A period of life we need to talk about — the stigma that still surrounds menstruation

Irish Examiner

6 days ago

Unlike menopause, which in 2021 shifted from a taboo topic to a mainstream one, the conversation around menstruation in Ireland has been lacking, even though the average woman will spend a combined total of 10 years menstruating.
Period poverty — the inability to afford menstrual products or access facilties — remains a fundamental issue. A 2022 Healthy Ireland survey found that almost 25% of women had experienced at least one indicator of period poverty.
Despite that sobering statistic, positive change is happening. In 2022, the HSE launched its Period Dignity project, which, in addition to providing free period products to vulnerable women and girls, has focused on education and wellness, and addressed period stigma.
In 'tampon tax' terms, Ireland is a trailblazer, as the only EU country to apply a zero rate of Vat to all menstrual products, with newer products, such as menstrual cups, period pants, and menstrual sponges finally being zero-rated in 2023.
Period stigma is still a huge problem, with a 2023 menstrual health workplace survey by the Financial Services Union finding that 50% of the 1,064 respondents felt uncomfortable discussing menstrual health at work, with 20% commenting that periods were subject to 'workplace jokes'.
Latterly, women and girls in sport have been at the forefront of breaking the stigma around menstruation. In March of 2023, the Irish women's rugby team made history as the first female Six Nations team to permanently switch from white to navy shorts to mitigate period anxiety among players. Similarly, many inter-county ladies' Gaelic football teams have opted for black shorts.
'Our younger generations, coming up, are questioning things and questioning traditions,' says Dr Katie Lydon, who has previously served as team doctor for the Dublin senior ladies' football team.
Troublesome periods can lead to girls prematurely dropping out of sport, she says, an opinion that's backed up by Sport Ireland research, which, in 2021, found that discomfort, lack of access to appropriate facilities, and poor understanding or support around menstrual health were all contributing factors.
Atlantic Technological University (ATU) launched its Period Promise campaign, their first campus-wide Healthy Campus initiative dedicated to menstrual health, dignity, and equity.
Lydon, who favours 'open dialogue and discussion' around periods, says that girls with problematic periods often end up being put on the contraceptive pill.
'If it keeps a girl in sport longer, it's done its job,' she says.
'But are there other ways we could keep the girl in sport? Are there other ways we can help?'
Lydon isn't 'anti-pill', but points out that it is a medication that comes with side-effects and can, in some instances, serve as a 'band-aid' to mask problematic symptoms, when uncovering their root cause might prove more beneficial.
'[With their menstrual cycle] women have that natural feedback mechanism, and we're so lucky in that regard,' she says. 'We can see the effect of what we're doing to our bodies on a monthly basis.'
Periods can give an insight into health, with the absence of them pointing to over-training or poor nutrition, while severe pain or abnormally heavy flow can indicate a possible underlying health condition.
Dr Katie Lydon, who favours 'open dialogue and discussion' around periods, says that girls with problematic periods often end up being put on the contraceptive pill.
The biofeedback provided by period trackers can help female athletes understand how factors such as sleep, diet, overtraining, and stress affect their cycle and how adjusting these factors can have a positive impact over a measurable timeframe.
Sport Ireland, through its Her Moves initiative, supports period tracking and offers an invaluable Female Athlete Toolkit handbook, available for download on hermoves.ie, which looks at menstruation and menstrual health through a sporting lens.
Education is key
Education around periods is key. A 'spot survey' conducted on the student population by Yvonne Kennedy, wellbeing officer and healthy campus co-ordinator at Atlantic Technological University Sligo, found that 65% of girls 'did not really understand their cycle'.
Kennedy spearheaded ATU's groundbreaking Period Promise campaign, with a personal experience proving the catalyst. A mother to two teenage daughters, Kennedy's elder daughter was 11, and in fourth class in primary school, when her periods started.
According to the HSE, the average age for girls to have their first period is 11, but any time between the ages of eight and 13 is normal.
There was no sanitary bin in the toilet adjacent to her daughter's classroom; only the sixth-class toilet had one. Kennedy contacted the school, who were, she says, 'taken by surprise' at her request that they install a sanitary bin in the mixed-sex, fourth-class toilet. The school hadn't come across the situation previously, and it was felt that a sanitary bin might prompt 'questions' from the boys.
