Adolescence is a time of change and challenges. For girls, menstruation is often treated as a taboo topic, something to be embarrassed about, whispered about, even avoided, making it harder for them to get the information and support they need during this important time in their lives.
The American Institutes for Research (AIR) and Sanitation First, in collaboration with the Tiruvallur district government in Tamil Nadu, recently conducted a baseline study to explore the stigma surrounding menstruation and the barriers that girls face in accessing menstrual products and information.
As part of this initiative, AIR collected survey data from 118 schools across 10 blocks in Tiruvallur. The survey aimed to gauge the current knowledge, attitudes, and norms related to menstruation by engaging 118 headmasters and teachers, 1,133 female students in class 8, and 413 male students in the same grade.
Disturbing attitudes towards menstruation
The findings from the study revealed some concerning attitudes and norms regarding menstruation among students. Nearly half of all the boys surveyed, 43%, believed that girls should not enter the kitchen while menstruating, and and even higher number, 58% thought that girls should refrain from entering religious places during their periods.
Interestingly, 70% of the boys surveyed felt that menstruation disables girls and women, a view that was shared by 40% of the girls. Further, 77% of girls believed that menstruating girls should not visit religious places. These findings reflect the deep-rooted stigma surrounding menstruation in the community, said Averi Chakrabarti, an economist with AIR’s International Development Division.
She pointed out these beliefs are a result of longstanding societal stigma. “What I found particularly interesting was the belief that menstruation disables women and girls. This is how stigmas take root. Our goal through this intervention is to provide accurate information, so these ideas don’t continue to spread,” Ms. Chakrabarti said.
The baseline study also highlighted an issue that has received relatively little attention: heavy menstrual bleeding. 15% of the girls surveyed had missed school due to heavy menstrual bleeding, a condition that often goes unaddressed in menstrual health discussions. “We want to understand whether this is due to the number of days girls are menstruating, the frequency with which they need to change pads, and whether they have adequate access to menstrual products,” said Ms. Chakrabarti.
‘Happy Periods’ programme
Following the baseline study, Sanitation First will implement the ‘Happy Periods’ programme, which has been running independently in Tamil Nadu since 2019, in 56 schools across the district. This programme is designed to educate students about the physical, mental, and emotional changes associated with puberty.
The curriculum covers topics such as the causes of puberty, the male and female reproductive systems, as well as the onset of menstruation (menarche) and first ejaculation (semenarche). “We try to normalise the experiences of adolescence and puberty for both boys and girls with accurate, science-based information, to equip them with the knowledge to make informed decisions about menstrual practices and inculcate gender-sensitive behaviours,” said Padmapriya T.S., chief executive, Sanitation First.
After the Happy Periods intervention, AIR will conduct an endline survey to measure the effectiveness of the programme. The study will involve both the treatment group, which consists of the 56 schools participating in the programme, and a control group, which will allow for a comparative analysis of the impact. Ms. Chakrabarti said, “We are taking an econometric approach, using a comparison group to derive robust results from the study.”
Awareness for teachers
An interesting insight from the baseline study was the perception of teachers and headmasters regarding who should provide menstrual health education. A staggering 95% of teachers and school leaders believed that mothers should be the primary source of menstrual health information.
M. Prathap, district collector, Thiruvallur, pointed to the role of teachers in supporting this education. “Teachers are often resistant to counselling girls in the midst of boys. Through this programme, teachers will receive awareness training to ensure they are better equipped to guide students. Each school will designate a nodal teacher to continue the initiative,” Mr. Prathap said, adding that the aim is to design a framework to implement it at more schools.
Disposal practices
The study also found unsafe practices around the disposal of menstrual products. Among the girls surveyed, 72% reported burning single-use plastic menstrual products, and only 3% buried them. These disposal methods were especially prevalent in the Thiruvalangadu and Tiruttani regions. “This will be further explored in the endline survey to assess the progress and potential solutions,” said Ms. Chakrabarti.
Published – June 21, 2025 07:00 am IST