Blog of the Society for Menstrual Cycle Research

Period Politics and Menstrual Social Activism

October 5th, 2015 by Editor

Guest Post by Margaret L. Stubbs

Menstruation Matters…Period! This phrase has become a rallying point for many advocates who seek to understand and improve menstrual life for girls and women. Advocates world-wide are concerned with access to menstrual supplies, especially in time of natural disasters like the recent earthquake in Nepal. Some focus on the need to improve basic sanitation in support of menstrual hygiene. Others focus on access to supplies for underserved women, for example, those who are homeless or incarcerated.  Some focus on product safety; some focus on the impact of product disposal on the environment, others promote alternative products like menstrual cups, or reusable pads.

All through October at re: Cycling, we’ll feature social and political activism around a range of menstrual issues. But, in a call-back to #MenarcheMonthre: Cycling’s September focus, for these efforts to succeed, menstrual education should highlight, early and often, the central place that menstruation holds in girls’ and women’s well-being, broadly considered.

Unfortunately, public menstrual education for our pre-menarcheal and newly-cycling girls is currently inadequate and in need of an update. We applaud those who are trying to remove menstrual stigma from product advertising, educational materials, and the social sphere. But stigma, along with a catalog of associated menstrual woes that can be expected, is still too often represented to our youngest girls.






After reviewing a plethora of books for young girls and a few websites on the topic, I gathered my observations into the paper Current Menstrual Education Resources: Still Room for Improvement, Stubbs, M.L. (2013, June) presented at the 20th Biennial Conference of the Society for Menstrual Cycle Research, New York, NY. They included the following:

  • Puberty is described as problematic, a period of being out of control.
  • Hormones are in control. (Subtext: you’re not).
  • Mixed messages abound and are confusing: e.g.,
    • Expect to feel weird. It’s normal!
    • Symptoms (e.g., feeling a little sick, tired, irritable; having sore breasts, cramps) are normal, but don’t let them ruin your day.

Long overdue is a shift to presenting menstruation as a vital sign of women’s health, and a normal part of girls’ and women’s lives, as well as an accurate, but not alarming, girl-centered approach to talking about what’s normal and what’s not. This clearly exists in the biomedical literature on the topic: Menstruation in adolescents: What’s normal, what’s not. Annals of New York Academy of Science, 1135, 29-35, Hilliard, P. J. A. (2008). How about including some positive information about pubertal growth? And maybe some references to historical research about origin myths, and rituals or celebration that took place to celebrate menstruation? Can we reference women’s accomplishment, even while menstruating?

While we wait for public menstrual health education to catch up, advocates are out there taking on the challenge. Individuals like Kylie Matthews, known as @AuntFlo_28 on Twitter, regularly asks the question: How can I help you? and invites her 2000+ followers to share their best period advice. Suzan Hutchinson at Period Wise is committed to breaking the menstrual taboo by empowering girls and women to be more open and knowledgable about menstruation. Be Prepared Period offers online resources for parents, women and girls, helping all to prepare for positive menstrual experiences.

Menstrupedia, a site originating in India that offers a a “friendly guide to healthy periods,” is also a good example of what can be done to promote a more positive context for girls entering menstrual life.

Let’s embrace the spirit of all the menstrual social activists and inspire others to work for the enhancement of menstrual health and awareness.


Margaret L. (Peggy) Stubbs is a professor of psychology at Chatham University in Pittsburg, PA, and a member of re: Cycling’s editorial board. Her areas of expertise include psychosocial aspects of menstruation; attitudes towards menstruation, pubertal development; and menstrual education throughout the lifespan. 

Menarche on Degrassi: The Next Generation – Emma’s Dilemma

September 30th, 2015 by David Linton

Emma and Manny from Degrassi: The Next Generation

Menarche month began at re: Cycling with reference to the brilliant first period talk Roseanne gave her daughter Darlene in a 1989 episode of Roseanne. We’ve chosen to end it with another TV reference from the beloved Canadian series of series named for the fictional street near which it is set–Degrassi. 

The word “menarche” is commonly defined with reference to the biological changes that occur within a female’s reproductive system at the point when the menstrual cycle begins to function. However, the onset of menstruation is also a social occurrence that has been layered with significance in every culture and time. In contemporary societies with “advanced” media of communication, menarche has been depicted in a wide variety of ways, sometimes reflecting prevailing taboos and superstitions, and at others in ways that are informative or even liberating. The focus is often on what I have labeled “menstrual transactions,” that is, the way interactions with other individuals, frequently boys or men, structure the meaning of menstruation for both the girl and others in her surroundings. This post explores one example of how this transitional moment in a girl’s life has been represented in a broadcast television series.


