Menstruation Research Conference 2026
7–8 July 2026
Abstract Book
Brighton and Sussex Medical School
7–8 July 2026
Oral
A Change in the Cycle? Exploring a Group of Young Adults (18-30) Contemporary Menstrual Experiences in South Wales
Presenter: Maddison Wright
Affiliation: Cardiff Univeristy
This qualitative study investigates the socio-cultural factors shaping menstrual product choices and avoidances among young people aged 18–30 in South Wales, UK. It explores how broader social and cultural factors, such as, rapidly changing social media environments, environmental concerns, and widening product options can impact young people’s contemporary experiences of menstruation. By focusing on menstrual product use, preferences, and the reasons for avoiding certain products, the research explores the nuanced interplay between personal and societal influences. Using innovative, creative and participatory methods like object elicitation interviews, creative expression sessions, and a creative writing session, this study provides participants with opportunities to reflect on the underlying reasons for their choices. These methods created space for participants to explore how stigma is reproduced through expectations of concealment and control, and how it is simultaneously challenged through practices of openness, humour and reframing. Findings have been organised across four thematic domains: menstrual stigma, resistance to stigma, menstrual product choice and avoidance, and menstrual education. Participants described stigma as a persistent influence shaping disclosure, comfort and concerns around visibility, while also highlighting moments of resistance that signalled emerging shifts in how menstruation is discussed and understood among peers. Menstrual products were experienced as more than functional tools, reflecting broader cultural meanings around cleanliness, comfort, bodily control and sustainability. Across themes, menstrual education emerged as a foundational, cross-cutting influence, with unequal and inadequate formal education shaping early experiences of shame and uncertainty, and informal self-education functioning as a route toward menstrual literacy and empowerment. By centring young adults lived experiences, this research contributes to menstrual health and stigma scholarship by illustrating how cultural change is uneven and context-dependent, shaped by education, social relationships and material practices of menstrual management. It also demonstrates the value of creative methodologies for researching embodied and stigmatised topics, and highlights implications for inclusive menstrual education, improved product access, and more supportive institutional and public health approaches.
A Trauma Informed Menopause
Presenter: Amelia Brunt
Affiliation: (Organisation) Well Educated
To understand the perimenopause and menopause process through a trauma and resilience informed lens. The correlations between mental health, lived experiences and menopausal experiences. Menopause as a potential portal to trauma healing: integrative approaches to menopause.
Attendees will consider the menopause process through a non medicalised lens. We will look at current theories of nervous system regulation or dysregulation and how this applies to both emotional wellbeing and the peri/menopause experience.
Learning will be centred on mental health in peri/menopause, a trauma informed approach to peri/menopause and the menopause transition as a potential portal towards healing.
Outcomes: Linking the menopause experience to mental health and wellbeing more widely. Placing menopause within the landscape of menstruation, ‘wombhood’ and trauma; bringing a positive, strengths based lens to this terrain.
Experienced speaker and facilitator - I can make this work for the time available. Screen for images might be helpful but not necessary.A qualitative study exploring the perceptions of young women aged 16-19 years about the high rates of anxiety in their age group
Presenter: Ciara Thomas
Affiliation: University of Bristol, Population Health Sciences
Co-authors: Professor Judi Kidger, University of Bristol, Bristol, UK Professor Obioha C Ukoumunne, NIHR Applied Research Collaboration South West Peninsula, University of Exeter, Exeter, UK Dr Lucy Biddle, Associate Professor, University of Bristol, Bristol, UK Dr Myles-Jay Linton, Senior Lecturer, University of Bristol, Bristol, UK
Aim: To explore the views of young women aged 16-19 years as to why there are high rates of anxiety among their age group, how colleges and workplaces play a role, and what these settings can do in response.
Background: Young women face a disproportional risk of experiencing anxiety. By the age of 18, girls are more than twice as likely to experience anxiety compared to boys. To tackle this gender disparity we must understand the risk factors for anxiety in young women, which will inform the development of effective interventions.
Methodology: Semi-structured interviews were conducted with 25 young women. Reflexive thematic analysis was undertaken to develop interpretative themes. Reflexivity was practiced by documenting the researcher’s personal positioning and how this shaped analysis.
Findings: Three themes were created: ‘“It’s a trauma”: The policing of girls’ appearances and the internalisation of strict beauty ideals encourages self-objectification and triggers anxiety’; ‘“They see you as less of a human, so they treat you like less of a human”: The disempowered position of girls and women in society triggers anxiety through uncertainty’, and ‘“I’ve got a sister bond with them”: The power of friendships to protect against and cause anxiety’.
Conclusions: The rich qualitative data provided by this study improves our understanding of girls’ perceptions of the drivers of anxiety. These drivers merit further study to devise gender-specific mental health interventions. A wide range of intersecting factors were perceived to contribute to anxiety in girls, reflecting the complexity of this phenomenon. Key drivers identified include the meticulous evaluation of appearance; sexual objectification and harassment, and contradictory nature of girl friendships. Cognitive dissonance interventions are required that address uncertain sense of self and internal conflict that occurs while girls attempt to navigate the unattainable and often contradictory standards of femininity. Peer-support interventions are required that harness the emotional support girls provide each other to provide resilience against everyday stressors, while also addressing social contexts that encourage peer conflict and judgement.A realist synthesis of menstrual seclusion interventions in Nepal: How programs work, for whom, in which contexts, and why
Presenter: Sara E. Baumann
Affiliation: University of Pittsburgh, Department of Behavioral and Community Health Sciences
Background Menstrual stigma and inequalities continue to undermine menstrual dignity in many parts of Nepal, particularly through the persistence of chhaupadi—a menstrual seclusion practice rooted in social and religious norms. Despite policies criminalizing the practice and multiple programmatic interventions, chhaupadi remains, exposing menstruators to significant physical, psychological, and social harms. To date, no study has systematically examined which intervention components are most effective in addressing menstrual stigma and advancing dignity. This study aims to synthesize programmatic evidence to understand how chhaupadi interventions work, for whom, in which contexts, and why.
Objectives 1. To identify the contextual factors influencing menstrual seclusion intervention success; 2. To examine the mechanisms through which programs address menstrual stigma and inequality; 3. To generate actionable insights to strengthen menstrual dignity–focused programming.
Methods Using a Realist Synthesis (RS) approach, we analyzed scientific and grey literature alongside program documents, multimedia materials, and interview transcripts from consultations with program experts, implementers, and community members in Nepal. Data were examined through context–mechanism–outcome (CMO) configurations to identify how interventions produce change under specific social, cultural, and structural conditions.
Results: Three key preliminary findings emerged. First, multi-level stakeholder engagement—combining policy enforcement with grassroots and household-level dialogue—was critical to shifting deeply embedded stigma. Second, knowledge and behavior change strategies varied in effectiveness by context; while external messengers sometimes disrupted entrenched norms, trusted insiders were essential for sustained shifts in beliefs and practices. Importantly, education alone was insufficient without addressing social power dynamics and structural inequality. Third, male engagement and inclusive approaches were pivotal for advancing menstrual dignity, with experts highlighting the need to better integrate people with disabilities and LGBTIQ+ individuals into programming.
Conclusion: Advancing menstrual dignity in Nepal requires interventions that move beyond criminalization and awareness-raising to address stigma, gendered power relations, and structural inequalities. The findings are expected to provide program planners, researchers, and policy makers a strong conceptual grounding to design subsequent, contextually appropriate and evidence-informed menstrual health programs in a range of settings across Nepal.A standardized non-linear approach to studying menstrual cycle effects on brain and behavior
Presenter: Mateja Perović
Affiliation: Centre for Addiction and Mental Health
Menstrual cycles are major biological events with extensive effects on the brain. However, current approaches to menstrual cycle research face significant methodological issues including lack of standardization in conceptualization and measurement. Notably, hormone levels vary across the menstrual cycle in a non-linear fashion but researchers typically divide the cycle into phases which are then compared to each other as discrete groups, unintendedly masking within-phase variability. The current presentation will outline a novel method, validated in published work, which treats the cycle as a standardized, continuous variable with non-linear properties. Major advantages of this approach include increased data resolution, reduced bias from individual variance in cycle length, and capacity for comprehensive characterization of the full extent of variance in outcomes of interest across the menstrual cycle. Notably, it can be applied to both cross-sectional and repeated measures data, increasing sensitivity and statistical power in exploratory studies, and boosting data resolution of gold-standard longitudinal approaches. Utility of the method will be demonstrated using multimodal (hormonal, behavioural, and neuroimaging), largely publicly available data, using sampling techniques ranging from cross-sectional to longitudinal. The demonstration will be based on cognitive data, but the method can be applied to a broad range of clinical and physiological outcomes, recognizing the fact that the menstrual cycle is a multi-system vital sign and a key modulator of mental health.
Accessible Approaches to Menstrual Health Research with Adolescents with Disabilities
Presenter: Bushra Mahnoor
Affiliation: Mahwari Justice
This paper discusses the methodology used in a qualitative study with adolescents and young women with visual and hearing impairments in Pakistan, focusing on approaches that enable accessible participation in menstrual health research. Menstrual health scholarship frequently identifies stigma and lack of awareness as key barriers (Hennegan et al., 2019), yet less attention is paid to how research practices themselves structure participation, particularly for people who require communication and mobility accommodations. Disability studies argue that exclusion is produced through social and institutional design rather than individual impairment (Oliver, 1990; Shakespeare, 2013). The study aimed to explore how research design can enable the participation of adolescents and young women with disabilities in menstrual health research.
We conducted 15 in-depth interviews, two focus group discussions (n=11), and a co-creation workshop in Lahore. Pakistan Sign Language interpretation was integrated across interviews and focus groups to ensure communication access, and interviews with visually impaired participants were conducted remotely via Google Meet and WhatsApp in response to mobility constraints. After transcription, we coded all material in ATLAS.ti using thematic analysis and examined workshop discussions alongside interview data to inform the development of an accessible menstrual health toolkit.
The findings highlight how standard research formats often assume normative communication and mobility conditions, which can inadvertently exclude participants with disabilities. Integrating sign language interpretation, flexible interview formats, and accessible facilitation approaches enabled participants to engage more fully in discussions on menstrual health, stigma, and access to information. Insights from interviews and workshop discussions directly informed the design and content of the accessible menstrual health toolkit.
Throughout the research process, decisions regarding facilitation and format were shaped by participants’ communication and mobility requirements. This paper argues that menstrual health research cannot address inequality if research design itself excludes those who require adapted communication and mobility access, and highlights methodological considerations for more accessible menstrual health research.Acute Hospital Admissions Across the Menopausal Transition in Women with Depression: A Retrospective Cohort Study in Our Future Health
Presenter: Haya Deeb
Affiliation: Division of Psychiatry, The Centre for Clinical Brain Sciences CCBS - University of Edinburgh
Co-authors: Kelly Fleetwood - Usher Institute, University of Edinburgh, Edinburgh, UK Katie FM Marwick - Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
Background and Aim Times of reproductive transition such as menstruation and pregnancy have been associated with an increased risk of onset and worsening of both physical and mental health conditions. However, the association of the menopausal transition with acute hospital admissions remains uncharacterised. This study examined all-cause unplanned admission rates across the menopausal transition stratified by mental health history, compared to an age-matched male cohort.
Methods We used Our Future Health, a cohort study of adults in the UK linked with NHS England hospital admission records, to examine unplanned hospital admissions in postmenopausal women who experienced spontaneous menopause, and age-matched males. Time was indexed as years from self-report final menstrual period (-10 to +10). Women were stratified by self-reported mental health history: major depressive disorder (MDD), postpartum depression (PPD), and no mental health history. Admission rates per 1,000 person-years were averaged across periods consistent with STRAW+10: pre-menopausal (-10 to -5 years), peri-menopausal (-1 to +1 years), and post-menopausal (+5 to +10 years). Mixed-effects Poisson regression models were fitted adjusting for age at menopause, calendar year of admission, ethnicity, deprivation, and social isolation.
Results Among 270,622 women, 246,688 unplanned admissions were recorded. All-cause admission rates for the whole cohort rose from 41.1 per 1,000 person-years pre-menopausally to 57.9 peri-menopausally, before a modest rise to 62.0 post-menopausally — in contrast to the male cohort (n = 275,885), which showed a steady increase in admission rates with proxy menopause stage (42.5, 58.1, and 74.3 per 1000 person years). Women with MDD showed a peri-menopausal increase in admission rate compared to premenopause (aRR 1.11, 95% CI 1.05–1.18) with rates returning to pre-menopausal levels post-menopausally (aRR 1.00, 95% CI 0.91–1.09). Women with PPD also showed a peri-menopausal rise (aRR 1.21, 95% CI 1.12–1.30) with partial recovery of rates post-menopausally (aRR 1.16, 95% CI 1.05–1.29). In contrast, women with no mental health history showed a steady increase in admission rates peri-menopausally (aRR 1.28, 95% CI 1.25–1.30) and post-menopausally (aRR 1.43, 95% CI 1.40–1.47), mirroring the male cohort.
Conclusion Women with a history of MDD or PPD show an increase in all-cause hospital admissions during the perimenopause compared to pre and postmenopause. This is distinct from the steady increase in hospital admissions across menopausal stages in women without a mental health history, and in age-matched males. These findings may reflect a hormonally-driven peri-menopausal vulnerability with implications for healthcare planning and equitable support.Advancing Measurement of Menstrual Health in the Context of Contraception: A Person Centered Conceptual Model
Presenter: Emily Hoppes
Affiliation: FHI 360
Co-authors: Amelia Mackenzie(1), Jenni Smit(2), Marija Miric(3), Alison Edelman(4), Mags Beksinska(2), Angely Catano(3), Stephanie Chung(5,6), Eunice Cuevas(3), Maddison Delacerda(4), Marci Messerle Forbes(4), Leah Ingeno(4), Laura Jacobson(4), Mbali Khomo(2), Elena Lebetkin(5), Thandiwe Majola(2), Melissa Matos3(), Mbali Mavundla(2), Sarah McCaffrey(7), Alicia Mendez(3), Massiel Mendez(3), Nothando Mhlaba(2), Nzwakie Mosery(2), Lungelo Ndlovu(2), Bongeka Qiya(2), Kayla Stankevitz(6), Alexis Sullivan(1), Bongiwe Zulu(2)
Affiliations
1 Global Research, FHI 360, Washington, District of Columbia, United States
2 Wits MRU (Maternal, Adolescent, and Child Health Research Unit, University of the Witwatersrand), South Africa
3 Two Oceans in Health, Dominican Republic
4 Oregon Health & Science University, Portland, Oregon, United States
5 Global Research, FHI 360, Durham, North Carolina, United States
6 Department of Maternal and Child Health, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, United States
7 Global Research, FHI 360, Los Angeles, California, United States
Background & Objectives: Despite the central role of the menstrual cycle in health and wellbeing, menstrual experiences are rarely measured systematically in biomedical research, including clinical trials, in contrast to other physiological functions. Menstrual stigma and the historical exclusion of people who menstruate from research design have contributed to limited, inconsistent, and non–person centered measurement of menstrual health outcomes. These gaps are particularly evident in the context of contraception, where changes to bleeding and related symptoms, known as contraceptive induced menstrual changes (CIMCs), are common, meaningful to users, and influential in method satisfaction and continuation, yet remain poorly captured in clinical trials.
Methods: We developed a person centered conceptual model of menstrual health experiences using qualitative data from 18 focus group discussions with 106 people experiencing menstrual changes while using hormonal or intrauterine contraception in Durban, South Africa; Santo Domingo, Dominican Republic; and Portland, Oregon, United States. Focus groups employed interactive, participatory methods—including ideation card activities, abbreviated body mapping, and guided discussion—to elicit detailed accounts of menstrual changes and their impacts on daily life, health, and wellbeing. Data were analyzed using a collaborative virtual affinity mapping approach. Findings were then integrated with relevant theory, global research agendas, and existing conceptual models from the menstrual health and patient reported outcomes literature.
Results: The resulting conceptual model situates menstrual health within the broader contraceptive experience and comprises three interconnected components. The first captures the baseline menstrual cycle and key domains of menstrual change, including pain, bleeding volume, bleeding patterns, and characteristics of blood (e.g., color consistency, and smell). The second addresses impacts—practical, mental, emotional, social, and distal—on health, quality of life, relationships, and contraceptive decision making. The third highlights perceptions, including beliefs, expectations, information sources, and understandings of what constitutes “normal” menstruation. Across domains, experiences were overlapping and interrelated, with social and informational context playing a central role in how menstrual changes were interpreted and managed.
Conclusions: This person centered conceptual model provides a rigorous foundation for improving how menstrual health is conceptualized and measured in contraceptive research. By centering lived experience across diverse global contexts, the model can inform measurement of contraceptive-induced menstrual changes that enhance comparability across studies, improve clinical guidance and product labeling, and support more informed, person centered decision making for people who menstruate.Analyzing Menstrual Stigma Through a Feminist Disability Studies Lens: From Self-Surveillance Practices to the Incommunicability of Pain
Presenter: Tessa Peery
Affiliation: University of North Carolina at Greensboro - Women’s, Gender, & Sexuality Studies Department
This Women’s, Gender, and Sexuality Studies Master’s thesis analyzes menstrual embodiment and menstrual stigma through a Feminist Disability Studies lens. It examines the incommunicability of menstrual pain; critiques the exclusionary language of the Americans with Disabilities Act of 1990 (ADA) as it pertains to menstruators; and analyzes recent menstrual product advertisements that promote narratives of hyperproductivity, ableism, and athletic ‘toughness’. The project further explores the social coercion placed upon menstruators to self-objectify, self-surveil, and conceal their menstrual status in order to conform to normative expectations of positivity and hyperproductivity.
Methodologically, this thesis draws upon autobiographical narrative, local accounts of denied legal protections and workplace or academic accommodations, and a critical analysis of three contemporary menstrual product TV advertisements. Key concepts of this work include crip time, hyperproductivity, ableism, the incommunicability of chronic pain, and menstrual stigma and invisibilization.
From this analysis, menstruation is conceptualized as a unique phenomenon, in that it is normalized yet stigmatized, expected yet unacknowledged, cyclical yet chronic, and common yet rendered invisible. Menstruators’ quality of life and self-perception are biopolitically shaped by institutional structures, media narratives, and dominant medical approaches to pain management. By reimagining systemic institutions, social norms, and the concepts of time, productivity, pain, and stigma, this thesis calls for the creation of safe spaces and ‘cranky’ attitudes in which menstruators can adequately express menstrual pain, refuse expected notions of self-surveillance and objectification, and redefine Western ideas of liberation and empowerment through their lived realities of menstrual embodiment.Assessing the Burden and Determinants of Menstrual Disorders among Young Adult Women in India: An epidemiological approach
Presenter: Puja Das
Affiliation: International Institute for Population Sciences (IIPS), Mumbai and Department of Public Health and Mortality Studies
Background: Menstruation is an intrinsic biological process that marks the journey from menarche to menopause. Menstruation regulates the gynecological function and confirms childbearing potentiality throughout a women’s life course. Despite its biological importance, menstrual health remains an underexplored domain within the broader field of public health which affecting the physical, psychological, and social well-being of young women. This study examines the burden of menstrual disorders and their impact on the quality of life among young adult women aged 15–34 years in West Bengal, India. Methodology: A community-based cross-sectional survey was conducted among 420 women selected through cluster random sampling from both rural and urban settings in West Bengal, India. Data were collected using a structured questionnaire that captured socio-demographic characteristics, lifestyle factors, self-reported menstrual symptoms. Menstrual disorders were constructed based on self-reported menstrual symptoms. Quality of life was assessed using standardized indicators used by WHO-HQOL scale. Quantitative data analysis was performed using STATA-16 version software. The analysis included descriptive statistics, bivariate analysis, chi-square test and binary logistic regression to examine the relationship between dependent and independent variables. Results: Study results found that over 75 percent of women had faced any of menstrual disorder. The findings explored that dysmenorrhea, premenstrual syndrome (PMS), oligomenorrhea, poly cystic ovarian diseases (PCOD) were found to be very common and prevalent menstrual disorder among study respondents. Menstrual distress, including pain, fatigue, and mood changes, further reduced well-being. Quality-of-life differences were also influenced by residence, occupation, and caste. Regression analysis further confirmed significant negative effects of major menstrual disorders on high quality of life. Dysmenorrhea and PCOD were 0.03 times and 0.25 times less likely to report a high quality of life. Conclusion: The study underscores the urgent need for improved menstrual health services, early diagnosis, and community-based awareness to enhance the overall well-being of young women in India.
Assessing the impact of group‑based menstrual health workshops and psychoeducation on menstrual pain among adolescent girls in Nepal: Evidence from the MeJARa cluster randomised controlled trial
Presenter: Mel Channon
Affiliation: Department of Social and Policy Sciences, University of Bath
Co-authors: Prof Emma Fisher, University of Bath Dr Rebecca Evans, University of Bath Silviya Chaulagain, CREHPA, Nepal Aditi Rai, CREHPA, Nepal Dr Mahesh Puri, CREHPA, Nepal
Objectives Menstrual pain, stigma, and limited menstrual knowledge substantially affect adolescent girls’ wellbeing in Nepal, where many reach menarche without prior information about menstruation. This study aimed to evaluate whether a community programme of group-based menstrual justice workshops and psychoeducation could reduce menstrual pain interference and improve menstrual health and psychosocial outcomes among adolescent girls.
Design A cluster randomised controlled trial with baseline and post intervention assessments, incorporating intention to treat, per protocol, and complier average causal effect (CACE) analyses.
