As a woman living with endometriosis, I have personally navigated the physical and emotional challenges of a condition often intertwined with societal stigma surrounding menstruation. My experience has shaped my academic interest in exploring how menstrual shame – an issue not only rooted in the bodily experience of menstruation but also deeply influenced by cultural and social norms – affects women’s everyday lives. In examining these dynamics, this piece aims to highlight how the social stigmatization of menstruation, influenced by patriarchal structures, reproduces feelings of shame (Bobel, 2010). The consequences of this are  explored here, including how shame limits open conversations on the topic, deters women from seeking help for health concerns, reduces sexual liberty, and leads to alienation from their own bodies.

Despite increasing awareness and advocacy for open dialogues about menstruation, the issue remains highly stigmatized in society (Costos et al, 2002). Taboos and misconceptions that date back centuries have led to perceptions of menstruation as being ‘unclean’, ‘impure’, and ‘off-putting’, which manipulate menstruators into feeling shameful and embarrassed (Amini, 2024). Menstrual taboos serve to isolate, exclude, and even ban women from public and private domains, preventing their full involvement in public life as well as in their own complete subjectivity (Wood, 2020). Menstrual blood is theorized as the marker of shame which some people believe is more disgusting than other bodily fluids.  Symbols or reminders of blood, such as tampons, seem to make people uncomfortable and lead them to distance themselves from menstrual bodies. Just the idea of menstruation alone is enough to lead people to alienate others from social spaces (Johnston-Robledo and Chrisler, 2020).

As a result of menstrual stigma, adolescent women engage in highly planned and measured actions to conceal, disguise, and regulate their menstruation, both physically and verbally (Jackson and Falmagne, 2013). The taboo limits the extent to which women feel comfortable talking about their menstrual cycles and discussions exist only in private, within a context that depicts menstruation as a health or hygiene problem that must be solved (Kissling, 2006). Women living with more serious conditions like endometriosis are often labelled “menstrual moaners” when voicing their concerns and are led to feel dramatic when they voice concerns of their pain and suffering (Winkler et al, 2020: p. 272). Period talk is typically humorous, and many people resort to using euphemisms or impersonal pronouns to avoid feeling shameful when discussing the topic (Bobel, 2019). By internalizing these negative discourses stressing that menstruation should be clandestine, women are deprived of social connections with one another.

Shame experienced as a consequence of menstrual stigma contributes to gendered health inequalities. Menstrual stigma creates barriers to medical care and awareness, perpetuating cycles of medical misogyny, delayed diagnoses and treatment, and preventable suffering (Endometriosis UK, 2023; Winkler et al, 2020). Historically, medical practitioners believed that menstruation was linked with insanity, and women should be gynecologically examined before being admitted to asylums, as the womb could reveal the cause for mental health issues. Medical discourses serve to pathologize female bodies, which further stigmatizes them by placing them as subordinate to male bodies (Sitar, 2017). The incessant perpetuation of taboos and stigma regarding menstruation leads to pain relating to more serious health issues, such as endometriosis, being dismissed as normal either by the menstruator or medical professional (Winkler et al, 2020). The ongoing journey to my diagnosis has been long and painful, from being told during puberty that being in debilitating pain during my period was something normal that I would eventually grow out of, to male doctors trying to convince me getting pregnant would solve all my problems – despite this not being what I want. Research has shown that 62% of women would avoid visiting their doctor with symptoms of endometriosis due to feelings of shame and thinking that they would not be taken seriously (Endometriosis UK, 2017). Endometriosis is linked to reduced quality of life, due to the adverse impacts on education, employment, social wellbeing, childbearing capabilities and relationship outcomes (De Graaf et al, 2013). People who suffer with endometriosis frequently face prejudice, gaslighting, misdiagnosis, negligence, and medical misogyny, leading them to internalize these negative attitudes towards their bodies and exclude themselves from social spaces due to shame (Winkler et al, 2020).

Furthermore, the sense of alienation experienced through menstrual shame is linked to lower levels of sexual activity and higher levels of sexual risk. Women report that sex education in school delivers stigmatizing messages that lead them to feel too ashamed to engage in sexual activity during their period. The negative connotations of period sex often reflect onto women’s perceptions of their own bodies, leading them to believe it is disgusting or shameful to menstruate (Gunning et al, 2019; Schooler et al, 2005). A survey conducted by Bodyform (2023) revealed that 28.8% of respondents thought having sex when either themselves or their partner were menstruating was “disgusting”, and a further 44.73% of respondents would not be happy to do so. Such ideas are consistent with prevalent discourses surrounding female sexuality, which characterise women’s bodies as objects of male desire rather than locations of personal pleasure. Women are not generally considered to have their own sexual needs, let alone assert them (Schooler et al, 2005). Additionally, women living with endometriosis find that the condition impacts their relationships, not only because of the difficulties navigating daily symptoms, but due to painful intercourse causing a lack of pleasure and satisfaction, limiting sexual activity and even causing them to avoid it completely (Bien et al, 2020). Research suggests that the complexities of living with endometriosis makes it difficult to maintain healthy relationships and can lead to divorce (De Graaf et al, 2013).

Menstrual stigma is manifested through various social norms that strengthen patriarchal control over women’s bodies and reinforce their subordinate position (Bobel, 2010). Taboos that portray menstruation as impure, unclean, and shameful exclude women who menstruate from participating in various aspects of their social and sexual lives (Amini, 2024). Menstruation is a natural occurrence, but the stigma surrounding it prevents people from admitting, discussing, or displaying it (Schooler et al, 2005). This has consequences for women’s health, as symptoms of endometriosis are often ignored or dismissed, with little consideration for the way they affect women’s social, educational, professional, sexual and romantic lives.

In this piece I have highlighted how menstrual shame leads to negative bodily experiences, impacts women’s health and sexual relationships, and silences women’s lived experiences of everyday life.  In doing so, I hope readers will reflect on their own experiences and encourage a different, more-informed, way of thinking about menstruation.

This article was published during Endometriosis Awareness Month in the hope of shedding light on the condition and the lived realities of those affected.

References

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