‘Children should be taught about the whys and wherefores of menstruation, before it happens.’

Dr Eleanor Draeger, specialist in Genitourinary Medicine (Sexual Health and HIV), blogs about why we need better menstrual wellbeing education for our children for Gynae Cancer Awareness Month.

Children learn that bleeding is a something to worry about from a very early age. They are given plastic cutlery and crockery, so that they don’t break anything and risk cutting themselves. If a parent or carer breaks a glass near them, they are told to stay still until the jagged shards are safely moved out of harm’s way. When they fall over and scrape their knee in the playground at school, they are given lots of attention, a plaster and a note from the teacher to take home. Even very small children know that if they see blood on themselves or a friend that they need to seek help from an adult to deal with the problem.

And yet, once puberty kicks in and periods start, children are expected to see fresh blood coming out of their vagina and not be alarmed. This is possible if they have been taught what periods are before that point. I have lost count of the amount of people who have told me how scared they were when they first had blood in their knickers as a child because no one had told them what menstruation was before it happened to them. And sadly, that still happens now – a survey of over 2000 young people run by the Sex Education Forum in 2015 found that 24% of female respondents did not learn about periods before they started having them.

Children should be taught about the whys and wherefores of menstruation, along with everything else that changes when they go through puberty, before it happens.  This would go a long way both to reassure children about what is happening to their bodies, and also help to reduce the social stigma of menstruation. In the Girlguiding girls attitude survey in 2018, 26% of girls aged 11-21 said they felt embarrassed to talk about their period, and 21% said they had been made to feel embarrassed or ashamed about their period.  We need this to change, so that people are not put off from seeking help for either troublesome periods, or unusual vaginal bleeding, in a timely fashion.

I once saw a woman in clinic who had been coping with extremely heavy periods for two decades. She bled so much every month that she had to wear two menstrual pads at night, and often had to change the sheets in the morning anyway.  The reason she had finally been to the GP for help was because she was missing up to 3 days of work each month because she couldn’t leave the house when her bleeding was at its height, and as a result her job was at risk.  After a series of tests to check that there was no sinister cause for the bleeding, the GP had referred her to our clinic for consideration of an Intrauterine device. This solved her heavy periods virtually overnight – and 6 months later she had stopped bleeding entirely. I asked her why she hadn’t sought help before, and she told me that her mother and aunt had ‘suffered with heavy periods’ and she thought it was just something that she had to endure.

It would be helpful in reducing shame around menstruation if society as a whole was more matter of fact about all things period-related. If you have abdominal cramps and need to take painkillers for them, why not tell your children or co-workers why? And if your children see your menstrual cup drying out on the bathroom sink and ask what it is, tell them. While you’re doing your weekly shop, why not ask your children to go and find the right brand of tampon for you, instead of sending them off to look for bread or tinned tomatoes? Why can’t we have more adverts on tv that are honest about periods? Less blue liquid soaking into pristine white menstrual pads, and more hot water bottles, bars of chocolate, big pants and paracetamol!

The statutory guidance for relationship, sex and health education came into force on 1st September 2020, and health education includes the new topic of menstrual wellbeing. This should be a springboard for schools to use to start teaching all children how to have a better relationship with their bodies and understand how periods work. We shouldn’t just be teaching children that they bleed ‘once a month’ and will need to use a pad. We should be telling them that the menstrual cycle can be variable, and that many children will not have a regular cycle for at least the first 14 months of having periods. And tell them that there is a normal range for the amount of bleeding that they can have – and that if they are having to miss school or work because the bleeding is so heavy, then they can and should seek medical help for that. Reducing the stigma that currently surrounds menstruation would ensure that they do this quicker.