Emma’s Dilemma

One of the most positive and explicit portrayals of a girl’s first period appeared in the popular Canadian series directed at a young audience, DeGrassi: The Next Generation. Emma, the main character in the series, a girl known for her activism and responsible behavior, gets her period while sitting outside of school talking to her best friend. She is wearing a light-colored skirt and in several shots a bright red stain is visible on the back. On this particular day Emma and her friend, Manny, are scheduled to give an oral book report in front of their class and the only thing they can find for Emma to wear is a pair of gym shorts that are much too large for her. As they give the report, two young boys sitting in the front row tease her for her baggy shorts asking, “Has Emma peed her pants?”  She silences and stuns them by frankly responding, “No, I just got my period, for the first time.” They shrink in their seats. However, a somewhat more mature boy sitting in the back of the room, one who Emma has a flirtation with, is aroused from his torpor to a state of interest and appreciation for her courage as well as her implicit sexuality.

The DeGrassi clip demonstrates a rich variety of menstrual transactions. Emma’s close girlfriend comes to her rescue and even another girl, who is normally antagonistic toward Emma, gives her a pad and some “womanly” advice. Menstrual needs supersede social competition or status differences–a classic case of menstrual bonding. Perhaps most interesting is the behavior of the boys. The two young kids who tease Emma are silenced and stunned by her blunt assertion. I think of this as an effective use of her WMD–her Weapon of Menstrual Destruction. In contrast, the more mature boy, appreciates her for her assertiveness.

Missing from the four-minute clip of the transaction described above is an earlier scene in which Emma and her mother are seen walking through a shopping mall eating ice cream cones where a leering man says as they pass, “Hmmm, I’d like to lick that.” Emma shrinks away but her mother turns and confronts the man saying, “Don’t you ever talk to a woman that way!” The scene acts as a role modeling moment for Emma who replicates it in her response to the teasing boys.

Unfortunately, not all TV menarche moments are this positive. But let’s hope for more first period talks from moms like Roseanne and more socially significant, self-structured menstrual experiences from girls like Emma.

David Linton is an Emeritus Professor at Marymount Manhattan College. He is also Editor of the SMCR Newsletter and a member of the re: Cycling editorial board. His research focus is on media representations of the menstrual cycle as well as how women and men relate to one another around the presence of menstruation.

Menarche and the Growing Up of Menstrual Cycles and Ovulation

September 28th, 2015 by Editor

Guest Post by Dr. Jerilynn C. Prior, UBC, Centre for Menstrual Cycle and Ovulation Research

16-year-old Jody is anxious to talk to someone. This is what she wants to say:

“My period is out of whack!  I never know when it is coming. I only get it a few times a year. . . . Is that normal?”

To answer Jody we need to ask her how old she was when her period started. In asking that we’re trying to figure out how far she is into the normal process that our cycles must go through before they are fully mature. What she describes is perfectly natural for the first year after menarche. But if her period came when she was 11 (meaning she has a gynecological age of 5), she’s experiencing something that needs careful consideration. In this post, as someone who has studied menstrual cycles for at least 30 years  and who cares deeply that all girls mature into normally menstruating and ovulating women, I’ll ask the questions that Jody might ask, and answer as honestly as the evidence allows.

Menarche is a marker of our entry into womanhood. But it is not the start of our reproductive maturation. It is rather one lone step on a reproduction growing up pathway that has been going on for several years already. If you are a mother/grandmother with a preteen child you will one day become aware that her/his sweat is now strong and smelly, like a hot and bothered adult. Or that there is longer, darker hair on his/her arms and legs. These changes are officially called “adrenarche” and are evidence that the sex-hormone-producing layers of the adrenal glands (that also make the stress hormone, cortisol, a salt-retaining hormone and sympathetic nervous system hormones epinephrine and norepinephrine) are now growing up and making male-type hormones.

“What’s a  normal age to start your period?”

Jody got her first period a few months before she turned 16. All her friends (at least those who didn’t keep it a secret) had gotten their periods long before then. Her parents had divorced when she was 12, she was upset because she was close to her dad and rarely saw him anymore.   

