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"You're going to bleed. Period." Educating girls about menstruation

This article was published in Scientific American’s former blog network and reflects the views of the author, not necessarily those of Scientific American


On a crowded mid-afternoon train from Oxford to Manchester several weeks ago, I found myself seated beside a smiling, elderly woman and—as such things go—we soon fell into conversation. Now, it’s easy for one to forget in such situations that one is in fact speaking to an animal; little old ladies are notoriously crafty at creating the illusion that you are conversing with something other than an anomalous kind of ape. But as luck would have it, I had been left immune that day against such deceptions owing to a peculiar conversation with an anthropologist colleague at Oxford, a conversation that left me in a state of mind in which even grandmotherly charms couldn’t keep me from noticing the spirited old ape before me. The hour-and-a-half journey to Manchester saw us meandering through stories of her childhood in Ireland, her many travels, a fruitless marriage to a now-dead husband whom she never really loved, her cats, her wayward niece ... but throughout all this my mind kept returning to the one unutterable, burning question that I’d first boarded with at the Oxford train station: what did this old woman remember about having her first period?

My curiosity was inspired by the peculiar conversation mentioned before. That morning, my anthropologist colleague had called my attention to a fascinating study—a study now long in the tooth in its own right—published by University of New Hampshire psychologist David Pillemer and his colleagues in a 1987 issue of the Journal of Adolescence . Pillemer, best known for his work in the area of “flashbulb memories” (especially vivid memories of surprising, emotionally intense events that people can recall in extraordinary detail and with great confidence, although the accuracy of these recollections is often questionable), discovered that adult women who were uninformed as girls about the bloody practicalities of getting their first period had much more vivid, detailed memories of the event than those who had known what to expect. The women who’d been unprepared as girls could tell you exactly what they were doing when it happened, what they were wearing, who was in the room, and so on, whereas the women who’d been prepared in advance as girls could hardly recall a thing about their first period.

These findings intrigued me, but even more intriguing was a question that I’d never really considered before, which is the question of how adolescent girls—especially those ill-informed girls caught off-guard by their first period—confront such a stark, abrupt introduction to their own creatureliness. Without a doubt, the best studies on the subject of menarche are those that have attempted to reconcile individual differences in age of female pubertal onset with various evolutionarily relevant variables in girls’ social environments. For example, in now-classic work, psychologist Jay Belsky from Birkbeck College, as well as University of Arizona’s Bruce Ellis, discovered that girls growing up in homes where the biological father is absent but the stepfather is present tend to mature faster than those living under the same roof as their biological fathers (their bodies are essentially competing with their mothers for the attention of this genetically unrelated male, not exactly a family-friendly finding). And a study out just this month in Personality and Individual Differences reports findings that age at menarche is negatively correlated with women’s preference for more masculine voices in prospective male partners, hinting at a possible adaptive strategy whereby environmental cues triggering early puberty leads girls to pursue short-term reproductive strategies with masculine men.


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But Pillemer’s work on menarche and flashbulb memories made me curious about the more immediate, subjective experiences of girls who are faced inexplicably with the fact that their uterine linings are literally falling out of their vaginas. There’s a smattering of empirical studies on girls’ firsthand experiences with menses, most coming with a rather heavy-handed feminist slant. But several very thoughtful analyses have appeared since Pillemer’s report. Some now-adult women apparently thought that they’d been wounded or had haemorrhaged on their first menses, which reminds me of that shower scene in Steven King’s Carrie (you know the one).

An obvious challenge with studying the question of girl’s psychological experiences with menarche, of course, is the ethical one. This is something that Northamptom College researcher Anne Burrows learned to her dismay when she attempted to interview recently menarcheal teenagers in Britain. “The sensitivity of the topic became apparent to me,” writes Burrows in a 2005 report of the Journal of Reproductive and Infant Psychology , “from the response of the Head Teacher at one of the schools that I approached to participate in the study. From the outset, the Head was unhelpful and negative, and expressed two main concerns about this ‘sensitive topic.’ He suggested that ‘nobody would want to talk about it’ and that there would be ‘hell to pay’ from his many ‘conservative parents’ if he put his name to the research.”

