Breaking Through Menstrual Shame and Discomfort

Season Osborne

December 06, 2019

"We are still seeing so many young people feel unprepared when they get their first period or confused about what it is," said Nadya Okamoto, founder and executive director of a nonprofit that distributes menstrual products. "And we see so many boys who don't even know what menstruation is. I think physicians can play a really big role in that."

Considering that an estimated 800 million women menstruate every day, it's not something that should be taboo, explained the 21-year-old social activist.

"I hope that the takeaway is to constantly push the boundaries on being more open about menstrual health and to ask questions in a really destigmatized way," said Okamoto, who has taken a year off from Harvard College to campaign against period poverty and took the podium for the final keynote speech at the American Academy of Pediatrics (AAP) 2019 National Conference in New Orleans.

In 2014, at age 16, she and her friend Vincent Forand founded PERIOD, a nonprofit organization that distributes menstrual products to homeless girls and women in Portland, Oregon.

Its mission — to "end period poverty and stigma through service, education, and advocacy" — mobilized young people and spread beyond Oregon. It now has more than 700 chapters at universities and high schools in 50 states and 30 countries.

A notable number of menstrual products has been handed out by the organization, which proclaims "853,702 periods served" on its website.

The closing plenary speech is meant to inspire pediatricians to leave with energy to do good things in their communities, said Cassandra Pruitt, MD, chair of the AAP national conference planning group.

"Adolescent reproductive health is important, as is overcoming disparities in access to needed supplies," said Pruitt.

I hope that the takeaway is to constantly push the boundaries on being more open about menstrual health and to ask questions in a really destigmatized way.

Professionals attending this conference are in an ideal position to advocate for "basic menstrual health products and access to menstrual hygiene, and we do that through engaging young people," Okamoto told Medscape Medical News. "So the pediatrician–young people alliance, or intersection, is just really perfect here."

Call to Action

"This idea that only women can talk about menstruation is ridiculous," said Cora Collette Breuner, MD, a pediatrician at Seattle Children's Hospital. "Every man or woman should talk about it."

Breuner is involved with a homeless-youth clinic affiliated with Seattle Children's Hospital. She also speaks to high-school and middle-school students in different socioeconomic areas about puberty and menstrual health.

"We don't do a good enough job asking about the availability of feminine-hygiene products," she said. "We don't think of that. We just assume if they are having their period, they have access to these products. But we don't know."

"I like to make sure that they have free pads and tampons in all the teachers' classes, whether the teacher is a male or female, and in all the bathrooms and nurses' offices," said Breuner.

"It isn't just a money thing," she added. Menstrual periods are a quietly accepted part of an adolescent girl's life, but are often not discussed with friends, family members, or even doctors. "There's a stigma."

American Academy of Pediatrics (AAP) 2019 National Conference.

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