Breaking the Cycle: Integrating Menstruation into the Global Health Agenda

By: Odette Hekster, Deputy Managing Director, PSI Europe and Emma Beck, Associate Communications Manager, PSI 

When it comes to sexual and reproductive health and rights (SRHR), we think of pregnancies – preventing an unplanned one, ensuring a safe one.

Of STI testing and Pap smears. Of safe abortions.

Sometimes, screenings.

But rarely, menstrual health.

This is a gap.

Menstruation is the bedrock of how women and girls – and all people who menstruate – make the SRHR decisions that shape their lives. From misperceptions around bleeding changes that impact contraceptive use, to the harmful stigmas that prevent menstruators from making healthy and autonomous choices for their bodies, we are missing, and will continue to miss the mark if comprehensive SRHR services fail to include menstrual health and hygiene (MHH).

We can achieve a world in which every menstruator can make informed, healthy decisions for their bodies and lives.

But to get there, we must understand MHH in its complexity, and catalyze the funding that supports and scales MHH programming, policies and research to get MHH on the SRHR agenda.

The Case for Integration

As PSI and The Case for Her’s latest publication, “Technical Brief for the Integration of Menstrual Heath in SRHR,” documents, MHH provides an entry point and essential lens to understand and approach women’s SRHR journeys.

Among the publication’s findings:

  • Global health practitioners have often overlooked menstruation. And the consequences are high: Girls and women who don’t receive appropriate education about their menstrual cycle and fertility often lack confidence and ownership of their own bodies; the evidence shows that when girls and women understand their cycle, they gain valuable insights about their fertility and overall health, equipping them to make better consumer-powered decisions, especially in fragile and humanitarian settings.
  • Menstrual blood contains unique health data. Medical research suggests that menstruation can be useful to detect signs of HIV, diabetes, endometriosis and cervical cancer.
  • MHH supports contraceptive continuation: Across developing countries, menstruators often express worry that contraception could hurt their fertility—and worse, rob them of their dreams of motherhood; adapting counseling to lead with side effects, including changes to menses, supports women and girls to choose (and stay on) a contraceptive method that works best for them.
  • Promoting gender equality starts with MHH: MHH in SRHR programming can challenge harmful gender norms that affect how women and girls make independent health and body choices. 
  • When it comes to young people, periods are a more easily accepted entry point… than, say, sex: Leading with puberty and menstruation is better embraced in conservative settings in which sex and contraception remain taboo, and by young people who may be more concerned with body changes than planning for a family.
  • Young girls have MHH questions, but often no trusted sources to turn to for timely, accurate and pragmatic information: Reaching young people where they are and how they say they need is key. Based on young people’s insights, PSI-powers dedicated social media pages to connect young people to safe spaces where they can chat with their peers about topics that matter to them. PSI network members have reported that many girls and women send private posts to page administrators with questions and concerns about their menstrual cycles, with a keen focus on fertility.

Together, we can drive toward a future in which women and girls, men and boys, can contribute to the health and welfare of their families, their communities and their nations as a whole.

That vision starts with the period.

Eager for more? You can read the full technical publication here.

Photo credit: © 2013 Tanwe Shende/ GlobeMed at UCLA, Courtesy of Photoshare

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