Every month, nearly 1.8 billion people worldwide menstruate (Rohatgi & Dash, 2023). Menstruation is a normal, healthy bodily function, and it is core to our existence. And yet, it continues to be highly stigmatized and woefully under-addressed in terms of education and support. As such, menstruation is an ongoing source of emotional and physical distress for individuals. The oft-associated shame, embarrassment, confusion, and unmitigated discomfort have powerful downstream effects on health, body image, sexuality, education and opportunities, and overall well-being. How we approach menstruation is indicative of a broader issue around female health disempowerment and requires stigma-defying positive interventions to truly change the tides.

Perhaps the most pressing issue surrounding menstruation is period poverty, or lack of access to necessary products, or in some parts of the world, even hygiene facilities (Jaafar et al., 2023). While the United States fares much better than more impoverished countries, period poverty exists in the U.S. as well. A recent study found that nearly two-thirds of low-income individuals were unable to afford necessary menstrual supplies in the past year (Sebert Kuhlmann et al., 2019). Additionally, in a 2023 State of the Period Report commissioned by two leading menstrual-support organizations, nearly one-quarter of menstruating adolescents and adults struggled to afford supplies (Thinx & Period.com, 2023). The implications around period poverty are emotional (e.g., stress or embarrassment), as well as disruptive to learning or earning a living (e.g., absenteeism, poor performance, and reduced engagement; Munro et al., 2021). While one would never be expected to bring their own toilet paper to school or public bathrooms, menstrual supplies are often unavailable in desperate times of need.

Beyond access to supplies, we also fall short on menstrual education and preparation in schools, homes, and health or community care centers. Many youths feel confused and embarrassed about what is happening and how to handle it (Yang & Chen, 2023). Without preparation, the beginning of menstruation can create tremendous anxiety. Anecdotally, a nurse at a Cambridge Massachusetts Elementary School recently described a situation in which a 10-year-old thought she was dying upon discovering blood. In an Australian study, only 16% of menstruating students reported feeling completely confident about managing their periods by their college years (Munro et al., 2022).

There are downstream effects of inadequately preparing and supporting youth around menstruation and their changing bodies. For one, puberty is a critical risk period for eating disorders and body image issues, and studies have pointed to a link between menstruation and increased body dissatisfaction and perceived body size (Klump, 2013; Teixeira et al., 2013). If we are not talking about hormonal changes or normalizing these experiences, girls are at risk for internalizing these potentially devastating beliefs. In fact, many females misinterpret premenstrual syndrome (PMS) symptoms as violations of norms around being female (e.g., being easily irritated; Ussher, 2004). In other words, we can pathologize normal or common premenstrual experiences, potentially impacting self-esteem.

Perhaps none of this can be addressed without addressing the entrenched stigma around menstruation, which inhibits support-seeking or even talking about these challenges (Michel et al., 2022). Even in more advanced nations like the U.S., this social stigma persists, imparted through powerful socialization agents, such as commercials and educational pamphlets, and even doctors and parents. It is astounding to consider that in a study of over 2000 adolescent girls and women, more than half reported feeling ashamed of menstruating (Thinx and Period.com, 2023). Along with this shame often comes the fear of public humiliation, were one to bleed through clothes or be seen bringing a pad or tampon to the bathroom. Period shame permeates many aspects of life, including one’s sexual health (Schooler et al., 2005). Menstruating females are often seen as less sexy, less pure, and more annoying, which seems to further this experienced shame (Forbes et al., 2003). Even reminders of menstrual blood, such as tampons, can lead to avoidance and social distancing (Roberts et al., 2002). Menstrual stigma is a hidden stigma, as girls and women go to great lengths to conceal their periods. These behaviors increase self-consciousness and hypervigilance, especially in adolescents (Oxley, 1998). The ongoing stigma attached to menstruation is detrimental to self-esteem, body image, support-seeking, and sexual and overall health (Stubbs, 2008).