Setting Two in Nepal: Kaski (Gandaki Province) and Surkhet (Karnali Province). Participants 1,920 girls aged 13–18 years were enrolled and randomised to intervention or control clusters. A matched caregiver or household head was also interviewed. 1,821 girls (903 control and 918 intervention) participated in the post-intervention survey. 1,860 (97%) of the matched adults participated in the follow-up.
Intervention Girls in intervention clusters participated in twelve weekly workshops covering menstrual biology, pain psychoeducation, coping strategies, communication skills, and healthy practices. Caregivers and community members attended four complementary sessions addressing menstrual beliefs and supportive responses. Control clusters received no intervention. Of those assigned to intervention clusters, 815 girls participated in the intervention with 316 (34%) attending all 12 sessions in-person and a further 246 (26%) receiving catch-up information so that they received information from all sessions.
Primary and Secondary Outcome Measures The primary outcome was menstrual pain interference (12 item scale). Secondary outcomes included menstrual knowledge, menstrual stigma, ability to reduce menstrual pain, depressive symptoms (DSRS), and anxiety (GAD 7). Analyses incorporated cluster robust standard errors and stratification variables. CACE models used randomisation as an instrument for full attendance.
Results (preliminary analyses as full data received March 2026) 92% of participants who attended workshops reported that they would recommend the workshops to friends. Pain interference showed a modest, non-significant decrease amongst compliers (p=0.069), while the ability to reduce menstrual pain improved markedly (CACE=+0.35, p < 0.001). Menstrual knowledge also increased significantly among compliers (CACE=+1.22, p=0.001). Depressive symptoms decreased significantly among compliers (CACE=−1.79, p=0.007). Menstrual stigma showed only a small reduction.
Conclusions The intervention was effective in improving menstrual knowledge, coping capacity, pain management skills, and depressive symptoms, with the strongest effects observed among girls who received the full programme. Modest shifts in pain interference and stigma indicate that some outcomes may require longer follow up or broader community change. Twelve month follow up will assess the durability of these effects and their implications for wider sexual and reproductive health trajectories.Association between Menstrual Restrictions, Menstrual Product, and Fertility among Women in Nepal
Presenter: Binda Khatri
Affiliation: University of Texas at Austin
Association between Menstrual Restrictions, Menstrual Product, and Fertility among Women in Nepal Menstruation is a biological process; however, it has been a subject of debate because social and cultural dynamics are added to this natural process in many parts of the world. Questions range from various restrictions surrounding menstruation to the inaccessibility of hygienic products that menstruating women have to deal with. In the context of Nepal, the menstruation restrictions are pervasive; according to the Nepal Demographic Health Survey (NDHS, 2022), around 85% of reproductive-age women face at least one or more restrictions, and only around 48% use hygienic menstrual blood collection products. Much research talks about the prevalence of variations in menstrual restrictions and the blood-collecting products by respondents’ socioeconomic characteristics in Nepal. Typically, these studies are conducted in small geographical settings using a small sample size. There are very few nationally representative studies. Similarly, menstruation, a biological transition in the body, has been made a social marker in societies in Nepal, imposing several norms, but there is no study to my knowledge that either examined the association between the menstrual restrictions and fertility or blood collection products and fertility. Consequently, this study seeks to investigate the association between two potential drivers (menstrual restrictions and blood-collecting products) and the number of children among reproductive-aged women in Nepal. This study utilized the nationally representative data, NDHS 2022. The outcome measure was the number of children ever born, and the focal predictors were the number of menstrual restrictions and the blood collection products; respondents’ socioeconomic characteristics were adjusted as control variables. Univariate, bivariate, and multivariate statistics were used for data analysis. The findings show that there is a positive association between the number of menstrual restrictions and the number of children (IRR= 1.008, p<0.05). Similarly, there is an inverse association between the use of hygienic menstrual blood collection products and the number of children ever born (IRRunhygienic=1.049, p<0.001). This study shows that socially and culturally embedded practices, menstruation rituals, and the unavailability of hygienic menstrual products are associated with women’s fertility. Having children is a very big decision for every woman, and understanding the factors that are associated with it is crucial to provide reproductive agency to women. These findings are important for sociological research on gender inequality, demography, life course theory, and women’s health. Keywords: Blood Collection Products, Menstrual Restrictions, Nepal, Number of Children
Associations Between Cardiometabolic Profile in Pregnancy and Risk of Primary Dysmenorrhea in Offspring: The ABCD Study
Presenter: Siyu Zhou
Affiliation: Department of public and occupational health
Context Primary dysmenorrhea (PD), characterized by pain during menstruation and associated social consequences, affects the majority of reproductive age women. As several cardiometabolic aspects contribute to the presence of PD, we aim to evaluate whether the fetal programming hypothesis, related to intrauterine conditions affecting offspring’s reproductive health later in life, could be applicable. Objectives To evaluate to which extent the individual and clustered maternal cardiometabolic profile during pregnancy are associated with dysmenorrhea in female offspring at age 15-16 years, and whether these associations are mediated by the offspring’s age at menarche. Methods Data were obtained from a prospective birth cohort, the Amsterdam Born Children and their Development (ABCD) study. Mothers with menstruating female offspring were included (n=982). PD was defined as menstrual abdominal and/or back pain leading to analgetic use. Maternal cardiometabolic profile during pregnancy period included pre-pregnancy body mass index (pre-pBMI), glucose levels, systolic and diastolic blood pressure, triglycerides, and Apolipoprotein A1 at the 12th week of gestation. Multivariable logistic regression was performed to analyze both individual and clustered cardiometabolic profile components. Results The prevalence of PD in the ABCD cohort was 49.2%. The risk of dysmenorrhea was higher in offspring of mothers with a higher pre-pBMI (OR: 1.15, 95%CI: 1.01-1.30). This association was partially mediated by an earlier age at menarche. Conclusion our findings indicate that maternal pre-pBMI is associated with the risk of PD in their offspring at the age of 15-16 years. This association is partially mediated by an earlier age at menarche. In order to better understand PD, our observations suggest the need for future research to take into account the early life (prebirth) courses.
Attention-deficit hyperactivity disorder (ADHD) and menstrual cycle symptoms in females: Findings from a cross-sectional survey
Presenter: Amandine Sénéquier
Affiliation: Queen Mary University of London, Department of Psychology
Background. Attention-deficit hyperactivity disorder (ADHD) has gained increasing recognition in girls and women in recent years, yet its relationship with menstrual cycle-related symptoms remains unclear. Although emerging evidence suggests that ADHD symptoms may be influenced by the hormonal fluctuations occurring during the menstrual cycle, differences in menstrual cycle-related symptoms between females with and without ADHD have not been well characterised.
Research aim. To investigate differences in menstrual cycle-related symptoms between females with and without ADHD, taking menstrual cycle phases into account.
Objectives. 1) To compare the frequency and functional impact of menstrual cycle-related symptoms on females with and without ADHD. 2) To determine whether differences between groups (ADHD vs. no ADHD) vary by menstrual phase (premenstrual phase, menstruation and the remaining cycle phases).
Methods. In this cross-sectional study, 374 females aged 18-38 years completed an online questionnaire collecting data on demographics, self-reported ADHD diagnosis, ADHD symptoms and the frequency and functional impact of menstrual cycle-related symptoms across the premenstrual phase, menstruation, and the remaining cycle phases. Menstrual cycle-related symptoms were measured using a purpose-designed instrument adapted from existing measures. For each menstrual cycle phase, symptom frequency and functional impact were analysed categorically and as continuous total scores derived by summing item responses. Group differences between participants with and without ADHD were examined using Chi-square tests and multinomial logistic regressions for categorical outcomes, and independent sample t-tests for continuous summary scores.
Results. In total, 182 (48.66%) participants reported an ADHD diagnosis. Those with and without reported ADHD did not differ significantly in demographic characteristics. Females with ADHD reported significantly higher total scores on menstrual cycle-related symptom frequency and functional impact across the premenstrual phase, menstruation, and the remaining cycle phases compared with those without ADHD (p<0.001). Similarly, at the item-level, females with ADHD reported higher frequency and functional impact of several menstrual cycle-related symptoms in all cycle phases and across all symptom domains including somatic, gastrointestinal, cognitive, and neurological symptoms, compared with individuals without ADHD. For example, females with ADHD were more likely to report low back pain, nausea, bloating and fatigue during the premenstrual phase and menstruation compared to females without ADHD.
Conclusion. Females with ADHD reported greater menstrual cycle-related symptom frequency and functional impact than those without ADHD across all cycle phases. These findings suggest that menstrual symptom experiences may differ between females with and without ADHD and warrant further investigation.Attitudes towards Organisational Menstrual Leave Policies and Menstrual Education: A Multi‑Study Experimental Investigation
Presenter: Ekaterina Stepaniak
Affiliation: University of Lausanne, Faculty of Business and Economics
Co-authors: Professor Patrick Haack, Faculty of Business and Economics, University of Lausanne Professor Clara Kulich, Faculty of Psychology and Educational Sciences, University of Geneva
Menstrual leave, a policy allowing employees to take time off for menstrual-related symptoms (MRSs), is receiving increasing attention in research and practice. The policy has sparked debate: Some argue it effectively supports menstruators at work, whereas others worry it may reinforce discrimination against women or disadvantage the dominant group – cisgender men. This research explores attitudes toward menstrual leave and tests whether providing information about MRSs can reduce resistance and increase policy support.
We conducted online between-person experiments. Study 1 involved 145 Swiss HR professionals (113 women; Mage = 41.56), Studies 2 and 3 ‒ 1,425 UK Prolific participants (715 women, 5 non-binary participants; Mage = 41.41). Participants were randomly assigned to the following conditions: menstrual leave; menstrual leave with information about MRSs; sick leave (control); or sick leave with information about general illness symptoms (additional control in Study 3). In Studies 1–2, the MRSs presented were severe, and menstrual leave was explicitly available monthly, whereas the frequency of sick leave was not specified. In Study 3, the frequencies were balanced across all conditions. Participants first read about a hotel that had adopted one of the leave policies. In the two “information” conditions, they also additionally received details about MRSs or general illness symptoms. They then reported perceived unfairness, support for the policy, expected support from supervisors (and colleagues in Study 3), expected misuse, and their own likelihood of taking leave (Studies 2-3).
As expected, providing MRS information increased personal support for menstrual leave relative to menstrual leave without information (Study 2-3). However, when the monthly availability of menstrual leave was specified—regardless of accompanying information—participants anticipated greater misuse of menstrual leave compared with sick leave. Emphasising severe MRSs also reduced women’s own willingness to use menstrual leave. Furthermore, participants expected lower support from supervisors (Studies 1–2) and colleagues (Study 3) for menstrual leave than for sick leave, regardless of information provided—an effect reflecting third party prejudice.
Overall, these findings suggest that while menstrual education can increase support for menstrual leave, it is important to focus on general rather than severe MRSs, signalling that anyone concerned may take leave if they feel the need. Limiting the duration of menstrual leave may also reduce concerns about misuse. Finally, the results point to perceived third-party prejudice, which may hinder policy adoption. Future research will examine whether this prejudice is real or perceived and how it might be corrected.Autonomic Nervous System Activity and Affective Variability Across Menstrual Cycle Phases: A Scoping Review
Presenter: Arushi Handa
Affiliation: Independent Researcher (Counselling Psychologist- Private Practice, India)
Co-authors: Arnav Sharma, Student, KR Mangalam University, Gurugram, India
Background: Fluctuations across the menstrual cycle have been strongly linked to variability in affective states. The autonomic nervous system (ANS) has been proposed as a potential intermediary linking menstrual cycle changes to variations in affect. Some evidence suggests that ANS parameters such as heart rate variability (HRV), baroreflex sensitivity (BRS), electrodermal activity, muscle sympathetic nerve activity (MSNA) and pupillary light reflex (PLR) may vary across menstrual cycle phases. The presence of estrogen and progesterone receptors in the central autonomic regulatory regions including the hypothalamus and brainstem nuclei suggest potential pathways through which hormonal signals may influence autonomic regulation. However, the nature, magnitude and consistency of these relationships is currently unclear. Studies vary considerably in which ANS parameters are measured, and how variability in affect and menstrual cycle phases are operationalized and measured.
Objectives. This scoping review will examine the nature and scope of empirical evidence on associations between ANS activity and affective outcomes such as mood variability, emotional regulation and other psychological symptoms across menstrual cycle phases. It aims to map and synthesize the range of definitions and measures used for ANS parameters, mood and menstrual cycle phases, along with identifying understudied populations and methodological gaps that may shape future research directions.
Methods. Prisma-ScR guidelines and the JBI framework are used to conduct systematic searches across MEDLINE, Embase, PsycINFO, Scopus, CINAHL, and Europe PMC. Relevant terms (such as menstrual cycle, ANS, heart rate variability, emotional regulation etc) are used. Searches will be supplemented by grey literature screening, hand searching through selected key journals, and citation tracking through Google Scholar. Eligible studies must be quantitative, and meet a predefined eligibility criteria. Two independent reviewers will screen abstracts and full texts, and resolve disagreements through either consensus or by consulting a third reviewer. Extracted data will be charted using tables, as well as using descriptive summaries. Database searches and title and abstract screening are currently in progress.
Expected contribution. This review hopes to provide a structured map of the existing evidence base around ANS and affect variability across menstrual cycle phases. It also hopes to identify relevant gaps in terms of geographic and demographic diversity of samples, representation of clinical population and so on. Findings aim to inform the development of integrative mechanistic frameworks linking hormonal, autonomic, and affective changes, with implications for both future research and clinical understanding.Beyond Blood: Social Impact of Menstrual Stigma in Spain
Presenter: Sara Sanchez Lopez
Affiliation: Universitat Politécnica de València
This study examines the social impact of menstrual stigma in Spain, based on the premise that while menstruation is a biological process, its meanings and consequences are largely shaped by cultural norms that influence how it is perceived, experienced, and managed in everyday life. The objective is to analyse how stigma and taboo affect participation, wellbeing, and interactions with institutions, and to identify social factors that may mitigate these effects.
A nationwide cross-sectional mixed-methods survey was conducted with 4,028 participants aged 14 years and older, residing in or born in Spain. The questionnaire included items on demographics, menstrual knowledge and practices, access to healthcare, and perceptions and experiences related to menstruation. Quantitative data were analysed using descriptive statistics to contextualise patterns of behaviour and participation, while qualitative open-ended responses were analysed thematically through an inductive and iterative process, guided by a constructivist approach that attends to the social meanings attached to menstruation.
The findings indicate that menstruation commonly influences everyday participation, particularly in activities involving bodily exposure or public visibility, such as wearing certain types of clothing, swimming, going to the beach, or practising sports. While some respondents described limiting their activities due to physical symptoms such as pain or fatigue, many also referred to anxiety, fear of leakage, and social discomfort, reflecting the internalisation of stigma and expectations of discretion. In educational and professional contexts, participants frequently reported attending classes or work despite discomfort, hesitating to take leave, and feeling pressure to minimise or conceal menstrual needs in order to meet productivity norms. Experiences of exclusion and judgement were also described in interpersonal and cultural settings, alongside accounts of being discredited through gendered stereotypes.
At the same time, the study highlights the importance of supportive social environments. Peer empathy, sorority, and institutional flexibility were identified as key protective factors that help reduce stress, enable participation, and promote more positive menstrual experiences. However, persistent gaps in menstrual education and the limited integration of menstrual health into clinical interactions continue to pose barriers to wellbeing and equity.Beyond Data-Driven Technologies: Material and Fluid Approaches to Interacting with Menstrual Bodies
Presenter: Yixun Li
Affiliation: Institute for Design Informatics, University of Edinburgh
Background: Menstruation has often been surrounded by silence and shame across cultures, requiring a variety of concealment, medical modification and self-management. While the rise of Femtech has brought new visibility, it frequently reframes menstruation through lenses of datafication and normativity. Specifically, these emotional, physical, and social experiences are quantified and transformed into standardised numeric data within menstrual trackers, which is then constructed as objective self-knowledge. However, such approaches simplify and homogenise what are otherwise complex, messy, and embodied experiences. Meanwhile, the one-sidedness of data representation may result in confusion and anxiety for individuals whose lived experiences and self-perceptions do not align with their datafied selves.
Aim: This work explores how design can move beyond data-driven menstrual tracking to support more embodied, subjective and situated engagements with menstruation.
Method: To investigate menstruators’ highly subjective experiences, we adopted a Research through Design approach, where insights are generated through making and reflecting on design artefacts. Three projects will be presented to illustrate this further.
Projects: (1) The journey of menstruation, a cultural probe comprising journaling and weaving practices to explore qualitative, situated experiences of menstruation beyond what is typically captured by menstrual tracking technologies. Eight participants engaged with the probe for nearly a full menstrual cycle, and they were then interviewed to explore how they perceived, deconstructed, and materialised their menstrual experiences.
Building on insights gained from the ‘Menstrual Journey’ project, I have further developed a digital application. By integrating weaving practices into this digital period-tracking app, it encourages users to personalise the style and meaning of the materials, recording their menstrual experiences through weaving rather than digital data. In doing so, it facilitates menstruators’ recognition and acceptance of the complexity, irregularity and subjectivity of menstrual bodily experiences.
MenstaRay, a biomimetic interactive artefact using soft robotic materials, aiming to represent intangible and ineffable menstrual pain experiences through bodily and dynamic interactions. It features a double-sided design, depicting the coexisting yet contradictory experiences of menstrual pain and self-care. By inviting people to engage with their menstrual pain in emotional, sensory, and interpretive ways, it may create space for individuals to express, share, and reflect on their experiences.
Beyond the Blood: Exploring Dysmenorrhea, It’s Magnitude, Determinants, Impact, and Health-Seeking Behaviour among School-Going Adolescents in Central India, A Mixed-Methods Study
Presenter: Dr Devipriya S
Affiliation: All India Institute of Medical Sciences Nagpur, Department of Community Medicine
Co-authors: Dr Pradeep R Deshmukh, Professor and HOD, Department of Community Medicine, AIIMS Nagpur
Aim and Objectives: To find prevalence, determinants, coping strategies, health-seeking behaviours, and the functional and emotional impact of dysmenorrhea among adolescent school-going girls in rural Central India. Methods: This study enrolled 546 post-menarcheal adolescent girls from two rural schools in Central India. The quantitative component assessed prevalence, determinants, and impact using standardised questionnaires, while the qualitative arm explored health-seeking behaviours through in-depth interviews until thematic saturation. By convergence model of triangulation data analysis, integrated statistical testing (95% CI, Chi-square, Odds Ratios) with a rigorous thematic analysis that synthesised 105 initial codes into five overarching themes. Results: Majority of participants 92.7% (95% CI: 90.6-94.7%), experienced dysmenorrhea. 51.2% reported moderate severity, 26.7% mild, and 20.1% severe pain. Late adolescence (AOR = 7.78; 95% CI: 2.75-21.97; p < 0.01) and family history of dysmenorrhea (AOR = 2.26; 95% CI: 0.97-5.25; p = 0.05) emerged as significant determinants in multivariate analysis. Dysmenorrhea imposes mild to high functional and emotional impact on daily lives of 73.82% of participants. It caused physical, emotional, and psychological distress, which is exacerbated by inadequate school infrastructure (dedicated sick rooms), leading to difficulty concentrating and absenteeism. Mothers (80.79%) were identified as primary source for adolescent school-going girls, with healthcare professionals and media (9.7%) playing less central role. Communication barriers, especially those rooted in gender and personal discomfort, significantly impede open dialogue about menstruation. Participants primarily relied on bed rest (71.34%) or heating pads (10.28%) to relieve pain. Strategies like yoga or exercise were less reported. Reliance on traditional home remedies over formal pharmacological interventions. Study highlighted role of familial support—from mothers, grandmothers, and fathers—providing remedies, rest, and comfort. Majority (67%) had not sought formal treatment for dysmenorrhea within the past year. Among 33% who did seek treatment, 30.83% consulted a doctor, followed by traditional practices (12.48%). Health-seeking behaviour remains largely limited to informal sources due to normalisation of menstrual pain, exacerbated by lack of menstrual education, fear of medication side effects, and structural barriers like absence of school sick rooms and a shortage of local specialists. Conclusion: While dysmenorrhea affects adolescent well-being and academic performance, management remains largely passive due to pain normalisation and structural barriers to professional healthcare. Study highlights critical need for formal menstrual education and improved school infrastructure to bridge gap between high prevalence and limited clinical health-seeking behaviour.
Beyond the Classroom: Menstrual Support & Wellbeing
Presenter: Precious Nzekwe
Affiliation: Brighton and Sussex Medical School
Introduction At any given time, approximately 300 million individuals globally are managing menstruation [1]. Among university students, menstrual disturbances are highly prevalent, with 72.7% reporting dysmenorrhoea and 51.3% experiencing premenstrual syndrome (PMS), reflecting a significant burden within this population [3]. While menstruation is often framed within reproductive health discourse, its broader academic, psychological, and social implications remain underexplored. The physical symptoms of menstruation are frequently accompanied by psychosocial consequences, including reduced concentration, absenteeism, and withdrawal from social engagement. These effects challenge the holistic concept of menstrual health, defined as complete physical, mental, and social wellbeing [3]. The impact therefore extends beyond biological processes, influencing academic participation, equality, and overall quality of life within higher education settings [4]. This study aims to examine the multidimensional impact of menstruation on university students, exploring both symptom burden and the institutional challenges faced in managing menstrual health.