This curious air of embarrassment, secrecy and shame surrounding menarche is a recurring theme in the empirical literature, and in fact this negative view of menstruation displays a surprising cross-cultural regularity. Even in some African nations where the first menses is publicly celebrated and the girl is doted on with special attention and gifts (perfumes, dresses, pajamas, towels), adolescent females are often deeply uncomfortable with their new biological state of affairs. A Zambian woman interviewed by York University psychologist Ayse Uskul described how embarrassed she’d been that her menstruation had become public and pointed out how she’d in fact shied away from all the attention being showered on her by her relatives.

Such anecdotes would appear to pose some serious problems for traditional feminist theories, which tend to argue that Western negative attitudes toward everything from menstruation to vaginas at large are simply the result of cultural constructions. “How society officially views and treats menarche does not mean that the girl who is having her first menstruation will experience the event in the same positive way,” says Uskul. Communal ostracism of menstruating girls is also fairly common. One woman from South East Asia said that she decided to become an atheist when she was told that she couldn’t participate in any religious rituals or even enter the temple while having her period. But there are also a handful of societies in which menarche is more or less shrugged off as just one of those things and public menstrual bleeding seems to stir up about as much awkwardness as a sneeze. Among the Kayapo of the Amazon, for instance, there is no such thing as makeshift sanitary protection or hygienic napkins; rather, the word there for menstruation is translated literally as “stripe down the leg.”

According to most Western females, however, nothing could be more nightmarish than the prospect of “leaking” in public, and so perhaps it’s not too surprising that so many teenagers say that, in retrospect, their preparation for womanhood amounted to little more than a how-to guide for hiding their menstrual blood from all other eyes. This is certainly what Burrows found with the few British girls she managed to interview about their personal experiences with menstruation; rather than linking it positively with their own emerging femininity and sexuality, they looked on it with distaste and shame. These 12- to 15-year-olds saw menstrual blood as a hygienic crisis; one teenage girl described it as smelling like an unwashed dog. All of these girls were intensely paranoid about becoming associated with menstruation, worried for instance that boys would rifle through their purses and find their pads or that someone would notice their wearing them, and so they chose their behaviors and clothes carefully. Some spoke in code with one another to allow information about their menstruation to be communicated without exposing them—a girl asking a friend if she could “borrow her lipstick” meant that she needed a tampon.

In fact, the same trends of shamefulness and secretiveness were found a decade earlier among American girls in a separate study. In a 1995 report published in Adolescence , University of Massachusetts at Boston psychologist Elissa Koff, along with Wellesley College psychologist Jill Rierdan, noted that although some type of sex education incorporating the basic facts about menstruation are now routine in school curricula:

It must seem paradoxical [to fourth-, fifth- and sixth-graders] to be told that menstruation is normal and natural and something to be happy about while being instructed both to conceal its occurrence and to carry on as if nothing were happening.

 

When the researchers asked 157 white, middle-class ninth-grade girls what advice and information they would give to younger girls about menarche, there was lots of talk about “managing menstruation” (how to get tampons, what to wear and what not to wear, asking your mother for help, coping with cramps, etc.) but an astonishing absence of feedback about what menarche means biologically. Only one girl—one lone teenage girl of this entire group of 157 participants—ever linked menstruation to reproduction, saying simply that she would tell a naïve younger girl “why they get a period and that since they have it they will be able to have babies.” This doesn’t mean that all the other girls hadn’t put two-and-two together. But it does show clearly that, in the minds of these newly fertile adolescents, reproductive biology—that is to say, the actual purpose of periods—was a complete afterthought in their thinking.

An extraordinary article by Cornell University’s Joan Jacobs Brumberg helps to make sense of how menarche—and menstruation more generally—has become so desexualized in contemporary society. In this 1993 review piece from the Journal of the History of Sexuality, Brumberg shows how society’s approach to menarche has changed dramatically over the centuries. Many of these changes can be traced back to physician Joseph Lister’s concept of antisepsis seeping into public discourse in the 1860s. Once the medical community began to advocate for “antiseptic cleanliness,” argues Blumberg, doctors—invariably male doctors—were handed over the reins for instructing girls about becoming women, conveniently freeing American middle-class mothers of the burden involved in having to discuss such things with their own daughters. “By all accounts,” writes Blumberg, “the mother-daughter dialogue was a terribly painful process characterized by great awkwardness and maternal reserve.” In the years before 1920, for example, only 10 percent of immigrant mothers in western Pennsylvania provided their daughters with any preparation for menarche.

