Despite recent conversations about menstrual health, more changes are necessary to improve women’s lives

The United Nations’ third Sustainable Development Goal aims to ensure healthy lives and promote wellbeing for all. Yet women all over the world must face shame, confusion, and unpreparedness every month due to cultural stigmas surrounding menstruation. These stigmas have material impacts on women’s lives and Bhutanese development; from school absenteeism during menstrual cycles, to infringement on religious rights, to highly taxed period products. Addressing misconceptions is crucial to overcoming discrimination against women and other marginalized communities.

The topic of menstruation in Bhutan is under-researched, but the conversation around women’s health is growing. So, what is the current menstruation landscape in Bhutan? And what needs to be done to achieve menstrual equity? These questions need clear answers for policymakers and civil society groups to improve women’s lives.

Studies show that Bhutanese people understand what menstruation is but not why it is caused. UNICEF and several government agencies, for example, found that 83% of schoolgirls and 43% of nuns recognized menstruation as a physiological process.  However, 50% of survey participants did not know the causes of menstruation or perceived it as either a curse from God or a disease. The results demonstrate the need to cover these topics more deeply in school curricula.

In a separate study by WaterAid and UNICEF, researchers found that a key barrier to menstrual education was the fact that teachers often reported “inadequate knowledge and training” on the matter, while many felt “uncomfortable teaching life skills or sexual and reproductive health.”

The lack of menstruation literacy among teachers has wide-reaching consequences. First, students will not learn to make informed menstruation hygiene choices. Second, authority figures in schools will not contribute to normalizing a natural and healthy process for females. Finally, taboos and misconceptions will remain unaddressed. Clearly, there is a pressing need in Bhutan for more comprehensive menstruation education for both students and teachers.

Along with providing a place to learn, schools are meant to provide students with clean, functioning, and private spaces. Without proper water, sanitation, and hygiene (WASH) facilities, girls will often stay home during their menstrual cycles. High rates of absenteeism can have detrimental effects on women’s lives and the Bhutanese economy more broadly. Deployment and maintenance of WASH facilities in schools and nunneries is, therefore, key to promoting female education and economic growth.

Periods can be extremely challenging for women due to various misconceptions and taboos prevalent in Bhutan. These range from beliefs that women should not enter temples while menstruating to the idea that women experiencing menstruation are being possessed by evil spirits. Menstruation hygiene practices such as drying reusable pads are also considered shameful among young adolescent females.

Misconceptions like these can have adverse effects on Bhutanese society for three overarching reasons. First, they can cause women to avoid seeking proper medical attention for menstruation-related conditions, such as polycystic ovary syndrome, urinary tract infections, and yeast infections. Second, stigmas can negatively affect girls’ school attendance and performance. Roughly 32.5% of adolescent schoolgirls have reported skipping school during their periods out of fear others will make fun of them. Lastly, misconceptions can perpetuate gender-based discrimination by infringing on women’s religious rights. Not being allowed to enter temples while menstruating—a sacred right to religious practice—reinforces discriminatory practices against women.

Menstruation is a natural and healthy process. Oftentimes, however, even acknowledging the subject in public is thought to be inappropriate. Over 75% of adolescent nuns and 55.8% of schoolgirls, for example, deemed that it was important to buy sanitary pads without being seen. 

That said, public advocacy on menstruation is changing attitudes for the better. Campaigns such as Red Dot and Happy to Bleed are designed to promote hygienic menstruation practices, address misconceptions and taboos, and protect women’s bodily dignity. Social media is also helping to normalize discussion about the topic. Social media accounts such as Global Shapers Thimphu and Respect Educate Nurture Empower Women (RENEW) actively share posts on menstruation and have become important advocacy tools that help cultivate a safer environment for Bhutanese females. These platforms are promoting healthy menstruation practices, calling out taboos and misconceptions, and giving a voice to women to change the status quo of our menstruation culture for the better.

During the pandemic, the government included sanitary products as an essential commodity. Growing companies like Chechay sanitary pads and flourishing online conversations around menstruation are signs of a society embracing women’s rights. The needle towards menstruation equity seems to be moving in the right direction.

However, there is much more to be done. Below are four recommendations to improve menstrual equity in Bhutan. 

The Ministry of Education should prioritize educational reforms for both students and teachers to correct menstrual misconceptions. Education programs on menstruation in schools and nunneries should have tailored comprehensive course content that examines social attitudes on menstruation and covers menstrual hygiene management (MHM). For teachers, the government and NGOs should provide more consistently available resources, such as standard health curricula and MHM refresher workshops. 

Focused national policies and budget support for menstrual hygiene products would improve MHM in a sustainable way. The government should implement a WASH policy that mandates safe, clean, and functioning facilities for menstrual hygiene, such as gender-specific toilets, provisions for disposing of period-related products, and handwashing facilities. Moreover, period products should be free, especially in schools. The Ministries of Health and Education, along with the National Assembly, should allocate budget resources to provide free sterile sanitary pads and other alternative products in schools. 

Fiscal incentives are needed for menstrual equity. Similar to countries like Scotland and New Zealand, the government of Bhutan should abolish the “pink tax”—a 5% sales tax on sanitary products imported from India, and a 30% import tax plus 5% sales tax on sanitary products imported from other countries. Menstruation related products should be tax-free. 

Menstrual advocacy should be part of greater sexual education generally. Conversations surrounding menstrual health and stigmas should be part of a broader push to tackle other sexual stigmas, such as homosexual and transgender rights. In supporting greater menstrual education, the government, NGOs, and youth organizations should also champion rights for all marginalized people facing sexual discrimination.

Contributed by

Mende Thuji Yangden