By Sade Oguntola
Daily, schoolgirls in low and middle-income countries discover blood on their clothing for the first time in school environments without toilets, water, or a supportive teacher, mentor or role model to help them understand the changes happening in their bodies. Yet, the physiological basis of menstruation, biological changes at puberty, the menstrual cycle, infection risks posed by poor practices, and the material disposal options available to girls are hardly ever discussed openly. The silence surrounding it burdens young girls by keeping them ignorant of this natural phenomenon. Even when adolescents seek information about menstruation, adults usually feel shy, uncomfortable, and reluctant to discuss it because of socio-cultural and religious misconceptions and prescriptions.
Due to this, girls are not adequately educated about what is happening to their bodies and how to stay healthy and maintain their self-esteem during menstruation Worst still, “culturally, limited discussions on menstrual and sexual related matters encourage the widespread dissemination of false information. This is worsened by girls seeking answers to their concerns from their peers and social media where they also encounter false information thereby making them vulnerable to unscrupulous elements in the society to prey on their innocence,” Dr Oyindamola Adeyemi, the president of Medical Women’s Association of Nigeria (MWAN), Oyo branch, said.
She spoke at the donation of books on adolescent health titled ‘What Adolescents are Asking about Menstruation” to four different secondary schools in Ibadan to mark the first anniversary of Dr Oyindamola Adeyemi-led MWAN Oyo State chapter executive. According to Dr. Adeyemi, ensuring that adolescents have access to valid information is important because they seek information about menstruation, and adults usually feel shy, uncomfortable and reluctant to discuss it because of socio-cultural and religious misconceptions and prescriptions.
She added: “due to this, girls are not adequately educated about what is happening to their bodies and how to stay healthy and maintain their self-esteem during menstruation. When mothers decide to provide information, they pass on cultural taboos and restrictions to be observed. Sometimes, all they are told is if they sit near a boy or allow a boy to touch them, they will get pregnant.” Ironically, the level of ignorance of this natural phenomenon is high.
In a study among adolescent girls in Nigeria, it was reported that only 33.8% of the girls knew that the range of a single menstrual cycle is from day one of menstruation to the beginning of the next menstruation and only 2.5% of the girls were aware that a normal menstrual cycle varies between 21 to 35 days. Although 56.5% of the adolescents in the study knew a woman could become pregnant when she engages in unprotected sex during a certain phase of her menstrual cycle, none knew that phase of the menstrual cycle. Most of the boys had heard about menstruation and had an idea about what menstruation is with most of them describing it as “the flow of blood through the vagina of a female.”
The boys revealed that terms such as “Red card” and “Palm oil” are used to describe menstruation in schools and within the community. The period of adolescence is particularly of concern because myths, taboos, socio-cultural restrictions and inaccurate information about menstruation ends up limiting their daily and routine activities, and have the potential to negatively affect their self-esteem, reproductive health and schooling.
For instance, in some cultures, it is taboo for women and girls to bath during their periods, touch a cow, or look in a mirror; they are excluded from water sources, food that others will eat or cooking activities, religious rituals, sanitation amenities and the family home.
Dr Tawakalitu Salam, a consultant family physician and general secretary of the MWAN Oyo state branch, stated that myths and taboos still abound on menstruation even though they have no scientific basis. “For instance, some say that the menstrual pain will not stop until the adolescent has her first intercourse. It is a misconception. Painful menses is common in adolescents and it is due to contractions in the womb. They can manage the pain by taking painkiller tablets. It is also a misconception that if a girl does not menstruate regularly something is wrong. There is a condition called oligomenorrhea, in which case the girl might miss her menses without being pregnant. It is common in the first and second year that their menses started. However, a missed menses that becomes regular needs to be reported to the doctor.”
Other beliefs, myths and misconceptions about menstruation include that menstrual blood is dirty or impure; you cannot get pregnant while menstruating and women have bad luck and must not be allowed to carry out some special obligations in such times, and everyone’s period is the same.
In a remark, Dr Omolara Smith said when girls do not menstruate, it is a problem for parents as in the future they might not be able to get pregnant and give birth to babies. She added: “Menstruation is something that one should be proud of; it is a problem for the parent if a girl does not menstruate because it is a sign of future fertility. So girls need to be proud of their bodies and what is happening in them, but always ensure that is done hygienically.”
However, she said barriers to menstrual hygiene such as inadequate water for washing, lack of soap, poor privacy, non-functioning or unclean toilets and no disposal facilities to support the hygienic management of menstruation in the school environment may prevent girls from attending school, particularly during their periods and must be tackled.