Methods A mixed-methods design was employed using an anonymous online survey developed and distributed via Qualtrics. The survey was disseminated through posters and social media across three campuses in Brighton and Hove. Over 80 students participated. The quantitative component comprised structured multiple-choice and Likert-scale questions assessing symptom prevalence, academic disruption, and access to support. Data were analysed using descriptive statistical methods, including frequencies and percentages, to identify patterns in symptom burden and academic impact. The qualitative component included open-ended questions exploring personal experiences, perceived barriers, and views on institutional support. Responses were analysed using thematic analysis following Braun and Clarke’s six-phase framework, enabling identification of recurring themes within participants’ lived experiences.
Discussion Findings demonstrate a substantial menstrual health burden among students, including dysmenorrhoea, PMS, polycystic ovarian syndrome (PCOS), and premenstrual dysphoric disorder (PMDD). Quantitative data indicated significant academic disruption, while qualitative themes highlighted inadequate institutional support, limited awareness, and the absence of formal accommodations. These findings underscore the need for universities to implement targeted interventions, including improved access to menstrual products, health education, and supportive policies. Addressing menstrual health as a structural and institutional issue may reduce absenteeism, improve engagement, and promote equity in higher education. Framing menstrual health as a human right is central to this discussion, as it upholds dignity, prevents discrimination, and ensures equal participation in academic life [5].
Conclusion Menstrual health significantly affects academic performance, psychological wellbeing, and student equality. Universities must recognise menstrual health as a legitimate public health and educational concern. Providing comprehensive support systems can foster a more inclusive and equitable academic environment, ensuring that students who menstruate are able to participate fully in university life.
Beyond the Luteal Phase: Mood and Cognitive Changes in Premenstrual Syndrome
Presenter: Miflah Hussain
Affiliation: University of Nottingham Malaysia, School of Psychology
Co-authors: 1. Ms, Carmen Boon, University of Nottingham Malaysia (Malaysia). 2. Ms, Hasya Fatiha Zuraimy, University of Nottingham Malaysia (Malaysia) and The International School for Advanced Studies (Italy). 3. Ms, Aysha Fateeha Binti Ahmad Sharudin, University of Nottingham Malaysia (Malaysia). 4. Ms, Danea Binti Mohd Fadzli, University of Nottingham Malaysia (Malaysia). 5. Dr, Po Ling Chen, University of Nottingham Malaysia (Malaysia).
Aim and Objectives: Menstruating women frequently report changes in psychological functioning (e.g., mood and cognition) during the luteal phase preceding menstruation, and individuals with Premenstrual Syndrome (PMS) report pronounced changes that disrupt daily life. However, it remains unclear whether differences between individuals with and without PMS are confined to the luteal phase or reflect more stable, trait-like differences. In a series of studies, we used prospective daily symptom reports collected across two menstrual cycles to characterise PMS severity. We then examined: 1) whether individuals with PMS show greater disturbances in selected aspects of mood and cognition than those without PMS, and 2) whether such disturbances are confined to the luteal phase.
Methods: Standardised questionnaires were used to assess mood disturbances, emotion regulation, empathy, and decision-making tendencies (impulsivity and risk-taking). Computerised behavioural tasks were used to measure emotion recognition, empathy, and decision-making. To assess phase specificity, measures were obtained during both the follicular and luteal phases. The recruited sample size across studies ranged from 41 to 99.
Results: Across both menstrual phases, individuals with PMS reported greater mood disturbances in specific dimensions (e.g., depression, anger, tension) and poorer emotion regulation than those without PMS. However, in individuals with PMS, we observed a luteal phase-specific reduction in positive affect. Emotion recognition accuracy was largely preserved across groups and phases, although individuals with PMS showed an increased tendency to categorise subtle facial expressions as threatening in the luteal phase. Behavioural measures indicated greater risk aversion in individuals with PMS across both phases, whereas questionnaires did not detect this difference. Lastly, impulsivity and empathy were generally not affected by PMS status or menstrual phase, but cognitive empathy increased during the luteal phase in both groups.
Conclusions: These findings indicate that the psychological profile associated with PMS is heterogeneous. Certain characteristics (e.g., some mood dimensions and risk aversion) appear to reflect stable differences between individuals with and without PMS, whereas others (e.g., positive affect and threat-related emotion perception) show luteal phase specificity in individuals with PMS. In contrast, cognitive empathy varies across menstrual phases but is not affected by PMS, and impulsivity appears unaffected by either PMS or menstrual phase. Overall, our findings suggest that the influence of PMS and menstrual phase on mood and cognition is selective rather than uniform. The results also highlight the importance of combining self-reports and behavioural measures when assessing cognitive and affective processes, as they may reveal dissociable patterns.Beyond the Pain: Understanding Lived Experiences and Mental Health Impacts of Menstrual Pain among Adolescent Girls in the Volta Region
Presenter: Sitsofe Gbogbo
Affiliation: University of Health and Allied Sciences, Fred N Binka School of Public Health
Co-authors: Ms Priscilla Klutse; Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho PMB 31, Ghana
Mr Israel Wuresah; Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho PMB 31, Ghana
Ms Sarah Odi Mantey; Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho PMB 31, Ghana
A/Prof Julie Hennegan; Australian Women and Girls’ Health Research Centre The University of Queensland, School of Public Health, Edith Cavell Building, Herston Rd, Herston Qld 4006, AustraliaBackground: Menstrual pain among adolescent girls represents a significant public health concern that significantly impacts educational achievement, psychological well-being, and overall quality of life. Despite growing global attention to menstrual health management, limited research exists on adolescents’ menstrual pain experiences, management strategies and impact on their mental health in Ghana, particularly regarding the intersection of traditional practices and modern interventions. Objective: This study aimed to explore how adolescent girls experience and manage menstrual pain, and to understand its impact on their academic and psychological well-being in the Volta Region of Ghana. Methodology: A qualitative study design was employed to explore menstrual pain management among adolescent girls in the Volta Region of Ghana. Twenty-five adolescent girls were purposively selected from five districts in the Volta Region for in-depth interviews (IDIs). Semi-structured interview guides were used during recorded IDIs, supplemented by field notes. The interview transcripts were thematically analysed using MAXQDA 2024 software. Results: The findings revealed significant variations in adolescents’ menstrual pain experiences, particularly regarding the timing, duration, and intensity of the pain. Participants reported utilizing a combination of over-the-counter medications and traditional non-pharmacological approaches, such as heat therapy and rest, to manage their pain. Cultural beliefs, including those related to sugar consumption and stress, also played a pivotal role in shaping their pain management strategies. Furthermore, menstrual pain had a profound impact on adolescents’ lives, leading to substantial academic disruptions, including reduced concentration, decreased class participation, and school absenteeism. Also, participants reported experiencing emotional distress, including feelings of guilt, anger, and irritability, shame, self-isolation, episode of depression and suicidal thoughts. Conclusion: Findings emphasize the need for comprehensive support systems in schools, culturally sensitive health education, and integrated approaches to pain management that acknowledge both traditional and modern interventions. findings reinforce the importance of addressing menstrual health as a crucial factor in achieving educational equity and supporting adolescent well-being.
Black Women’s Experiences of Seeking Support for Menstrual and Gynae Health Issues: Findings from the first Black Women’s Reproductive Health Report
Presenter: Simran Kaur
Affiliation: Research assistant/early career researcher at Nottingham University working on a non mensutrual health related project. I currently explore the effectiveness of non clinical mental health interventions
Co-authors: This research and report are the result of the hard work and commitment of the Black Women’s Reproductive Health project team. The team was led by Victoria Abrahams (Project Lead and Manager).She was supported by the project and research team who are made up of research leads, report writers, peer support group facilitators, project coordinators, event organisers and volunteers:
Christine Gibson: Project Coordinator, Research Lead and Report Writer Danielle Perro: Project Coordinator, Research Lead and Report Writer Jasmine Joanes: Project Coordinator, Report Writer and Event Organiser Isabelle Saville: Project Coordinator and Peer Support Group Facilitator Holly Seglah: Project Coordinator, Research Lead, Report Writer and Peer Support Group Facilitator Laura Shipp: Research Lead Simran Sahiba Kaur Takhi: Research Lead and Report Writer Alexandra Leach: Volunteer Naomi Forrest: Volunteer
We are grateful to partner charities and non-profit organisations, including Freedom4Girls, (F4G)Operations team Sheona Masterton; Amy Randles; Megan Crossland (previously F4G).
Thanks is also expressed for continued support from Freedom4Girls Trustees. This publication also acknowledges the continued support and financial contributions made by The African Pot Project (T.A.P): Otis Thomas; Angeli sweeney; Meatta Kromah; Alexandra Leach. Project support was also provided by Bloody Good Period.
This study draws on findings from the first Black Women’s Reproductive Health (BWRH) Report. The research aims to document how Black women understand, manage, and seek help for menstrual and reproductive health concerns, and to identify the structural, cultural, and clinical barriers that shape their healthcare experiences.
The objectives were to: (1) capture the lived experiences of Black women regarding menstrual pain, reproductive health conditions, and help‑seeking; (2) examine how racism, misogynoir, and menstrual stigma influence access to care; (3) assess the quality of menstrual and reproductive health education available to Black women; and (4) generate evidence to inform culturally competent, equitable healthcare provision.
A mixed‑methods design was used, combining an online survey, focus groups, and peer‑support sessions. Survey data captured demographic information, general health, menstrual symptoms, missed work, and experiences accessing healthcare and education. Qualitative data from focus groups and peer sessions provided deeper insight into perceptions of pain, interactions with healthcare professionals, and education around menstrual health. A literature review contextualised the study within existing evidence on racial disparities in pain management and under‑diagnosis of conditions such as endometriosis. Data analysis involved descriptive statistics for survey responses and the creation of themes using interview data.
Findings indicate that Black women frequently experience severe menstrual pain, uncertainty about what constitutes “normal” symptoms, and significant disruption to daily life, including missed work. Many participants reported limited menstrual health education, contributing to delayed help‑seeking and normalisation of debilitating symptoms. Experiences with healthcare providers were often characterised by dismissal, minimisation of pain, or assumptions shaped by racial bias. Participants described barriers to accessing timely diagnosis and treatment for conditions such as fibroids and endometriosis, despite these conditions disproportionately affecting Black women. Stigma, shame, and cultural silence around menstruation further compounded these challenges.
Whilst non peer reviewed, this study centres the experiences of Black women, highlighting intersecting structural and interpersonal barriers when seeking gynaecological healthcare. Improving outcomes requires culturally competent education, anti‑racist clinical practice, and targeted investment in research that centres Black women’s experiences. This report demonstrates what Black British women would like to see regarding the future of reproductive healthcare and highlights the urgent need for continued data collection to address longstanding inequities in reproductive health.
The BWRH project acknowledges women as not defined by a female reproductive system and advocates for more research to be conducted involving trans and non-binary communities.
Access the report here: https://tapproject.co.uk/wp-content/uploads/2022/08/a40c0490-2880-4ffc-b231-386415f0bd3f.pdfBreaking the Cycle. Evaluating the Impact of the Dignity Campaign on Period Poverty in Rural Lesotho
Presenter: Zandile Winile Sakoane
Affiliation: Maleah Foundation
Period poverty remains a significant barrier to the wellbeing and educational success of adolescent girls. This challenge is especially visible in rural schools, where limited resources make menstrual health management difficult. Menstruation is a normal biological process. However, for many girls it becomes a source of stress, shame, and lost opportunities because they lack basic products and clear information. This study explored how period poverty affects girls in rural educational settings and assessed the extent to which targeted interventions can improve their daily lives.
The research focused on adolescent girls in Mokhotlong District in Lesotho. It used qualitative methods. These included in-depth interviews, focus group discussions, and participant observation. The study examined the work of World Vision Lesotho through its Dignity Campaign. The aim was to understand how access to menstrual products and menstrual hygiene education shapes girls’ experiences and participation in school.
Findings show that the Dignity Campaign plays a meaningful role in reducing the burden of period poverty. The initiative provides disposable pads, reusable pads, and washing soap. It also offers menstrual health education that explains safe use, cleaning, and care of reusable materials. Girls reported that this combination of products and knowledge strengthened their confidence. It also improved their ability to manage their periods with dignity. They felt more prepared to attend school consistently. They engaged more actively in lessons. They also described a reduction in shame and anxiety linked to menstruation.
The study also identified practical gaps. Some girls struggled to maintain reusable pads because water and soap were not always available at home or school. Others expressed discomfort tied to cultural beliefs and stigma. These findings show that product distribution alone is not enough. Effective solutions must include continuous education, stronger community involvement, and sensitivity to cultural norms that shape beliefs about menstruation.
The study concludes that the Dignity Campaign significantly improves girls’ menstrual hygiene practices and reduces school absenteeism. It strengthens their sense of agency and supports broader goals of education and empowerment. To sustain these gains, the study recommends a holistic approach. This should combine reliable access to menstrual products, consistent menstrual health education, and culturally responsive engagement with families, teachers, and communities.
Keywords: adolescent girls. Dignity Campaign. menstrual hygiene. menstrual products. period poverty.Breaking the Silence: Addressing Period Poverty at Minority-Serving Colleges
Presenter: Joyvina Evans
Affiliation: Howard University-Health Administration
Background and Aim Period poverty—the inability to afford or access adequate menstrual hygiene products—extends beyond financial barriers to include limited menstrual health education and inadequate sanitation facilities. It is a global public health and equity issue affecting millions worldwide (Rossouw & Ross, 2021; UN Women, 2025). Although the issue has gained attention among college populations, limited research focuses on minority students, particularly those attending historically Black colleges and universities (HBCUs). This proposed workshop aims to highlight the impact of period poverty on minority college students and discuss strategies campuses can use to improve menstrual health access and equity.
Objectives -Share insights on students’ access to menstrual products at an HBCU.
-Highlight how students manage when products are not available.
-Discuss how menstruation affects students’ emotions, confidence, and participation in class.
-Explore simple, practical ways colleges can support students and improve menstrual equity on campus.
Methods Preliminary data were collected through an anonymous online survey administered to students at an HBCU. The survey assessed access to menstrual products, coping strategies during menstruation, perceptions of campus support, and emotional and academic impacts, including anxiety, embarrassment, menstrual accidents, and class absenteeism.
Results Seventy-seven students completed the survey. More than half reported using non-menstrual substitutes (e.g., tissues or toilet paper) or borrowing products due to lack of access. Approximately 70% believed the university does not provide adequate menstrual supplies. Many respondents reported anxiety, self-consciousness, and menstrual accidents on campus, with several indicating that these challenges contributed to missed classes or reduced academic participation.
Workshop Relevance This workshop will use these findings to facilitate discussion on menstrual equity in higher education, particularly within minority-serving institutions. Participants will explore policy and programmatic solutions, including expanding access to free menstrual products, improving menstrual health education, and addressing stigma. The session will provide actionable strategies for educators, administrators, and public health professionals seeking to support student well-being and academic success.Burden of Menstrual Disorders and Its Effect on Quality of Life among Young Adult Women in India
Presenter: Puja Das
Affiliation: International Institute for Population Sciences (IIPS), Mumbai and Department of Public Health and Mortality Studies
Background: Menstruation is an intrinsic biological process that marks the journey from menarche to menopause. Menstruation regulates the gynecological function and confirms childbearing potentiality throughout a women’s life course. Despite its biological importance, menstrual health remains an underexplored domain within the broader field of public health which affecting the physical, psychological, and social well-being of young women. This study examines the burden of menstrual disorders and their impact on the quality of life among young adult women aged 15–34 years in West Bengal, India. Methodology: A community-based cross-sectional survey was conducted among 420 women selected through cluster random sampling from both rural and urban settings in West Bengal, India. Data were collected using a structured questionnaire that captured socio-demographic characteristics, lifestyle factors, self-reported menstrual symptoms. Menstrual disorders were constructed based on self-reported menstrual symptoms. Quality of life was assessed using standardized indicators used by WHO-HQOL scale. Quantitative data analysis was performed using STATA-16 version software. The analysis included descriptive statistics, bivariate analysis, chi-square test and binary logistic regression to examine the relationship between dependent and independent variables. Results: Study results found that over 75 percent of women had faced any of menstrual disorder. The findings explored that dysmenorrhea, premenstrual syndrome (PMS), oligomenorrhea, poly cystic ovarian diseases (PCOD) were found to be very common and prevalent menstrual disorder among study respondents. Menstrual distress, including pain, fatigue, and mood changes, further reduced well-being. Quality-of-life differences were also influenced by residence, occupation, and caste. Regression analysis further confirmed significant negative effects of major menstrual disorders on high quality of life. Dysmenorrhea and PCOD were 0.03 times and 0.25 times less likely to report a high quality of life. Conclusion: The study underscores the urgent need for improved menstrual health services, early diagnosis, and community-based awareness to enhance the overall well-being of young women in India.
Can virtual exposure to nature alleviate mood disturbances in premenstrual syndrome?
Presenter: Boon Carmen
Affiliation: University of Nottingham Malaysia, School of Psychology
Co-authors: Dr Chee-Mun Fang, School of Science, Monash University Malaysia Dr Po Ling Chen, School of Psychology, University of Nottingham Malaysia Dr Ahamed Miflah Hussain Ismail, School of Psychology, University of Nottingham Malaysia
Research Aim and Objectives: Premenstrual syndrome (PMS) is characterised by disruptive physical and psychological symptoms repeatedly occurring in the last few days of the menstrual cycle (the luteal phase). We examined whether brief, naturalistic multisensory exposure to a natural environment (i.e., a forest) can improve various aspects of mood in the luteal phase, in individuals with and without PMS.
Methods: Seventy-two eligible female participants were categorised as individuals with (N=58) or without (N=14) PMS, using prospective daily records of PMS symptoms obtained over two consecutive menstrual cycles. During the luteal phase of their third menstrual cycle of participation, they completed validated questionnaires measuring broad (e.g., positive and negative affect) and specific (e.g., depression, anger, tension) dimensions of mood, both before and immediately after a brief 30-minute naturalistic, multisensory virtual exposure to a predetermined environment. The environment was either characteristic of natural surroundings (i.e., a walk through a forest) or urban surroundings (i.e., a walk through busy streets), and mimicked real-world surroundings in visual (on a screen), auditory (through headphones), and olfactory sensations (ambient scent). Hormonal measures from saliva samples confirmed that the participants were indeed in their luteal phase.
Results: Prior to the exposure, participants with PMS scored higher in negative affect, depression-dejection, anger-hostility, and total mood disturbance (all ps < .030; Cohen’s d range: .517 - .619), than participants without PMS. Exposure to virtual environments in general led to significant reductions in negative affect, tension-anxiety, depression-dejection, anger-hostility, vigor-activity, confusion-bewilderment, and total mood disturbance (all ps < .008; partial eta squared range: .101 - .193), regardless of type of exposed environment. Post-hoc tests confirmed that nature exposure reduced fatigue and total mood disturbances (all ps < .001), whereas urban exposure did not. Interestingly, greater severity in PMS symptoms was associated with greater reductions in positive affect after urban exposure (r = -.361, p = .033).
Conclusion: Overall, individuals with PMS recorded higher levels of mood disturbances than individuals without PMS in the luteal phase of their menstrual cycles. Exposure to nature alleviated levels of fatigue and total mood disturbances in individuals with and without PMS alike. We also found that individuals with PMS may be more sensitive to mood disturbing elements of urban environments. We believe naturalistic exposure to a natural environment could potentially be used as an accessible tool to alleviate mood disturbances experienced in PMS.Caste and Menstruation: An Inquiry on Inclusive Menstrual Health Policies In India, A Qualitative Study of The Arunthathiyar Community in Salem
Presenter: Shiwani Agrawal
Affiliation: Baala Action Lab
Caste is a striking identity marker in the socio-cultural and political milieu of India which impacts the way individuals lead lives. This is further intensified by the intersection of gender, despite many non-discriminatory legal frameworks including MHHM policies in India. This research tries to create recommendations on a caste-inclusive policy framework by analyzing qualitative data collected from Salem district of Tamil Nadu with 50 stakeholders of the Arunthathiyar community; focusing on access to public resources, experiences of discrimination, and identity-based stigmas, that impact the lives of menstruators in marginalized communities.
Changing Menstrual Norms: Evidence from a Community-Based Randomized Intervention in Nepal
Presenter: Eva Marti
Affiliation: University of Lausanne, Faculty of Business and Economics
Menstruation remains one of the last major taboos despite affecting half the global population during their reproductive years. While menstrual stigma and feelings of disgust are widespread, they are particularly pronounced in certain cultural contexts, where they can lead to forms of social exclusion and restrictions on participation in everyday activities. In some agricultural communities in Nepal, menstruation restricts women’s participation in social and economic activities, reinforcing gender norms from an early age. The personal and societal costs of such stigma are increasingly documented. Although the literature on menstrual health and hygiene interventions is expanding, there is still limited evidence on programs that explicitly aim to reduce menstrual stigma. Existing studies also tend to focus on adolescents, overlooking adult populations—both women, who often act as enforcers and followers of menstrual norms, and men, who are frequently excluded under the assumption that menstruation is a “women’s issue.” Because social norms operate at the community level, effective interventions may need to engage non-menstruators. Our study therefore examines not only whether a stigma-reducing intervention is effective, but also contributes to a broader policy question: who should gender norm interventions target in resource-constrained environments? We evaluate a bottom-up intervention developed by the Global South Coalition for Dignified Menstruation (GSCDM), an experienced local NGO. Their approach combines perspective-taking, scientific information, and a legal rights framework in deliberative group workshops where participants reflect on and renegotiate existing norms. A central component is the use of personal narratives and facilitated discussions that encourage empathy and emotional engagement, allowing participants to reflect on the lived experiences of menstruation and the consequences of stigma. Rather than relying on top-down instruction, this approach fosters open dialogue and collective reflection on entrenched norms. The intervention was tested through a randomized controlled trial with 2,000 married farming men and women. The study compares two workshop formats—women-only groups and mixed-gender groups—to assess whether engaging men improves stigma-reduction efforts. We also examine spillover effects among female friends of participating women to understand how changes in beliefs spread within communities. Data collection for this mixed-methods study concluded in February 2026. Alongside survey and behavioral outcomes measuring changes in beliefs, stigma, social norms, well-being, and reported behaviors, an explanatory qualitative component explores the mechanisms through which the intervention operates—including the role of empathy, emotional engagement, and personal narratives—and how effects may be moderated by household dynamics, particularly in multigenerational households.
