Menstruation is a natural process that begins in females usually between the age of 11 and 14 years and is one of the indicators of the onset of puberty among them. Despite being a natural phenomenon, it has been shrouded with secrecy, limitations and myths in many societies. For instance, in India,menstruation invites several restrictions on women such as prohibition from touching water and cooking, attending religious and cultural ceremonies, entering religious/cultural sites and engaging in community activities.

The stigma around menstruation has a severe impact on the social development of girls and women in India due to the following

• Exclusion from public life: Restrictions such as prohibiting menstruating females from entering temples or kitchens or touching holy books can reinforce the idea that women and girls have less claim to public spaces, and their ability to participate in public life is limited.
• Undermining socio-economic advancement: The cultural shame attached to menstruation and shortage of menstrual products prevent menstruating women from going to school and undertaking jobs. This not only undermines gender equality but also restricts their socio-economic advancement.
• Hygiene and health issues: Approximately 88% of menstruating women in India resort to using unsafe sanitary methods like newspapers, old rags, husk, ash, leaves, etc., which increases their susceptibility to infection.
• Barriers to opportunities: A common misconception is that women and girls have diminished physical and emotional capacities due to their menstrual cycles. This can create barriers to opportunities thereby reinforcing gender inequality.
• Heightened vulnerability: The onset of menstruation, called menarche, is looked upon as an indication that girls are ready for marriage or sexual activity. This can undermine their human rights, as it leaves them vulnerable to a host of abuses, including child marriage and sexual violence.

Steps to combat these taboos and myths include

• Raising awareness: Raising awareness among adolescent girls about menstrual health and hygiene through community-based health education campaigns can prepare them better for onset of menstruation. This can be done by:
• Improving the educational status of women, as it plays an important role in improving the health status of the community at large and overcoming cultural taboos, in particular.
• Including menstrual hygiene management curriculum in schools.
• Educating males: Educating the male members of society about menstruation being a natural phenomenon in order to bring about an effective change in society and destigmatising menstruation.
• Availability of associated infrastructure and menstrual products: Provision of sanitary napkins and adequate facilities for sanitation and washing should be made available keeping gender requirements in mind in educational institutions, public offices, etc.
• Sensitization of health workers: This is to ensure dissemination of knowledge in the community and mobilize social support against busting menstruation-related myths.
• Menstrual leave policy: The State should formulate menstrual leave policy for working women and female students to encourage the right to rest without being penalized in any way.

A multi-dimensional approach is required to address prejudices and myths related to menstruation. There is also a need to link physical infrastructure and water and sanitation projects to health education and reproductive health programmes and address the issue in a more holistic way.