Menstruation has long been a neglected topic, but a new generation of researchers are now shedding light into the shadows.
“Girls are literally selling their bodies to get sanitary pads,” says Dr Penelope Phillips-Howard. “When we did our study in Kenya, one in ten of the 15 year old girls told us that they had engaged in sex in order to get money to buy pads. These girls have no money, no power. This is just their only option.”
It’s only been in the last few years that researchers have finally begun delving into the subject of menstruation, and the impact it has on the lives of young girls and women in low-income countries.
For millions of them, a universal lack of clear information and education makes menstruation a source of shame and embarrassment. And in some cases, researchers are now uncovering ways in which menstruation brings even higher costs that may affect the course of a young girls life.
“The persistent taboo around menstruation means that limited information is available to young women,” says Sabrina Rubli of Femme International. A study by the Canadian organisation in Nairobi revealed that 80% of girls had no idea what their period was before they started.
That sense of shame, the sense of being guilty of an activity so secret that that no one will even talk about it, is then compounded by cultural prejudices and beliefs around menstruation which vary from country to country and region to region. In some cultures, it emerges, women are told that eating certain foods during their period will make them smell bad, in others women are sent away from the home or not allowed to bathe, while yet in others an association is made between menstruation and sexual activity. One Ethiopian girl told a researcher; “When I menstruated, my father saw me washing my underpants… He asked me what it was and I told him nothing. He demanded an answer and picked up a stick to hit me.
“I dropped everything and ran to my mom. My mother told my father not to hit or scare me because it is normal for girls to experience this. My father said, ‘I send her to school to learn, but instead she goes into the forest with anyone [to have sex] and comes back home.’ My mother tried to explain, but my father did not believe her. He said that menstruation happens only after a girl has had sex with a man and that I am not ready. Then, he beat me and asked me to tell him who did this to me.”
Schools in particular can be full of pitfalls. There may not be adequate bathroom facilities; many have shared latrines, no locks on the doors, and no running water. According to the research, some teachers are unsympathetic and teaching methods may compound the problem. In sub-Saharan Africa, for example, teachers prefer students to stand up when they answer a question, and girls often talked about their anxiety that they would have to stand up and reveal stains on their clothing.
“Sometimes when I am in class and the teacher is teaching, I don’t concentrate on what is being taught because your mind is always on the thought that when you stand and your clothes will be blood stained and the teacher will see, hence you don’t concentrate.” Partly as a result, and partly for all the other reasons, girls often miss school when they are menstruating. The World Bank has estimated that a girl may thus miss between 10-20% of her education.
And even the basics – things that many women take for granted, like buying sanitary ware – become a burden for these young girls. A 2013 study in Kenya revealed that girls end up using whatever they can lay their hands on; old clothes, blankets, cotton wool or tissue, and even, very occasionally, grass or leaves. Parents are either unwilling or unable to come up with money for sanitary ware, and so girls ask boyfriends for money. A 2015 study [pdf] by this same team heard girls’ accounts of having sex in order to get money for pads from the girls: “‘Some people exchange sex for money,” one young girl told her interviewer. “The money is used to buy pads. Maybe she is being given money then they have sexual intercourse.’Continue