 While all of this may seem disheartening, we know that positive interventions can improve well-being in any area of life, with reproductive health being no exception. In fact, Mpower. (pronounced “empower period”) is an example of a grassroots, non-profit organization that focuses on early and positive interventions around menstruation for youth. One might refer to this arm as positive sexuality and reproductive health, with interventions designed to improve flourishing through better education and support around one’s reproductive health. Mpower. is tackling some of the challenges listed above through a stigma-defying intervention: Period Parties. These parties are hosted at local, public elementary schools during non-school hours, where students in grades 3–5 are invited, with any family member(s) in tow. Three main objectives contribute to the aim of increasing well-being around menstruation and reproductive health:

Establish new, positive social norms

Simply talking about menstruation has been shown to create more positive attitudes about it (Culpepper, 1992). However, when you pair discussion and education with a party atmosphere that includes balloons, music, cupcakes, and games, the message that periods should be associated with embarrassment and shame is strongly challenged. There is an undercurrent of celebration around this developmental milestone and our ever-changing bodies. Most often, the highlight is the “special guests,” or older students who share their first-period story, “I wish I had known” tips, or emotions or beliefs they have experienced or held. These stories challenge assumptions, normalize and validate different experiences, and change the narrative around periods. At these parties, menstruation is no longer taboo. Period parties create a new social norm, which includes asking questions, sharing stories, seeking support, and openly discussing among peers, doctors, and parents. Social referents—well-connected students who have the confidence to continue these dialogues in school—around menstruation also emerge.

Increase preparedness and confidence

Since the average age of a first period is 12.4 years, most students attending these parties have not yet menstruated. With early intervention, these youths can feel more prepared and confident navigating menstruation early on. Pre-party surveys show that most students arrive with high negative emotions, such as anxiety and stress, and low readiness, knowledge, and confidence around menstruation. Research shows that information, positive perceptions, and comfort talking about menstruation all positively predict confidence (Munro et al., 2022). As youth gather to make their own period packs, they begin to ask questions about supplies and menstruation, often for the first time. Later, a doctor will share her own first-period story, how menstruation works (what is happening to your body and why this is important), and how to feel empowered around it. Other activities engage students further in learning how to care for their bodies and learning where to go for support.

As students leave, their personalized period packs are often tucked into their backpacks, ready as needed. In one Boston-area school, a fourth-grade teacher described a scene the next morning where students all took out their period packs, in the presence of their male classmates, to discuss and share contents. This outcome is supported by research, in that openly talking about menstruation can provide youth with the confidence to engage in those conversations, even if it may embarrass peers (Fingerson, 2006). In fact, confidence in managing menstruation can be a source of agency, which refers to the ability to take action in service of one’s well-being and fulfillment and empowerment for youth (Fingerson, 2006; Seligman, 2011). These interventions remind youth that they are not alone, that support and resources exist, and that they can handle any challenges related to menstruation.

Associate menstruation with positive emotions.

Since menstruation has a negative stigma attached to it, it may be difficult to believe that it could be associated with positive emotions. Yet, it is possible (Munro et al., 2021). For individuals who regard periods favorably, there is a higher level of resilience and confidence associated with menstruation. Positive emotions, which these parties aim to evoke, increase support-seeking and help challenge stigmas and taboos by broadening thinking around menstruation. Students are often dancing and laughing, artistically expressing themselves, and excitedly showing each other the contents of their menstrual goody bags or self-care kits. Post-party surveys also show an increase in positive emotions and decrease in negative emotions, which is also supported through qualitative feedback. Youths express feelings of happiness, gratitude, love, support, and relief. As one student recently wrote, “Thanks for being there for everyone that might be afraid and scared (like me).”

As researchers Johnston-Robledo and Chrisler (2020) put it, “a party could help her realize that she, like other girls and women in her life, can overcome the embarrassment and have positive, even playful attitudes toward menstruation.” At the very least, there is an ever-present need for females to be more empowered around their health, whether it’s sexual and reproductive health or any other area. We know from research that psychosocial well-being and health improves with education, access to supplies, and de-stigmatizing efforts (Yang & Chen, 2023). Females who feel empowered are more likely to take better care of themselves and those around them (Kiani et al., 2018). When we couple these positive interventions and experiences with particularly vulnerable chapters of human development, we increase the chances of longer-term well-being.

Note: This article and the research cited herein uses the terms girl, woman, and female. I acknowledge that it is a limited and binary classification that does not represent all menstruating individuals. As much as possible, neutral terms were chosen, with the intention of being more inclusive of different gender identities.

References

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About the author | Erin Dullea (C’21) is a positive psychology practitioner, coach, writer, and devotee of the science and practice of self-compassion. A former business leader and career-transition coach for women, Erin’s training includes a Master’s degree in Applied Positive Psychology from the University of Pennsylvania, as well as multiple coaching certifications. Erin has been a contributing author to the Huffington Post online, and her work has been featured in various publications and podcasts. She is also the founder of MPower., a community-based project that provides positive interventions for youth around menstruation. Erin continues to be a strong advocate for body positivity and healthy relating to oneself and has held various roles within the eating disorder prevention and recovery field. Erin’s most meaningful work, however, continues to be raising her four children, who keep her honest, humble, and, mostly, happy.