Chhaupadi after Abolition: How Legal, Public Health, and Rights-Based Interventions Shape Menstrual Seclusion and Women’s Autonomy in Far-Western Nepal
Presenter: Nikita Paudel
Affiliation: Yale Jackson School of Global Affairs
Co-authors: Nirajan Khadka, SRHR Advisor, Aama Surakshya Nepal
Research Aim: This study examines how chhaupadi, a system of menstrual seclusion imposed on women and girls during menstruation and the postpartum period, has persisted, adapted, or transformed in far-western Nepal as a result of two decades of legal, public health, and rights-based abolition efforts, and how those interventions have shaped women’s autonomy during menstruation.
Objectives: 1. To trace the development of abolition efforts across legal, public health, and rights-based intervention streams. 2. To examine how these interventions are translated across ecological levels of governance and social life. 3. To identify the ecosocial processes through which the practice itself has persisted, adapted, or transformed under reform pressures. 4. To assess whether these changes have meaningfully expanded women’s autonomy during menstruation.
Methods: This project uses a qualitative case study design focused on Sudurpashchim Province, particularly Achham, alongside national policy processes in Kathmandu. The study draws on three evidence streams: documentary analysis of legal, policy, and implementation materials from 2005–2026; an interdisciplinary review of public health, governance, legal, and socio-cultural scholarship on chhaupadi; and semi-structured interviews with key informants, including government officials, elected representatives, NGO and INGO practitioners, journalists, health workers, teachers, and community-facing actors. The analysis is guided by Nancy Krieger’s ecosocial constructs: embodiment; pathways of embodiment; cumulative interplay of exposure, susceptibility, and resistance; and accountability and agency. These constructs are applied across ecological levels (global, national, regional, community, household, and individual) to examine how those processes shape the persistence, adaptation, or transformation of menstrual seclusion and women’s autonomy during menstruation.
Results: The study is in the final analysis stage and is expected to be completed and submitted to my institution by April 25, 2026. Preliminary findings suggest that abolition efforts have been more effective at delegitimizing visible forms of chhaupadi than at dismantling the social and material conditions that reproduce it. Early evidence indicates that interventions often shift where and how menstrual seclusion occurs rather than eliminate it altogether: criminalized huts may disappear while segregation is displaced into courtyards, attached sheds, peripheral rooms, or in-house restrictions. Initial analysis also suggests that women’s autonomy during menstruation remains constrained by the cumulative interaction of kinship authority, fear of spiritual sanction, local moral expectations, uneven institutional implementation, and weak service infrastructures.
Conclusion: Although final analysis is still underway, the study suggests that abolition has reconfigured the ecology of menstrual seclusion. An ecosocial approach helps show how law and policy can alter the form and visibility of discriminatory practice without necessarily transforming the deeper pathways through which stigma, restriction, and risk are embodied. This study contributes a more integrated account of how menstrual policy operates in practice and whether it meaningfully expands bodily autonomy.Cisgender Boys and the Menstrual Movement
Presenter: Kate Bowen
Affiliation: University of Bristol
In this presentation, I will consider how the menstrual activist movement positions cisgender boys. I will also draw on my qualitative research with 21 young people in the Southwest of England to highlight how integral relationships are for menstrual activism.
Menstrual activism is a social movement that focuses on disrupting menstrual inequities or menstrual challenges disproportionately affecting some people compared to others. The menstrual movement has centred the menstrual activism of cisgender girls, and sometimes menstruating trans and gender diverse young people. However cisgender boys have not commonly been positioned as activists or potential activists who do, or could, contribute to the menstrual movement. In response, I will draw on my (post) qualitative research with 21 young people in the Southwest of England to argue that cisgender boys can be menstrual activists, but only when they have relationships with people and non-humans that help them to become menstrual activists.
The research that inspires this presentation involved 21 young people from secondary schools in England taking part in five research workshops where they told stories about how menstruation is part of their everyday lives. Each workshop lasted between 1-2 hours and involved activities including: object interviews, focus groups and an activity which I call ‘diffractive debriefing.’ The menstruation stories of young people emerged in each of the workshops.
In this presentation, I will utilise postmodern philosophy to analyse a story that a cisgender boy called Alfie told as part of my research project. My analysis will be inspired by concepts from the philosophies of Karen Barad (2007) and Deleuze and Guattari (1987). Drawing on such philosophies, I will highlight how Alfie became a menstrual activist when he interacted (or ‘intra-acted’) with other people and objects to tell his story about how menstruation comes up in his everyday life. As part of doing this, I will explain how Alfie’s relationships with his phone, a song about menstruation and his cisgender and gender diverse peers helped him to become a menstrual activist. I will then draw on the theory of intersectionality to consider whether all cisgender boys get to relate to people and objects that can help them to become menstrual activists. I will finish the presentation by asking attendees to consider whether the menstrual movement could or should help cisgender boys to become menstrual activists.Cluster-Randomised Trial of Menstrual Hygiene Interventions to improve girls’ participation in school activities in Ghana
Presenter: Dr Emmanuel Anongeba Anaba
Affiliation: University of Technology and Applied Sciences, Navrongo-Ghana. Department of Population, Family and Reproductive Health
Background: Poor menstrual hygiene management poses a serious threat to girls’ participation in school activities. In Ghana, 95% of adolescent girls miss school during menstruation due to inadequate access to safe menstrual materials, water, sanitation and hygiene facilities. There is limited and inconsistent evidence on the effectiveness of menstrual hygiene interventions in addressing girls’ participation in school activities. Objective: This study aimed to evaluate the effectiveness of a multi-component menstrual hygiene intervention on school attendance and participation among adolescent girls in the Binduri and Pusiga Districts of Ghana. Design: This study employed a two-arm parallel cluster-randomised trial involving 22 public junior high schools (clusters) and 686 adolescent girls. The participants were randomly assigned to the intervention group (11 clusters, 343 participants) and the control group (11 clusters, 343 participants). A multi-component menstrual hygiene intervention was implemented in the intervention schools, while the control schools received no intervention. The intervention included providing subsidised sanitary pads, menstrual hygiene booklets and training, soap, handwashing facilities, dustbins, and sensitisation against period teasing. Data were analysed using descriptive statistics, bivariate and mixed-effect binary logistic regression. Results: The average age of the participants was 15.5 years (SD = ± 1.2). The average age of menarche was 13.7 years (SD = ± 1.4). The prevalence of school absenteeism and participation in school activities were 32.1%, 68.4% respectively. At baseline, there was no statistically significant difference in the outcomes among the two groups. At post-intervention, the participants in the intervention group had reduced odds of school absenteeism (AOR = 0.54, 95% CI: 0.29–0.98) compared to those in the control group (p < 0.05). Additionally, the participants in the intervention group had higher odds of participating in school activities during menstruation (AOR = 5.80, 95% CI: 1.60–20.93) compared to those in the control group (p < 0.05). Conclusion: This study has demonstrated that providing subsidised sanitary pads, as part of a behaviour change communication intervention, was effective in reducing menstruation-related school absenteeism and increasing participation in school activities during menstruation. The findings of this study suggest that prioritising access to affordable menstrual products alongside menstrual health education has the potential to promote gender equity in education and improve the overall well-being of adolescent girls.
Common Threads: An Arts-Based, Trauma-Informed Exploration of the Mental Health Impacts of Chhaupadi (Menstrual Seclusion) in Dailekh, Nepal
Presenter: Dr. Sara Baumann
Affiliation: University of Pittsburgh, Department of Behavioral and Community Health Sciences
Co-authors: Hannah Schwarz, 1 Nikita Sharma, 2 Annika Agarwal, 3 Bhimsen Devkota, 2,4 Mary Hawk, 1 Sara Parker, 5 Guna Raj Shrestha, 6 Ada Youk, 7 and Elizabeth Miller 3 1 University of Pittsburgh, Behavioral and Community Health Sciences, USA 2 Bikash Shrot Kendra, Nepal 3 University of Pittsburgh, School of Medicine, USA 4 Tribhuvan University, Nepal 5 Liverpool John Moores University, UK 6 Menstrual Health and Hygiene Partnership Alliance, Nepal 7 University of Pittsburgh, Dept. Of Biostatistics, USA (Please note that, given the community-engaged and participatory nature of this work, more than five co-authors made meaningful and substantive contributions to this submission).
Background Menstrual stigma and inequalities continue to undermine menstrual dignity in many parts of Nepal, particularly through the persistence of chhaupadi—a menstrual seclusion practice rooted in social and religious norms. Despite policies criminalizing the practice and multiple programmatic interventions, chhaupadi remains, exposing menstruators to significant physical, psychological, and social harms. To date, no study has systematically examined which intervention components are most effective in addressing menstrual stigma and advancing dignity. This study aims to synthesize programmatic evidence to understand how chhaupadi interventions work, for whom, in which contexts, and why.
Objectives 1. To identify the contextual factors influencing menstrual seclusion intervention success; 2. To examine the mechanisms through which programs address menstrual stigma and inequality; 3. To generate actionable insights to strengthen menstrual dignity–focused programming.
Methods Using a Realist Synthesis (RS) approach, we analyzed scientific and grey literature alongside program documents, multimedia materials, and interview transcripts from consultations with program experts, implementers, and community members in Nepal. Data were examined through context–mechanism–outcome (CMO) configurations to identify how interventions produce change under specific social, cultural, and structural conditions.
Results: Three key preliminary findings emerged. First, multi-level stakeholder engagement—combining policy enforcement with grassroots and household-level dialogue—was critical to shifting deeply embedded stigma. Second, knowledge and behavior change strategies varied in effectiveness by context; while external messengers sometimes disrupted entrenched norms, trusted insiders were essential for sustained shifts in beliefs and practices. Importantly, education alone was insufficient without addressing social power dynamics and structural inequality. Third, male engagement and inclusive approaches were pivotal for advancing menstrual dignity, with experts highlighting the need to better integrate people with disabilities and LGBTIQ+ individuals into programming.
Conclusion: Advancing menstrual dignity in Nepal requires interventions that move beyond criminalization and awareness-raising to address stigma, gendered power relations, and structural inequalities. The findings are expected to provide program planners, researchers, and policy makers a strong conceptual grounding to design subsequent, contextually appropriate and evidence-informed menstrual health programs in a range of settings across Nepal.Community- led approaches to strengthening menstrual health and well-being in Uganda
Presenter: Sandrah Nabuule Manuella Senfuma
Affiliation: African Empowerment Hub Uganda
Title: Community-led approaches to strengthening menstrual health and well-being in Uganda
Background Menstrual health is a key component of health and wellbeing for Adolescent Girls and Young Women (AGYWs) in Uganda and across the world. Many communities in Uganda especially low income settings are still grappling with stigma, silence, misinformation, affordability of menstrual health products which is a significant barrier to girls’ dignity, wellbeing, and participation, in school, community and peer-led activities which undermines their confidence. These barriers are more pronounced amongst girls and young women living with disabilities such as Cerebral Palsy and Autism who have often faced double stigma, limited access to menstrual health services and increased dependence on care givers for menstrual health management.
Problem Statement There is a persistent record of menstrual stigma which has limited disbursement of information around menstrual health and hygiene, limited access to menstrual friendly infrastructure and services which has continued to undermine girls’ active participation and performance in school and engagement around the community. Many of these barriers have notably been identified in areas like the Karamoja region of Uganda which is one of the poorest regions in the country with water scarcity, entrenched gender norms as well as economic vulnerability which increases girls’ vulnerability and increases the risks of school dropout, gender based violence, teenage pregnancy and early marriages.
Methodology At African Empowerment Hub Uganda (AEHU) we are implementing a community-led model that to integrate menstrual literacy, community engagement and practical support rendered to girls and young women. Some of the activities we implement include school and community literacy sessions, safe spaces for dialogue with girls, engagement with parents, teachers, community and religious leaders who we believe are of influence in the community and families. Through this program we have managed to promote access to reusable sanitary pads while incorporating psychosocial support and skills building activities. The program intentionally includes adolescent girls and young women living with disabilities by engaging care givers, providing tailored menstrual health education and creating supportive safe spaces that address unique menstrual management needs to bring together girls with disabilities In 2025 we reached up to 12,000 adolescent girls and young women including those living with disabilities in more 20 secondary and primary schools and 5 undeserved communities in Kampala and Karamoja region; Kaberamaido, Kihihi, and Katwe with the intention to address cultural norms and structural inequalities affecting menstrual health
Results Earlier studies and findings have proven that strengthening literacy around menstrual health and fostering supportive communities reduces the risks of shame and silence amongst girls and young women. Reports from similar interventions have shown increased confidence among girls and improved their participation in school and community activities. Community engagement has played a role in shifting norms around menstrual health through encouraging open dialogues, promoting male involvement, addressing myths and misconceptions while advocating for affordable menstrual health products. Caregiver management has improved awareness and support for menstrual management among girls living with disabilities thereby reducing stigma and improving dignity.
Conclusion Community led and context responsive menstrual health interventions provide a clear pathway to addressing period poverty and improving the wellbeing of adolescent girls and young women while advancing gender equality. AEHU’s experience has proven that integrating information on menstrual health and menstrual hygiene reduces stigma, creates safe space, create awareness and promotes dignity amongst girls and young women in Uganda.Conjuring the Weird: Understandings of a Reproductive Lifecycle for Premature Menopause
Presenter: Jessica Edwards
Affiliation: Goldsmiths University London
Davina McCall’s 2021 and 2022 menopause documentaries on Channel 4, may be understood as an example of how popular media discourses influence understandings and experiences of menopause (Jermyn, 2024). In McCall’s documentary, Hailey Cockman is shown to experience premature menopause at the age of 14, and since the documentary’s streaming, gained some media presence through her Instagram profile and online interviews, such as in the Daily Mail. However, contemporary media representations discuss menopause mainly in relation to ageing (Banet-Weiser 2018), the workforce (Rottenberg, Orgad and Gilchrist 2024) and biomedical understandings of a ‘normal’ reproductive lifecycle (Dillaway 2011). Cockman receives in the documentary only a few minutes of airtime, which mainly show her speaking about fertility and doctors disbelief of her ‘abnormal’ menopause symptoms. This, I argue produces an image of a reproductive lifecycle bound to normative biomedical framings of what counts as a ‘normal’ menopause. As premature menopause falls outside of what dominant discourses have framed as a reproductive lifecycle, where menopause is treated as a separate bodily process from menstruation, and mainly addressed in relation to ageing, I will explore how premature menopause may pose alternative conceptualisations of how we understand a reproductive lifecycle within the tension between the ‘normal’ and ‘abnormal’.
Using an interdisciplinary case study approach, I will compare Marissa Carnesky’s performances with the re-presentation of Hailey Cockman in McCall’s documentary. Marissa Carnesky’s performances, Dr Carnesky’s Incredible Bleeding Woman and The Magic Thrills of Her, including off-stage practices, may serve as a metaphor and visual cue how premature menopause can be embodied and understood within an ‘(ab)normal’ reproductive lifecycle. Carnesky’s performance explored through performances on stage and regular practices off stage, embodied understandings of menstruation, fertility and reproductive bodies. Last year’s (2025) performance lecture at the V&A in London, also included a performance on menopause. Further, I am drawing on Kartsaki (2024) “Weird Woman”, in which weirdness is used as tool for rupturing dominant categories, allowing to turn the familiar and dominant into something strange. Thus, the concept of ‘weirdness’ may create hybrid bodies, which transcend hierarchical social orders.
This paper concludes by asking: How can we understand a reproductive lifecycle outside normative perceptions of menopause? And, how might Carnesky’s performance allow us to understand reproductive bodies differently?Cycles of Change: A Mixed-Methods Pilot Study of Menstrual Cycle Awareness and Menstrual Challenges
Presenter: Melany Birdsong
Aim: This pilot study investigates whether Menstrual Cycle Awareness (MCA), a mindfulness-based behavioral and somatic practice, is associated with changes in menstrual pain and psycho-emotional challenges.
Objectives: (1) To evaluate reported changes in menstrual pain and other cyclical symptoms following sustained MCA practice; (2) To examine whether MCA alters participants’ perception of and response to menstrual challenges; (3) To identify specific MCA practices associated with reported improvements.
Methods: A mixed-methods observational pilot study was conducted with graduates (N = 19; ages 30–51, mean age = 40) of the UK-based Red School’s Menstruality Leadership Program. Participants completed a 23-item web-based survey assessing menstrual symptoms prior to and following MCA practice (practice duration: 8 months–9 years), symptom severity (e.g., 0–5 pain scale), and perceived life impacts. Quantitative analysis was conducted alongside thematic analysis of open-ended responses.
Results: Eighty-nine percent (89%) of participants who experienced menstrual symptoms prior to practicing MCA reported improvement following sustained engagement. Before MCA, 47% rated menstrual pain at the highest severity level (5/5); after practice, no participants reported level 5 pain and 69% rated pain at 0–1. Participants also reported reductions in mood instability, anxiety, depressive symptoms, and perceived life impairment. Three MCA practices were most commonly associated with improvement: (1) slowing down during the premenstrual phase, (2) intentional rest during menstruation, and (3) attuning work and relational demands to cyclical energy shifts. For participants with persistent symptoms, MCA shifted their interpretation of symptoms from pathology to physiological communication, reducing stress reactivity and improving perceived quality of life. Most participants engaged additional therapeutic modalities, suggesting MCA may function as a catalyst for behavioral modification. Duration of MCA practice appeared associated with greater reported benefit.
Conclusion: Findings suggest that MCA may represent a promising biopsychosocial framework for addressing menstrual challenges beyond symptom suppression. Although limited by small sample size and observational design, this study identifies patterns that warrant larger, controlled research examining MCA as a behavioral-somatic intervention within menstrual health scholarship.Designing and Rolling-out an Intervention to address Menstrual literacy and menstrual pain in Nepal
Presenter: Dr Rebecca Evans
Affiliation: Department of Social and Policy Science, University of Bath
Co-authors: Ms Rosie Barber, University of Oxford (UG) Ms Gwennan Evans, University of Newcastle (UG)
Background Stories of the dangers of using certain menstrual products abound in many cultures. Is this just scare-mongering or a justified concern? In many LMICs certain menstrual products are shunned due to concerns about them interfering with fertility. Here in the UK, a HIC, attitudes are rather more blasé. But that might be because it seems unthinkable that period products can be as unregulated as they are. Currently there is no law requiring manufacturers of period products to list their ingredients, and research by WEN has found tampons, pads and period pants to contain heavy metals, among other chemical residues. Aim We conducted a systematic review of the literature to collect observational and experimental data on the effects of lead and cadmium exposure on the uterus, in order to gain an understanding of the aetiology of adverse effects on the female reproductive system. Method The study was registered on PROSPERO 2026 CRD420251246022. We searched PubMed, Springer Nature and Web of Science publications for observational or experimental studies on female mammals from January 1st 2015 until December 31 2025. We included experimental studies on primary cells or cell lines from female mammals or humans in vitro. Database returns were screened independently by two researchers (RB and GE) for inclusion in the review. Any conflicts in the decisions were resolved by a third reviewer (RE). A data extraction table was prepared in Excel and completed by RB. Effects were grouped both deductively and iteratively (augmented by AI analysis (Co-pilot)), into themes.
Results The search returned 1247 articles of which 40 met the inclusion criteria. The themes that emerged were that lead and cadmium were associated, in a dose dependent manner, with 1) reduction in uterine size and weight, 2) structural and histological damage to uterine tissue 3) changes to endometrial thickness and glandular tissue 4) oxidative stress and biochemical damage to uterine cells, 5) reduction in cellular viability and increased cell death 6) hormonal (oestrogen and progesterone) signalling disruption.
Conclusion Cadmium and lead exert a wide range of toxic effects on the uterus. The structural changes provide an insight into the aetiology of menstrual disorders, and the changes in oestrogen and progesterone signalling support the common theory that heavy metals serve a metalloestrogenic role within the uterus, thus disrupting the menstrual cycle and subsequent fertility. This work highlights the dangers of exposure to Lead and Cadmium on the reproductive system and users of period products should be aware of what is in them.Deuda and Menstrual Seclusion: An Arts-Based Inquiry from Dailekh District, Nepal .
