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Menopause In Slums: How The WASH Sector Is Failing Menstruators

“What the hell can a slumdog know?” asked the policeman in Slumdog Millionaire released in 2009.

More than 64 million people were living in India’s slums as per the 2011 census. Divided into nearly 13.8 households, they formed 17.4 percent of India’s then 1.2 billion population.

Life Clearly Isn’t A Pleasure Cruise In Slum Areas

Shanty, overcrowded, unhygienic, etc. are adjectives used for India’s infamous slums. With lack of ventilation, light, breathable air, sanitation facilities, and well, individual dignity, these slums often become the bitter truth of glorious metropolitans.

Life clearly isn’t a pleasure cruise in these areas. But is it the same for every person living there? The answer is a clear NO! But let’s narrow things down a bit and talk about a much-ignored issue in most discourses around menstruation – menopause.

Dealing with menopause mostly is not an enjoyable experience for menstruators – with irregular flows, hormonal changes, hot flashes, etc. menstruators go through an immensely uncomfortable change in their life.

Individuals while experiencing perimenopause and menopause are in a constant need to use toilets – they experience vaginal dryness, heavy flows, and irregular cycles, and are often more vulnerable to urinary tract infections.

What can help them to avoid these problems? Personal hygiene and sanitation. Consequently, what do they not get access to? You guessed it, personal hygiene and sanitation.

The 2011 census stated that one-third of the slums had no indoor toilets and 64 percent were not connected to any sewerage systems.


But clearly, various governments have been trying to solve this issue; yet, lack of menstrual hygiene during menopause is a pertinent problem for policy-makers. Despite the existence of various community toilets in nearby areas, menstruating individuals choose not to use them for various reason as listed below-

Community Toilets Are Located In Faraway Locations.

Individuals during menopause often experience irregular flows which mostly occur spontaneously, this makes their frequency of using toilets more than menstruating and non-menstruating individuals. Most community toilets are located far off from slum residences and require users to travel for 35-40 minutes (to and fro) every time they want to use them. Most menopausing individuals (who usually are in their 30s to 40s) play an integral role in managing their households and utilizing this much time for their personal hygiene, that too, multiple times a day does not resonate with them for obvious reasons.

Too Many People, Not Enough Toilets.

Another issue is the number of users per toilet, community toilets are often overcrowded and require users to wait for 10-15 minutes in a queue. A report[3] by NDTV revealed that out of the 3 community toilets in Geeta Nagar, each has 20 seats whereas the slum’s population is more than 50,000. Considering the distance issue, this increases the total time menopausing individuals have to invest.

Lack of toilets in schools and thereby inability to access hygienic menstruation practices remains the major cause of drop out of girls from school. Representational image.

Furthermore, cleaning oneself during menstruation often takes more time than per se, urination.

No Female-Friendly Toilets

Most of these toilets only have urinals and not enough space to bathe and/or clean themselves properly. Furthermore, most of these toilets have broken locks and doors posing a serious issue towards the user’s privacy. Additionally, a major motivation i.e. sanitary pad dispensers are also not available in these toilets giving most menopausing individuals no motivation to use these toilets.

No 24×7 toilets

Most of these toilets are closed at 10 pm leaving users with no other alternative to go to. Menopausing women have designated deserted areas where they go to discharge their menstrual waste and clean themselves. Usage of such locations often poses security concerns to the individual and privacy concerns to individual dignity. The anxiety caused by apprehension of being seen often acts as a catalyst and mental health issues for menopausing individuals.

Costly toilets

A study revealed that the expenditure of using community toilets is 104 times more than the expenditure of families that have their own toilets. A pertinent issue here becomes the socio-economic structures in slums.

A study revealed that 66.6% of families living in slums have a monthly income of less than Rs 10,000 which clearly suggests that individuals have to prioritize some basic needs over others. Furthermore, many families in slums are regulated under patriarchal authority – which clearly means that even if menopausing women want to choose menstrual hygiene over basic needs per se food, the men of their families won’t let them do so.

The problem worsens when authorities fail to recognize that vulnerable groups often have more vulnerable groups among them – discrimination does not stop at any socio-economic level and is often, meticulous in nature.

The sheer neglect of the existence of individuals who are going through menopause which is evident in the existing mechanisms is an absolute reflection of gender inequality – a concept that often gets ignored under the shadows of poverty.

The creation of equality involves equity of resources and India, as a country, will not achieve gender equality until it starts caring about individuals who are bleeding and the ones who won’t be bleeding in the future.

Featured image is for representational purposes only.
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