Half of the world’s population has a period, but how much do we know about our bodies and menstruation? These are the barriers standing in the way.
Approximately 1.8 billion people across the globe will menstruate every month, according to UNICEF. In Australia, roughly half of our population has had a period.
Despite this, our understanding of sexual and reproductive health is lacking and we’re doing those with uteruses a disservice because of it.
Deficits in menstrual health literacy exist in low-, middle- and high-income countries, such as Australia.
Stigma, cultural and linguistic barriers, inadequate information for queer people, and issues identifying severe period pain, make conversations about menstruation difficult to have.
GenWest is an organisation that operates out of Footscray to provide health, social and family violence services to those in the West, whilst advocating for gender equity.
GenWest’s sexual and reproductive health (SRH) coordinator Alice Borthwick-Peters told The Swanston Gazette why Australia needs to improve our awareness surrounding menstruation.
“This is a subsection of healthcare that intersects with everybody’s lives,” she said.
“All people, regardless of sex or gender, need to be educated because it is something that impacts 50 per cent of the population directly, but indirectly it has a significant impact on more.”
Ghada is a nineteen-year-old student from Hoppers Crossing. She got her first period just as she started secondary school, but at 17 years old, she was diagnosed with Polycystic Ovary Syndrome (PCOS).
This endocrine disorder tends to affect people during their reproductive years, with the World Health Organisation estimating that 8 to 13 per cent of people with uteruses have the condition.
PCOS can make menstruation irregular and impact fertility.
“I didn’t get a lot of information about PCOS. It was something you had to find out yourself,” Ghada said.
Ghada began noticing a pain in her lower abdomen that coincided with weight gain and facial hair growth. She said that she “kept having to tell the doctor something was wrong”.
“They just said you have to live with it.”
Borthwick-Peters from GenWest said this experience isn’t uncommon.
“Historically, there has been a sort of push to just get on with it and this sort of normalisation of severe pain can be quite harmful,” she said.
“We’re finding that young people with uteruses’ understanding of pelvic pain conditions is improving, but there are still a number of people who think it’s normal to have such severe pain that you can’t go about your daily living activities.”
Ghada, who also has diabetes, began seeking out information online about how to manage her symptoms. She altered her workout routine and food intake to what she had read.
However, these changes “did more harm than good” as they affected Ghada’s insulin levels.
After speaking with a dietitian who helped create an eating and exercise plan that met her specific needs, Ghada has been able to manage her PCOS symptoms and regulate her period.
Ghada said, “Women are self-medicating because they don’t know” about reproductive health disorders and “more response and more action should be taken” to bridge that gap in understanding.
“It’s mostly important to know your own body and your own cycle, so you can tell if anything changes and then you go and seek help,” Borthwick-Peters said.
As a healthcare service provider in Melbourne’s multicultural west, GenWest is focused on providing support for culturally and linguistically diverse communities.
In the year ending June 2020, Melbourne’s west had the third highest net overseas migration in the country, and the suburb of Point Cook is home to residents who were born in 146 different countries.
“You don’t quite realise how many colloquialisms are in our healthcare system until you start to talk to refugee and migrant people, and language we use quite casually, like saying ‘Going to the GP’ and that sort of thing, don’t translate well,” Borthwick-Peters said.
GenWest works closely with schools and community groups delivering education initiatives in Easy English, Hindi, Vietnamese, Nepali, Afghan Urdu, and Pakistani Urdu.
Interpreters allow a range of other language groups to engage with programs and content as well.
This fast-growing area requires SRH programs that cater to its residents, ensuring no one is locked out of obtaining necessary information about their cycle.
“Talking in language, considering the cultural context, trying to get people from similar cultures to them to talk with them… facilitates those community conversations and recognising that they’re the experts on their own culture and their own body,” Borthwick-Peters said.
Whilst understanding menstruation and its impact on the body can be a struggle for most, gender-diverse people are also facing the challenge of accessing SRH information that reflects their experiences.
“Body dysmorphia or gender dysphoria might be exacerbated by menstruation,” Borthwick-Peters said.
AJ, 18, is from Truganina. They are AFAB (assigned female at birth) and use they/he pronouns.
“My period made me anaemic [and] I was tired all the time,” he said.
“I missed out on the day we had sex ed, so I missed the whole thing because of one day.”
When it comes to incorporating LGBTQIA+ sexual and reproductive health into the curriculum, AJ said, “it definitely needs to be more prominent”.
“I really don’t know why you wouldn’t want more accessibility.”
In 2021, GenWest or as it was known then, Women’s Health West, moved to rebrand and expanded its services to include trans, gender-diverse and non-binary people.
According to Borthwick-Peters, this “reflects the increasing understanding we’re having that gender equity impacts everyone and to have true gender equity, we need to support all people who experience marginalisation as a result of their gender.”
Earlier this year, the organisation also submitted an application to the Victorian Civil and Administrative Tribunal to be temporarily exempted from the Equal Opportunity Act to employ gender-diverse and non-binary people.
This legislation states determining employment based on gender or other personal characteristics is illegal. However, some organisations such as GenWest which provide services to marginalised communities, can seek an exemption to carve out a specific space for the representation of these groups.
For AJ, they believe that LGBTQIA+ sexual and reproductive health education needs to be curated by those who have lived experience.
“Having actual gender-diverse people leading these things or being on the panel of who is deciding, is important,” he said.
Recent evidence collated by health institutions around the world support AJ’s call.
Research from the US published in An International Journal for Research, Intervention and Care, found gender-diverse people feel there is a “disregard for correct pronouns and medical history” and an “awkwardness in using respectful language when discussing pregnancy or menstruation” in mainstream healthcare.
For Ghada, implementing SRH into the biology curriculum in schools is another way young people can become more informed about menstruation, “instead of being segregated into different rooms” because “that is what made it taboo.”
Learning about periods “majorly makes a difference on the values and beliefs of a person,” she said.
But according to Borthwick-Peters from GenWest, “having those conversations at home with parents is fundamental.”
“We do ask how young people prefer to receive their sexual and reproductive information and by and large, a lot want to receive it from parents or caregivers,” she said.
“It’s a difficult concept to accept that your child is growing up and maybe they’re having sex and maybe they’ve got their period, and what does that mean for your role as a parent?”
“So, part of where I hope sexual and reproductive health education is heading, is how to equip parents to have those conversations and support the work that happens in schools and community settings.”
There is still much work to be done to ensure Australians are truly informed about what menstruation and SRH means for people with uteruses.
However, by addressing these gaps in our understanding now, the opportunity to provide better quality health programs to young people is very much within our reach.
For more information on GenWest and the services they provide, visit https://www.genwest.org.au/.
If the content in this article has been distressing in any way, the following helplines can be good places to start in finding support:
QLife 1800 184 527 - Queer helpline, 3pm - midnight every day
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