Presenter: Nirajan Khadka
Affiliation: SAMIP Research project, Advisory Board Member & SRHR-Advisor, Aama Surakshya Nepal
Co-authors: Dr. Sara Bauman, University of Pittsburgh, SAMIP research project Dr. Sudha Ghimire, SAMIP research project team member & Tribhuwan University Dr. Bhimsen Devkota, SAMIP research project team member & Tribhuwan University Ms. Nikita Paudel, SAMIP research project team member
Key words: Menstruation, Menstrual Seclusion, Women’s Health, Deuda, Arts-based research
Women’s reproductive and menstrual health outcomes are shaped not only by access to health services but also by deeply embedded social, cultural, and structural determinants that regulate women’s bodies, mobility, and participation in everyday life. In Dailekh; poverty, geographic isolation, and limited health infrastructure intersect with longstanding cultural norms to shape women’s health experiences. Harmful menstrual practices such as chhaupadi (menstrual seclusion) persist despite legal prohibition, exposing women and girls to physical risks, nutritional deprivation, psychological distress, and loss of dignity. Understanding such complex practices requires approaches that move beyond biomedical perspectives to capture lived experiences, cultural meanings, and community norms. The objectives of the study were to explore how women’s Deuda songs express lived experiences, coping strategies, and aspirations related to menstrual seclusion; and to analyze the symbolic and narrative meanings embedded in the lyrics to deepen understanding of the gendered and cultural dimensions of menstruation in rural Nepal. Rather than treating songs solely as artistic expression, the study approaches them as narrative forms through which women articulate lived experiences, collective memory, and aspirations for social change. The research was conducted as part of a broader Human-Centered Design (HCD) initiative titled Strengthening Actions in Menstrual Health and Hygiene Interventions for Promotion of Women’s Health in Nepal (SAMIP). During a ten-day HCD workshop in Dailekh, ten women participants collectively composed and performed Deuda songs reflecting their experiences of menstruation, menstrual seclusion, and gendered norms. The lyrics of five songs were documented and analyzed thematically. The lyrical analysis revealed important insights into the socio-cultural landscape of menstrual seclusion in rural Nepal. The songs described women’s lived experiences of menstruation and chhaupadi, highlighting themes of health risks, fear of social and spiritual consequences, restrictions on food and mobility, and emotional distress associated with isolation. At the same time, the songs expressed coping strategies, solidarity among women, and emerging resistance to harmful practices. The collective creation and performance of songs also fostered open dialogue around menstruation, enabling participants to transform a traditionally taboo topic into a shared community narrative. Arts-based methods such as Deuda, when integrated into participatory research approaches like Human-Centered Design, can provide powerful insights into women’s lived realities while encouraging collective reflection and dialogue. Culturally grounded methods not only generate rich qualitative data but also create spaces for community engagement and social transformation, supporting more contextually responsive menstrual health interventions in Nepal.Developing policy recommendations for school-based interventions to improve menstrual health support: a patient and public involvement and engagement approach
Presenter: Dr Gemma Sawyer
Affiliation: Psychology, University of Exeter
Co-authors: Prof Abigal Fraser, MRC Integrative Epidemiology Unit, University of Bristol Prof Deborah A. Lawlor, MRC Integrative Epidemiology Unit, University of Bristol Prof Gemma C. Sharp, School of Psychology, University of Exeter Prof Laura D. How, MRC Integrative Epidemiology Unit, University of Bristol
“Background The latest Women’s Health Strategy for England highlighted the impact of menstruation on education as a priority area for additional research and action. This resulted in recent research demonstrating associations between problematic menstrual symptoms during adolescence, including pain and heavy bleeding, with worse attendance and attainment. Further insight, however, is needed to understand how current school practices may be contributing to these associations and identify areas for improvement. This co-produced project aimed to engage with various groups to generate a key set of recommendations to enhance menstrual health support in schools.
Methods Patient and public involvement and engagement (PPIE) workshops were conducted with 25 young people (11-19-years-old), 8 teachers, 8 menstrual health researchers and/or organisations, and 4 council and/or public health officials. Workshops were conducted online and in-person, as well as individually and in groups, depending on the contributor’s preference. Discussions were participant-led and centred around current menstrual health experiences and practice in schools, suggestions for improvement, and the barriers and facilitators to improvement. Initial recommendations were drafted and circulated with all public contributors for follow up feedback through an online survey. Insights were utilised to update the recommendations.
Results Four recommendations were identified: (1) provide the ‘Period Product Scheme for Schools and Colleges in England’ as statutory funding with additional guidelines for schools and funding to provide period starter kits to disadvantaged pupils and other menstrual-related provisions; (2) improve the latest Relationships and Sex Education curriculum to ensure students are provided with the necessary information at the right time; (3) incorporate menstrual health and wellbeing into local council Healthy Schools Awards (addressing education, period products, and menstrual health policies); (4) develop a menstrual health policy in all schools led by a dedicated member of staff addressing toilet access, available products and provisions, and flexible arrangements and support.
Conclusion PPIE and co-production are valuable methods to generate useful and feasible policy recommendations that consider multiple perspectives. Young people are motivated to inform menstrual health policy and are passionate about removing menstrual-related barriers to education and broader wellbeing. Long-term funding, political will, population-wide knowledge, and reduced stigma were highlighted as important requirements to effectively delivering the identified recommendations.”Diagnosis experiences and support needs of individuals living with Polycystic Ovary Syndrome (PCOS)
Presenter: Sharon Manship
Affiliation: University of Kent, Centre for Health Services Studies
Research Aim: To explore the diagnosis experiences and support needs of individuals living with Polycystic Ovary Syndrome (PCOS)
Objective: To understand the lived experiences of individuals living with PCOS in Kent, Surrey and Sussex and to co-develop with those living with the condition a set of recommendations to address issues around diagnosis and improve ongoing support
Methods: An evidence synthesis of the existing literature was conducted via a systemised scoping review. Additionally, semi-structured one-to-one interviews with a sample of 12 participants living with PCOS were undertake to further explore individual experiences
Results: The scoping review search strategy produced 1786 results and 213 potentially relevant papers, which were screened and resulted in the final papers selected for inclusion (n=16). The review of the literature uncovered a number of challenges and negative experiences of diagnosis PCOS, including time delays, lack of knowledge of healthcare professionals (HCPs), gatekeeping of referrals, feeling stigma and shame and limited provision for mental health support. The interviews uncovered that despite experiences being nuanced, they were broadly similar to the literature, and these and additional issues were experienced both pre and post-diagnosis. Challenges included a lack of knowledge of HCPs and patients, lack of support systems, unclear care pathways and wide misinformation about the condition, which impacted on the quality of life and wellbeing of individuals. The needs of those living with PCOS included better support from HCPs, more training and education, better recognition of all aspects of the syndrome, a person-centred and empathetic approach, more focus on the mental health aspects of the condition, accessible and evidence-based information and peer support.
Conclusion: The illness burden of those living PCOS is experienced variety of ways, including biophysically, psychologically and socially. Diagnostic experiences and support needs are varied and nuanced, and should therefore be addressed using a person-centred, empathetic and holistic approach, which treats the whole person instead of targeting individual symptoms. The findings indicate the need for a improved health literacy for both professionals and patients and multidisciplinary care which goes beyond the clinical approach, as well as wider societal supportDocumenting school non-attendance due to Menstruation-related symptoms among adolescents from a School Absenteeism Reporting App in the UK
Presenter: Ellie Bailey
Affiliation: Brighton and Sussex Medical School, Global Health and Infection Department, University of Sussex
Co-authors: Miss Ellie Bailey (4th year medical student), Dr Sid Mookerjee, Dr Chi Eziefula, Dr Anne Gatuguta. Brighton and Sussex Medical School, Department of Global Health and Infection, University of Sussex
A survey of 14–21-year-old girls in the UK found that nearly two million have missed a part or full day of school at some point during their education because of their period due to physical symptoms, period-related illness, embarrassment, lack of access to, and inability to afford period products. There is a lack of quantitative UK research to characterise the magnitude of menstruation-related absence, which is necessary for creating policy to support menstrual health and wellbeing. The aim of this project is to explore to what extent menstruation affects school attendance in adolescents in the UK. Anonymous menstruation-related absence data, from September 2022 to November 2025, was extracted from a UK-wide absence reporting database using keywords relating to menstruation. Raw data were cleaned and descriptive analysis using Excel v.2601 and SPSS v.30.0.0.0 was conducted. Demographic characteristics, proportion, frequency distribution, and length of all absences due to menstrual health were reported. Data without valid illness identifications were excluded from analyses. Out of 1,631,777 total absences reported between September 2022 and November 2025, 19,503 were menstruation-related and reported by 8,826 individuals from 662 schools. 93.46% (n=8,248) had 1-5 menstruation-related absences across this period. A further 3.92% (n=346) had six to eight absences, and the remainder had greater than eight. One individual reported 52 absences. Data showed increasing proportion of reports by year, 0.66% (n=923) of all absences were due to menstruation from September to December 2022, 1.01% (n=4,048) in 2023, 1.23% (n=6,658) in 2024, and 1.44% (n=7,874) in 2025. The mean age of individuals reporting menstrual absence was 13.6 years, and most reports were made from secondary schools (90.12%, n=17,577), and primary schools (5.19%, n=1,012), with the remainder from sixth forms/colleges, education centres, and all-through schools. There were more absence reports from urban areas, 92.73% (n=18,085) compared to rural areas. Menstrual health affects school attendance which has further implications for performance and long-term achievement. The data analysed underrepresents the extent, as it includes only documented period-related absence, and does not capture symptoms that wider menstrual symptomatology. Our research demonstrates the need for large-scale, nationwide research to explore the factors contributing to UK menstruation-related school absences, including period poverty, health education, stigma and menstrual morbidity.
Drawing out the myths: Preliminary findings from conducting creative workshops on period pain with UK adolescents
Presenter: Tristin Agtarap
Affiliation: University of Bath
Aim: This presentation aims to share reflections and preliminary findings from a qualitative study involving creative, participatory workshops with adolescents in UK educational contexts. The workshops were designed to explore and challenge myths surrounding periods and period pain. This study forms part of a multi-phase project that aims to develop school-based resources to improve menstrual literacy in education.
Objectives: To reflect on the use of drawing-based workshops in menstrual research and to share preliminary findings from workshops exploring adolescents’ beliefs, experiences, and perceived myths surrounding period pain.
Methods: Our presentation will provide an overview of the approach we took to conduct a series of participatory workshops delivered across 6 UK secondary schools and colleges and one parent-teen summit event. Workshops combined facilitated group discussion with a creative drawing activity run in parallel. Questions included discussion-based prompts (e.g. What are some things you’ve heard about periods or period pain that you are unsure about, or don’t think are true?) and drawing-based prompts (e.g. How does it feel when people believe myths about periods? What might that feeling look like, if you could draw it?). Participants respond to prompts either verbally and/or through drawing on large paper tablecloths using markers. Workshop data will be analysed using reflexive thematic analysis and pictorial analysis. We will discuss our rationale and reflections on incorporating a drawing-based component into the standard structure of qualitative workshops, and the value this methodology may offer menstrual research in particular.
Results: Workshop data, including drawings and audio transcriptions, are currently being generated. This presentation will share preliminary qualitative insights and visual outputs from the workshops, with developing themes related to menstrual health literacy, myth-busting, and navigating period pain with confidence.
Conclusion: This presentation will highlight the potential of creative, participatory workshop methods to better understand menstrual literacy and experiences of period pain in educational environments. By making period pain visible (through art, conversation, and research), our multi-phase project aims to support schools to develop a positive and understanding culture surrounding menstruation.
This work was funded by a Wellbeing of Women Research Project Grant (Award Ref: RG2509) made in partnership with Reckitt Health Ltd. Prof Jordan’s work and conclusions were conducted independently and were not influenced by the funding source.Embedding Dignity in Research Practice: Community-Based Participatory Research in Kenya, Malawi, Eswatini, Mexico, and Peru
Presenter: Emma McHugh
Affiliation: Department: Center for International Development; Institution: Point Loma Nazarene University
Menstruation remains highly stigmatized worldwide, limiting access to education, quality menstrual products, and adequate health resources for those who menstruate. While global attention to menstrual equity has increased, many initiatives fail to center community-defined priorities or produce immediate local impact. Even well-intentioned and theoretically robust solutions may fail to achieve intended outcomes when applied without sustained community partnership and cultural adaptation.
Drawing on over 1,000 individual and focus-group interviews with women and men across Kenya, Malawi, Eswatini, Mexico, and Peru, this qualitative study examines lived experiences of menstruation, product accessibility, education, cultural taboos, and government support. This meta-analysis highlights the substantial need for quality menstrual products that are affordable, culturally significant education that is inclusive of men and women, and interventions that prioritize dignity for menstruation at large. Using a community-based participatory research (CBPR) framework, this model moves beyond data extraction to develop immediate, community-driven programming alongside quality research. Most significantly, this study argues that menstrual health management is a central pillar to comprehensive poverty alleviation.
CBPR is not merely an ethical research approach but a critical mechanism for advancing menstrual equity by generating expansive qualitative insight while facilitating tangible, locally grounded change. This analysis offers a replicable framework for integrating research and action within global menstrual health management initiatives.Emotion Regulation Across the menopausal Transition : Implications for Women’s Mental Health
Presenter: Milna Sajee
Affiliation: Alliance University, Department of Psychology.
Although a substantial proportion of global female population navigates through menopausal transition, the associated mental and physical distress remain incompletely understood and addressed. The reason being the interconnection between biological, psychological and sociocultural factors compounded by evolving identity and shifting life priorities. such multifaceted influences makes the menopausal experience more complex and demand for individually tailored, integrative and psychologically informed solutions to women’s mental health. There are many factors which are under explored, such as emotion regulation.
This conceptual paper examines the role of emotion regulation as a mediator or moderator in the mental wellbeing of menopausal women. Through emotion regulation individuals regulate the intensity, duration, and expression of emotional experiences. These strategies may prevent the escalation of emotional difficulties from developing into more serious mental health conditions. Grounded in Gross process model by James Gross and Response style theory by Susan Nolen Hoeksema this paper argues that emotional outcome during menopause can be regulated through various emotion regulation strategies. Maladaptive behaviours such as rumination and emotional suppression may have adverse effect whereas, cognitive reappraisal and self-compassion conceptualised by Kristien Neff may function as protective buffers.
This conceptual study proposes a three layered conceptual framework linking biological sensitivities, and cognitive reappraisal to mental health outcomes during menopausal transition. Although this analysis is conceptual in nature, the psychologically grounded approach has implications for mental health literacy, interventions and integrative menopause care. This frame work contribute to a nuanced and empowered understanding of menopausal women’s mental health.Employment experiences and problematic menstruation in the UK’s hospitality sector: implications and recommendations for organisations
Presenter: Gabriella Goodrich
Affiliation: Heriot-Watt University
Hospitality is the UK’s third largest employer, representing 10% of the workforce, with women comprising nearly two-thirds of those in customer-facing non-supervisory positions. Despite the economic significance of this industry and its high proportion of female employees, it is scarcely represented in literature on menstruation and employment, which has primarily focused on professional, office-based work. Hospitality is characterised by ‘often demeaning, stressful, and physically exhausting’ work, in which workers are expected to spend hours standing, walking, and interacting with customers with few breaks and no option to work from home, making it particularly difficult to manage pain and bleeding. This research aims to identify the organisational practices, policies, and attitudes that create barriers to managing menstruation in customer-facing work and develop recommendations for employers to make their workplaces more inclusive and accessible to menstruating employees. 21 semi-structured interviews of UK-based hospitality workers were conducted, thematic analysis was used to analyse the data, and recommendations were developed from the findings.
The first key recommendation concerns destigmatisation and open communication around menstruation, working adjustments, and impairment. Among participants with positive employment experiences, the most prevalent theme was the ability to discuss their symptoms and needs openly and request adjustments without judgement. In contrast, participants whose colleagues and supervisors stigmatised working adjustments and impairment experienced hostility and felt pressured to minimise their needs, to the detriment of their physical and mental wellbeing. Organisational culture that prioritises customer satisfaction above employee was also a substantial contributor. The second key recommendation concerns equitable access to properly maintained toilets with period products provided; rules preventing staff from using ‘customer’ toilets and instead restricting them to inconveniently located and poorly maintained ‘staff’ toilets were among the most significant barriers to managing bleeding. The third key recommendation relates to flexibility within uniform and dress code policy to allow employees to pick clothing that facilitates quick toilet use and does not exacerbate pain, bloating and high body temperature. Participants whose employers had rigid requirements for work-issued clothing, tight or light-coloured clothes, and gendered dress codes found it a hindrance, while those whose employers allowed flexibility found it alleviated discomfort and anxiety. This research seeks to highlight how the ‘problem’ lies not with the menstruating body, but the organisational practices that do not account for or accommodate it.Evaluating Reusable Menstrual Products in Deployed Maritime Settings: A Service Evaluation Exploring Acceptability, Feasibility and Operational Impact
Presenter: Ruth Guest
Affiliation: Royal Navy
Background: Managing menstruation in the deployed maritime environment presents unique challenges, including long watches, restricted access to toilets, communal laundry, and limited waste disposal. Reusable menstrual products (RMPs) may offer operational, environmental, and comfort-related advantages, but evidence within UK Armed Forces populations is limited. Methods: A multi-method evaluation was conducted following the distribution of 170 reusable product kits (period pants and menstrual cups) to Royal Navy, Royal Marines and Royal Fleet Auxiliary personnel. A total of 69 participants completed a REDCap survey, including quantitative items and free-text responses. Quantitative data were analysed descriptively; qualitative data underwent hybrid codebook-reflexive thematic analysis. Results: Most participants had previously relied on disposable products (tampons 63; pads 64), with fewer using period pants (30) or cups (23). During the trial, 62 tried period pants and 41 tried the menstrual cup, typically for 2-6 months. Overall, 74% (51/69) reported the trial changed their views of reuseable products. Period pants were widely described as “game-changing” improving confidence, sleep, and leak protection during watches, flying, and wearing white uniform. Key quantitative benefits included suitability across bleeding patterns (heavy 24; moderate 36) and consistent use despite irregular cycles (31). Challenges centred on washing/drying in male-run or communal laundries and visibility under uniform. Menstrual cups offered extended wear time and reduced waste but were limited by difficulties with insertion, removal, and sterilisation in shared facilities. Conclusion: RMPs - particularly period pants - are highly acceptable and operationally advantageous for servicewomen at sea. Addressing infrastructure barriers, offering greater product choice, and standardising cleaning provisions could support Defence-wide implementation.
Evaluating the menstrual health research landscape
Presenter: Hannah Westwood
Affiliation: University of Glasgow, School of Critical Studies
This presentation investigates the language used to characterise “the algorithm” on the digital contraceptive app Natural Cycles and its social media advertisements. I contend that it is necessary to pay attention to how algorithms are characterised in reproductive tracking apps, as these technologies intervene on how we manage and view a ‘healthy’ reproductive body. I ask: (1) how does the Natural Cycles app use AI?; and (2) how does the Natural Cycles app and marketing position “the algorithm”, and to what effect? To answer these questions, I draw on data collected from a year-long walkthrough (Light et al., 2018) of the Natural Cycles app, and an analysis of its influencer advertisements on Instagram. Overall, I show how the characterisation of the algorithm is used to lend the product legitimacy and scientific authority.
Natural Cycles harnesses AI in the form of a machine-learning algorithm that uses temperature data from previous menstrual cycles to predict ovulation. However, the Natural Cycles algorithm is proprietary, and therefore it remains unclear exactly how fertility status is calculated (Freis et al., 2018). Its website claims that the app is between 93% and 98% effective, and that “the algorithm” does not produce outputs it is not confident in. Nonetheless, there have been several reports and countless personal testimonies of the app failing (e.g. Sudjic, 2018; McEvinney, 2023).
Both the influencer advertisements and Natural Cycles app use the language of “the algorithm” to lend legitimacy and authority to its fertility outputs. In the 46 adverts analysed, messaging about the algorithm remained similar, with each caption sharing a variation on the following: ‘the algorithm analyses hormone-driven temperature fluctuations in order to confirm fertility status’. Some posts took this a step further, claiming that the algorithm ‘determines’ their fertility status. Meanwhile, daily use of the app during the walkthrough revealed continual messaging about the algorithm. This included encouraging the user to add more data so the algorithm can ‘get to know you’, not confirming ovulation when ‘the algorithm needs more data’ and motivating sharing of past health history ‘to help the algorithm adapt to you’.
This framing forefronts “the algorithm” as the scientific authority behind the fertility predictions, lending them authenticity, despite concealing exactly how it works. Natural Cycles thus positions the algorithm as an authority on the reproductive body, constructing the fallacy that it is only through these technologies that users can understand their reproductive health and fertility.
Freis, A., Freundl-Schutt, T., Wallwiener, L., Baur, S., Strowitzki, T., Freundl, G., Frank-Hermann, P. (2018). Plausibility of menstrual cycle apps claiming to support conception. Frontiers in Public Health, 6, 98. https://doi.org/10.3389/fpubh.2018.00098
Light, B., Burgess, J., & Duguay, S. (2018). The walkthrough method: An approach to the study of apps. New Media & Society, 20(3), 881-900. https://doi.org/10.1177/1461444816675438
McEvinney, K. (2023, September 6). Doctors warn about social media link to abortion rise. BBC News. https://www.bbc.co.uk/news/uk-scotland-66671765
Sudjic, O. (2018, July 21). ‘I felt colossally naive’: The backlash against the birth control app. The Guardian. https://www.theguardian.com/society/2018/jul/21/colossally-naive-backlash-birth-control-appExamining the multiple ‘spoiled identities’ of autistic, menopausal women at work.
