Heather Watson of Great Britain hits a forehand in her match against Victoria Azarenka of Belarus during day four of the Fed Cup/Africa Group One tennis event in Budapest, Hungary.
Credit: Julian Finney

NEW YORK — "Girl things."

These apparently revolutionary words were uttered by the British tennis star Heather Watson recently after failing to advance in the Australian Open. 

The world took notice. But the way she said it, and what was said about it, continues the same sort of menstruation shaming that we've had since society's beginnings. It's a painful culture for women in developed countries, and a health crisis in areas like Tanzania, Cambodia, and Pakistan.

Why the continued need for euphemism? Why the suggestion of shame and taboo when half the global population experiences monthly menstrual blood flow? Isn’t it time we overcome the fear that remains associated with menstruation?

Some online stories noted with excitement that the word has been uttered aloud in the world of elite sports. Others expressed heightened concern that Heather Watson may have turned the clock back, and threatened the increasing presence of women in economic and political spheres. Still others lamented that a young woman’s honest remark about her natural physical experience had somehow damaged equality between the sexes.

Would the reaction have been the same if a young male tennis player had remarked that the stomach flu had kept him from his top game that day? Or if a young woman had expressed disappointment that a nagging injury had impacted her game?

Heather Watson’s story led to a flow anecdotes from female athletes recounting experiences with their menstrual periods during competition: reports of missed titles, of cramping, of records achieved (or not), and of medical approaches for suppressing or managing their menstrual cycle for peak performance.

In common among girls reaching menarche in Africa, Asia and elsewhere is the powerful imperative to hide their menstruating status, to avoid public acknowledgement of their discomfort or to seek accommodation because they are menstruating. This is the universal culture of menstruation.

I’ve spent the last decade exploring girls’ experiences of menstruation and education in low-income countries around the world. There, the fear is of another sort in the countries where I (and my “menstrual colleagues” as we call ourselves) have conducted research with girls in and out of school. 

In Tanzania, Uganda, Rwanda, Ethiopia, Ghana, Kenya, Cambodia, India, the Philippines, Pakistan, Bolivia, Tajikistan and beyond, girls are reporting feelings of shame, embarrassment and fear the first time they get their menstrual period.

For many girls, the first sight of blood on their undergarments causes a panic that they have a deadly disease. Other girls express fear that the blood will lead to punishment, with parents potentially accusing the girls of misbehaving (such as having sex). This in turn leads to silencing girls, and an internal struggle to manage, scared and alone this normal healthy developmental event.

Menstruating elite athletes are taught to carry on and perform as best possible or find a way to control their body’s natural rhythms so they will align with the competitive schedule. Schoolgirls in Tanzania, Bolivia, Cambodia and elsewhere are taught to carry on and walk long distances to school. Some attend schools that may lack adequate toilets or water for managing their menstrual periods. Hide it is the lesson above all else.

People fear what they do not understand. So for the girls of Africa and Asia and elsewhere who are getting their first period with no prior guidance or support, a universal commitment is needed to end this state of fear.

I am not suggesting that the world should start shouting about menstruation from the rooftops. What I am suggesting is that if we do away with the euphemisms, we’ll be taking a significant step in doing away with the fear.

Marni Sommer is associate professor of sociomedical sciences at the Mailman School of Public Health, Columbia University. She has studied issues of menstruation in Tanzania, Cambodia, and Pakistan.

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