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More than half of the women surveyed in a study carried out by a team from the Universitat Politècnica de València (UPV) and the Consejo Superior de Investigaciones Científicas (CSIC), claim to not have known how to manage their first period. This study, published in the journal BMC Women's Health, analyzes the information received about menstruation, the desired information and the information that has the greatest impact on how menstruation is experienced, and finds that menstrual education in Spain is still deficient.

"Menstruation continues to be treated as an uncomfortable subject that has to be hidden and what is hidden is not talked about, is not investigated, is not legislated and does not receive the necessary attention. And menstrual health requires this attention," says Sara Sánchez López, a researcher at the INGENIO Institute, a joint centre of the UPV and the CSIC, and lead author of the study.

The study was conducted through an anonymous online questionnaire to more than 4,000 people, both men and women born or living in Spain between May 2021 and January 2022. The questions addressed issues such as education received about menstruation, comfort to talk about it, emotions experienced during menarche, menstrual hygiene products, economic impact, and social impact, among others.

Their results are revealing: the four most common emotions reported during the first menstruation were embarrassment (23%), worry (20%), fear (16%), and stress (15%).

The study also shows that 35.7% of the women surveyed did not know much about what their periods were when they first started and 56.1% did not know enough about how to proceed. On the other hand, there are numerous testimonies collected in this study in which menstruation has been the cause of mockery or derogatory comments.

Besides, the research found a trend between the information available on how to handle the bleeding and the number of times people recall experiencing embarrassment, fear, worry, and disgust, suggesting that knowing what to do when they have their first period reduces the likelihood of experiencing these emotions. "Unfortunately, only 5% of the people surveyed remember having received this information at school," notes Sara Sánchez López.

On the other hand, the data indicate that despite all the social changes that have occurred in these decades, the emotions experienced during first menstruation in Spain have not varied significantly from the 1950s to the early 2000s.

"The ambiguity of current legislation regarding the contents on menstruation leaves it up to the discretion of the centre or even the teacher how much time to devote to the subject and what contents to include. Often, it is merely named in its biological function as part of human reproduction," says Rocío Poveda Bautista, also a researcher at INGENIO and co-author of the study.

However, the lack of information is not limited to the first rule. This study shows the need for reliable and accessible information on how to manage menstrual pain, symptoms of endometriosis and other similar disorders, or on when to see a specialist. Overall, it concludes that more knowledge is needed about how the menstrual cycle affects the whole body and how it varies throughout life, including menopause.

"This study is intended to serve as a guideline for the creation of efficient legislative and social measures. It is a call to action so that menstrual health education, which is still deficient today, is incorporated into the curriculum, to ensure that every schoolchild in Spain receives basic and reliable information on this topic," concludes Santiago Moll López, from the Department of Applied Mathematics at the Universitat Politècnica de València and co-author of the study.

Along with researchers from the UPV and CSIC, this study has also benefited from the valuable contribution of Dr. Dani Barrington from the University of Western Australia, an internationally recognized expert for her research and activism on menstrual health.

Reference Sánchez López, S., Barrington, D.J., Poveda Bautista, R. and S.E., Moll López. Spanish menstrual literacy and experiences of menstruation. BMC Women's Health 23, 161 (2023). https://doi.org/10.1186/s12905-023-02293-4