In well-nourished girls and young women the first period occurs between the ages of 10 and 14 with an average in North America of about 12.5 years. The average age at menarche is now a year or two younger than it was about 50 years ago, perhaps because of better nutrition and health care. If a girl is 14 and has no flow, this is normal if she is showing some breast development. Getting first flow after age 16 is not normal and is associated with later life risks for fragility fracture (breaking a bone with a fall from standing height). This is usually caused by stresses and is something from which she can totally recover called hypothalamic amenorrhea. Rarely is it something genetic or a disease but rather a protective response because of stress of several kinds—emotional/social, nutritional, illness or over-exercise, and often a combination of several.

We now know that Jody has hypothalamic delay of her menarche.

“What’s normal for cycles in the first year after your period starts?” 

I would like to tell you that we’ve carefully studied large random groups of girls through their first year after menarche from whole populations. However, that would be untrue. One Swiss physician and his wife collected information from hundreds of girls and women with some of them recording from their first flow until menopause. Here’s what they found in that first year: cycles were quite far apart (about 40-50 days on average), quite irregular and unpredictable (R. Vollman, 1997). In a random population study of about 300 teens ages 15-19 from Copenhagen County in Denmark, 77% said their cycles were regular (between 21 and 35 days apart), 22% said they were irregular, and 2 of 100 had not yet reached menarche or were experiencing amenorrhea (Munster, 1992).

“Will I ever be able to have children?”

Obviously, to become pregnant and to carry a pregnancy to a normal childbirth, requires a grown-up reproductive system. The key part of that is ovulating, releasing an egg that could be fertilized, embed into the endometrium and eventually make a placenta and the very complex blood vessel system required for a healthy baby. So what’s normal for ovulation in the first year after menarche? Susan Barr (professor of nutrition at the University of British Columbia) and I studied girls ages 9 to 11 who had not yet menstruated over two years (Barr 2001). During that time some of them got their period. When they did, we asked them to collect morning saliva one day a week and especially during the third and fourth weeks from their flow. We measured progesterone in saliva and discovered that none seemed to have ovulated until 10 months from menarche (Kalyan, 2007).

Vollman, in studying young women from after their first menstruation, found that fewer than four of any 10 cycles showed evidence of ovulation during that first year (Vollman, 1977). That rare ovulation, however, was unlikely to support a pregnancy based on a Canadian study of exercising teens ages 15-19 and averaging 2.5 years after menarche. It showed that these young women might have regular cycles and that they often ovulated, but that the luteal phase (the length of the time after ovulation until flow) was very short (Bonen 1981). It takes many days for progesterone, produced during the luteal phase, to transform the endometrial uterine lining into something secretory that supports a fertilized egg. If the adult and fertile luteal phase length is 10-16 days, as evidence suggests, these teens experienced luteal lengths of 4-8 days (Bonen, 1981) that would not be fertile.

What happens when a seven-year-old gets her period?

September 24th, 2015 by Editor

Guest Post by Suzan Hutchinson

Do you remember being seven years old? Engage your imagination for a few minutes and try re-entering your seven-year-old world. Remember what fun life was. Recall what grade you were in, and what you enjoyed about school. Reconnect with your friends and with a few special memories.

Photo provided by Suzan Hutchinson

Menarche is not a word in a seven-year-old’s vocabulary, but there are girls who experience their first menstrual periods at age seven or even younger as a result of precocious puberty. Leaving aside the multiple medical causes of such early onset, let’s focus on how this pubertal milestone differs for those among us who experience precocious puberty. While no two experiences are identical, some of the common realities include:

  • Discovering blood on your underclothing or on toilet paper, then, at best, not being able to figure out why you are bleeding since you did not cut or hurt yourself, or, at worst, being scared you are bleeding to death
  • Having adults treat you differently from your peers, sometimes because they know you are menstruating, other times because they expect you to be able to do things a much older child would do because physically your body appears older than its chronological age
  • Learning new hygiene habits, like how to wear, change, and dispose of pads (nearly all girls who start this young begin exclusively with pads or a combination of pads and liners)
  • Navigating a world that doesn’t account for seven-year-olds who are menstruating, including schools that don’t accommodate children who might need to carry purses or other items into the bathroom, or provide bins in bathroom stalls for disposing of used products
  • Feeling isolated and alone with parents and other adults constantly telling you what to do, when, and how, while also being reminded that it is private and that you cannot tell your friends about your bleeding

This is challenging enough, but it is only the tip of an iceberg. While there are some helpful resources for parents to help their daughters with these practical issues related to menstruation, there are no easy answers to managing the moodiness or easing the emotional edges while dealing with other hormonally driven changes.

Because of these and other challenges, some families choose medical intervention to halt pubertal progression and suppress menstruation until their daughter is older. This response is also the default with preschool-aged girls and an option for any girl who is diagnosed with precocious puberty.

