Issue #2 | Breaking the cycle: Period politics and menstrual health in South Africa
Iza Munir Hamdani
Research Strategy & Content Specialist | MSc Sociology | Aspiring PhD Researcher in the Sociology of Education
This study, conducted by researcher Sinazo Nomsenge, looks at experiences of menstruation in South Africa, focusing on the sociocultural context that shapes these experiences. It highlights the growing global research on menstruation, especially in low- and middle-income countries, which has effectively driven policy, advocacy, and shifts in social norms. Unlike other Global South countries, South African qualitative research on menstruation has been limited, often focusing narrowly on adolescents in school, and therefore creating blind spots in understanding menstrual experiences more broadly.
This paper synthesises qualitative research from 2012 to 2022, with the aim to:
Methods
Nomsenge conducts a systematic search of four academic databases (ScienceDirect, JSTOR, EBSCOHost, and Scopus) using search terms related to menstruation and menstrual hygiene, connected to South Africa.
To be included in the study, the research needed to be qualitative or mixed-methods with qualitative data, conducted in South Africa between 2012 and 2022. It also had to be published in peer-reviewed journals or accessible university repositories, focusing on menstruation or related social aspects. On the other hand, quantitative, medical, economic, or reproductive health studies that didn’t focus on menstruation were excluded, alongside reviews, commentaries and organisational reports. After screening the initial 1872 results, 18 studies met the inclusion criteria for analysis in this review.
The data were analysed using narrative synthesis* to identify themes and integrate findings into a coherent story. Most studies involved school-attending adolescents and university students, with some including adults and homeless women. Data collection methods across the studies primarily involved interviews and/or focus groups.
*As a research method, narrative synthesis involves the systematic review and synthesising findings of multiple studies to summarise and explain their findings. This type of research can be statistical, but it mostly takes a ‘textual’ approach.
Findings
a) Menstruation in schools
School toilets and sanitation facilities are often inadequate, either because they are broken, unclean, or that they might be lacking water, disposal bins and privacy. Undoubtedly, this results in poor menstrual hygiene.
Avenues to obtain menstrual products include the family, schools, NGOs, and sponsors, though both disposable and reusable products come with their respective challenges. Disposable pads tend to cause anxiety about leaks, and require financial resources as they are used up. On the other hand, reusable products reduce dependency on financial resources, but they’re often reported to be uncomfortable and stigmatised in terms of cultural resistance linked to beliefs about virginity and promiscuity.
As for the psychosocial impacts, fear, shame, and anxiety are the primary emotions felt surrounding menstruation, especially at menarche (the first period that a person experiences). These feelings are caused by factors like a lack of information, or even misinformation, and sometimes from uncomfortable comments from teachers and male students. Ultimately, the fear of leaks and general social discomfort leads to social withdrawal and decreased attendance, less participation in sports activities, and difficulties concentrating. However, some girls reported that they preferred to attend school on their period, so that they could avoid doing household chores.
b) Menstruation beyond school
Similar to schoolgirls, adult women and university students face challenges related to inadequate sanitation and limited access to menstrual products. Homeless women reported most often resorting to improvised materials, as well as high levels of stigma and emotional distress.
The sociocultural context being studied dictates that menstruation should be seen as a medical condition needing intervention. Religious and cultural norms also impose strict cleanliness, secrecy, and concealment, while patriarchal beliefs link menstruation to female desirability and hygiene. Cultural taboos include avoiding certain foods, social events, and contact with men during menstruation. There are even fears of ‘witchcraft’ associated with menstruation that lead to secretive practices when it comes to disposing of used menstrual products.
However, some women did report positive experiences of menstruation, which included family celebrations of menarche and viewing menstruation as a sign of health and maturity.
Conclusion
This study concludes that menstrual experiences in South Aftica are shaped by a combination of sociocultural beliefs, inadequate infrastructure, and limited access to menstrual products. Secrecy is a common coping strategy for dealing with cultural norms that stigmatise menstruation. While improvements in product availability and facilities help, their acceptance depends heavily on cultural context.
Nomsenge’s work stands out because it provides a comprehensive synthesis of qualitative research on menstruation in South Africa over a decade. It highlights the complex interplay between sociocultural beliefs, material conditions, and menstrual product access. Importantly, it reveals gaps in research and interventions that focus predominantly on school settings, neglecting broader societal contexts and diverse populations. The study calls for culturally sensitive, context-specific approaches to menstrual health that are widened beyond the scope of schoolgirls’ experiences.
Real World Applications
Undoubtedly, this research paper offers perspective for policy and program development, like designing menstrual health policies that address sociocultural diversity in schools, workplaces, and communities. Also, it calls for infrastructure improvement within those institutions, including upgrading sanitation facilities in schools and universities and communities with gender-sensitive designs that consider privacy and hygiene.
Also, the study’s findings can be used to advocate for education and awareness surrounding menstruation, like literacy programmes that include boys, male teachers, and other community members to reduce cultural stigma and encourage an open conversation. This could also be extended to cultural and religious leaders, helping reshape menstrual narratives and debunking false ideas.
Nomsenge, S. (2024). Menstruation and Society in South Africa: A Desktop Analysis. South African Review of Sociology, 54(1), 58–77. https://doi.org/10.1080/21528586.2024.2347262
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3moHearing that some of the women did report still having positive experiences and even familial celebrations, despite the more negatively aligned connotations of menstruation across sociocultural and religious contexts, is quite uplifting. Did the authors provide any hypotheses or relevant sociodemographic data that could perhaps be used to begin explaining why the experiences and internal culture surrounding menstruation within said families contrasted so significantly from the larger culture in which they exist in?