The article is written by Dr Vikas Abnave, Senior Researcher (YAG Pvt Ltd ), Ms Soumyashree Mohanty, Research Associate (CYDA)
Menstruation is a natural and essential aspect of female biology, yet in India, it continues to be enveloped in silence, misinformation, and taboo. According to a UNICEF report, nearly 71% of adolescent girls in the country are unaware of menstruation until their first period—an alarming statistic that reflects deep-rooted societal neglect of menstrual education. Despite being a universal experience, menstruation is often framed as impure or shameful, shaped by patriarchy, cultural myths, and restrictive gender norms.
This silence has far-reaching implications: it undermines health, reinforces stigma, limits opportunities, and denies young girls the right to understand and manage their own bodies with dignity. In an effort to uncover these layered issues, a mixed-methods study titled ‘Perception Towards Menstrual Health Management (MHM) Among Adolescent Girls and Women’ was conducted across five districts in Maharashtra—Pune, Nashik, Ahilyanagar, Chhatrapati Sambhajinagar, and Nagpur—engaging 143 respondents through survey.
This report presents key findings from the study, offering critical insights into awareness levels, emotional and physical challenges, hygiene practices, and the broader socio-cultural landscape surrounding menstruation. It also amplifies the voices of adolescent girls and women, whose lived experiences reveal both the progress made and the gaps that persist in menstrual health education and support. By focusing on these voices, the study aims to inform and inspire more inclusive, empathetic, and actionable approaches to menstrual health management in India.
The key findings of the research are summarized below:
Awareness and Knowledge about Menstruation
A significant 39.9% of participants in the study reported having no prior knowledge of menstruation before experiencing their first period, highlighting the critical absence of early menstrual education. This lack of preparedness not only fosters confusion and fear but also perpetuates a culture of silence and stigma surrounding a natural biological process.
When it comes to sources of information, the study found that 63.6% of respondents learned about menstruation from their mothers, while only 20.3% credited teachers or schools, and a mere 1.4% cited health workers or NGOs. These figures highlight a major gap in institutional responsibility and reveal the heavy dependence on familial knowledge, which may be limited or influenced by prevailing taboos.
Recognition of Menstruation as a Natural Biological Process
Encouragingly, many respondents expressed an understanding of menstruation as a natural and essential part of female development. Their words reflect a shift in perception:
“It’s a natural monthly process in females that needs proper care, hygiene, and more open conversations.”
This evolving awareness points to progress in challenging taboos and normalizing conversations around menstruation.
Persistent Stigma, Shame, and Embarrassment
Despite this progress, menstrual stigma remains deeply entrenched. 28.7% of participants admitted feeling shy while purchasing menstrual products, and 18.2% hesitated to discuss menstruation openly. Moreover, 51.8% either view menstruation as a taboo or are uncertain, reflecting ongoing societal discomfort.
Even though 72.7% of respondents rejected the belief that menstruation is impure, 11.9% still associated it with impurity, and 15.4% were unsure. These mixed perceptions reveal that misconceptions continue to affect how menstruation is understood and experienced. Respondents from the study mentioned:
“Laj watte (I feel shy).”
“It feels awkward when men are around.”
“I feel embarrassed and confused.”
Physical and Emotional Challenges
Menstruation is not solely a physical experience—it has profound emotional and psychological dimensions. Participants frequently described pain, discomfort, and mood fluctuations, including anxiety, irritability, and emotional sensitivity. These insights emphasize the importance of a holistic approach to menstrual health that includes mental and emotional well-being.
“Pain, cramps, mood swings, nausea, insomnia.”
“Now, for four days, my legs and stomach will hurt a lot.”
“Irritability, low mood, increased sensitivity and emotional outbursts.”
“Chidchida pan (irritability), mood swings.”
“Tension yeto (I feel tension).”
Social and Cultural Restrictions
Cultural taboos continue to restrict the mobility and participation of menstruating girls. While 71.3% of respondents rejected restrictions on daily activities during menstruation, 19.6% supported such practices, indicating the persistence of regressive norms in some households.
“At our house, we must sit in one corner and can’t touch anything.”
“Because of myths, menstruating girls are treated as untouchable.”
Menstrual Hygiene Practices and Product Usage
Most participants (72%) use disposable sanitary pads exclusively, while eco-friendly alternatives such as menstrual cups (2.1%) and reusable cloth pads (3.5%) remain underutilized, reflecting limited awareness or access to sustainable options.
Hygiene habits are strong—96.5% of respondents reported always washing hands before and after changing menstrual materials. However, disposal practices remain inadequate, with 51.7% disposing of used products in regular dustbins and only 32.2% using designated sanitary bins.
Alarmingly, 71.3% of respondents were unaware of how long it takes a sanitary pad to decompose, revealing a substantial knowledge gap around menstrual waste and environmental sustainability.
Regarding sources of MHM education, 42.0% received information through schools or colleges, 36.4% from family or friends, and just 16.1% through NGO-led awareness programs, showing the limited reach of formal campaigns.
Access and Institutional Support
Just 49.0% of respondents reported consistent access to clean, private spaces for menstrual management. The remaining 51.0% faced significant constraints that compromise dignity and hygiene. Additionally, while 49.7% received products or support in schools or workplaces, 35.0% did not, indicating institutional gaps that require urgent attention.
Affordability remains a barrier for 41.3% of participants, and only 48.3% felt that menstrual hygiene education in schools is adequately covered.
Moving Towards Empowerment and Inclusive Education
The study also found hopeful signs of change. An overwhelming 85.3% of respondents supported open discussions about menstruation, and 87.4% advocated for including boys and men in menstrual education to foster gender sensitivity and reduce stigma. Positive, empowered voices are beginning to emerge:
“It’s not a shameful thing, it’s a blessing for us (women).”
“When I hear the word menstruation, I think of strength, womanhood, and the power of nature.”
Conclusion and Suggestions: This study highlights the multifaceted nature of menstrual health perceptions among adolescent girls and women in Maharashtra. While there is growing recognition of menstruation as a natural process and a willingness to engage in open dialogue, deep-seated stigma, widespread misinformation, and infrastructural gaps continue to hinder progress. These challenges impact not only physical health but also emotional well-being, dignity, and gender equality. To move towards a more inclusive and empowering approach to menstrual health management, the following key actions are recommended:
Comprehensive menstrual education: Integrate early, inclusive, and accurate menstrual education into school curricula, addressing both biological and socio-cultural dimensions. Programs should actively engage girls, boys, and community members to break taboos and foster shared understanding.
Access to affordable and sustainable products: Ensure the availability of safe, affordable, and eco-friendly menstrual products, particularly in marginalized and rural areas. Promoting sustainable alternatives can also reduce the environmental impact of menstrual waste.
Improved sanitation infrastructure: Provide clean, private, and safe facilities for menstrual hygiene management in schools, workplaces, and public settings, recognizing that infrastructure is critical to ensuring dignity and participation.
Mental health support: Acknowledge the emotional and psychological aspects of menstruation by offering accessible counselling and support services, especially for adolescents navigating menstrual stigma, stress, and discomfort.
Coordinated community and institutional efforts: Encourage collaborative action among families, educators, healthcare providers, community-based organizations, and policymakers to design and implement holistic and effective menstrual health programs.
By addressing these interconnected needs through a rights-based, empathetic, and evidence-informed approach, we can create an environment where all menstruators are supported to manage their health with dignity, confidence, and care.