Presenter: Gemma Gray
Affiliation: Heriot-Watt University, School of Social Sciences (Management)
Autistic menopausal women face a unique set of overlapping stigmas, creating exclusion, misunderstanding and marginalisation at work. Despite growing research relating to both menopause at work and autistic women in the workplace, the compounded nature of these ‘spoiled identities’ remains underexplored, as does the role that stigma plays. This research aimed to understand the employment experiences of professional, late-diagnosed autistic women during menopause, uncovering their employment decisions and influencing factors including inequality and stigma.
Stigma creation is complex and multifaceted, situational, relational and individualistic with no universal experience of stigmatisation. By moving beyond Goffman’s original definition of stigma into contemporary stigma theory built upon it, three foundational concepts emerge as particularly relevant to autistic, menopausal women at work: people/place, power and passing. The stigma experienced by menopausal women at work is compounded when also autistic.
To fulfil the research priorities of the autistic community and illicit meaningful, lived experience led research, participatory Steering Groups with autistic menopausal women in senior leadership positions were used by the lead author, who is herself autistic. The aim is to research with, rather than on, autistic women. This emancipatory research resulted in research method choices and creative research approaches being developed and employed in the pilot phase (the main phase of research will take place later this year). Designed to counter traditional research that can perpetuate harmful power dynamics and/or fail to capture nuanced experiences of multiple-marginalised groups, this research prioritised the voices of the underrepresented (menopausal, autistic women). The resultant observations were based on participant lived experience not researcher preconception, adding neurodivergent and age-related nuance to contemporary stigma theory.
For autistic, menopausal women, who are marked by multiple stigmatising categories including disability, ageing and menopause, stigma is all pervasive at work. By examining foundational concepts of stigma, specific to the working lives of autistic, menopausal women, we provide greater understanding of their intersectional experiences and support needs. Concurrently, by fully centring autistic, menopausal women in research about their experiences, we elicit greater self-understanding and empower women to potentially transform their menopause journey, often perceived as a negative phase, into one of positivity and potential thereby challenging the stigmatised perceptions of this pivotal life stage.Experiences and Perceptions of Menstruation and Menstrual Poverty in Romania
Presenter: Diana Elena NEAGA
Affiliation: Nicolae Titulescu University
In our paper, we aim to present the main findings of the research “Experiences and Perceptions of Menstruation and Menstrual Poverty in Romania”, conducted at the request of the Pe Stop Association. In Romania, menstruation and menstrual poverty remain largely underexplored, and our study seeks to shed light on how these experiences are lived and perceived. Our objectives were to find out how menstruation is experienced, the level of knowledge and education regarding menstrual health, access to menstrual products, and the perceptions, myths, and challenges associated with menstrual experiences. In order to do so, we used a mixed-methods approach, combining quantitative and qualitative tools. The core of our research was a semi-structured questionnaire completed by 1,558 respondents between May and August 2025, using a snowball sampling. The quantitative data were complemented by five semi-structured interviews with women experiencing menstrual poverty, aimed at contextualizing and deepening the survey findings. Our results highlight the central role of education in shaping menstrual knowledge and practices, as well as significant gaps in collaboration between families, schools, and healthcare institutions. The findings also point to the persistence of a culture of menstrual shame, which maintains menstruation as a private and often difficult experience, despite its broader social and economic implications. Our research also reveals strong support and an urgent need for the development and implementation of public policies addressing menstrual health and fostering social inclusion.
Exploring Men’s Perceptions, Attitudes, and Knowledge of Women’s Menstrual Experiences in Mbarara, Uganda
Presenter: Madison Lindeman
Affiliation: University of Bristol
Aims: The aim of this research was to understand and explore the menstrual experiences of women in Mbarara, Uganda as they move across the city and occupy different spaces such as at home, work, and journeys in-between. This is significant as the majority of research has focused on the menstrual experiences of adolescent girls, neglecting the needs and realities of women in adulthood.
Objectives: In order to gain a more nuanced understanding of women’s menstrual experiences as well as how women perceive menstruation themselves, it was imperative that men were included within the discussion.
Methods: A qualitative research design was employed to address the research aims and objectives. Ethnographic fieldwork including interviews, focus group discussions (FGDs), and walking interviews took place in Mbarara, Uganda between October 2024 and July 2025. Five FGD were held with men with each group having between five and eight participants. A total of thirty-three men aged between 21 and 63 were recruited using purposive and snowball sampling. FGDs were conducted in the local language, Runyankore, with local research assistants. The FGDs were recorded, manually transcribed, and translated. All the data were analysed using reflexive thematic analysis.
Results: Findings revealed that most participants had a negative perception of menstruation, typically viewing menstruation as a burden. This was because menstruation was commonly associated with increased spending for men, undertaking more household tasks (such as cleaning or cooking), and a lack of sex with their wives resulting in extramarital affairs. Despite this, men also reiterated that menstruation is an imperative process that is essential for producing children and can be a sign that their partner is healthy. However, norms regarding menstrual stigma and silence still existed. Some participants described how menstrual blood is disgusting and how women should not do certain tasks while menstruating, such as attending religious spaces or cooking. Nonetheless, most men recognised the challenges that menstruation and associated symptoms can cause for women and described how menstrual pads should be more affordable for women and how menstrual education needs to be improved across Uganda.
Conclusion: This study offers valuable insight into men’s perceptions and understanding of menstruation in Mbarara, Uganda. This is important as men’s perceptions of menstruation can influence how women experience menstruation themselves, particularly if women are financially supported by their partner. Furthermore, this research provides more evidence engaging with adult men as they are often excluded from such research and discussions.Exploring Menopause Experiences among University Teachers in Sylhet: A Qualitative Study
Presenter: Sumaiya Begum
Affiliation: Shahjalal University of Science and Technology, Sylhet. Department of Anthropology.
Co-authors: Faria Binte Arif, Arif, Lecturer in the department of Anthropology at Shahjalal University of Science and Technology, Sylhet, Bangladesh.
Menopause is the complete end of the menstrual cycle. The Possible menopausal stage is 46-60 years old. 51 +- 3 years is the international menopausal stage of a woman. Menopausal stage is a very disturbing phase for a woman initially and generally. It is not only a biological milestone but also it affects emotional and social well-being. This study investigates the experiences among working women in the menopausal phase and how they deal with challenges faced in workplace. This study seeks to provide a deeper understanding of the fact that it brings both physical and emotional challenges to women’s working lives. The study follows a qualitative approach to investigate experiences women face in related to workplace in the menopausal phase. It is conducted among teachers aged between 45-60 years at Shahjalal University of Science and Technology, Sylhet, Bangladesh. It follows purposive sampling to select women who had direct experience with menopause and could share their experience. This study is used case study methods, In depth Interviews to collect data based on the research objectives. A semi-structured guideline is used to conduct the In-depth Interviews to understand their personal stories in detail. The result of this research reveals that high physical and mental workload were responsible for menstrual irregularities and early menopause. Those women suffered irregular menstruation; their hypertension and elevated BMI were more common. So, there is a significant connection between workplace stress and reproductive health outcomes in female workers. Difficulty concentrating, stress, irritability, hypersensitivity, anxiety, emotional difficulties are identified as the key factors for the mental health challenges during menopause. Professional self-efficacy, work quality, perceived workplace support, perceived health are affected by somatic and psychological menopausal symptoms. To cope with the hot flashes, often bring extra clothes or dressing in layers. Sometimes they keep the windows open for refreshment or refresh themselves in the washroom. To solve the concentration problem and forgetfulness, they double check one’s work to prevent mistakes. This study helps to understand that menopausal changes are determined by not only biological fact, but also by social, psychological and cultural dimensions. So, menopause in relation to workplace needs education and consideration both at policy levels and in research.
Exploring Menstrual Cycle Effects of Antecedents on Physical Activity and Diet: A Systematic Scoping Review
Presenter: Lucia Volpi
Affiliation: University of Vienna
Research aim: Physical activity (PA) and diet can fluctuate throughout the menstrual cycle. Yet, the underlying mechanisms remain unknown.
Objectives: This systematic scoping review aimed to (1) provide a critical assessment of the methodologies, identify (2) relevant predictors of PA and diet throughout the cycle based on the Theoretical Domains Framework (TDF) and (3) knowledge gaps.
Methods: PubMed, PsycINFO, and Web of Science were searched from inception until September 2024. Peer-reviewed English publications were included if they reported on PA or diet and TDF constructs in relation to the menstrual cycle in biological female populations of reproductive age currently not suffering from conditions impairing PA or diet.
Results: Of 9,247 screened records, 36 were included, comprising 28 primary studies and 9 reviews. The TDF component of emotions was the most explored in both diet and PA studies, although the latter investigated a broader range of constructs (e.g., social influences, attention). The menstrual phase, pain and bleeding impaired PA and performance. The results on diet remained inconclusive.
Conclusion: Small samples, cross-sectional designs, heterogeneity of menstrual cycle assessments and a lack of explicit sex-based recruitment limit generalizability. Gaps include several TDF constructs (e.g., self-efficacy). Longitudinal designs and objective assessments of the menstrual cycle and behaviours in larger heterogeneous samples are needed.Exploring Receptivity-Aware Timing as a Driver of Engagement in Digital Health Interventions
Presenter: Alexandre de Montleau
Affiliation: Institute for Implementation Science in Health Care - Centre for Digital Health Interventions: CDHI
Co-authors: Marcia Nißen, Tobias Kowatsch CDHI
Sustaining user engagement remains one of the most persistent challenges facing Digital Health Interventions (DHIs).
While substantial research has examined, for instance, persuasive design, gamification or the personalization of content, comparatively little attention has been paid to when interventions are delivered in relation to users’ momentary capacity to receive and act on support. Yet, even well-designed interventions often fail when they are delivered at moments that are misaligned with users’ preferences, daily routines, cognitive load, or physiological state or their circumstances and environmental context.
Within the Just-In-Time Adaptive Intervention (JITAI) paradigm, timing is often treated as a technical optimization problem, yet its role in shaping engagement trajectories over time remains insufficiently understood. In particular, the relationship between states of receptivity (i.e., whether users are cognitively, physically, and contextually able to engage at a given moment) and sustained engagement with DHIs has rarely been examined explicitly. Our interest in this workshop centers on advancing engagement research by explicitly examining this intersection.
We are currently developing and prototyping PULSE, a Personalized, User-Level Scheduling Engine, as a modular system that will deliver personalized digital health support at opportune moments by leveraging multimodal context data.
Our design hypothesis is that better-timed interventions (i.e., aligned with users’ states of receptivity) may foster engagement and adherence with DHIs. Conceptually, PULSE will follow a leveled implementation approach that will allow us to progressively integrate richer contextual information into timing decisions: At the initial Level 1 (Past Interaction Patterns), PULSE uses historical interaction data to identify probabilistic windows when users are most likely to respond, enabling basic personalization of notification timing. At Level 2 (External Context Information), the system incorporates contextual factors such as weather and location to refine timing and adapt to situational constraints (e.g., outdoor activities). At Level 3 (Internal Physiological State Information), physiological signals (e.g., menstrual cycle phase or post-surgical recovery state) are integrated to account for fluctuations in energy, fatigue, and physical readiness. This leveled approach is not only a conceptual and technical design challenge, but a research strategy.
It allows us to investigate how increasing contextual richness affects engagement, and to ask whether receptivity-aware timing improves (a) sustained use of DHIs and (b) the implementation of intended health behaviors in everyday life. Through this workshop, we aim to contribute to a broader research agenda that recognizes receptivity-aware timing as a promising but under-theorized pathway for designing DHIs that users not only respond to, but continue to engage with over time.
Additionally, we would welcome the opportunity to share an early prototype of PULSE which operationalizes receptivity-aware timing through a modular and progressively context-enriched architecture, as a concrete starting point for discussion around design choices, evaluation strategies, and engagement implications.Exploring how women with endometriosis and/or adenomyosis navigate family building options in high income countries: a qualitative systematic review and thematic synthesis
Presenter: Subhashree Meher
Affiliation: Department of Applied Health Sciences, University of Birmingham
Co-authors: Dr Eleanor Molloy, Professor Laura Jones, Dr Amy Delicate Affiliation: Department of Applied Health Sciences, University of Birmingham, Birmingham, United Kingdom
Background: Endometriosis and adenomyosis are chronic gynaecological conditions characterised by the presence of endometrial-like tissue outside its normal location. While distinct pathological entities, they share hormonal drivers, overlapping symptoms, and substantial impacts on reproductive health. Women of reproductive age with these conditions often face complex decisions about family building. Existing research largely focuses on fertility preservation and assisted reproductive technologies (ART), while adoption, surrogacy, fostering, and other non-traditional pathways remain underexplored in peer-reviewed research. This review addresses this gap by examining how women with endometriosis and/or adenomyosis navigate family-building options in high-income countries. In doing so, it highlights how menstrual and gynaecological conditions shape reproductive identities, decision-making, and experiences of healthcare.
Objectives: 1. To understand how women with endometriosis and/or adenomyosis explore family-building pathways. 2. To examine how women consider and assess biological and non-biological family-building options. 3. To identify the personal, social, emotional, and contextual factors influencing family-building decisions. 4. To explore women’s experiences of challenges and supports encountered in pursuing family-building pathways.
Methods: A qualitative systematic review was conducted following PRISMA and ENTREQ reporting guidelines. Six databases (Medline, Embase, Web of Science, PsycINFO, Scopus, and CINAHL) were searched using terms developed with the SPIDER tool, targeting qualitative and mixed-methods studies examining women’s family-building experiences. Thematic synthesis followed Thomas and Harden’s three-step framework, employing inductive coding to generate analytic themes and inform the development of a conceptual model.
Results: Thirty-one studies from 11+ countries published between 2005 and 2025 were included, representing the voices of 5643 women and drawing on 47,745 first person social media posts from women with endometriosis. No studies focused on adenomyosis; therefore, the synthesis concentrated on endometriosis. Women described complex challenges in reproductive decision making shaped by changing health status, personal circumstances, and medical advice. Clinical discussions often prioritise spontaneous conception or ART, with limited exploration of alternative family-building options. Women frequently reported negative healthcare experiences, including feeling dismissed or inadequately informed, which contributed to mistrust and concerns about reproductive autonomy. In response, many turned to online communities for information, validation, and peer support, although this often carried significant emotional burden.
Conclusion: Women with endometriosis want clear, balanced information about their reproductive options and support to pursue family building options aligned with their values and circumstances. These findings highlight the need for policy and clinical guidance that prioritise patient-centred care, safeguard reproductive autonomy, and recognise diverse family-building pathways for women living with endometriosis.Exploring identity change in chronic pelvic pain
Presenter: Lisa Pye
Affiliation: University of Buckingham, School of Psychology
Co-authors: Dr Helen Clegg, University of Buckingham, School of Psychology Dr Jenna Gillett, University of Buckingham, School of Psychology
Research suggests that living with chronic pelvic pain (CPP) can challenge identity. Adjusting to chronic pain may therefore necessitate adjusting the sense of self. Although identity challenge and change have been observed in CPP, there has been no formal psychometric assessment of this, partly due to a lack of validated measures for use in this area. It therefore remains unclear if there are more or less favourable identity change outcomes and how to best assess this is CPP. To explore this, this study sought to assess the utility of an identity reconstruction measure for use in this population and to explore associations between identity reconstruction factors and a number of psychological, affective and demographic factors.
Methods 293 adults living with suspected or diagnosed gynaecological CPP for 6 months or more completed an online quantitative, cross-sectional survey. The three-factor Identity Redefinition Assessment Scale (IRAS) measured identity change. Measures of pain interference (PROMIS PI8a), depression (PHQ9), anxiety (GAD7), pain self-efficacy (PSEQ), pain acceptance (CPAQ8) and psychological inflexibility (AAQII) were also completed. Information about pain severity and duration as well as demographic data was collected. The three-factor structure of the IRAS was assessed with confirmatory factor analysis and then further explored with exploratory principal components analysis (PCA). Relationships between identity change and the other variables were explored with hierarchical multiple regression.
Results The three-factor structure of the IRAS was not supported. Exploratory PCA suggested an alternative four-factor structure that was a better fit for the data, though these factors did not all demonstrate acceptable reliability. Regression modelling showed some variance in identity factor score was explained by acceptance, self-efficacy, pain interference, pain severity, pain duration and working status. Depression, anxiety and psychological inflexibility did not explain significant variance in any identity factor score.
Conclusions The IRAS may not be the most psychometrically robust measure for assessing identity change in CPP. The lack of clear relationships between identity reconstruction factor and the other variables suggests that there may not be any one identity change outcome that is more or less favourable than the others. Future research should therefore consider identity challenge management from a different approach, for example by considering identity from a more contextual than content-focused perspective.Exploring the Intersections Between Violence and Menstrual Health: A Mixed-Method Systematic Review of Prevalence, Risk Factors, and Impact on Adolescents Aged 10 to 19 Years
Presenter: Gloria Dansoa Savage
Affiliation: Brighton and Sussex Medical School, Medicine
Co-authors: Gloria Dansoa Savage1, Eleesha Ford1, Chi Eziefula1, Anne Gatuguta1, BSMS and University of Sussex
Introduction: Current evidence suggests that violence negatively affects menstrual health (MH). Adolescence is a critical developmental period, in which individuals experience menstruation whilst navigating significant biological, social and environmental changes, including exposure to violence. However, research examining the intersection between violence and MH during adolescence remains limited. Aims: to identify MH-related violence that adolescents experiences and how menstruation can increase vulnerability to violence. Methods: A systematic literature search was conducted across EMBASE, PubMed, Global Health, and CINAHL for studies published between 01/01/2000 and 15/12/2025, using predefined search terms. One primary reviewer performed study selection, data extraction, and quality assessment. To increase validity and rigour, a second reviewer screened and extracted data for 10% of records, with inter-rater agreement of Cohen’s k=0.85 for screening and k=0.82 for data extraction. Quality assessment was performed by a single reviewer through the Mixed-Methods Appraisal Tool following standardised, detailed guidance. Results were synthesised using a segregated narrative approach. Random-effects meta-analysis was performed where appropriate. Results: Thirty-two studies from 47 countries (20 quantitative, 8 qualitative, 4 mixed-methods) were included. Across studies, interpersonal violence was frequently associated with adverse MH outcomes. One study reported associations between bullying and premenstrual disorders (i.e. premenstrual syndrome and premenstrual dysphoric disorder) (OR 3.14; 95% CI 2.75–3.60), whilst physical and sexual abuse were linked to menstrual morbidities, including cycle irregularities (OR 1.77; 95% CI 1.18–2.64). Exposure to childhood violence was also associated with earlier menarche (e.g., sexual abuse OR 1.41; 95% CI 1.15–1.72). A pooled analysis of two longitudinal studies examining sexual violence and earlier menarche suggested a positive association but was not statistically significant (OR 1.78; p=0.303) and showed substantial heterogeneity (I2 70.71%, 95% CI:0.00-99.95). Conversely, menarche was associated with increased risk of self-harm (OR 1.31; 95% CI 1.04-1.64). Qualitative evidence suggests that menarche may increase vulnerability to sexual coercion and transactional sex in contexts of menstrual stigma and product insecurity. Conclusion: The findings of this review suggest a bidirectional relationship between violence and MH in adolescents. Interpersonal violence (e.g., bullying and abuse) was linked to adverse menstrual symptoms (e.g., premenstrual disorders), whilst early menarche was associated with increased vulnerability to sexual violence and self-harm. These findings highlight the potential value of the integration of MH assessment into existing safeguarding and violence-prevention frameworks, as menstrual indicators (e.g. menarche timing, menstrual stigma and product insecurity) could support the recognition of vulnerable adolescents.
Factors Affecting Healthcare Access for Dysmenorrhea: A Scoping Review
Presenter: Fódhla Ní Chéileachair
Affiliation: University of Stirling
Background: Dysmenorrhea (period pain) affects 71.3% of the 1.8 billion menstruators globally and can severely impact daily functioning. Individuals with dysmenorrhea report delaying or avoiding healthcare, as well as experiencing trivialisation and diagnostic delays from healthcare systems. This may leave underlying conditions (e.g., endometriosis, PCOS) untreated and limit access to evidence-based management. Understanding the multifactorial challenges in accessing care across high-income countries (HICs) is essential to improving these gaps.
Research Aims: To comprehensively map influential factors affecting healthcare access and its consequences for individuals with dysmenorrhea in HICs.
Methods: This scoping review followed the JBI’s guidance and the PRISMA-ScR guidelines. Sources were drawn from four peer-reviewed databases and from grey literature across OECD countries using webscraping. Levesque and colleagues’ (2013) Conceptual Framework of Access to Healthcare guided extraction and synthesis, illustrating a pathway of factors affecting healthcare access and its consequences.
Results: From k= 176 studies across over 22 OECD countries, common factors were identified at individual, social, and healthcare system levels. These include menstrual stigma and the normalisation of painful periods, fear of negative social perceptions, the financial burden of repeat consultations and access to specialist care. Healthcare experiences were shaped by trivialisation, testimonial injustice, and dissatisfaction with treatment and continuity of care.
