted to know when they could get pregnant.

In private messages, menstruators’ questions get more personal. What menstrual symptoms were normal? What indicated a health problem? And when should menstruators seek a consultation with a provider? In Haiti, for instance, girls and women are predominantly interested in menstrual pain, mood swings, vaginal hygiene, how their periods should smell and the likelihood of getting pregnant or contracting STIs or HIV during menstruation.

In Côte d’Ivoire, girls and women ask Entre Nous’ “Sage Femme Gabi” – a youth-friendly, trained midwife – questions around the perceived dangers around sex during menstruation. Men engage, too, and ask most often about when a woman is fertile.

  1. All eyes (and posts) on menstrual products.

“What are pads and tampons for?”

Women and girls often ask questions like this. In Angola, a post about reusable cloth pads received substantial attention. And in Côte d’Ivoire, women ask how to use these products.

  1. Periods, and contraceptive use

“I had a contraceptive injection and my periods have been irregular ever since. Why?”

The social media posts PSI teams create often explain the link between contraception and its potential effect on menstruation. From Mozambique to Guatemala, women and girls ask about menstrual symptoms linked to hormonal contraceptive use, such as irregular bleeding or bad cramps. Across many countries, girls and women continually share their fear that contraception could harm their cycle – or worse yet, completely stop them from having their period, affecting their ability to conceive. And in cultures in which girls often face pressure to prove their fertility after marriage, the prospect of no longer seeing that monthly bleed creates a cause for concern.

These comments underscore how important it is to integrate menstrual health into counseling to help menstruators understand how contraception can change bleeding patterns, as well as cycle regularity, length and density. This knowledge sets realistic expectations among women and girls who voluntarily choose contraception and supports them in understanding that contraception is safe, valuable and reversible and should also be chosen according to their lifestyles and bleeding preferences.

Menstruators are hungry for information. But to engage on the topic, they need safe spaces in which conversation around the period is normalized.

And that’s where these PSI social media pages come into play. These social media pages are a piece of a larger movement to strike down barriers that block women and girls from accessing core menstrual health information—and they make period talk as normal as any lifestyle or health conversation.

Girls and women across the developing world do not get adequate menstrual health education, creating a void that fuels period-shame and compromises menstruators’ ability to make decisions for their bodies and their lives. It’s time for the global health community to make menstrual health central to any reproductive health conversation, and it’s time for us to listen to what women and girls say they want so we can reach them and serve them, exactly how they ask for it.

Banner Image: © 2016 Public Health Ambassadors Uganda, Courtesy of Photoshare.

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