Let’s Talk. Period

At a social level, increasingly, girls are expected to compete with their male counterparts. Whether it’s in education, sports or their careers, women and girls are breaking down barriers and showing that whatever boys can do, they can do equally well, if not better. This is all being done with period cramps and other discomforts that are well hidden from the public eye.
Women and girls attend school, college and the workplace often without usable toilet facilities; not to mention the non-existent sanitation options for women while travelling long distances or in public transportations such as trains and launches.
With health and social issues directly and indirectly connected to issues of menstruation, we still do not talk about it, address it, and educate our daughters about it.  If every girl gets it and every girl knows about it, why not talk about it?

Why is it important to talk about periods?
Looking at it from a medical perspective, there are hundreds of health conditions and diseases related to menstruation (the period) and menstrual cycle (the time from the beginning of one period to the next), so dealing with periods in a clean and smart manner is imperative.
It is very important for a woman to have regular periods, especially if she is trying to conceive. During each menstrual cycle, levels of the hormone oestrogen rise, resulting in an egg developing and being released by the ovary (ovulation). The womb lining thickens in preparation for a possible pregnancy.
The egg travels down the fallopian tube and if it meets a sperm and is fertilised, a pregnancy can occur. The egg lives for about 24 hours and if it isn’t fertilised, it will be absorbed into the body.

The lining of the womb will come away and leave the body through the vagina mixed with blood. This is a period.
So by now you should be able to understand that if there are no regular periods, there won’t be regular ovulation and no pregnancy.
If the period doesn’t start by 16 years of age, it’s called “delayed menarche” and needs medical attention. If the period starts and then stops it may be due to stress, extreme weight loss, medications or even conditions such as polycystic ovarian syndrome (PCOS).
If the period starts on time, but is too heavy or happens too often, it may cause too much blood loss which can eventually lead to anaemia if supplements or adequate nutrition is not given.
Periods may be irregular in the beginning which is normal but it can also be caused by unsuspected pregnancy, PCOS or thyroid problems. Periods can often be painful (the pain can range from mild to severe), due to the uterine muscles contracting to remove the blood, but in few cases this may indicate an underlying disease such as endometriosis, fibroids, pelvic inflammatory diseases, etc.
These are few examples of the diseases related to periods. Maintaining proper hygiene alone can get rid of many complications and infections.

What are the dangers associated with poor hygiene?
It is extremely important that the girls are taught about the importance of hygiene and the potential risks if hygiene is not maintained. The risk of infection is higher than normal during menstruation. A plug of mucus normally found at the mouth of the cervix is dislodged and the cervix opens to allow blood to pass out of the body.
This creates a passage for bacteria to travel back into the uterus and pelvic cavity. In addition, the pH of the vagina is less acidic at this time which can increase the chances of gaining yeast infections such as Thrush (Candidiasis). Some examples of poor hygienic practices include unclean sanitary pads which can cause infection; infrequent change of pads that can cause local skin irritation and rashes; and wiping from back to front, which can lead to bacteria from the bowel to move to the vagina.

Teaching our daughters, helping the future
Parents, guardians, older siblings, especially sisters play a crucial role in teaching girls about their bodies particularly on this important rite of passage.  Girls who were taught about their bodies, menstruation cycles and how to hygienically manage their periods, are found to be more confident, able to participate in school and other social events.
Different girls become women at different ages and the first period can start anytime and anywhere, so it is good to start preparing yourself early on. Once she starts her period explain to her what is happening and slowly answer her why’s and how’s.
Most parents avoid talking about periods because of the uncomfortable topic of sex and reproduction, but these topics can be better handled in a culturally sensitive way if you start preparing yourself to have the “talk”.
Given cultural barriers, sometimes it is easier for an aunt or an older sister/cousin to talk to your daughter. Reaching out to close female confidants will show your daughter that she has a community, a support system. Teach her how to manage her first period, and whom she can go for help with how to use a pad, how often to change it and the importance of maintaining hygiene.
Show her how to dispose used pads. Help her to be prepared for leaks, unexpected irregular period dates and stomach cramps.
Take her shopping. Let her decide what kind of sanitary napkins she wants, and what form of undergarments she might be comfortable using. If she’s uncomfortable shopping with you, give her some space. Instead of giving her a list of dos and don’ts, take her out and celebrate the day. Boost her confidence with some compliments. Let her know that what she’s going through doesn’t have to be scary and that she always has someone to talk to.
If you think you still have questions of your own, remember, as a parent, there is nothing wrong in admitting that you don’t have answers to everything.  Mothers please remember that realities of today’s girl children are far different from what you had experienced during your adolescence.  If you are unsure about any topic related to menstruation (irregularity, cramps, sanitary napkins and feminine products, etc.), you can find important and culturally relevant information on the web at sites like Maya.  If you are still unsure, make an appointment with a health professional to have a candid conversation that will be beneficial to both you and your child.
If mum isn’t around, your daughter should be comfortable asking you — the Dads — to get her a packet of sanitary napkin instead of wearing the same dirty one. Braving an uncomfortable moment now can help your daughter from avoiding major medical complications in the future. For her health and happiness, be as supportive as you can, be as open as you can. You will raise a more confident and self-assured woman if you acknowledge her new womanhood in a positive manner.
For more information on menstruation, please visit www.maya.com.bd.  For medical advice, ask your question to our doctors on “Maya Apa Ki Bole”.

Sources:
*http://changeobserver.designobserver.com/media/pdf/unicef_girls.pdf
**http://www.realising-rights.org/docs/monograph_menstruation_BRAC.pdf
By Dr Kazi Mashfia Fardeen, Medical Specialist, maya.com.bd