A sanitary bin was duly installed in the toilet, with the situation a learning experience for the school, heightening awareness of its responsibility to cater for pupils' menstrual needs, regardless of age, and the value of age-appropriate education.
Kennedy, who 'had made a lot of assumptions that a lot of things had changed in the time since I had got my period', realised they hadn't. She was pursuing a master's degree in workplace health and wellbeing, and found there was a dearth of research on women's health generally, and none in to 'how periods affect girls from as young as nine years of age'.
The divergence between her academic work and experience as a mother of girls led to her pioneering the campus-wide Period Promise initiative, which has four pillars: Ethical and sustainable period care, menstrual dignity and awareness, menstrual health education, and menstrual health policy advocacy. Period Promise sparked a student-led social media campaign, #NailTheStigma, to foster 'period positivity,' to educate and to raise awareness of the topic of periods, and break any associated stigma. Kennedy says it has had 'massive reach'.
Period Promise has proven highly impactful, and its achievements include the installation of 160 free period-product dispensers campus-wide, a collaboration with Sligo Rovers that has supplied the team with ethical, eco-friendly period products, and an ongoing goal of breaking period stigma.
'It really is just about ramping up the conversations and it's about ramping up the education and awareness,' Kennedy says.
Workplace policies
While menstruation policies remain rare, workplace menopause policies are now the norm, featuring accommodations and support for employees, as well as education and training for all staff.
Private-sector organisations now routinely provide paid leave for their employees as part of such policies (the Bank of Ireland offers up to 10 days), while much of the public sector is also on board, with the HSE, An Garda Síochána, and the civil service all having menopause policies or guidance documents in place.
Cork-based GP Dr Monica Oikeh points out that in 2023, Spain became the first country in the EU to legislate for paid menstrual leave. 'It's something the Government should take more seriously,' she says.
In terms of the workplace, she favours catch-all wellbeing policies over specific menstruation policies, as 'some people really don't want to talk about their period'.
She would like employees to have the right to work from home or take a day's leave, if they are experiencing debilitating period symptoms.
Trade union Fórsa, which in 2022 found that only 1% of surveyed employees had the protection of a menstrual health policy in their workplace, launched its #StopTheStigma campaign in 2023 to change the workplace conversation.
Dr Monica Oikeh favours catch-all wellbeing policies over specific menstruation policies, as 'some people really don't want to talk about their period'.
At Solvotrin Therapeutics, the makers of Active Iron, a wellbeing policy on menstruation evolved from surveys conducted for its Better Days Period campaign. Of those surveyed, the top three symptoms were 'cramps, fatigue, and mood swings', says head of marketing Claire Lynch.
'Over 80% said they just put up with [disruptive period symptoms]. When asked about work specifically, 18% said [menstrual symptoms] had stopped them from attending work at least once, and 41% of women suffering period symptoms were told not to worry and 'just get on with it'.'
The results prompted 'a focus internally to support the women in our business as well' and a wellbeing policy was adopted.
'If employees have pain or discomfort from their period or menopause, and it prevents them from performing their work duties, they can take leave, or if they feel like they don't want to come in that day, they can work remotely,' Lynch says.
Claire Lynch of Solvotrin Therapeutics: 'If employees have pain or discomfort from their period or menopause, and it prevents them from performing their work duties, they can take leave, or if they feel like they don't want to come in that day, they can work remotely."
A GP note isn't required, and discretion is in-built; employees can simply say, 'I want to use the policy today.' The leave isn't capped. 'We felt capping it would put a barrier there,' she says. 'The whole purpose of this [policy] is to avoid that period stigma and to break it down.'
The company also provides its employees with free, ethical, and eco-friendly period products, access to a period tracker app, and plans to introduce free webinar workshops, in addition to promoting workplace awareness around menstruation and menopause for all employees.
'The feedback has been really positive,' says Lynch.
ATU Sligo's Yvonne Kennedy is optimistic, too. 'I'm hoping we can start a movement.
'That was always my aim behind Period Promise. It's not just products, it's a movement for change.'
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