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Wednesday Wisdom

Menstruation Matters

- Reflect -

It is not often that I am in a store with both of my teen boys, but the half-term break afforded us an opportunity to do what they loathe more than anything in the world: the chance to shop.

The proliferation of online shopping means they are generally spared what they view to be an extremely mundane, thankless excursion. Let’s face it, searching for toilet roll and aisle 30 isn’t comparable to being on one’s phone, gaming or watching something on Netflix. It also involves something else that the online world has displaced: face to face interaction.

Having to ask for things, particularly if it involves any kind of ‘sanitary product’, and being able to push through accompanying social embarrassment, is an area where teens are ill-practised these days.

I aimed to address this on a supermarket excursion and gave my boys a list of ‘embarrassing’ items to locate. My eldest responded with incredulity and a blanket ‘no way!”. My youngest, who wasn’t familiar with any of the items on the list, seemed unperturbed and started racing round the aisles, locating what we needed and returning to dump them in the trolley. Watching them mull over ‘what things were’ in the sanitary products section made me chuckle, but it also made me aware of how little they knew things that are so fundamental to girls and women. “What are these?”, my youngest asked, holding up a box of tampons. “What does sanitary mean?” “What are wings?” “These look like nappies!”.

You get the picture; I was able to educate but also normalise discussion about menstrual care. Yes, they had both previously learned about the menstrual cycle in school, but those lessons didn’t explore the lived experience of girls their age who must navigate menstruation every few weeks; the cramping, the discomfort, the mood fluctuations, the management of it through the school day and the implications for participation in sport. We discussed all of it and my hope is that they left their supermarket sweep experience with more understanding, knowledge and empathy. In short, menstrual education isn’t just for girls and it isn’t something that should just be left to one parent either. At some point, members of our families, partners and loved ones will go through significant hormonal changes. These can be extremely challenging and require whole family support and empathy.

- Motivate -

Last week I tuned into a brilliant presentation by a PhD researcher called Ailbhe McKinney, based at The University of Edinburgh. She was addressing an audience of teachers on the theme of supporting neurodiverse girls in puberty. Ailbhe discussed how the onset of periods has become younger over the last century.

Interestingly, whilst they tend to start at around the age of twelve on average, they can begin at the age of eight (for a detailed and thought-provoking synopsis of contemporary explanations of early puberty, read this recent article from The New Yorker). There is some preliminary evidence to suggest autistic girls may be getting their periods earlier than other children, hence the need for parents, carers and educators to ‘get in early’, with pre-emptive strike conversations designed to reduce any anxiety. Like many aspects of children’s lives, the more understanding they have and the more events they can anticipate, the less chance there is for imagined worries to become amplified, knowledge gaps to be filled by ill-informed peers, or for them to feel blind-sided by change. Initiating and repeating conversations about body changes will be particularly important for neurodiverse children.

Conversations may already have started online. Children might be viewing and engaging with memes or visual content on platforms like TikTok, for example. Ailbhe pointed out how many of the cartoonish or visual depictions of periods, cramping or menstruation can tell a story for humour, which may be overly dramatic, inauthentic, or alarming.

Having had a look through TikTok, there is health education content on there, but it’s mixed in with unsolicited advice and personal accounts. There are approximately 923.4M views on TikTok pertaining to or referencing the Kardashian family’s period cramps! Before you sit your daughter down and initiate a chat, it is best to check what they already know or what they have already seen on social media. What have friends, cousins or big sisters told them? What have they read about online purposefully or seen inadvertently? What questions do they have? By being open and interested in what they already know and by uncovering what their baseline understanding is, you have the best chance of starting the conversation in an age-appropriate and meaningful way.

For some children, ‘one big chat’ may not work, and it may need to be broken down into several smaller chats, over a series of weeks. Be cool, calm and practical. Understanding periods and taking care of yourself during menstruation (in and out of school) takes practice and it is important that young women feel supported.

You don’t have to go it alone. There are lots of books available that can help explain periods and period care, but choose one that you are comfortable using. It is best to read it before you show it to your child. If your child is neurodiverse, Robyn Steward’s The Autism-Friendly Guide to Periods is a lovely book that Ailbhe recommended for use. This book features photographs of pads, how to put them on and what they look like used. We’ve found a similar book for girls with learning disabilities. Showing photographs, as opposed to abstract illustrations, can reduce confusion and anxiety as girls will know what to expect more clearly. One key point that Ailbhe mentioned is that we don’t want to be overly positive, or indeed overly dramatic, about periods, but should instead veer towards neutral, factual information.

Happily, there is a ‘one stop shop’ treasure trove of evidence-based material on periods for the whole family, made available on the University of Edinburgh Hope Website. If you are a teacher, there are even ready-made lesson plans available for you to use in class.

Educating children at home and at school is one part of the jigsaw, but we also need to ensure that our daughters can clearly identify exactly who they can talk to when at school, as and when they need products, support or a change of clothing. Teachers, is it clear how girls can access this help in your setting?

