When I was in 5th standard - about 10 years old - my mother sat me down and had 'The Talk' with me. If you don’t know what The Talk between a mother and daughter at that age comprises, the gist of it is: 'You are a girl and that means you are going to bleed in your pants. Every month. For the rest of your life. So… good luck with that.'
I asked her some innocent follow-up questions - Did she also get periods? Did it hurt? Did my father know about this? (That last one was my way of checking if the men were in on this bit of trivia, or if all the women of the world were all secretly running espionage on all the men.)
She probably expected more but I recall getting bored pretty soon. More pressing matters - like perfecting The Rock's chokeslam move on my little brother - awaited my attention for now.
Within the next few years, all my girl classmates and I got our periods. But it was not until we were 15 that our school decided to have its own belated version of The Talk with us.
One fine day, our class teacher told all the girls to stand up, form a queue outside the classroom, and whisked us off to the school basement. There, she proceeded to deflate our excitement with this rather stale bit of information that was not news to a single girl in the room.
At 15, we already had a repository of menstruation factoids in our heads - some right, some very wrong - from books, parents, and gossip. And this sterilized Talk - which conveniently glossed over the role of menstruation in women’s reproductive health - was no improvement on our current repository.
An hour later, we sauntered back into the classroom and realized the boys were going crazy with curiosity over our secret meeting. Really, the only takeaway we got out of that morning was the joy of watching those pesky boys stew in suspense.
And that, ladies and gentlemen, is a comprehensive description of all the sex-ed that was imparted at one of India's capital city’s most progressive schools.
I want to talk this week about how, for most women, this virtually absent education marks only the beginning of a lifetime of being blindsided by our own biology.
It begins at puberty when a girl either wakes up to find blood on her bedsheet, or worse - much much worse - gets up from her chair at school and has other girls inform her that there is a bloodstain on her skirt.
In fact, during The Talk at my school, our teacher told us, “When I got my first period, I was convinced I had cancer and was going to die.” Such thoughts are eerily common among young girls who are allowed to experience their first period by their parents and teachers without any prior intimation.
For most women, this is just the beginning. From periods to pregnancies to miscarriages to breastfeeding to peri-menopause and finally menopause - our natural bodily functions continue to catch even the most well-informed of women unawares.
Why is this?
As far as I can tell, there are two reasons for this.
The first reason is scientific.
Modern medical science just does not invest as much in women's healthcare as it does in men's. And this is true even in the most developed countries of the world.
According to The Guardian, “In the UK, less than 2.5% of publicly funded research is dedicated solely to reproductive health, despite the fact that one in three women suffer from a reproductive or gynaecological health problem. There is five times more research into erectile dysfunction, which affects 19% of men, than into premenstrual syndrome, which affects 90% of women.”
The second reason is social.
Whatever little knowledge the medical world has gathered on this shoestring research budget is kept inaccessible to most young girls and women by the stigma attached to talking about periods.
Chums, Aunt Flo, that time of the month - are all codewords whispered among women and girls in hushed tones, like criminals. And the result of treating this natural biological process like an unspeakable crime is that there is hardly any woman in India who has not been in the dark about how her own body works at some point in her life.
These Whispers have done a lot of damage to all of us.
After Ameya was born, her mother suffered postpartum depression - a condition that, according to WHO, affects up to 75% of new mothers. In up to 15% of cases, this may turn into severe postpartum depression, especially when left untreated and unaddressed.
In Ameya's mother's case, the depression went untreated and unaddressed for decades - and morphed into lifelong mental health disorders like anxiety, Obsessive-Compulsive Disorder, and even bouts of schizophrenia.
"I grew up seeing my mother clean the house obsessively and constantly. She was triggered by many things - one of her triggers was menstruation. She thought period blood was dirty. When I first got my period, she panicked. My father never spoke to me about periods. So I absorbed from my mother this notion of periods being dirty. I hated my periods, and began hating my body for getting them."
Ameya's mother could not stand the sight of the 'dirty blood' so she asked Ameya to use a tampon instead of pads from her very first period.
