A recent investigation by Public Health England, has exposed reproductive health as an urgent public health issue, highlighting concerns around menstrual health education.
According to the report, women acquire most knowledge of menstruation at school. Yet, information provided under the national curriculum has been criticised as being a ‘far cry from lived experiences’. It is no surprise, therefore, that women across all age groups have expressed the need for more practical information, to be able to distinguish between ‘normal’ and abnormal reproductive health.
As a consequence, many women live for years with undiagnosed menstrual health disorders, accepting physical and emotional pain as ‘normal’. This issue is echoed in findings from a first-of-its kind study from Plan International UK which looked at the stigma surrounding menstruation.
The research found that:
79 per cent of those with periods have been concerned by symptoms linked to it, such as heavy bleeding, severe pain and irregularity
But of the 1,004 14- to 21-year-olds asked more than a quarter (27 per cent) said they were too embarrassed to speak to a health professional about their concerns while menstruating
More than half (54 per cent) said they hadn’t sought medical advice because they thought their symptoms were typical
A total of 13 per cent were told they were exaggerating
Menstrual Health Education in School
The current ‘sex and relationships’ curriculum for secondary education leaves a lot to be desired, especially if the following ‘best practice’ guidance on teaching menstruation is anything to go by:
The onset of menstruation can be alarming for girls if they are not prepared. Research shows that about a third of girls are not told about periods by their parents and 10% receive no preparation at all before their first period. As with education about puberty, programmes should include preparation for menstruation.
Schools should also make adequate and sensitive arrangements to help girls cope with menstruation and with requests for sanitary protection.
What is painfully evident, is the lack of information being provided around reproductive and menstrual health in school. There is no inclusion of PMS (Premenstrual Syndrome) for example, yet 30-40% of reproductive women suffer from PMS, with 3–8% experiencing severe symptoms. Endometriosis, which affects around 1 in 10 women, is not even mentioned in the existing curriculum.
Last month, Endometriosis UK launched their #whatiwishilearned campaign, aimed at improving menstrual health education and wellbeing in schools. You can read more about it and sign a petition to get menstrual wellbeing included in the curriculum here.
At this point, it is also important to recognise that male reproductive and urological health, including infertility, hormonal issues and the male menopause, are also underrepresented (actually, they're not included. At all).
It begs the question:
How can we expect men and women to take control of their reproductive health, if they have no awareness of potentially life-changing conditions?
A breeding ground for menstrual stigma
In an age of increasing diversity and inclusion, it is astounding that such a natural human process is still perceived as taboo. This is especially true in the workplace, where many women are afraid to disclose menstrual health problems for fear of being ridiculed or being perceived as weak or incompetent. This causes them to suffer in silence, falling prey to dysfunctional coping mechanisms which can have a negative impact on mental health and wellbeing. Yet, if we look at how menstrual health education is delivered in schools, stigmatisation should come as no real shock.
More often than not, girls are invited to take part in an exclusive ‘period talk’, in which boys have absolutely no involvement. While this does have some obvious advantages (such as girls feeling more comfortable asking questions without the presence of boys) it can exacerbate feelings of shame and embarrassment, which then continue into later life. In order to understand and empathise with women, it is important that boys also learn about the potential physical and emotional impact of menstruation. After all, they are likely to encounter women in all aspects of their life and could find themselves as a vital source of support to a partner, daughter or colleague.
It is clear that the existing model for menstrual health education is not fit for purpose. We need a new offering to include: hormones and hormonal health; menstrual problems; pregnancy and post-natal mental health; menopause; nutrition and exercise for reproductive and menstrual health; and infertility.
It is time we provided better information, guidance and advice to our young people by putting menstrual and reproductive health at the top of the education agenda.
To organise a FREE talk on menstrual health and wellbeing at your school, college or university, get in touch at firstname.lastname@example.org
Public Health England, 2018. What do women say? Reproductive health is a public health issue.
TheDepartment for Education and Employment, 2000. Sex and Relationship Education Guidance.
Ryu, A., Kim, T.H., 2015. Premenstrual syndrome: a mini review. Maturitas, 82, 436–440.
Giudice, L.C., 2010. Endometriosis. New England Medical Journal, 362, 238998.
Dudley,C., Kerns.J., Steadman, K. 2017. More than “women’s issues”: women’s reproductive and genealogical health and work.