Periods: Psychological and Social Aspects

I remember my first period. Most girls do. I was 13 or 14 years old and it was a school day. I usually came from school to home alone. Bu that day my mother came to get me. When asked why, she said that, when she was doing laundry she found brownish red blood stains on my clothes and informed me about my periods. I was both scared and elated. I had heard horror stories of my classmates of how the flow was unstoppable and heavy. I was introduced to menstrual pad and instructed on how to wear and dispose it.

Periods change a woman’s life a lot more than people can think of. The change is not just biological; there are psychological and social implications as well. A whole new set of challenges, previously unknown to the girl comes on her face. Right from Pre Menstrual Syndrome, mood swings, painful cramps to a social hush-hush around periods.

In this article, I will try to tackle the issues surrounding periods with broad strokes on psychological issues and an emphasis on social issues

Psychological Issues:

Let’s try to understand the psychological changes one by one.

Pre Menstrual Syndrome
Premenstrual Dysphoric Disorder

Pre Menstrual Syndrome or PMS: Ever heard of the term PMS thrown around casually? An ‘angry’ and ‘nagging’ woman who puts her foot down to be heard is generally told “Are you PMSing? You need to calm down”. Just like the terms Depression and OCD are thrown around casually, PMS too suffers the same fate. We need to educate the masses that the psychological changes happening to a female in periods are not in her control. Similarly, if a woman is assertive, there is no need to invalidate her with a sexist remark to make her feel that she is a lesser being.

The term which has sexist implication is an actual medically proven issue suffered by women before their menstruation cycle. The changes are behavioral and physical in nature. The changes start around one or two weeks before menstruation cycle begins and resolves when the bleeding starts. Some prevailing symptoms are :

Depressed or depressive mood
Mood swings
Anger or irritability
Feeling sleepy
Food cravings
Feeling less energetic
Having acne
Feeling heavy or bloated
Breast tenderness
Muscular or joint pain
Headaches
Change in libido

Premenstrual Dysphoric Disorder or PMDD: PMDD is the extreme and impairing form of PMS. The symptoms found in PMS and PMDD are more or less the same. But while PMS is common (occurring in more than 50% of women), PMDD is not (occurring in 3 to 5 % of women). The intensity of the symptoms is so much that it impairs the woman and does not let her complete her normal tasks successfully.

Along with the PMS symptoms, some of the peculiar symptoms to distinguish the PMDD from PMS are:

Trouble in concentration
Hypersomnia or Insomnia
Radical changes in appetite
Decrease of interest in usual activities
Anxiety
Feeling overwhelmed

To give a concrete understanding, here is a table :

While PMS does not need doctor’s intervention, PMDD is solved by gynecologist. The gynecologist will usually ask the patient to keep a record of which symptoms are most frequent and how long do they last. This will help the doctor to form a pattern and treat the patient accordingly.

Some of the most common treatments medically done are:

Anti depressants such as Selective Serotonin Reuptake Inhibitors (SSRIs) to reduce during periods. Examples: Fluoxetine and Sertraline
Birth control pills to stop ovulation to reduce the symptoms of PMDD
Nutritional supplements such as magnesium, calcium or L-tryptophan
Changes in diet, regular exercise, meditation, mindfulness and an overall healthy lifestyle

Of course the below treatments are to be taken under medical supervision only.

Social Issues: I remember one day, sitting with my cousins in a circle at home. Me, two other females; one aged 17 and other 26 and a male cousin of age 15. We were talking about our day-to-day lives when I mentioned my menstrual cramps and how they bothered my office work. My older cousin looked around suspiciously for elder family members and made sure her brother was not listening. She gave a stern glance to me, giggled and shushed me for mentioning ‘periods’ out loud. As someone who comes from a home where my father never shied away to know more about menstruation, this felt like a glimpse of the phenomenon everyone was talking about: Shame around menstruation

Menstruation does not have an easy acceptance in our society. Even with our modernity and education, periods are mentioned in hushed tone and coded words such as ’that time of the month’. Menstruation is a part of woman’s life and is a natural biological function and nothing more than that. Yet, women are subjected to social and religious restrictions such as .:

Banishing women from kitchens as it is believed that their touch during periods spoil the food. Banishing women from temples and other religious places as they are considered ‘impure’ during their menstruation
Ostracization of women at homes. They are kept at separate living quarters with separate utensils to eat and clothes to wear. The things used in periods are not used in otherwise daily life.

In a survey done by Indian Journal of Community Health, it was found that restriction done most was on going to temple: 87.4 % and other restriction was on touching pickles: 48.6 % (Ruchi Juyal, Jayanti Semwal, S D Kandpal, 2013)

Besides these, women face a lot of challenges , especially in adolescent years. Some of the issues faced are:

Lack of awareness about menstrual hygiene
Lack of awareness of diseases such as vaginosis, yeast and Urinary Tract Infection
Usage of rags, ash, leaves, newspaper, hay or sand. The period stains are also a source of shame and embarrassment for many females
Lack of access to hygiene products and especially female hygiene products such as underwear, menstrual cups, menstrual pads, sanitary towels, soaps and pain medication. This situation is known as ‘period poverty’
Lack of education on how to manage menstrual waste. Most women in rural areas burn or bury their menstrual material used , depending on their cultural practice
Child marriage, sexual activity, early pregnancy or child birth done because the society believes a woman is ready for these activities after her first period
Girls remaining absent during days of menstruation or dropping out of school due to lack of access of female hygiene products
Discouragement of genital washing due to cultural restrictions
Practice of female genital mutilation to curb women’s sexuality, enhance the aesthetic of the genitals and control women as a group
A social taboo around using contraceptive methods by women since they affect menstrual cycle. This taboo comes from the belief that ‘only real women menstruate’

So what can be done about the taboo of menstruation? :

The first change starts with us. When we will accept periods as normal function without stern looks, hushed voices or giggles in social situations, the other person will at least try to learn and change their behavior
Schools need to sensitize the male gender about periods and teach them about periods with much-needed dignity and accuracy
In rural areas ,tribal areas and dalit areas, distribution of female hygiene products is to be done. Kindly check the this article for the grassroot work done by a man for tribal women: Efforts by 27-years old man leads tribal woman to leave unhealthy menstrual practices
Conversation about menstrual leave need to start in public and private workplaces to normalize periods and its effects on women
Women need to converse with their male relatives, friends and other counterparts about periods to end the silence on periods

While the government and world institutions too are trying their level best to end taboo around periods and also end the harmful activities done in periods, ultimately we as people need to stand up and start normalizing menstruation.