For those families that do not intervene, menarche will be her first of many childhood menstrual periods. In most cases these girls menstruate for several years before they can comfortably confide in peers who are then experiencing their own menarches.

Whether or not your family is ever directly impacted by precocious puberty, it is important that you have a general awareness. Here are some key facts about menarche in the United States:

  • For girls, puberty starts well before menarche. For most girls the onset of puberty is first evidenced by the development of breast buds (pubic hair appears first for the rest). If your daughter has breast buds before age seven, pubic hair before age eight, or menarche before age 10, then it is worth discussing this early development with her pediatrician and, quite likely, she receive a referral to a pediatric endocrinologist for further evaluation.
  • It is also important to know that normal puberty starts in girls at a younger age than most parents expect. Today, more than 1 in 7 (15%) American girls start puberty at age seven, and that number climbs to more than 1 in 4 (28%) by age eight. And while the average age of pubertal onset continues a decades-long decline, the average age for menarche has been much more stable. Today the average African-American girl will start puberty at age eight years, nine months; the average Hispanic girl at age nine years, three months; and the average Asian American or Caucasian girl at nine years eight months. Among all girls, the average age for menarche is now around 12 years, six months.

Do you remember much about second grade? Whatever you remember, remember that girls with precocious puberty often have some rather grown-up memories by the time they are in the second grade.

Suzan Hutchinson, a menstrual educator, coach and activist, is the founder of Period Wise. She works for Lunette and has held multiple volunteer roles with the Toxic Shock Syndrome Awareness non-profit organization You ARE Loved. Follow Suzan on Twitter @periodwise and like PeriodWise on Facebook.

How do mothers pass on knowledge about menstruation to their daughters?

September 21st, 2015 by Editor

Guest Post by Sheryl Mendlinger, PhD

The impetus of my research on menstruation started many years ago when my daughter Yael was in her teens in the 1990s, and came home from school and told me that her friends said, “If you use tampons you could lose your virginity.” Therefore, none of them were using tampons. We lived in a diverse community and many of her friends’ parents had immigrated from North Africa, Iraq and Europe to Israel. I started thinking that what we learn from our mothers, especially about menstruation, can impact our lives in so many ways. Years later when I chose my topic for my PhD, I examined mother-daughter dyads from North Africa, Ethiopia, Europe, North America, the Former Soviet Union, and Israeli born, in order to better understand how mothers transmit knowledge about health behaviors, specifically about  menstruation, to their daughters.

Photo of a menstrual hut provided by Sheryl Mendlinger

A model of knowledge acquisition for learning about menstruation was developed that included:

  • Traditional knowledge—informal knowledge passed through the generations
  • Embodied knowledge—observing others or experiencing oneself
  • Technical knowledge—the products used, and
  • Authoritative knowledge—learning from books, professionals, etc.

One of the most interesting aspects of this research is the stories the women shared about their menarche experiences. Certain celebrations that have continued through the generations may give either a positive or negative valence to the way women view menstruation. Traditional knowledge and rituals often provide strong emotional support for daughters allowing a comfortable transition through this key developmental stage. Several women whose origins were from Europe spoke about “the slap.” One mother told the story that when she got her first period her mother slapped her across the face, which she did to both of her daughters. The mother said the reason was something about the blood coming back and the daughter said it was something about the blood not going to your mind. The actual historical reasons for the slap vary and include: the manner in which it was performed could determine the duration of menstruation; it was necessary for a girl when she becomes a woman as protection against disgrace; and the rush of blood will make the girl have a wonderful color of her life. Often the rituals continue, but the rationale for the tradition has been lost.

The older Ethiopian women talked about their experiences at menarche which included special foods that their mother’s prepared, and then the young girl would go to the menstruation hut where she would stay until the completion of her period and be pampered by other women of the community. Women often looked forward to that time as a fun week away from chores and a brief vacation from everyday life, and a time to be with their women friends. As one woman said “In Ethiopia there is no rest until you go to the hut; only during menstruation does the woman rest.” The mothers however did not continue these traditions, even preparing special foods, following immigration to Israel.

