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I’m A Doctor And This Is Why I Think We Need To Smash The Taboo Around Periods

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WASH logoEditor’s Note: This post is a part of #NoMoreLimits, a campaign by WASH United and Youth Ki Awaaz to break the silence on menstrual hygiene. If you'd like to become a menstrual hygiene champion, share your story on any one of these 5 themes here.

Discussed by Dr Sinchan Das:

India is one of those ancient civilisations where the seeds of education, medicine, science, culture and art were first sown. But this land of glory was eventually submerged under a huge amount of social stigma. India is a country where ‘sex’ still considered a taboo subject. Different concepts regarding sex have prevailed in society for a long time.  However, a suspicious atmosphere has been created around sex. This hindrance is one of the principal causes of sexually transmitted diseases (STDs) and the ever-growing rate of sexual violence.

It is a common trait of the human mind to feel interested in matters that are hushed up. Sex does not mean the ‘sexual act’ or ‘sexual performance’ only; rather, sex denotes ‘sexuality’ and ‘sexual identity’ also. Sex is a basic psycho-neuro-endocrine property of all living beings, expressed by the means of different sexual behaviours and actions. So, it is immaterial to consider sex as a ‘sin’ or ‘offence’ and it must not be considered as a subject of hindrance.

In this male-dominated society of India, several customs are superimposed over women. There are several such customs regarding menstruation as well.. Even in this modern era, women – especially those from rural areas – still hesitate to talk about the sexual matters. Hence, they cannot even share their problems regarding menstruation or anything that may involve the reproductive system. As a result of this, gynaecological disorders remain unidentified during the first few stages. Due to this hindrance and ignorance, lots of pathologies remain unnoticed and untreated for a considerable period of time. By the time they are diagnosed, the level of threat has gone way up. So, hindrance and myths may result in compromisation of health and compromisation of expenditure.

Menstruation or menstrual bleeding is a similar physiological phenomenon as digestion, excretion, circulation and others; so, it must not be considered as something different or a matter of hindrance.

Menstruation is the cyclical discharge of blood, mucous, stripped of endometrium, leucocytes and an unfertilized ovum at an regular interval of average 28 days (21-35 days). The duration of a menstrual cycle is about 4-5 days and the amount of blood loss is estimated to be 20-80 ml with an average of 35 ml.

Menstruation must not be a ‘sin’. There is a serious need for sexual education and awareness regarding reproductive physiology, so that a woman can easily come forward and share her usual and unusual experiences from the very first day of her menstrual life (menarche). This may play an important role in the identification of reproductive pathology in an initial stage, through which we can avoid many serious pathologies very easily. On a serious note, menstruation is not solely an endocrinal issue; rather, it is better to say that it is a psycho-neuro-endocrinal issue. For that reason, we have to maintain a healthy atmosphere to maintain healthy reproductive functions.

Let us make a short summary of the different menstrual pathologies commonly occurring during the reproductive life of a woman.

1. Dysmenorrhoea: Dysmenorrhoea means painful menstruation of sufficient magnitude so as to incapacitate day-to-day activities.

2. Mittelschmerz’s Syndrome: In this case, there is an onset of ovular pain in the mid-menstrual period. The pain usually located in the hypogastrium or in either iliac fossa. This pain generally lasts less than 12 hours and it is associated with slight vaginal bleeding and excessive mucoid vaginal discharge.

3. Pelvic Congestion Syndrome: There is a disturbance in the autonomic nervous system which may lead to gross vascular congestion with pelvic varicosities. The patient has a congestive dysmenorrhoea without any demonstrable pathology. The patient complains of vague disorders with a backache and pelvic pain with or without dyspareunia.

4. Premenstrual Syndrome (PMS): PMS is a psycho-neuro-endocrine disorder of unknown Aetiology, often noticed just prior to menstruation.

5. Menorrhagia: It is defined as cyclic bleeding at normal intervals; the bleeding is either excessive in amount or duration. Common causes are – a) DUB; b) Fibroid of uterus; c) Adenomyosis; d) Chronic tubo-ovarian mass.

6. Polymenorrhoea (Epimenorrhoea): It is defined as cyclic bleeding where the cycle is reduced to an arbitrary limit of fewer than 21 days and remains constant at that frequency.

7. Metrorrhagia: Metrorrhagia is defined as irregular, acyclic bleeding from the uterus.

8. Menometrorrhagia: Bleeding is so irregular and excessive that the menses cannot be identified at all.

9. Oligomenorrhoea: Menstrual bleeding occurring more than 35 days apart and which remains constant at that frequency.

10. Dysfunctional Uterine Bleeding (DUB): It is defined as a state of abnormal uterine bleeding without any clinically detectable organic, systemic and iatrogenic cause.

11. Secondary amenorrhoea: Absence of menstruation after minimum a successful menstrual bleeding. These above-mentioned pathologies are the results of different grades of pathologies, which need to excluded carefully. To minimise the rate of reproductive pathologies, infertilities, maternal and child mortality rates, we have to educate ourselves with proper sexual education and erase all hesitations regarding sexual matters from the root.

Let's ensure that no girl is limited by something as natural and normal as her period by making menstrual hygiene education compulsory in schools.

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

  • Mobilising young people between the age of 18-35 to become ‘Eco-Period Champions’ by making the switch to a sustainable menstrual alternative and becoming advocates for the project
  • All existing and upcoming public institutions (pink toilets, washrooms, schools, colleges, government offices, government buildings) across East Delhi to have affordable provisions for sustainable menstrual product options

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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