"As a child, I had no idea how to use a tampon - it was uncomfortable and painful. Meanwhile, my mother started keeping me in a different room in the house for five days a month. She would give me food in different plate and different cutlery that the rest of the family never touched. Every month, I would become an untouchable in my own home. I used to dread these as the five worst days of my life."
A few years later, Ameya's mother suffered a miscarriage, and the burden of taking care of her fell on Ameya.
"My father would hardly be around, let alone take care of her at this time. I was the only one at her side as she lay in bed, and bled for weeks. I used to wonder, ‘Why has God had made women's bodies in such an unkind way? Why do we have to suffer so much?’ The mental agony literally shut my body down. I didn't get my periods for 8 months after this."
In the absence of any healthy conversation about menstruation with either of her parents, Ameya - who should have felt alarmed at her periods stopping - felt relieved instead.
"I thought God had saved me from 'the problem'. I thought 'I can be free like a man now!' I had no inkling that this was a condition called PCOS (Poly Cystic Ovarian Syndrome) and that it needed medical attention. My mother - who should have stepped in and taken me to a doctor - brushed it aside as board exam stress. She was probably relieved herself."
Ameya ended up living with undiagnosed PCOS for years.
"My periods would vanish for months at a time. Each time, I would celebrate when I should have been concerned about my health."
Women with PCOS are often insulin resistant. Their bodies can make insulin but can't use it effectively, increasing their risk for type 2 diabetes (Source).
And sure enough, at 23, Ameya discovered that she was pre-diabetic.
"I realized then that my health was in an alarming condition because the PCOS had been left untreated for so long. My insulin resistance was off the charts. A lot of damage had already been done, and even with extreme lifestyle changes, I might never be able to reverse all of it."
Ameya's family’s reaction to the diagnosis was to blame her for it.
"They would tell me, ‘This happened because you are overweight. You cannot have kids (not true). Who will marry you now?’ It almost made me laugh because they were the reason I was in this condition in the first place."
In fact, Ameya's mother's OCD has still not been acknowledged by her family.
"To this day, she cleans her hands so obsessively that the skin of her hands starts scaling off. But for my family, acknowledging that she has a mental health issue would bring shame to the entire family. So they let it fester. I have tried to consult the world's best doctors for her, but the entire family, including her, is in denial. And nobody can help a patient who refuses to get help."
Her father has, to this date, never spoken to her about her periods.
"Growing up, he was my only parent who was mentally sound. He could have stepped in and helped me establish a healthier relationship with my body. But he didn't. Today, he keeps giving me weight loss tips. It really triggers me because he does not accept his own responsibility in letting my condition get to this point."
When she started seeking medical help for her PCOS, women's doctors - being the way they are in our country and the world - brought little solace too.
"Doctors would blame it on my weight too. None of them told me that my PCOS itself could be the cause behind the weight gain. They prescribed hormone medication that gave me terrible mood swings. There has been such poor research done on PCOS. They call it a lifestyle disease, like diabetes. But diabetes - which affects men more - has had millions of dollars of research behind it. Hardly any research exists on the causes and management of PCOS because it is a 'women's issue'."
"Thankfully, I recently found a doctor who finally explained to me how my mental stress as a child and my genetics (both my parents are diabetic) played a big role in causing my condition. He also showed me the ways I can take charge of my body and manage my condition better."
Armed with this empowering prognosis, Ameya has taken charge of her physical and mental health in an inspiring way.
"Physically, I started practicing yoga, exercising and eating healthier to control my insulin. Mentally, I got into therapy and started practicing meditation. A big part of therapy was to forgive my parents and move on."
After 15 years of being at war with her own body, Ameya has finally found peace with her womanhood.
"Therapy taught me to accept that womanhood is about making friends with my body. I love my body now, and I cheer myself every month I get a period. From celebrating when I did not get my periods, to celebrating when I did get them - it has been a long journey."
