Period stigma and language
Shame and stigma around menstruation are universal. Inappropriate, incomprehensible or negative language further perpetuates period stigma. The natural process of menstruation is often obscured by code-words such as ‘monthlies’; medical language such as ‘endometrium’; or acronyms like ‘MHM’.
An online study in English, French and Spanish encompassing South America, East & West Africa, Asia and Europe, wanted to know more about the knowledge and language used around menstruation. The study found that most people prefer to use local or colloquial words around menstruation. Period in English, regla in Spanish and règles in French are most widely used and understood.
No acronyms, please
The study invited over 1600 respondents to spell out acronyms commonly-used by academics, non-government organisations, activists and practitioners. The acronyms WASH, SRHR, MHM and MH all relate to menstrual, sexual and reproductive health, and water and sanitation; and are regularly used in advocacy, communication and education relating to menstruation, and 80% of respondents across all three languages did not recognise any of them.
Acronyms further obscure the already hidden and stigmatised topic of menstruation. Few people are brave enough to ask what an acronym means, especially if they are speaking to a doctor, teacher or their boss. Acronyms exclude those not ‘in the know’, create a barrier and limit access to knowledge. If the purpose of a document or conversation is to obscure the message and reduce access to only those already familiar with the topic, then acronyms are an ideal code. Every time someone does not use an acronym, even when speaking to a colleague, it opens the topic up, and chips away at the stigma and secrecy of periods.
Health or hygiene?
Even if spelled out in full, ‘menstrual hygiene management’ obscures the reality of periods and implies that this natural process requires a complicated office-based management approach. The term ‘menstrual hygiene’ limits periods to cleaning, whereas ‘menstrual health’ encompasses all aspects of menstruation such as well-being, gender equality, education, equity, empowerment, and rights. Menstruation is best associated with health to popularise it as natural, positive, and related to all aspects of well-being, rather than hygiene, which, although important, may limit menstruation to sanitation and cleaning.
The term “menstrual health” is increasingly used in WASH, health, and development sectors for advocacy, programming, policy, and research. A menstrual health definition composed by leading academics and practitioners of the Global Menstrual Collective was published in April 2021, to ensure ‘menstrual health is prioritised as a unified objective in global health, development, national policy, and funding frameworks, and elucidate the breadth of menstrual health, and facilitate a shared vocabulary through which stakeholders can communicate across silos to share learning.’ (author’s italics.) This new definition is to be presented at the UNFPA Menstrual Health Symposium in May 2021 and is a fantastic tool for improving cross-sectorial work and understanding of menstruation.
We found knowledge of female reproductive anatomy was low, even among university graduates. On a simple diagram, over 35% of respondents could not label ovaries or the vagina; and 60% could not identify the uterus. Sharing knowledge about periods creates empowerment and informed choice, for a healthy period and increased bodily autonomy. It would be a valuable addition to have further research to evaluate how much technical detail and anatomy is necessary to facilitate safe and dignified periods. It seems likely that understanding detailed reproductive anatomy and medical terminology may be less important than learning how to track period days, wash hands, and use a menstrual cup safely. Whatever the level of detail though, discussing and educating around periods can be a powerful gateway for broader discussions around health, life skills, and sexual and reproductive health.
A growing number of organisations, donors and governments now acknowledge that menstruation is a normal, natural process but which may need their support. However, dignified, healthy periods require more than simply access to products. Knowledge of products is needed too – by users, teachers and health workers. While 93% of all our respondents recognised photos of single-use pads, only 34% of those in East and West Africa recognised menstrual cups. A limited understanding of menstrual products compromises individuals’ ability to manage their periods to enable full lives. With increasing understanding of the environmental impact, and high cost, of single-use ‘disposable’ pads and tampons, menstrual cups should be an option for every person who has periods.
Call to Action
Familiar language is more effective in communications, advocacy and campaigns. To improve all communications around menstruation, we recommend that policymakers, donors and practitioners:
- Call a period a period and avoid medical and technical jargon.
- Use period in English, regla in Spanish and règles in French.
- Discuss periods openly and avoid slang such as ‘monthlies’.
- Avoid all acronyms like ‘MHM’ in speech and text, even with experts.
- Include re- useables in menstrual education, especially menstrual cups.
- Use ‘Menstrual Health’ rather than ‘Hygiene’ or ‘Hygiene Management’
Our study was conducted in three languages, across four continents, with 1633 respondents. This evidence should help to inform menstrual health advocacy, education and funding, whether writing or speaking in French, Spanish and English, both in the menstrual community, and also outside, such as donors, educationalists, practitioners, civil servants and politicians.
Janie Hampton is a menstrual health activist and author who wrote the British government’s first policy on international reproductive health in 1992. She co-founded the inter-sectoral Menstrual Cup Coalition and has advised governments and NGOs in Africa, Asia, UK and USA.
Any opinions stated in this blog are those of the author(s) and are not necessarily representative of or endorsed by the Sanitation Learning Hub.
To read the full research, see https://menstrualcupcoalition.org/wp-content/uploads/2021/05/Menstrual-Language-Report-21-05-21.pdf Hampton, Osborne and Sweetland, Call a period a period: Exploring the language and knowledge of menstruation. April 2021. Link to PDF
One-page briefings in English, French and Spanish:
Hampton, Osborne and Sweetland, Call a period a period: Exploring the language and knowledge of menstruation, April, 2021, English briefing note. Link to PDF (English)
Hampton, Osborne et Sweetland, Appeler les règles les règles explorer le language et la connaissance des menstruations, Avril 2021. Note d’information. Link to PDF (français)
Hampton, Osborne y Sweetland, Llamemos a la regla ‘la regla’: explorando el lenguaje y conocimiento sobre la menstruación, Abril,2021. Nota informativa. Link to PDF (español)
Researchers: Janie Hampton BA MSc, Menstrual Cup Coalition; Alethea Osborne MPhil Oxon, Gender and Social Development Specialist; Charles Sweetland BSc MSc, Data Analyst, University of Exeter.