The older women born in North Africa spoke with joy and excitement when they reminisced about getting their periods for the first time and the celebrations that surrounded this event. Their mothers were an integral part of this transition in life from child to woman. Some of the traditions included: mothers giving their daughters pieces of jewelry and preparing special foods; performing the ritual of putting three of the daughters’ fingers in flour so that they should only get their period for three days; and the oil ceremony. Mothers told their daughters to look and smile at their reflection in a bowl of olive oil, and then their faces were rubbed with oil. These girls were told that the image they saw on that day should continue and they should enjoy a happy life. The women noted that the oil would smooth a woman’s passage into womanhood. This oil ceremony was accompanied by a festive meal with traditional foods including honey-dipped, oil-fried cakes. When these women, the elders, were asked if they continued this tradition with their daughters, they all answered an emphatic no, of course not.

These special traditions and ceremonies that were so important from the past were often not continued into the next generation. It appears that the change and adaptation to the new culture and environment took precedence and provides an explanation for why these mothers did not continue these traditions with their daughters.

Recently however, there has been a movement to find positive and meaningful ways for young adolescent girls to celebrate the onset of menstruation in the western modern society. In my study there was an example of the daughter of an American immigrant who grew up on a Kibbutz, an agricultural collective community in which children grow up together in children’s homes.  She spoke with enthusiasm, excitement and had positive memories when remembering how each time a girl in her age group got their period, they would celebrate with gifts. These celebrations took place together with the girls in their age cohort rather than with their mothers.

Through this research we gained a better understanding of the influences and attitudes related to menarche that a mother passes on to her daughter, and the changes that take place following immigration and acculturation to the new society.

The 1970s and the Menstrual Dance: Naturally … a Girl

September 10th, 2015 by Saniya Lee Ghanoui

“Menstruation is just one routine step in a normal and natural cycle that is going on continuously in the body,” says the female narrator of the 1946 film by Walt Disney called The Story of Menstruation. “There’s nothing strange nor mysterious about menstruation. All life is built on cycles, and the menstrual cycle is one normal and natural part of nature’s eternal plan for passing on the gift of life.” That film is believed to be the first in the United States to discuss openly the female body and the process of menstruation, including the first film to use the word vagina. In this blog I will focus on one particular menstrual education film, Naturally … a Girl, to explore how it differed from previous other prominent films.

Naturally … a Girl, released in 1973 and produced by the Personal Products Company (Modess—the same makers involved in Molly Grows Up), presents a playful, colorful, and a new technique not seen in menstrual education films before: the interview.  While an authority figure is present throughout the thirteen minute film, she only performs as a guide to keep structure in the film and provide the basic biological information. It is the numerous interviews—with racially diverse girls from pre-period to those menstruating for over six years—that execute the reliability factor so important in advertising.

Throughout the film young girls are shown dancing in brightly-colored tights and leotards against a black screen. Sometimes there is a single girl dancing and other times there is a group of young women, and in all instances the dancing creates a sense of voyeurism that the girls are there to perform for the audience’s eye—whether they know the audience is watching or not is never fully revealed. The girls are all said to be twelve years old and are in varying stages of physical development. Some still possess the more square shape of a young child while others have fuller breasts and wider hips. The camera is above the girls and looks down as they lie on the black background, thus giving the viewer a shot of the girls’ entire bodies. The allure of this shot is created through a sense of scopophilic eroticism at the girls as the audience voyeuristically gazes at them moving their bodies in a tight space and close to each other.

As with the menstrual education films before it, Naturally … a Girl has an omnipresent authority figure who works as a narrator and makes an appearance at the end of the film noting how lucky she feels to be a woman. Employing montages the film narrativized the notion that all girls are different yet experience the same problems and concerns growing up. Doing so deletes the need to break the fourth wall, as with Molly Grows Up and As Boys Grow, since the numerous faces and distinctive interviews form a feeling of relatability by difference. While this creates a viewer interest it does not necessarily promote any involvement on the part of the audience. To solve this the film utilizes questions throughout; basically the film functions as a pop quiz for the audience members by asking them questions, often with multiple choice answers, and a brief moment to answer.

Overall, though, the film better encapsulates women as multifaceted beings than its predecessors. By the end of the film the narrator is introduced as a woman who, as she says, used to dream of acting and is now an actress. She reassures the audience that being is better than dreaming and what follows is a montage of working women: nurses, teachers, police officers, flight attendants, lineworkers, and mothers. The last line of the film sums up the film’s overall message from a young girl (still missing teeth) who concludes that being a woman “is better than being a boy.”

Saniya Lee Ghanoui is a PhD student in media history at the University of Illinois at Urbana-Champaign. Her dissertation looks at the history of sex education films in the United States and Sweden.

Why young teens need real periods–not the Pill

September 8th, 2015 by Laura Wershler

Guest Post by Dr. Lara Briden, ND

Photo supplied by Lara Briden

The onset of menstruation (menarche) is an important time for girls. It heralds their future fertility, of course, but it’s much more than that. Menarche is also when girls start to make female hormones for the first time.

