28-05-2025
Beyond the whispers: Why menstruation needs to be everyone's business
'When we were young, our mother would buy sanitary pads for us; sometimes our father would also buy them for us. Now we buy pads for ourselves; sometimes our husbands get them for us. We don't have any problem in asking our husbands to buy pads for us. We don't buy pads ourselves because we feel shy to ask the shopkeeper. There are mostly men at the shops —that is the reason we feel shy to ask them.' - Woman in Telangana, participant in the PEnMen-pilot study
The PEnMen-pilot study was conducted by The George Institute for Global Health, India to understand perceptions and practices related to menstrual hygiene and the environment around it. This quote echoes a sentiment that is familiar across many parts of India: While men—be they fathers, husbands, brothers, or even sons—are often the ones buying menstrual products, why is the topic of menstruation still wrapped in silence? Girls and women often feel too shy to buy sanitary pads themselves, especially when male shopkeepers are involved. Many of the stores selling menstrual hygiene products are owned and operated by men. Yet, menstruation is a subject largely confined to women and young girls, spoken about in whispers or euphemisms, and rarely acknowledged in public spaces or family conversations.
This contradiction points to a deeper cultural issue. At individual, family, as well as community levels, the awareness and understanding of menstruation—particularly among men and boys—remain limited, thus restricting the spaces for women to openly share their experiences, concerns and specific needs during menstruation, and denying men the opportunity to contribute to the health and well-being of their female associates. Owing to this, the physical discomfort, emotional toll, and practical challenges women face during menstruation are often ignored or minimised. Painful periods, hormonal changes, lack of privacy, and inadequate water and sanitation facilities are real struggles that rarely find space in mainstream conversations.
Progress made thus far
India has made significant progress in menstrual health and hygiene management over the last decade. Awareness campaigns, product innovations, and government initiatives have led to increased access and visibility.
Many civil society organisations and social enterprises in India are now playing a vital role in promoting menstrual health by challenging stigma, improving access to products, and raising awareness. Goonj reframes menstruation as a dignity issue, distributing reusable pads through its 'Not Just a Piece of Cloth' initiative. Boondh promotes sustainable products like menstrual cups with education programs, while Good Universe runs awareness workshops engaging both women and men. Others like Menstrupedia, Eco Femme, Aakar Innovations, and Sachhi Saheli use innovative tools—from comics to eco-friendly pads and school campaigns—to normalise conversations and ensure access. Together, they are helping build more informed, inclusive, and empowered communities around menstrual health.
Government agencies and international partners have launched several initiatives to promote menstrual health and hygiene in India. UNESCO India's #SpotlightRed campaign developed age-appropriate teaching and learning modules on menstrual hygiene management for adolescents, aiming to break taboos through education. The #KeepGirlsInSchool campaign, focused on improving access to menstrual products and creating supportive school environments to reduce dropout rates among adolescent girls. Similarly, the Youngistaan Foundation, in partnership with UNICEF India, has led community outreach programmes engaging youth and promoting awareness through on-ground and digital platforms.
Efforts at the policy level with the Operational Guidelines for promoting menstrual hygiene among adolescents by the National Health Mission, and the National Menstrual Hygiene Policy opened for public comments in November 2023, also point towards a positive shift in this direction.
The problem of period poverty
This progress however, remains uneven. While these campaigns, initiatives, and efforts have increased visibility and initiated important conversations, their reach remains uneven, particularly in rural and marginalised communities.
The National Family Health Survey-5 (NFHS-5) in 2019-21 showed ~20 percent increase in the use of hygienic menstrual products from 58 percent in NFHS-4. However, period poverty is still found to be significant amongst girls and women from low socioeconomic status contexts. Many still face barriers in accessing safe, affordable, and sustainable menstrual products, especially in rural and low-income urban areas. Stigma, cultural taboos, and misinformation continue to affect how menstruation is perceived and experienced. These perceptions can lead to exclusion from daily activities, limit school attendance, and reduce confidence and self-esteem among those who menstruate. Families may impose restrictions, and communities often lack the infrastructure or education to support healthy menstrual practices. Further, increased awareness amongst adolescent girls and women does not directly translate into agency to make informed decisions about hygienic menstrual products and practices, in the absence of supportive families and communities.
Schools 'teach' it, but don't talk about it
Even in educational settings, where menstruation is part of the curriculum, open conversations around menstruation are not promoted amongst boys and girls. The presence of a chapter on the female reproductive system and menstruation within textbooks does not guarantee classroom discussion of menstruation. And even if there are class sessions on menstruation, they may not translate into real, respectful conversations in classrooms or school campuses. Teachers and other school officials consider it a girls' issue and often try to avoid discussing these details in an open forum. Prior studies from India also suggest the importance of addressing gender- and context-specific communication experiences among adolescents in India's patriarchal society. Limited information, with existing communication gaps, result in inequities in adolescents' menstrual health, and consequently, long-term disparities in their reproductive health outcomes later in life. Knowledge alone is not enough if the culture continues to suppress dialogue.
Also Read: Women in red: On an optimum menstrual hygiene policy
Men must be part of the conversation
A crucial yet often overlooked aspect of menstrual health is the role of men not only as decision-makers and sponsors of purchases in families, but also as supportive family and community members. In many households, male family members are the ones purchasing pads and also allocating the budget for such products, along with investments in water and sanitation facilities. This positions them as key decision-making stakeholders within the household, shaping the attitudes and culture at home, yet they are often uninformed about the products they're buying—the toxic materials being used in manufacturing the sanitary pads, challenges related to disposal, the basic hygiene facilities needed for adopting safe menstrual practices, and their implications on the health of women as well as the environment.
It is equally important for men to understand these nuances, not just to support better purchasing decisions, but also to uphold women's autonomy to choose the most comfortable and safe menstrual products for their bodies, which are also environment-friendly. Studies have shown that engaging with boys from early ages, in sensitising them and breaking the myths around menstruation has a positive shift in their knowledge, attitudes, and perceptions towards puberty and menstruation.
Moving forward: normalise, educate, include
To truly advance menstrual health and hygiene in India, we must normalise conversations across genders and generations. Menstruation is not just a 'women's issue'—it is a public health matter, a social justice concern, and a human rights issue. Menstrual health education must extend beyond schools. Educating boys and men; sensitising families and communities; empowering girls to speak up and exercise their agency; and creating inclusive spaces for discussion are all essential and need to be done together.
Breaking the silence starts at home! It is in everyday conversations, at schools, in markets, in policymaking spaces, and in community meetings. When men and women can talk freely and respectfully about menstruation, we move one step closer to a society that upholds dignity, equality, and well-being for all.
(Dr. Sudha Kallakuri is Senior Research Fellow, The George Institute for Global Health India. Email: skallakuri1@ Dr. Deepika Saluja is Thought Leadership Advisor & Program Manager, Ubuntu Initiative for Building Partnerships in Africa, The George Institute for Global Health India. Email: dsaluja@ Dr. Josyula K. Lakshmi is Professor, Indian Institute of Public Health, Hyderabad. Email: jklakshmi@