It’s a fascinating tale, Blumberg’s careful study of the social evolution about our attitudes toward menstruation, and one that I wholeheartedly recommend you read for yourself. It reads like something of a conspiracy theory involving backroom dealings between the personal hygiene industry, the public education system, the medical establishment and uptight moms. For example, the first disposable “sanitary napkins” appeared after World War I. Sold as Kotex, these were made from a substance called cellucotton, which was the invention of a chemist named Ernest Mahler working at the Kimberly-Clark Corporation. Mahler originally invented cellucotton as a type of absorbent surgical cotton to be used for injured soldiers in the allied troops. He was probably surprised to learn that some clever young Red Cross nurses found a different application for his invention altogether. Mahler’s employer, Kimberly-Clark, went on to make a handsome bundle with this serendipitous discovery, combining smart marketing with the newly branded “medicalization” of menses. By 1946, their brand of Kotex Products had cleverly joined forces with Walt Disney in producing the first corporate-sponsored educational film on the subject. Called The Story of Menstruation, this animated film has been seen by over 93 million American women. Menstruating the “American way” now meant being educated on the matter by a ten-minute Disney cartoon without any reference to sexuality—rather conveniently, a booklet called Very Personally Yours , complete with a monthly calendar for keeping track of cycles, was circulated to girls by their public school teachers along with the cartoon viewings, a booklet that included generous advertisements for Kotex. Here’s how page 15 read:

 

Have you ever stopped to consider how your comfort and confidence can depend on your choice of sanitary protection? Maybe you take that protection for granted, like other modern conveniences. But consider the days away-back-when . . . B. K. (Before Kotex). When sanitary napkins were an unknown luxury a woman would have given her eye-teeth for! Before Kotex was invented, imagine the nuisance of home-mades. The disagreeable chore of laundering. Not to mention the health risks, the embarrassing bulges, the chafing—the all-around discomfort of those bulky makeshifts women had to put up with! … Kotex sanitary napkins gave them a freedom they’d never known before. Here was a pad that was really comfortable—really sanitary. And (praise Allah!) convenient to dispose of.

 

Now, far be it from me to say that Kotex didn’t revolutionize female personal hygiene and I’m sure many of my straight male friends are indeed praising Allah for the invention of Kotex. But the corporate dynamics are outrageously transparent, and they do make me wonder about those—here comes my British accent—bloody companies and their concern with the bottom dollar. And while douching with Disney may be a thing of the past, the legacy of this soiled history of preparing girls for menarche is still very much alive. Intriguingly so. In fact, I’ve often wondered if the tremendous reservation that most parents have in communicating with their children about sex has the ironic consequence of making their children more curious about it—a curiosity that translates into earlier and more frequent sexual activity. And that makes me wonder if there weren’t (and aren’t) perhaps some natural selection pressures at work here, forces favoring parental modesty over candor in the sex education of children.

I never did strike up the courage to ask my train seatmate about her menarche in 1930’s Ireland, but she didn’t seem any worse for the wear in any event. We parted ways with grins at Manchester—two awkward, intergenerational, non-bleeding apes.     

In this column presented by Scientific American Mind magazine, research psychologist Jesse Bering of Queen's University Belfast ponders some of the more obscure aspects of everyday human behavior. Ever wonder why yawning is contagious, why we point with our index fingers instead of our thumbs or whether being breastfed as an infant influences your sexual preferences as an adult? Get a closer look at the latest data as “Bering in Mind” tackles these and other quirky questions about human nature. Sign up for the RSS feed or friend Dr. Bering on Facebook and never miss an installment again. For articles published prior to September 29, 2009, click here: older Bering in Mind columns.

Bering in Mind is an official honoree of the 2010 Webby Awards for blogs in the category of culture.

Image ©iStockphoto.com/laartist

Jesse Bering is Associate Professor of Science Communication at the University of Otago in New Zealand. He is the author of The Belief Instinct (2011), Why Is the Penis Shaped Like That? (2012) and Perv (2013). To learn more about Jesse's work, visit www.jessebering.com or add him on Facebook (https://www.facebook.com/jesse.bering).

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