Menstrual pad with red glitter on blue colored background

Let’s break silence on menstrual health

By Karuana Mwai
Imagine this – a young girl, only twelve years old, finds herself huddled in the corner of her room, tears streaming down her chubby cheeks.

Confusion and fear grip her heart as she discovers a big patch of blood on her school dress, accompanied by piercing abdominal pain.

She believes she is cursed or facing a deadly disease. Her mother walks in, but shame fills the room, making it impossible for her to open up. Little does she know that this is a natural and inevitable part of her journey into womanhood.

Fast forward to today, where Tarqueen Nyambura, at 27 years old, sits calmly in her two bedroom in Mwiki as she reflects on that unforgettable moment in her life. Her journey from that innocent naive girl to the empowered woman she is today has been a profound one, shaped not only by her personal experiences but also by the unyielding support of her parents. 

Menstruation, a natural and healthy process, affects more than half of the world’s population. Yet, for many girls, menstruation remains shrouded in myths, misconceptions and cultural taboos.

Formative studies in Kenya reveal that a mere 50 percent of girls openly discuss menstruation at home, while only 12 percent feel comfortable receiving such information from their mothers. 

The silence around menstruation keeps women and especially young girls from learning essential information about their bodies. Without proper education and preparation, girls may feel ashamed, confused, and may develop low self-esteem when they experience their first period.

‘I was scared and confused when I saw blood. I hadn’t learned about menstrual health in school or at home. The only thing that came to mind was the story of the woman who bled for 12 years in the Bible, which we had learned about in Sunday School. I thought I was cursed and would suffer the same fate,’ Nyambura reveals as she sips her tea.

Thankfully, Nyambura’s mother, a now retired doctor, came to her rescue. She took Nyambura to the bathroom for cleanup and compassionately showed her how to use a sanitary pad and even provided painkillers to alleviate the discomfort. 

Misinformation and mockery by boys

The next day, despite her parent’s reassurance that menstruation was a natural process and wouldn’t hinder her usual activities, Nyambura found herself mostly seated in class, consumed with fear of leakage. Although this didn’t occur, she knew it was a harsh reality for some students at school. 

Recalling distressing incidents, Nyambura shares, ‘I witnessed some of my classmates getting their periods in class and they were mocked by boys. It led to some girls dropping out of school or developing low self-esteem.’

Amid the challenges, groups of girls who had already started their periods found solace in discussing their experiences and sharing what they were learning. Nyambura remembers some prevailing myths, such as believing that sneezing would cause blood to gush out or that the odor of pads would be detectable by others. Thankfully, Nyambura’s parents cleared up such misinformation.

While some girls resorted to sharing used pads due to limited access, Nyambura knew better thanks to her parents’ guidance. She discouraged such practices, encouraging others to ask for unused pads when needed. 

Sharing pads, however, can be perilous, as research shows that approximately 12 percent of people living in Nairobi’s slums have HIV, compared to 5 percent of the general population.

To compound the issue, Menstrual Hygiene Day, a global advocacy platform, highlights that 65 percent of women and girls in Kenya cannot afford sanitary pads.

Reproductive health issues and infections

Nyambura’s menstrual cycles were constantly plagued by severe pain and prolonged heavy flow, sometimes lasting up to two weeks. Her struggles took a significant turn during her high school years when she received a life-changing diagnosis: Adenomyosis. 

This rare condition occurs when the uterine lining invades the muscular wall of the uterus, resulting in inflammation, pressure, and heightened pain and bleeding during periods.

Grateful for the unwavering support she received, Nyambura fondly remembers, ‘Thankfully, my parents were very supportive and nurturing. Even when I was at boarding school, my dad made the effort to check up on me. And whenever I was at home during my periods, my mother would prepare my favorite meal,’ she shares, a genuine smile gracing her face.

Delving into the broader significance of menstrual health, Milton Munala, a Public Health Officer and Clinician at Kenyatta University Teaching and Referral Hospital, emphasizes the vital role of hygiene during menstruation. 

‘Maintaining proper hygiene during periods is essential to prevent infections like yeast infections, bacterial vaginosis, and urinary tract infections, which can have long-term effects on a woman’s health,’ he cautions.

Munala stresses the need for parents to educate their children about menstrual hygiene. ‘Teaching your children the importance of changing sanitary napkins every 4 to 6 hours is not only necessary but crucial for their hygiene. If reusable items are used, thorough cleaning with warm water and proper drying is vital before reuse,’ he advises.

Regarding the severity of menstrual pain, Munala urges parents to take notice. 

‘As much as cramping is common, if the pain that your daughter is experiencing is so intense that it makes it hard for them to go about their daily life, you should speak to your health provider,’ he emphasizes.

Setting the table for menstrual conversations

Munala further advises parents to approach menstrual conversations with their daughters by first understanding their existing knowledge to correct misinformation and reinforce accurate information.

‘Start by asking your child what they already know about periods and how they feel about it. Have any of her friends had periods and discussed it? This will give you insight into your child’s understanding and help you start the conversation,’ Munala suggests.

Amidst growing concerns over teen pregnancies, HIV, and other STIs, Munala emphasizes the crucial role of parents in discussing the connection between menstruation and fertility with their children.

Insights from Kenya’s Ministry of Health (MOH) reveal a knowledge gap among Kenyan girls, with only 54 percent of girls aged 10 to 14 and 61 percent of girls aged 15 to 19 understanding that menstruation is connected to fertility. These findings imply that many girls are unaware of the potential to become pregnant during their menstrual cycle.

The same research reports that 1 in 10 male and female adolescents have engaged in sexual intercourse, further highlighting the necessity of sexual health education to address these challenges and empower young women to embrace their bodies and menstrual cycles confidently.

Additionally, a study conducted by the Center for Reproductive Rights and Trust for Indigenous Culture and Health reveals another disconcerting fact. Only 12 percent of girls aged 12 to 19 and 38 percent of women aged 21 to 30 possess sufficient knowledge about menstruation in Kenya.

Although the Kenyan government mandates puberty education in schools, the existing curriculum primarily focuses on biological changes, neglecting crucial aspects like hygienic pad usage and disposal, and psycho-social elements.

Back at Mwiki, Nyambura sits in her living room, grateful for her parents’ unwavering support in combating period stigma and equipping her with essential knowledge about managing menstrual health. 

‘Among the many things my parents did right, providing me with accurate and timely menstrual health information and shielding me from period stigma stands out. I don’t know how I would have done it without their guidance,’ Nyambura reflects, cherishing the empowerment she gained from their open conversations.

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