Like Ameya, many young girls build unhealthy associations with menstruation at an early age. But the sad reality is that - in the absence of open conversations - even adult women are hurtling blindfolded towards the next phases of our reproductive journey.
Shruti is 42 years old. She always had regular periods but began noticing some big changes lately.
"In the last two years, I suddenly started getting extreme PMS (premenstrual syndrome). A lot of anxiety, irritability, impatience. My bones - the bones in my feet, my hands, even my eye sockets - would be in intense pain. My entire skin feels sensitive. The cramps are more intense too - my stomach hurts as if I have just had surgery. For two years now, I have had to take a 1000mg crocin tablet every 6-7 hours, throughout my periods."
The symptoms got even worse recently, and she decided to seek medical help.
"My periods became erratic. Sometimes, I would get two periods in a month. The bleeding became so heavy that I became anaemic. I met a doctor and she concluded that this was peri-menopause (the period before menopause). She was quite insensitive to the pain I was in. She said I would just have to bear the pain for a few years - it could be 2 years, 5 years, or even 10 years - she had no idea. The thought of living like this for another 10 years terrifies me."
Having a name to call it helped, though. Shruti started asking other women if they had experienced something similar.
“After suffering alone for two years, I started asking my friends and discovered that my symptoms were quite common among women my age. My mother-in-law told me that she went through it in her early 40s too - back when I was newly married. In fact, thinking back, I recall it felt like walking into a hurricane with my mother-in-law in the initial years. She has been very sweet with me since then, but would often be irritable and snap at me in those early years.”
“Only now did the penny drop in my mind to correlate her temper in those years with peri-menopause. If I had known then what she was going through, I would have been able to educate myself, sympathise, and maybe even help her through it. But women are taught not to talk about these things. So she never mentioned it, until I asked her now - 20 years later.”
Shruti says that this stigma around talking about women's reproductive biology causes a lot of damage.
"Peri-menopause can make the PMS ten times worse, and every almost woman goes through it. Yet, because we don't talk about it, there is no support system around it - at home or the workplace. If women in my family, my friends, or even my gynaecologist had told me what to expect, I would not have suffered so much for so long feeling anxious and all alone through it."
Shruti is a mother of three boys, which means she lives in a house with four men.
"A few days before I get my period, every emotion feels magnified. I feel vulnerable and close to an outburst all the time. But I can't have an emotional outburst in front of my family without 'Oh, it's that time of the month' jokes flying around. I just make a conscious effort to get out of their way. I have my outbursts when I am by myself."
Shruti thinks the way Indian families stigmatize periods has a strong bearing on women's lives in their own homes.
"Women in Indian families are taken for granted - we are supposed to listen to everyone but no one truly hears us. We are expected to have infinite patience, all the time. If you have an outburst, you are judged or mocked. PMS is a standard punchline for jokes used to reinforce that women go crazy on their period."
"Since we don't talk about what we are actually going through on our periods, there is no empathy among men for this essential biological function. When I see my husband handling my emotions on my period, I feel I am being humoured - like a child is humoured by an adult."
Shruti tries to see the men's perspective too. She understands that the lack of empathy comes from ignorance, not malice.
"I love my family, my husband, my sons. I know they are good men. It is really just conditioning. I have consciously started talking about periods with my kids to change their perspective of periods. At least now I can tell them sometimes, 'Kids, I have my period so please don't scream and shout around me.' I want to teach them to appreciate what I am going through. I don't want to be humoured. I don't want to have to hide my feelings in my own home. I want what I am going through to be understood and respected."
World Health Organization has declared 28 May as World Menstrual Hygiene Day. That is exactly one week from today.
Do your bit this week by having a family discussion around periods.
If you are a woman, tell your family what your periods are like for you - physically, mentally, emotionally. If you are a man, ask the women in your family what you can do to make their period days more comfortable for them.
It can be uncomfortable at first because of the ridiculous amount of unlearning we have to do as a society, but the more we talk openly about it, the easier it will get.
Open and aloud. Enough with the Whispers already.
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