Making hormones is not easy. It requires regular ovulation, and that can take a few years to become established. That’s why the early years of menstruation are exactly the wrong time to take hormonal birth control. Yet, unfortunately, that’s when more and more girls start taking it. According to a new study [1], this decade has seen a 50 percent jump in the number of young teens (12-15 years old) using medication such as Pills, injection, implant, and Nuvaring. These girls are at risk for many of the side effects of hormonal birth control including:

  • impaired bone density [2]
  • altered brain structure [3]
  • increased risk for depression [4]
  • suppressed libido [5]

Side effects occur partly from the synthetic hormones themselves and
partly from lack of girls’ own estrogen and progesterone.

Ovulation is How Girls Make Hormones

Ovulation is not just about making a baby. It’s also the main hormonal event in a menstrual cycle, and the only way to make estrogen and progesterone. When we shut down ovulation with hormonal birth control, we rob girls of the hormones they need for metabolism, bone health, cardiovascular health, mood, and more.

Girls who take synthetic pseudo-hormones via the Pill lose the ability to produce their own hormones. Pseudo-hormones have some similarities to real human hormones, but they also have many differences. For example, the progestin levonorgestrel causes hair loss, but the body’s own progesterone stimulates hair growth. The progestin drospirenone increases the risk of blood clots, but progesterone improves cardiovascular health. Ethinylestradiol, the synthetic estrogen in the Pill, impairs insulin sensitivity [6], but estradiol improves it. These synthetic hormones do not have the health benefits of the human hormones they replace.

Pill Bleeds Are Not Periods

Hormonal birth control is often prescribed to “regulate” periods, but that is nonsensical because a pill-bleed is not the same as a real period.

A real period is the end result of a series of important hormonal events including ovulation. In contrast, a pill bleed is a withdrawal bleed dictated by the dosing regimen of the drug manufacturer.

Newly menstruating girls often have irregular or heavy periods. That can make it tempting for doctors to suggest and for mothers to agree to give them hormonal birth control to mask the problem. But irregular and heavy periods are normal at that age. They occur because girls have not yet established regular ovulation. Hormonal birth control further suppresses ovulation, and that’s why it’s exactly the wrong thing to do. Hormonal birth control won’t promote future ovulation or menstrual regularity, and will probably make it even harder to ovulate in the future.

Better Treatment for Menstrual Problems

Teens have many non-hormonal treatment options for troublesome period symptoms.

Heavy periods: Teens will usually outgrow heavy periods after a couple of years. In the meantime, they can use natural treatments such as a dairy-free diet and the herbal medicine turmeric. Short term use of ibuprofen can also be helpful. I discuss these strategies in this article on Natural Treatment of Very Heavy Periods.

Irregular periods: Irregular periods are common in the first couple of years of menstruation and they usually do not require treatment. If periods do not start to become more regular, then please seek a medical diagnosis. The best treatment will not be the Pill, but rather it will be something to address the underlying cause of irregular periods. For example, the common hormonal condition polycystic ovarian syndrome (PCOS) requires diet and exercise to normalize blood sugar. The Pill is not appropriate treatment for PCOS, contrary to what your doctor might say.

Acne: Teen acne responds extremely well to a dairy-free, sugar-free diet and to the nutritional supplement zinc. Natural acne treatments work more slowly than the Pill, but they’re a better choice in the long term because they’re a permanent cure. In contrast, the Pill’s synthetic estrogen will only mask acne for the duration that it’s used. As soon as the Pill is stopped, acne will typically return even worse than it was before.

Better Birth Control

For those teens who need birth control, there are a couple of good non-hormonal methods. The advantage of a non-hormonal method is that it permits healthy ovulatory cycles and hormone production.

  1. Copper intrauterine device (IUD): Unlike hormonal birth control, the copper IUD does not suppress ovulation or hormones. Instead, it prevents pregnancy by impairing sperm motility and implantation. It is also highly effective with a failure rate of just 0.6 percent. The September 2012 guidelines from American College of Obstetricians and Gynecologists (ACOG) state that copper IUDs are safe for women who have never had children and for teenagers. This overturns a pervasive—but unfounded—opinion that IUDs should not be used until after childbirth.
  2. Combination condoms and Fertility Awareness Method: Teens should use condoms on every occasion of intercourse. In this way, they can avoid sexually transmitted disease as well as unwanted pregnancy. Teens can also learn to recognize their peak fertile days (charted according to fertility awareness-based methods), and then abstain on the those few days per month. Strategic, short-term abstinence will greatly reduce their risk of pregnancy in the unlikely event of a broken condom. Fertility awareness also teaches girls body literacy which is important for their future health choices. For Fertility Awareness information and a list of instructors, please visit Justisse Healthworks for Women.

