Stigmas surrounding menstruation are having a detrimental impact on girls’ futures, says child rights organisation Plan International, as the world marks Menstrual Hygiene Day today. For two billion women and girls worldwide, menstruation is a monthly reality. Yet in many low-income countries, women and girls still face serious challenges when it comes to managing their periods.

According to a study from the UN, one out of three girls in South Asia knew nothing about menstruation prior to getting it, while 48% of girls in Iran and 10% of girls in India believe menstruation is a disease. “Many girls around the world still lack access to affordable hygienic menstrual products. Instead, they are forced to use improvised materials, such as rags or leaves. Not only are they uncomfortable, but they can lead to leaks and infections,” said Darren Saywell, Plan International USA’s Director of Water, Sanitation and Health.

“Girls also lack access to clean, safe private toilets. There is no clean water within or near the toilets, which means there is nowhere to clean up and discreetly dispose of used menstrual products. “To make matters worse, women and girls often face harsh social taboos about menstruation which excludes them from certain activities, such as cooking or praying – and in some cases going to school.”

This situation can have a negative impact on girls and young women. Many young girls are forced to skip school during their period as they are embarrassed or do not have access to the facilities they need, while others drop out altogether. “When girls drop out of school at an early age, they are less likely return to education, leaving them vulnerable to early marriage, violence and forced sexual relations,” says Saywell.

When Christine, 17, from Uganda first got her period, her mother warned that she might fall pregnant if she slept with a boy – or even worse. “My mother told me to avoid going out at night as I could be raped,” says the teenager.

Additionally, a wide range of cultural taboos and social stigmas attached to menstruation can also impact the lives of women and girls. In places such as Nepal, many families in rural areas observe the tradition of ‘chhaupadi’ where in menstruating women and girls are isolated into separate huts or cowsheds. Other restrictions menstruating girls and women face include not being allowed to prepare food, wash their bodies, or enter places of worship.

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