Conclusion: Despite its impact, dysmenorrhea is often shaped by menstrual stigma at both individual and societal levels. Addressing harmful norms and improving access to specialist services and continuity of care are critical to closing care gaps for individuals with dysmenorrhea in HICs.Feasibility of EMPOWER-CT: Endometriosis Management and Promotion of Wellbeing using Evidence-based Research into Contrast Therapy
Presenter: Dr Laura Cowley
Affiliation: Population Data Science, Swansea University Medical School
Co-authors: Dr Mayara S. Bianchim, School of Psychology and Women’s Health Research Wales Centre, Cardiff University, Wales, UK Dr Kate Isherwood, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Wales, UK Dr Judith Roberts, Department of Psychology, Aberystwyth University, Wales, UK Dr April Rees, Biomedical Sciences, Swansea University Medical School Miss Rachel Joseph, School of Psychology and Women’s Health Research Wales Centre, Cardiff University, Wales, UK Dr Rebecca Anthony, DECIPHer, School of Social Sciences, Cardiff University, Wales, UK
Aim: This scoping review aims to systematically map and characterize the existing literature on the use of whole-body thermal therapies for symptom management and wellbeing among people assigned female at birth with dysmenorrhea, chronic pelvic pain, endometriosis, or adenomyosis.
Objectives: To describe the range and characteristics of included studies, the types and parameters of thermal interventions used, the outcomes assessed, and key findings including estimates of effect. To identify gaps in the evidence base and priorities for future research.
Methods: This work is led by members of the EMPOWER (Endometriosis Management and Promotion of Wellbeing using Evidence-based Research) Network. The review will be informed by the EMPOWER-VOICES patient and public involvement panel comprising people with lived experience of endometriosis. We followed the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) framework to structure the research question, eligibility criteria, search strategy, and data extraction form. We searched five electronic databases from 2000 to February 2026, including the Embase and Scopus databases, and the Medline, APA PsycINFO, and CINAHL Ultimate databases via the EBSCO platform. An abstract screening tool was developed to assist with the initial screening process. Both abstract and full-text screening will be conducted independently by two reviewers, with discrepancies resolved by a third reviewer or team discussion. All studies excluded at the full-text screening stage will be reported with reasons for exclusion provided. The principles of mixed-methods framework synthesis will be adopted to extract, map, chart, categorise and aggregate study findings. Data from each included study will be extracted by two reviewers independently and discrepancies resolved by a third reviewer. The review will be reported using the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analysis, Extension for Scoping Reviews) checklist.
Results: The search carried out in February 2026 identified 426 potentially relevant records. These were imported into the review management software Covidence. Screening and data extraction will be completed by April 2026, with full review findings expected by the end of June 2026. We will include a PRISMA flowchart in the results section of the review publication to describe the study selection process. Data will be synthesized descriptively in tabular and narrative format.
Conclusion: We will use the findings to inform a planned feasibility study on the use of contrast therapy to support symptom management and wellbeing among those with endometriosis, and to inform additional research projects to address any evidence gaps identified by the review.Female contraception provision in Primary Care practices in England
Presenter: Lauren Scott
Affiliation: Population Health Sciences, University of Bristol
Co-authors: Mr Matthew Bird, Population Health Sciences, University of Bristol Prof Laura Howe, Population Health Sciences, University of Bristol Dr Joanne Watt, Great Oakley Medical Centre, Corby Dr Isobel Ward, Population Health Sciences, University of Bristol
In England, the National Health Service (NHS) provides free contraception for people who menstruate (herein referred to as women), primarily via primary care general practitioners (GPs), alongside sexual health clinics and more recently through pharmacists in pharmacies. Survey data such as the 2021 Reproductive Health Survey has provided some information on contraception use, but scarce work has explored the complete landscape of female contraception in England. Understanding current patterns of access and usage will aid the development of policies to ensure access is equitable, and health policy and commissioning of contraception services can meet the public health need.
Using national primary care data (Clinical Practice Research Database Aurum) data and a retrospective observational cohort study design, we estimate the prevalence of contraception provision from primary care, as well as the different types of female contraception provided (pills, intrauterine devices [IUDs], implants, injections etc). Further, we explore sociodemographic predictors (including age and deprivation) of contraception provision, and reasons why women may be taking contraception, other than/ alongside pregnancy prevention (such as heavy menstrual bleeding or irregular periods). We included women aged 18-55 years on 31st December 2024, and up to 5-years of retrospective consultation and prescription data regarding contraception provision. To date, this is the largest study estimating the prevalence of female contraception use in England and we anticipate findings informing health policy nationally. With the upcoming publication of the revised Women’s Health Strategy for England, this evidence is timely.Free period products for better menstrual health? Policy enactment of the period product scheme in English high schools
Presenter: Petra Kolić
Affiliation: Manchester Metropolitan University, Department of Sport and Exercise Sciences
Co-authors: Dr Ben Ives, Manchester Metropolitan University Dr Christopher Morse, Manchester Metropolitan University Prof Paul Holmes, Manchester Metropolitan University Dr Joy Probyn, University of Salford Dr Lamiece Hassan, Government Digital Service
Research Aim: This research aimed to investigate how menstruation is experienced, interpreted, and negotiated in UK high schools from the perspectives of different school community members, with attention to lived experiences, perceived expectations, enacted behaviours, and associated meanings.
Objective: The primary objective was to develop a theory-informed understanding of menstruation as a socially constructed experience, examining how students and staff interpret, respond to, and reproduce norms that shape menstruation experiences, education, and management in high school.
Methods: This qualitative research study utilised focus groups as a method of data generation. We conducted 23 focus groups across 13 high schools, involving 169 school community members. This included eight focus groups with 64 female students aged 13-17 years old, seven focus groups with 43 male students aged 14-17 years old, and eight focus groups with 62 high school staff. Focus groups were audio-recorded, transcribed, and analysed using phronetic iterative analysis. Symbolic interactionist concepts of emotion norms and emotion work were applied as interpretive lenses to examine the emotional, interactional, and normative dynamics shaping participants’ experiences and perspectives.
Results: We unpack how menstruation in high schools was shaped by emotion norms and emotion work through four themes. First, menstrual health education functioned as early emotion-norm socialisation. Limited biomedical teaching left students without shared language or guidance for understanding emotions associated with menstruation or advocating for their menstrual needs, while staff expressed discomfort delivering menstrual health education. Second, toilet restrictions operated as institutional feeling rules, requiring menstruating students to suppress feelings, such as anxiety and discomfort, while maintaining composure in lessons, which often caused emotional strain and disrupted learning. Third, exceptions to toilet restrictions revealed ongoing emotion management by staff, who balanced care, authority, and regulations when responding to student requests. Inconsistent discretionary decisions created uncertainty and embarrassment for students, implicitly framing menstruation as a deviation from normal school conduct. Fourth, menstrual stigma was sustained through impression management strategies: students and staff concealed menstrual products, anticipated judgment from others, and avoided disclosure of their menstruation status, while teasing, particularly from male peers, reinforced gendered feeling rules.
Conclusion: We framed menstruation as a socially constructed experience shaped by stigma, restrictive policies, and expectations surrounding emotional regulation. Supporting menstrual health effectively in the daily high school routines, therefore, requires more than curriculum reform. Cultural and organisational changes are needed to validate student needs, reduce emotional strain, and equip staff to provide confident education and support.From ‘menstrual monstering’ to the ‘cycle as a “female” superpower’
Presenter: Samantha Schwickert
Affiliation: BTU Cottbus
Co-authors: Dr. Inga Winkler (she/her) Associate Professor Law Group, Department of Social Sciences, Wageningen University
While menstruation remains stigmatized through stereotypes of weakness and emotional instability, a new narrative increasingly frames the menstrual cycle as a source of empowerment, with concepts like cycle-awareness and cyclic living gaining prominence in popular media. Although critical menstruation research has gained traction globally, it still primarily focuses on the menstrual phase, often overlooking other phases of the cycle (Bauer 2022). Existing studies in social sciences and psychology tend to problematize menstruation and Premenstrual Symptoms (PMS), risking the reproduction of stereotypes about menstruating individuals as irrational or hormonally driven (King 2020; Ussher and Perz 2013). At the same time, in public discourse cycle awareness, symptom tracking, and cyclic work have become trends many women and people with menstrual cycles (WPMC) follow (Andelsman 2022; Hajkova and Doyle 2024; Pfender et al. 2025). Guidebooks, newspaper articles, and cycle coaches all promise to provide guidance on using the cycle as a ‘female superpower’ for a successful (work) life. Although these initiatives often include educational elements about menstrual health, the recommendations they make are usually not based on scientific evidence, since scientific research on cyclic work or living is not yet well developed. In contrast, framings such as menstrual positivity or ‘the cycle as a female superpower’ risk being exploited as forms of ‘emotional capitalism’ (Illouz 2007) echoing earlier movements like body positivity (Gill and Elias 2014; Przybylo and Fahs 2020; Røstvik 2022). This can potentially exacerbate neoliberal meritocracy, stereotyping, and bio-essentialism rather than dismantling them. Our work employs feminist critical discourse analysis (Lazar, 2007) to investigate how “menstrunormativities” (Persdotter 2020) have evolved and potentially expanded into “cycle-normativities” (Schwickert, 2026). The analysis focuses on cultural and media representations in Germany between 2020 and 2025. It includes at least 20 articles from the five biggest German newspapers, 24 articles from the five biggest German women’s magazines, and 29 German Instagram posts. By examining recurring themes in these discourses—such as cycle-awareness as a superpower for productivity or women as inherently cyclic beings—this research identifies tensions between feminist-emancipatory approaches and the commodification of menstrual experiences within meritocratic, patriarchal, and capitalist systems. While offering an alternative to traditional menstrual stigma, these discourses risk shifting responsibility for managing symptoms to individuals, thereby reinforcing neoliberal ideals of self-optimization. We argue that such developments fail to challenge body-hostile structures, instead contributing to the commodification of menstruating experiences. This analysis highlights the need for a more radical feminist-activist approach that resists capitalist appropriations of menstruating bodies and experiences.
From Baseline to Systems Change: Integrating WASH, Sustainability and Longitudinal Monitoring in School-Based Menstrual Health Programming in Nigeria
Presenter: Tara Akindele
Affiliation: Flo Haven Initiative, Nigeria
Menstrual health programming in low-resource settings has historically prioritised short-term product distribution without systematically integrating water reliability, sanitation infrastructure, disposal systems, and sustainable product literacy. This paper presents baseline data collected across multiple secondary school sites in Lagos and Ogun States, Nigeria, alongside early implementation insights from the SHE Initiative (Sustainable Health & Empowerment Initiative), a three-year systems-based menstrual health programme developed in response to those findings.
The aim of this research is to examine how menstrual product access, WASH (Water, Sanitation and Hygiene) infrastructure, and sustainability education interact to influence menstrual confidence, product uptake, and school participation. The objectives are: (1) to analyse baseline determinants of menstrual confidence and product use across 565+ participants; (2) to assess infrastructure barriers to safe disposal and in-school management; and (3) to explore early shifts in knowledge and confidence following structured sessions.
Baseline findings reveal significant structural gaps: 86% of girls in peri-urban Lagos reported that school toilets were not clean or private enough for safe pad changing; 87% reported no access to sanitary disposal bins; and 0% reported use of reusable menstrual products despite 90% expressing willingness to try them if guided. Across sites, menstrual confidence at baseline averaged approximately 50–60%, despite high reported prior awareness.
Pre- and post-session data from Ode Remo High School indicate a 26-percentage-point increase in reported student confidence (53% to 79%) following a structured menstrual health session, alongside gains in eco-product literacy. Unsafe disposal practices, including flushing (46%) and pit latrine disposal (31%), were common across sites, highlighting environmental and infrastructure constraints that informed the design of the SHE model.
Data collection utilises mixed methods, including KoBoToolbox baseline surveys, module-specific pre/post session checks, facility audits, and a longitudinal cohort tracking system with anonymous participants across pilot schools throughout the three-year programme period. The monitoring framework includes midpoint review triggers and termly pulse checks designed to assess exposure to external menstrual health education and strengthen data quality assurance. Full outcome evaluation is ongoing, and causal attribution is interpreted cautiously given the absence of a control group.
These findings underscore the need to move beyond distribution-only interventions toward integrated, school-based menstrual health systems that align product access with WASH reliability and youth-led monitoring structures.From Charity to Compliance: Early Litigation and Implementation of Rights to Menstrual and Menopause Accommodations
Presenter: Marcy Karin
Affiliation: Rutgers Law School, Ruth Bader Ginsburg Women’s Rights and Gender Justice Clinic
In the global menstrual movement, a second wave of legal reform is shifting the policy focus from charitable product provision to enforceable rights-based protections. 2026 marks the first full year of implementation for several landmark statutes addressing menstruation and menopause in educational and workplace settings. This presentation examines how these emerging legal rights are interpreted and enforced during their initial stages of implementation.
Using a comparative legal framework, I analyze early regulatory guidance and litigation in the United States and United Kingdom. In the United States, I evaluate how recent interpretations of the Pregnant Workers Fairness Act and Title IX recognize menstruation and menopause as bases for reasonable accommodations in workplaces and schools. I further examine pioneering regional protections, including laws adopted in Philadelphia (the first major U.S. city to protect menstruation and menopause at work) and Rhode Island (the first U.S. state to explicitly mandate workplace menopause accommodations).
A core focus of this analysis is early litigation such as Faus v. Indian River Central School District (N.Y. 2025), which framed menstruation as inseparable from sex discrimination protections in educational contexts. I analyze how this case operationalizes rights to specific reasonable modifications, such as flexible scheduling and bathroom access.
I contrast these litigation-centered U.S. developments with the United Kingdom’s implementation approach under the Employment Rights Act 2025, including the use of Menopause Action Plans (launched on March 4, 2026) and emerging “stop-the-clock” educational policies.
These legal developments raise important questions about whether formal rights translate into actual, meaningful accommodations for students and workers. By evaluating the early enforcement under these legal frameworks, this presentation explores whether post-2020 menstrual and menopause laws (the second wave) are achieving their intended goals of equal participation in education and work. I conclude by offering insights into the opportunities and limitations of using the law as a primary mechanism for advancing menstrual and menopausal justice across the life course.From Dialogue to Action: Advancing Menstrual Dignity Through a Participatory Framework for Policy and Practice
Presenter: Abigail Lennox
Affiliation: University of East London, School of Childhood and Social Care, Department of Social Work Counselling & Social Care
Co-authors: Prof. Meera Tiwari - University of East London, School of Childhood and Social Care, Department of Social Work Counselling & Social Care
Despite increasing recognition of menstrual health (MH) as a public health and human rights issue, significant gaps persist between growing academic awareness and the practical implementation of effective, dignity-centred interventions. In the UK and globally, MH continues to be shaped by persistent stigma, misinformation, and unequal access to supportive environments, disproportionately affecting marginalised communities (Babbar et al., 2022). While the policy and research landscape has expanded in recent years, menstruation remains insufficiently integrated into global and national health policy frameworks, constraining the translation of knowledge into meaningful structural change (McAllister et al., 2025). As a result, organisations and institutions frequently struggle to move beyond awareness-raising towards sustainable, systemic approaches to MH management.
This research addresses this gap by positioning dignity as a central and transformative lens for understanding and improving MH outcomes. Unfolding across three phases, it represents a sustained commitment to moving from conceptual frameworks to grounded, participatory practice. In Phase 1 (2018), the DIGNITY: MH framework was developed as a research-informed tool to assess and strengthen MH across seven interconnected domains, including wellbeing, education, participation, safety, and social inclusion. In Phase 2, the framework was piloted internationally with partner organisations in the UK, India, and Nepal, enabling organisations to identify gaps in support, surface lived experiences of menstruation, and implement targeted, context-sensitive interventions. Building on this foundation, Phase 3 advances a participatory co-design approach, translating research into practice through “Dignity in Action” workshops. These workshops bring together stakeholders from educational institutions, community organisations, and policy settings to collectively identify barriers, challenge stigma, and co-develop locally relevant strategies to improve MH.
Drawing on qualitative data generated through these workshops, this presentation will share: (1) how “Dignity in Action” workshops were designed and facilitated across diverse institutional and community contexts; (2) stakeholder-identified barriers to menstrual dignity, encompassing structural, cultural, and interpersonal forces that sustain stigma and inequality; and (3) the co-designed strategies and practical tools developed by participants to address these barriers within their own settings. We will also reflect critically on the methodological and ethical dimensions of participatory research in this field, including the challenges and possibilities of translating co-produced knowledge into lasting institutional change. By shifting the conversation from silence to collective action, this research offers a replicable framework for embedding menstrual dignity within policy, institutional practice, and community engagement. Contributing both conceptual depth and practical insight to the theme of menstrual dignity, inequality and stigma.From Embodied Experience to Ruling Relations: Menstrual Inequality in an English FE College
Presenter: Kendal Stoneystreet
Affiliation: Sheffield Hallam University, Institute of Social Sciences
This paper presents doctoral research exploring everyday experiences of menstruation within an English further education (FE) college, examining how menstrual dignity, inequality and stigma are institutionally organised. Whilst critical menstruation research has expanded significantly in recent years, FE colleges remain underexplored sites despite serving socially and economically diverse student populations navigating complex intersections of age, class, race, disability, migration status and caring responsibilities. Addressing this gap, the research conceptualises menstrual dignity not as an individual matter of self-management, but as socially and institutionally coordinated through the practices, policies and power relations that structure college life.
The research adopts an institutional ethnographic approach, drawing on the work of Dorothy E. Smith to trace how students’ everyday experiences are coordinated through institutional processes and broader “ruling relations”. Beginning from lived experience, institutional ethnography works outward to map how institutional power shapes what is recognised, supported or marginalised. An intersectional feminist framework informs the analysis, enabling attention to how menstrual stigma and access to dignity are patterned through overlapping forms of inequality. Lived experience is treated not as anecdotal but as a rigorous point of entry for analysing institutional power and producing evidence capable of informing educational policy and practice. By linking embodied, micro-level accounts to macro-level institutional relations, the research reframes menstrual inequality as a structural educational issue rather than a private concern.
Fieldwork is ongoing and combines sustained participant observation with interviews, focus groups and creative participatory methods. The research adapts the “mosaic approach”, originally developed in research with children and young people, to the FE context to support inclusive participation. This approach integrates talk-based, visual, spatial and activity-based techniques, enabling participants to communicate in diverse ways and on their own terms. It also considers practical access, scheduling around students’ timetables and ensuring participation does not create additional burdens or barriers. For example, hair and beauty students are interviewed while using the researcher as a model during assessed coursework, embedding discussion within familiar pedagogical practice. Neurodivergent participants are invited to engage in colouring activities during interviews to facilitate communication and reduce anxiety. ESOL students participate in mapping activities to articulate spatial and embodied experiences of menstruation within the college environment. These methods seek to reduce hierarchical dynamics and enable students to shape how their experiences are represented.
As data collection is in progress, this presentation focuses on the study’s conceptual framing, methodological innovations and emerging reflections rather than definitive findings.From Moss to Mooncups: How Should We Tell Menstrual History in Norwegian Schools?
Presenter: Ingvild Ruhaven
Affiliation: University of Agder
As a history teacher and educator through twenty years I have read hundreds of pages and taught hundreds of lessons about bleeding bodies on battlefields. But I have never read or taught anything about a menstruating woman. In my PhD-project I am developing a school project on menstrual history for students in Norwegian upper secondary school. But how do we tell menstrual history? In my conference paper, I will discuss some possible approaches and potential pitfalls.
The aim of my project is not limited to including menstrual experiences in the historical narrative (although this is important in itself); it involves exploring the didactic potential of menstrual history. Firstly, I explore how students articulate an understanding of the bodily event of menstruation as historically situated. Secondly, I explore how students reflect on the blind spot of menstruation in traditional historiography.
My methodology is a qualitative intervention study. I am implementing a school project in two classes of 18-year-old students (all genders). Students’ individual papers and focus group interviews constitute the material to be interpreted.
The school project focuses on Nordic menstrual history, which is a feasible and relevant scope given the Norwegian school context. However, as the students are asked to collect menstrual narratives from their parents and grandparents (who may come from a variety of ethnic and cultural backgrounds), the scope is not limited exclusively to the Nordics.
Still, the larger historiographical questions remain: Should we tell a techno-optimistic and product-oriented story “from moss to Mooncups”? Should we tell a story of progress from taboo to openness, from shame to pride, from biological curse to medicinal choice? How do we balance fascinating long lines with necessary in-depth studies? How do we highlight main features (and what are those?) without creating an oversimplified menstrual history?From Policy to Practice: Advancing Menstrual Health and Dignity in Nigeria’s Private Sector- Evidence from the Flow with Dignity Project.
Presenter: Hassana Maina
Affiliation: Anti Sexual Violence Lead Support Initiative, Federal Capital Territory, Abuja, Nigeria.