Menstrual Hygiene Management: A Global Panel Discussion

August 6th, 2015 by Laura Wershler

#SMCR 2015 Plenary Session Video Presentation:

“Menstrual health is like the rhino for ecology, it’s the thing that if we get wrong the whole ecosystem fails. And if we get menstrual health wrong the social ecosystem fails.”  

Menstrual Hygiene Management (MHM) is critically neglected in development programs leading to negative cascading effects, particularly for girls, in health, education, safety and productivity. This plenary session was presented at the 21st Biennial Conference of the Society for Menstrual Cycle Research on June 4th, 2015, in Boston, MA. A global first, the panel brought together activists, practitioners, funders and academics to share their unique work and discuss barriers and opportunities to form a global, lasting movement to mainstream menstruation management.

Megan White Mukuria  (ZanaAfrica)

Leeat Weinstock (Grand Challenges Canada),
Sinu Joseph (Myrthi),
Murat Sahin (WASH in Schools, UNICEF),
Archana Patkar (Water Supply and Sanitation Coordinating Council),
Beverly Mademba (WASH United)


Call for abstracts for the upcoming virtual MHM conference on October 22, 2015:

Menstrual education perspectives from Africa, India, Bangladesh, and the United States

May 22nd, 2015 by Laura Wershler

 Menstrual Education perspectives from around the world will be presented in two concurrent sessions at the 21st Biennial Conference of the Society for Menstrual Cycle Research at The Center for Women’s Health and Human Rights, June 4-6, 2015, Suffolk University, Boston. The conference theme is Menstrual Health and Reproductive Justice.

Menstrual Education Concurrent Session Friday, June 5th:

Confident Girls in Charge of their Own Lives
Chantal Heutink, Bilhah Anyango, Jackline Obado & Goretty Obure, Afri-Can Trust

Girls grow up feeling ashamed due to limited knowledge about menstruation and lack of proper sanitary means to take care of themselves during this period creates a huge backlog to these girls hence denying them the opportunity to take their place in the society. Menstrual Hygiene Management matters are important to bridge the gap and provide a pathway towards confident girls in charge of their lives.

Factors impacting on the menstrual hygiene among school going adolescent girls in Mongu District, Zambia
Anne Mutunda Lahme, Akros Global Health, Zambia 

The research showed that in a Zambian context the process of menstruation can turn into a threat to girls’ social, physical and mental well-being and ultimately their school careers, causing gender discrimination and violation of their rights. It also creates an atmosphere of emotional stress, leading to poor school performance.

GrowUp Smart: Demystifying the link between menstruation, fertility and sexuality
Jennifer Gayles, Kim Ashburn & Marie Mukabatsinda, Georgetown University Institute for Reproductive Health, @IRH_GU

GrowUp Smart is an interactive puberty education program for adolescents, parents and communities that links knowledge of the menstrual cycle to improved understanding of fertility and better reproductive health outcomes. This presentation will discuss findings from evaluation of the intervention’s effect on sexual and reproductive health knowledge, attitudes and behaviors.


Menstrual Education Concurrent Session Saturday, June 6th:

Health Education and Menstruation: What’s happening in the classroom?
Jax Gonzalez, Brandeis University Graduate School of Arts & Sciences

Preliminary research on educator’s familiarity teaching health education in elementary schools suggests that teachers experience a multitude of limitations when administering the curriculum. By using sociological theory through an intersectional lens this qualitative study provides an important insight into the lived experience of teaching the taboo.

Making Schools Menstrual Friendly: Enhancing experience of girls in public schools
Dhirendra Pratap Singh, Azadi Inc.

A presentation of findings and analysis from the Menstrual Friendly School Program in Balrampur District, Uttar Pradesh, India – an initiative to address the menstruation management needs of girls’ at school so that puberty does not result in school drop out, a risk facing ~30% of India’s 87.5 million adolescent girls.

Menstrual Hygiene Practices of Girls in Rural India
Rita Jalali, American University 

The purpose of this study was to understand menstrual hygiene practices of poor girls living in rural India; their unmet menstrual management needs; and knowledge and awareness about menstruation and commercial napkins. Data were collected through survey, focus group discussions and diary entries and show how poverty and water deprivation impact hygiene.