If you are a sports’ coach, your role is fundamental. 64% of school-age girls will stop playing sport by their mid-teens because of period pain and shame. An Adidas survey in 2021 reported that one in four girls dropped out of sport in adolescence, with fear of period leakage a key reason. Familiarise yourself with the #sayperiod campaign, launched by women’s health advocacy group, The Well HQ. Subscribing to their pledge gives you access to a variety of useful resources and infographics that can be used by coaches, teachers and girls themselves. Starting today, check that your kit is fit for comfort and purpose. If in doubt, ask the girls and young women that you work with.

Finally, if you’re interested in the environmental impact of traditional period products, take a look at the City to Sea ‘Plastic-Free Periods’ campaign. It contains some great information and resources which might prove useful starting points for conversation with your children.

- Support -

We have reflected on what support might look like for girls and young women who are approaching puberty or beginning to menstruate, but let’s try to remember that we only know this information due to available research and, for research to stay fresh and insightful, researchers need to engage with young people directly.

 So, would you allow your child to become a research participant and affect positive change in the world? Ailbhe McKinney, whose research we have highlighted above, is conducting something called ‘The Transition to Teenager Project’ and is seeking girls to take part. The aims of the project are to understand experiences of puberty, establish what leads to mental health problems and give girls a chance to voice what support they need. Fifteen adult women with autism, dyspraxia and ADHD contributed to the study’s design to ensure that it addresses high-priority research questions in line with the autistic, the ADHD and the dyspraxic community. The research team is actively seeking girls with a diagnosis of autism, ADHD, and/or dyspraxia (DCD), or those waiting to be assessed and are also interested in hearing from girls who do not have a neurodevelopmental condition. Their contribution could inform general understanding about the transition into adolescence.

If you do have a girl aged between 11 and 13.5, why not introduce the idea of research to her, talk about this project and even use it as an opportunity to discuss menstrual education more generally in family life? Research participation (in this case two, 30-minute, online meetings over a year) can give children and young people a sense of agency in the world, help them to feel empowered around topics that others might consider taboo and give them a sense of belonging to a wider community of like-minded young people. What’s not to like? Ailbhe is waiting for your email: a.m.mckinney@sms.ed.ac.uk or call/text 07388454435.

It’s also worth bearing in mind that period products cost money, and not everyone has equal access to them. An inability to get, or afford, sanitary products can have a huge impact on young people’s outcomes. There are now many charities which fight for menstrual equity and, as we approach the Christmas season, those who can, might consider supporting causes which help to relieve period poverty. For more information, take a look at Hey Girls!, Bloody Good Period, Period Poverty or Freedom4Girls.

- Is Your School Tooled Up? -

Chats about hormones shouldn’t begin and end with teenage girls. There is room for conversation about hormonal changes at all stages of family life. We recently ran a webinar on the menopause attended by over 140 people, led by Dr Fionnuala Barton a doctor and founder of The Menopause Medic. Watch back to learn more.

Earlier in the year, we also spoke to Dr Natalie Brown, co-author of a new study on the importance of menstrual cycle education. Listen now to find out what we discussed. If you’d like to find out more about the wide variety of period products and menstrual cycle tracking apps that are now available for teens, check out our article. You might also be interested in our list of useful books about puberty. Primary school staff may want to watch our webinar with experienced teacher, sex educator and author of This Period in My Life, Saskia Boujo, which is packed with practical tips for classroom use. Anyone interested on the impact of puberty on girls participation in sport and how we can encourage them to continue should listen to our interview with Dr Michaela James, watch our video or take a look at our list of 100 exciting sports to try.

At Tooled Up, we’re passionate about increasing girls’ participation in sport, so we’re inviting all of our future female football stars to take part in our keepie uppie challenge. We’ve posted Tooled Up footballs to PE departments in all of our co-ed and girls’ schools, along with full instructions for the competition and information about prizes. We’d love as many girls as possible to enter and want to hear about all of your football fun! Please let us know how you get on. 

We have a range of webinars with experts relating to issues of health in the pipeline. Book now to learn more about children’s cardiac health and keep your eyes peeled for upcoming events on diabetes, sugar consumption, obesity and allergies. You can also find material available now in the library on allergies, oral health, dental anxiety and supporting children undergoing clinical procedures.

Do you have any issues around health that you’d like to learn more about? Burning questions that you’d like to ask? Let us know and we’ll find an expert who knows the answers!

Finally, don’t forget that we have a couple of webinars running this week. Liz Keable joins us on Thursday evening at 7.30pm to introduce us to the idea of ‘metacognition’ and give us strategies for promoting optimal learning at home. Sign up here. School staff, we also have a webinar just for you on Friday lunchtime (12.30pm). Dr Ingrid Obsuth will draw on the latest evidence and clinical expertise to provide hints and tips on managing difficult behaviours in the classroom. Book your spot now.

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Have a great week.