Let us talk about periods

Gynaecologists say that the only way to increase awareness and reduce the stigma around menstrual health is to discuss it more openly

The Oscar-winning short documentary ‘Period. End of Sentence’, looks at how the taboo persists in India and how people are working to overcome it.

Menstruation is a normal biological function of a female body. In fact, it is an indicator of good health. However, socially and culturally crafted misconceptions of the same have given it a taboo status. This in turn has led its exclusion from policy making, as a result of which the health of many women in the country suffer.

May 28 marked Menstrual Hygiene Day, which was initiated by German-based NGO WASH United in 2014. The day hopes to address issues ranging from taboos and education to access to hygiene products.

Safe menstrual hygiene

It is important to understand that periods are natural and normal, and that the blood that comes out is not ‘bad’ or a ‘curse’, says Dr Gayathri Kamath, senior consultant, obstetrics and gynaecology at Fortis Hospital.

“From my practice in Bengaluru, I can have seen how the urban population has grown to be much more comfortable with talking about menstruation,” says Dr Prathima Reddy, director, senior obstetrician and gynaecologist at Fortis La Femme Hospital. Rural India, however, is still not part of this conversation. “When you can’t even talk about periods, good hygiene practices can be difficult,” she says. While cloth pads are a great alternative to disposable pads, for those who have deal with a lack of basic necessities such as access to toilets and even water this might not be the case.

Many girls are made to feel so uncomfortable about their periods that they discontinue their education. “There is still a risk of stains while using cloth pads. This can be extremely embarrassing for a growing girl, especially when they are surrounded by boys who are not cognizant of what’s happening,” she adds. Additionally, many women do not change or clean their cloth pads very often making them more vulnerable to infections and irritation.

A goal for most period activists worldwide is for every woman to have access to safe and easy to use hygiene products. The most convenient to use are sanitary napkins. “I would suggest pads that are cotton-like and have less synthetic material,” says Dr Gayathri.

Tampons and menstrual cups are the newer entrants. Many are still apprehensive of them as they have to be inserted into the vagina.

“There is a common misconception that using them will cause one to lose their virginity, but this is false. These methods are reported to be more comfortable, especially for women who are more active,” says Dr Gayathri. She adds that the idea that these items can only be used by sexually active women is also false. Dr Prathima adds that she has been getting more and more queries about the cup and she says it’s the best option if you are comfortable with it. “It is re-usable and thus environment friendly and above all it is very safe,” she says.

Combating the taboo

Much of the taboo surrounding the topic can only be broken by open discussion. “The effect of this openness is being seen in metropolitan cities like ours. Many women are now able to freely discuss menstruation with families, male peers and even with their bosses,” she says. Conversation leads to education which in turn leads to women having more comfortable periods as homes, workplaces and the public as people are more understanding of their needs during this time.

It also allows women to understand their bodies better, what is normal and not, what she should worry about and what happens to everyone around her.

For this understanding to permeate to rural areas, Dr Prathima suggests that school teachers or NGOs with an understanding of the locality initiate discussion. She adds that both girls and boys must be part of the conversation.

Dr Gayathri says that period taboos are perpetuated by things as small as wrapping period products in a black bag. “Next time ask for yours without a discreet wrapping. It is up to us to show that there is no shame in periods,” she says.

Disposal and risks

Women must change their pads every six hours or when it feels saturated, whichever is earlier. “Like cloth pads, these too can cause infection and irritation if left unchanged,” says Dr Prathima Reddy, director, senior obstetrician and gynaecologist at Fortis La Femme Hospital.

She adds that changing tampons every 8 hours or when saturated is also important.

“Leaving them in for too long or forgetting about them puts you at risk of something called the toxic shock syndrome which causes septic shock,” she explains.

When disposing both these items they must be wrapped well in paper. “It is important that they be well covered, both out of respect for who is handling your waste after you and for hygiene reasons,” says Dr Gayathri Kamath, senior consultant, obstetrics and gynaecology at Fortis Hospital. She adds that they must not be flushed down the toilet as they can cause clogging and drainage issues.

Menstrual cups can be used for 12 hours at a stretch, which is part of the reason they are preferred by women who are on their feet for long periods of time. “In between uses, they simply need to be rinsed out before being inserted back. Do remember to wash your hands after inserting them though,” says Dr Prathima.

After every cycle, they should be boiled in plain water for 3-5 minutes and then stored in a paper or cloth bag.