Borohawa | Grown Up Girl – A short film on managing menstruation in rural Bangladesh
Sara Liza Baumann, Old Fan Films & Richard A. Cash, Harvard T.H. Chan School of Public Health

Whether you live in South America, Africa, Europe or Asia, all women undergo a natural experience that signifies their transition from childhood to adulthood. It may have different cultural significance, and women have a variety of different experiences, but menstruation is a biological event that women around the world share. Setting out with the goal of increasing understanding of these questions, we traveled to a school in Mymensingh, Bangladesh to gather perspectives from adolescent school girls through this short film project.


Media Release and Registration for the SMCR Boston Conference on Menstrual Health and Reproductive Justice: Human Rights Across the Lifespan.

Menstrual Hygiene, Human Rights, and Gender Equality – A Focus on the Global South

May 18th, 2015 by Laura Wershler

Scholars and practitioners from the fields of human rights and water and sanitation will discuss menstrual hygiene from the perspective of gender equality on June 4th at the  21st Biennial Conference of the Society for Menstrual Cycle Research at The Center for Women’s Health and Human Rights, June 4-6, 2015, Suffolk University, Boston.

Human Rights in the Private Sphere: Menstrual Hygiene as a Priority for Gender Equality and Human Dignity
Inga Winkler, Scholar-in-residence, Center for Human Rights & Global Justice, NYU School of Law 

In many countries, menstruation is shrouded in taboo and secrecy. Removing the taboos and ensuring better access to menstrual hygiene is essential for achieving gender equality and realizing human rights. The presentation seeks to explore human rights obligations to create an enabling environment for women and girls to practice adequate menstrual hygiene. It discusses various strategies including awareness-raising and breaking taboos, promoting good hygiene, and embedding menstrual hygiene in policies and programs by using examples from different country contexts. With a topic as personal and culturally specific as menstruation, incorporating women’s and girls’ views and preferences into programs and policies cannot be overestimated.

Poor menstrual hygiene, stigmatization, or cultural, social or religious practices that limit menstruating women’s and girls’ capacity to work, to get an education, or to engage in society must be eradicated. Considering menstruation as a fact of life and integrating this view at all levels will contribute to enabling women and girls to manage their menstruation adequately, without shame and embarrassment—with dignity.

Investigate and Expose: Challenges in Building an Evidence Base around Menstrual Hygiene as a Human Rights Issue
Amanda Klasing, Researcher, Human Rights Watch

Menstrual hygiene has emerged recently as a human rights issue, but this recognition alone does not mean that human rights practitioners will take up the issue. One barrier is the perceived or real limitations in their methodology.

This paper considers how human rights fact-finding methods may not readily lend themselves to building the evidence base for menstrual hygiene as a human rights concern. It will explore examples of how, despite challenges, menstrual hygiene concerns can be exposed within the context of broader investigations and it will address how practitioners can more deliberately incorporate menstrual hygiene in their investigations.

An important first step is for researchers to recognize the impact of menstrual hygiene on a broad array of women’s and girls’ human rights. Next, researchers should consider how best to expose this in the course of their research. Finally, researchers should consider how to include menstrual hygiene in the recommendations it makes to governments and other duty bearers.

Menstrual Hygiene Management in Schools: Meeting Girls’ Rights and Needs in Zambia
Sarah Fry, Hygiene and School WASH Advisor, USAID WASHplus Project

Image by Sarah Fry

Zambia’s schools fall short of acceptable standards and ratios for access to safe drinking water and improved sanitation. The ratio of girls to toilet can be as high as 200:1. These shortfalls are believed to be factor in the high rate of school drop-out among girls, many of whom do not even finish primary school. As in other low-income contexts, dropout rates for girls in Zambia appear to increase after puberty. Menstrual hygiene management (MHM) is burdened with cultural taboo and myths. Girls are still excluded from school for as long as one month at their first menses.

USAID/SPLASH in Zambia address girls’ right to education by removing barriers to menstrual hygiene management in schools. SPLASH and the Ministry of Education research cultural norms, improve girl-friendly facilities and access to menstrual products, break taboos, and integrate MHM in the education system through water, sanitation and hygiene in schools

Menstruation is still a sensitive topic, but experience in Zambia has shown that taboos can break down rapidly and MHM can become a normal part of discourse around girls’ rights at local and policy levels.


Media Release and Registration for the SMCR Boston Conference.


Readers should note that statements published in re: Cycling are those of individual authors and do not necessarily reflect the positions of the Society as a whole.