Co-authors: Ohnan Gondyi Muhammad Kudu Mohammed
Anti Sexual Violence Lead Support Initiative, Federal Capital Territory, Abuja, Nigeria.Background: Menstruation is a natural biological process experienced by approximately 52% of Nigeria’s female population of reproductive age, yet menstrual health remains poorly institutionalised within the country’s labour and workplace policy frameworks. Persistent stigma, period poverty, and inadequate facilities compromise the productivity, dignity, and participation of menstruating employees, with up to 17% missing work due to menstruation and menstrual products consuming nearly 4% of a minimum wage salary. Nigeria’s National Policy on Menstrual Health and Hygiene Management (2025–2030) marks a pivotal shift by framing menstruation as a human rights and gender equality concern and recognising workplaces as critical implementation sites, yet translation into private-sector practice remains limited. Aim: This study examined menstrual health policy in Nigeria’s private sector, the organisational costs and benefits of workplace interventions, and the implementation experience of the Flow with Dignity Project; a civil society intervention advancing menstrual health dignity in private-sector organisations. Objectives: The study sought to: identify formal and informal menstrual health policies in private-sector organisations; explore employer and employee perceptions regarding productivity, absenteeism, and workplace culture; assess feasibility and value-for-money through a qualitative cost–benefit analysis (CBA); and document lessons for scaling policy adoption. Methods: This mixed-methods study was conducted by the Anti-Sexual Violence Lead Support Initiative (ASVIOL Support Initiative) under the Flow with Dignity Project across three private-sector organisations in Abuja, Nigeria. Data were collected through key informant interviews (KIIs) and thematic analysis was applied across five domains: menstrual health and productivity; informal policy mechanisms; workplace culture and stigma; organisational feasibility; and perceived benefits of formalisation. Findings were corroborated with a qualitative CBA. Results: Five themes emerged: a strong link between unmanaged menstrual health and reduced productivity; absence of formal policies with support remaining reactive and informal; low stigma but absent structural accommodation; concerns around cost and staffing gaps; and confidence that benefits reduced absenteeism, improved retention, enhanced reputation, and ESG alignment would outweigh costs. The CBA confirmed consistently positive ROI across all implementation scenarios. Conclusions: This study demonstrates a critical misalignment between Nigeria’s national menstrual health policy and private-sector practice. Civil society intervention grounded in capacity-building and policy advocacy can meaningfully catalyse policy adoption. Embedding menstrual health within HR, wellness, and ESG frameworks, anchored in national policy and reproductive justice principles, offers a scalable pathway toward menstrual dignity as a workplace norm in Nigeria. Keywords: Cost–benefit analysis, gender equity, menstrual health policy, menstrual leave, Nigeria, period poverty, private sector, workplace dignity
From Silos to Systems: Launching EMPOWER – a Collaborative, Patient-Centred Network for Evidence-Based Endometriosis Research
Presenter: Laura Cowley
Affiliation: Population Data Science, Swansea University Medical School
Co-authors: Dr Mayara S. Bianchim, School of Psychology and Women’s Health Research Wales Centre, Cardiff University, Wales, UK Dr Kate Isherwood, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Wales, UK Dr Judith Roberts, Department of Psychology, Aberystwyth University, Wales, UK Dr April Rees, Biomedical Sciences, Swansea University Medical School Miss Rachel Joseph, School of Psychology and Women’s Health Research Wales Centre, Cardiff University, Wales, UK Dr Rebecca Anthony, DECIPHer, School of Social Sciences, Cardiff University, Wales, UK
Aim: This scoping review aims to systematically map and characterize the existing literature on the use of whole-body thermal therapies for symptom management and wellbeing among people assigned female at birth with dysmenorrhea, chronic pelvic pain, endometriosis, or adenomyosis.
Objectives: To describe the range and characteristics of included studies, the types and parameters of thermal interventions used, the outcomes assessed, and key findings including estimates of effect. To identify gaps in the evidence base and priorities for future research.
Methods: This work is led by members of the EMPOWER (Endometriosis Management and Promotion of Wellbeing using Evidence-based Research) Network. The review will be informed by the EMPOWER-VOICES patient and public involvement panel comprising people with lived experience of endometriosis. We followed the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) framework to structure the research question, eligibility criteria, search strategy, and data extraction form. We searched five electronic databases from 2000 to February 2026, including the Embase and Scopus databases, and the Medline, APA PsycINFO, and CINAHL Ultimate databases via the EBSCO platform. An abstract screening tool was developed to assist with the initial screening process. Both abstract and full-text screening will be conducted independently by two reviewers, with discrepancies resolved by a third reviewer or team discussion. All studies excluded at the full-text screening stage will be reported with reasons for exclusion provided. The principles of mixed-methods framework synthesis will be adopted to extract, map, chart, categorise and aggregate study findings. Data from each included study will be extracted by two reviewers independently and discrepancies resolved by a third reviewer. The review will be reported using the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analysis, Extension for Scoping Reviews) checklist.
Results: The search carried out in February 2026 identified 426 potentially relevant records. These were imported into the review management software Covidence. Screening and data extraction will be completed by April 2026, with full review findings expected by the end of June 2026. We will include a PRISMA flowchart in the results section of the review publication to describe the study selection process. Data will be synthesized descriptively in tabular and narrative format.
Conclusion: We will use the findings to inform a planned feasibility study on the use of contrast therapy to support symptom management and wellbeing among those with endometriosis, and to inform additional research projects to address any evidence gaps identified by the review.From Stigma to Support: A Public Health Look at Menstrual Health in UK Schools
Presenter: Nicole Holt
Affiliation: Canterbury Christ Church University
Menstruation is a routine biological process experienced by approximately 1.8 billion people globally each month; however, menstrual health continues to be shaped by social, cultural and structural inequalities. An estimated 500 million people worldwide are unable to manage menstruation with dignity due to limited access to products, inadequate sanitation and insufficient education. These challenges reflect broader social determinants of health, including socioeconomic status, gender norms, stigma and access to supportive environments, positioning menstrual health as a significant but often overlooked public health issue.
Educational settings represent a critical context for menstrual health experiences. In the UK, the median age of menarche is between 12 and 13 years, with many girls beginning menstruation during primary school. Schools therefore become the first institutional environments in which menstruation must be managed within rigid structures such as timetables, attendance policies and uniform regulations. Inadequate menstrual support within schools has been associated with reduced concentration, restricted participation and increased absenteeism, with potential consequences for educational attainment, wellbeing and long-term health equity.
The aim of this review is to critically examine how menstrual health is experienced by girls and young women in UK educational settings, and to explore the implications of these experiences for public health. Objectives: 1) To review existing evidence on access to menstrual products, facilities and institutional support within UK educational settings; 2)To explore girls’ and young women’s experiences of menstruation in schools, with particular attention to stigma, identity and emotional wellbeing; 3) To examine the broader societal and public health implications of menstrual health inequalities within UK education systems.
This research adopts a literature-based narrative thematic review design. Academic and grey literature were identified through searches of databases and sources including Google Scholar, PubMed, Office for National Statistics (ONS) publications, UK government repositories and reports from organisations such as UNICEF and public health bodies. A thematic analysis approach was used to synthesise findings and critically examine how school environments shape menstrual knowledge, stigma and support.
We found across the literature, young women consistently report poor-quality or inconsistent menstrual education, discomfort discussing menstruation within school contexts and limited institutional support. These findings highlight the central role of schools in shaping menstrual health outcomes and demonstrate how inadequate provision can reinforce stigma and inequality. Addressing menstrual health in UK schools requires coordinated educational, structural and policy-level responses to promote dignity, inclusion and long-term health equity.From ‘Old Wives’ Tales’ to Digital Trackers: Mapping Menstruation in Ireland
Presenter: Dr. Harriet Wilkinson
Affiliation: Maynooth University, Department of Sociology
Menstruation, previously a hidden and ‘unspeakable’ physiological process, has become a topic of cultural interest and political activism evident in recent campaigns on period poverty. Yet coping with the menstrual cycle remains in large part individualised, falling within the remit of medical advice, limited educational interventions or commercial interests including digital tracking technologies. However, to date there have been no sociological studies of menstrual ‘management’ in Ireland, that demonstrate how the process of menstruation is socially constructed, culturally framed, politically situated, and ultimately lived as a specific physiological experience that resonates across the life course. This research aims to investigate often unspoken and informal social practices of menstrual ‘management’ passed down through kinship and peer networks.
Menstrual management is conceptualised as operating on three levels: at the subjective micro level of individual management, the meso level of kinship and peer dynamics and at the macro level of cultural, institutional, and commercial framings including technological management. These levels interact to produce a particular social imaginary, a set of values, institutions, and symbols through which menstruation is experienced, regulated, commodified, digitised and contested. I situate menstruation within the terrain of everyday experiences to assess it as a site of stigma but also of resistance. The aim is to understand menstruation within broader processes of gendered social change. The power of cross-generational dynamics in shaping how women and girls frame their embodiment, and their sexual and reproductive lives reveals much about the ‘stickiness’ of gendered norms, while also indicating sources of resistance, creativity, and gendered social change in Irish society.
This paper will examine a selection of body maps collected as part of my doctoral research. The presentation will examine how menstruation was embodied by participants, with particular attention to its affective dimensions, including the emotional, physical, and mental aspects of the menstrual experience.Gamifying Menstrual Literacy: The “BloomBox” Board Game as a Tool for Destigmatizing Menstrual Health Education in Namibia
Presenter: Dr. Tuwilika Nafuka
Affiliation: TupaBloom Digital Care Foundation, Projects
Research Aim: To evaluate the effectiveness of a gamified intervention (“BloomBox”) in improving menstrual literacy, reducing stigma, and bridging the gap between passive health education and active service utilization among Namibian youth.
Objectives: 1) Assess the impact of the BloomBox board game on adolescents’ knowledge of menstrual health and Sexual and Reproductive Health and Rights (SRHR). 2) Evaluate the intervention’s ability to create a psychologically safe space for discussing sensitive topics like menstrual dignity and stigma. 3) Determine the feasibility of using offline gamification as a referral pathway to health and psychosocial services.
Methods: A mixed-methods pilot study was conducted across 16 educational sites (10 high schools, 4 universities, 1 youth center) in Windhoek, engaging 1,722 youth (aged 13–24). The intervention utilized a “Board-to-Service” model where a physical board game simulated complex health scenarios, including menstrual health management, period poverty, and SRHR challenges. Data were collected via attendance registers, facilitator observation logs, qualitative educator feedback, and a post-intervention survey (n=37). To ensure an emotionally safe environment for minors, sessions were integrated into the formal Life Skills curriculum under the guidance of educators.
Results: The gamified intervention successfully engaged 1,222 high school learners and ~500 university students. Post-intervention survey data revealed that 92% of respondents felt “safer” discussing sensitive SRHR and menstrual health topics within the interactive game format compared to traditional classroom lectures. Additionally, 65% of participants reported acquiring new, actionable knowledge regarding their health rights and available support services. Qualitative observations highlighted high “participatory intensity” without aggressive incidents, indicating that the game mechanics effectively de-escalated stigma, normalized conversations around menstruation, and fostered open dialogue about menstrual dignity.
Conclusion: Gamification via the BloomBox model is a highly effective, person-centered “Service Delivery Innovation” for menstrual literacy and education. By embedding educational content and referral pathways into interactive gameplay, non-clinical environments can serve as destigmatizing, first-line educational hubs. Integrating collaborative “Serious Games” into school curricula offers a scalable, offline solution to combat menstrual stigma and improve health outcomes for disconnected youth. (Gamifying Menstrual Literacy: The “BloomBox” Board Game as a Tool for Destigmatizing Menstrual Health Education in Namibia
Presenter: Tuwilika Nafuka
Affiliation: TupaBloom Digital Care Foundation, Projects
Research Aim: To evaluate the effectiveness of a gamified intervention (“BloomBox”) in improving menstrual literacy, reducing stigma, and bridging the gap between passive health education and active service utilization among Namibian youth.
Objectives: 1) Assess the impact of the BloomBox board game on adolescents’ knowledge of menstrual health and Sexual and Reproductive Health and Rights (SRHR). 2) Evaluate the intervention’s ability to create a psychologically safe space for discussing sensitive topics like menstrual dignity and stigma. 3) Determine the feasibility of using offline gamification as a referral pathway to health and psychosocial services.
Methods: A mixed-methods pilot study was conducted across 16 educational sites (10 high schools, 4 universities, 1 youth center) in Windhoek, engaging 1,722 youth (aged 13–24). The intervention utilized a “Board-to-Service” model where a physical board game simulated complex health scenarios, including menstrual health management, period poverty, and SRHR challenges. Data were collected via attendance registers, facilitator observation logs, qualitative educator feedback, and a post-intervention survey (n=37). To ensure an emotionally safe environment for minors, sessions were integrated into the formal Life Skills curriculum under the guidance of educators.
Results: The gamified intervention successfully engaged 1,222 high school learners and ~500 university students. Post-intervention survey data revealed that 92% of respondents felt “safer” discussing sensitive SRHR and menstrual health topics within the interactive game format compared to traditional classroom lectures. Additionally, 65% of participants reported acquiring new, actionable knowledge regarding their health rights and available support services. Qualitative observations highlighted high “participatory intensity” without aggressive incidents, indicating that the game mechanics effectively de-escalated stigma, normalized conversations around menstruation, and fostered open dialogue about menstrual dignity.
Conclusion: Gamification via the BloomBox model is a highly effective, person-centered “Service Delivery Innovation” for menstrual literacy and education. By embedding educational content and referral pathways into interactive gameplay, non-clinical environments can serve as destigmatizing, first-line educational hubs. Integrating collaborative “Serious Games” into school curricula offers a scalable, offline solution to combat menstrual stigma and improve health outcomes for disconnected youth. (Genetics of hormone sensitivity: Childbirth, menstruation and menopause
Presenter: Jessica Mei Kay Yang
Affiliation: Centre for Neuropsychiatric Genetics and Genomics, Cardiff University
Co-authors: Dr Ganna Leonenko (Centre for Neuropsychiatric Genetics and Genomics, Cardiff University), Dr Antonio F. Pardiñas (Centre for Neuropsychiatric Genetics and Genomics, Cardiff University), Professor Lisa Jones (Psychological Medicine, University of Worcester), Dr Katherine Gordon-Smith (Psychological Medcine, University of Worcester), Professor Nicholas Craddock (National Centre for Mental Health, Cardiff University), Professor Ian Jones (National Centre for Mental Health, Cardiff University; Centre for Neuropsychiatric Genetics and Genomics, Cardiff University), Professor Veerle Bergink (Department of Psychiatry, Icahn School of Medicine at Mount Sinai; Department of Psychiatry, Erasmus Medical Center) Professor Valentina Escott-Price (UK Dementia Research Institute, School of Medicine, Cardiff University; Centre for Neuropsychiatric Genetics and Genomics, Cardiff University), Professor Arianna Di Florio (Centre for Neuropsychiatric Genetics and Genomics, Cardiff University)
Background: The postpartum period is the time in a woman’s life when she is at the highest risk for severe mental illness. The abrupt hormone shift at this time point offers a unique opportunity to study the impact of hormones, which could help us understand the biology of severe mental illness related to other reproductive time points. This study aimed to explore whether genetic markers which predispose a woman to experiencing severe postpartum mental illness are related to other reproductive events such as menarche and menopause.
Methods: The first genome-wide association study of postpartum psychosis was conducted on 771 cases and 8,536 healthy female controls from the Bipolar Disorder Research Network (UK) and the Erasmus Medical Centre (Netherlands). Healthy female controls were recruited through the national UK Blood Services, the 1958 British Birth Cohort (UK National Child Development Study) and the UK Household Longitudinal Study. Genetic correlations were conducted between postpartum psychosis and age at menarche, age at menopause, polycystic ovary syndrome (PCOS), preeclampsia and psychiatric disorders such as bipolar disorder, schizophrenia and major depression.
Results: Several variants reached a suggestive genome-wide significance level (p < 1 x 10-5), although none reached genome-wide significance. These mapped onto 13 genetic loci and 30 genes. Genetic correlation analyses are still on-going. Preliminary results show the genetic correlation with age at menarche and age at menopause to be not significant. The genetic correlation between postpartum psychosis and bipolar disorder type-I was highest and moderate with schizophrenia, lower for bipolar type-II and major depression and not significant for PCOS and preeclampsia.
Conclusion: These results suggest that postpartum psychosis shares genetic architecture with other major psychiatric disorders such as bipolar disorder type-I and schizophrenia and not with typical reproductive time points such as age at menarche and age at menopause. More research into severe mental illness during these reproductive time points is crucial to understand their shared and distinct biology.Ginhawa at Gaan: Co-Imagining Collective Care and Dignity in the Menstrual Experiences of Filipinos
Presenter: Rafaella Potestades
Affiliation: Lunas Collective
Co-authors: Sabrina Laya Gacad (Lunas Collective) Co-author Organizations: Pambansang Koalisyon ng Kababaihan sa Kanayunan (PKKK); Pioneer Filipino Transgender Men Movement (PFTM); Philippine Anti-Discrimination Alliance of Youth Leaders (PANTAY) (LBQ menstruators, prioritizing youth); Women with Disabilities Taking Action on Our Reproductive and Human Rights (WDARE); Likhaan
In the Philippines, menstruation is still commonly framed through medicalized and “hygiene-first” discourses that position the menstrual body as something to manage discreetly, leaving dignity undertheorized and lived experience underdocumented. This gap is sharpened by the coloniality of gender, where normative assumptions about “women,” purity, and respectability shape who is recognized as a legitimate menstruator and whose needs are sidelined. As a result, intersecting systems of oppression, such as stigma, exclusion, and uneven access to supportive infrastructures and care, compound menstrual life in ways that product- or WASH-centered approaches alone cannot fully explain. This study examines how Filipino menstruators frame menstrual health, perceive and experience menstrual dignity (or its absence), and imagine dignified menstruation and its implications for well-being and development. Using a feminist participatory action research (Goessling, 2024) design with creative, arts-based methods, it develops a decolonized account of menstrual dignity as lived freedom and relational well-being. Conceptually, it draws on the capabilities approach as a normative scaffold for dignity as real freedoms to function (Nussbaum, 2010), grounds meaning-making in Sikolohiyang Pilipino through ginhawa/kaginhawaan as culturally resonant wellbeing (Samaco-Zamora & Fernandez, 2016), and reads these through a decolonial feminist lens attentive to the coloniality of gender (Lugones, 2010). Grounding dignity in the experiences of diverse menstruators can help align government and development efforts with what dignity requires in practice, while extending decolonial understandings of menstrual health, dignity, and justice in the Philippines. (Note: Data gathering will be conducted this coming March 2026)
Gopad. Biotransformation technology applied in menstrual pads
Presenter: Torben Holm Larsen
Affiliation: Real Relief ApS
Menstrual waste is an increasingly significant yet under-addressed source of environmental pollution, particularly in low- and middle-income countries where formal waste management systems are limited. Globally, a substantial proportion of plastic waste escapes collection and contributes to land and ocean pollution. Disposable menstrual products are a key contributor; for example, billions of sanitary pads are discarded annually in countries like India, often ending up in open environments or landfills. Inadequate disposal infrastructure, compounded by cultural taboos, leads to unsafe practices—such as disposal in latrines—and contributes to stress, stigma, and adverse health outcomes, especially among school-aged girls. Despite its relevance to public health, gender equity, and sustainability, menstrual waste remains insufficiently addressed in WASH and development planning.
This study introduces Gopad™, a sanitary pad incorporating biotransformation technology designed to biodegrade in unmanaged, open-air environments. Unlike conventional “compostable” products requiring industrial facilities, Gopad™ undergoes a chemical transformation when exposed to environmental factors such as air, sunlight, heat, and moisture, converting into a non-toxic, bioavailable wax that subsequently biodegrades.
The research evaluates the product’s environmental safety and biodegradability using established standards, including BSI PAS 9017 for open-air plastic biodegradability, ISO 17556 for biodegradation, and OECD protocols for ecotoxicity. Laboratory and outdoor testing across tropical, temperate, and arid climates—representing regions most affected by plastic pollution—confirmed effective material transformation and degradation. Within 120 days, visible transformation into wax occurs, and over 90% biodegradation is achieved within two years. Chemical analyses demonstrated significant reductions in molecular weight, while environmental safety assessments showed no toxicity to soil organisms or plant life.
These findings validate the hypothesis that biodegradable menstrual products with verified environmental performance can mitigate pollution in low-infrastructure settings. Gopad™ represents a novel category of biotransformative menstrual products that do not require formal disposal systems, making them particularly suitable for humanitarian, peri-urban, and school contexts.
This work contributes to the intersection of menstrual health, environmental sustainability, and development by addressing a critical gap in menstrual waste management. It establishes a technical foundation for future research on user acceptability and real-world implementation, supporting progress toward multiple Sustainable Development Goals related to health, gender equality, sanitation, responsible consumption, and climate action.Hidden, managed, negotiated: How emotion norms shape menstrual health in UK high schools
Presenter: Dr Petra Kolić
Affiliation: Manchester Metropolitan University, Department of Sport and Exercise Sciences
Co-authors: Dr Ben Ives, Manchester Metropolitan University Dr Christopher Morse, Manchester Metropolitan University Prof Paul Holmes, Manchester Metropolitan University Dr Joy Probyn, University of Salford Dr Lamiece Hassan, Government Digital Service
Research Aim: This research aimed to investigate how menstruation is experienced, interpreted, and negotiated in UK high schools from the perspectives of different school community members, with attention to lived experiences, perceived expectations, enacted behaviours, and associated meanings.
Objective: The primary objective was to develop a theory-informed understanding of menstruation as a socially constructed experience, examining how students and staff interpret, respond to, and reproduce norms that shape menstruation experiences, education, and management in high school.
Methods: This qualitative research study utilised focus groups as a method of data generation. We conducted 23 focus groups across 13 high schools, involving 169 school community members. This included eight focus groups with 64 female students aged 13-17 years old, seven focus groups with 43 male students aged 14-17 years old, and eight focus groups with 62 high school staff. Focus groups were audio-recorded, transcribed, and analysed using phronetic iterative analysis. Symbolic interactionist concepts of emotion norms and emotion work were applied as interpretive lenses to examine the emotional, interactional, and normative dynamics shaping participants’ experiences and perspectives.
Results: We unpack how menstruation in high schools was shaped by emotion norms and emotion work through four themes. First, menstrual health education functioned as early emotion-norm socialisation. Limited biomedical teaching left students without shared language or guidance for understanding emotions associated with menstruation or advocating for their menstrual needs, while staff expressed discomfort delivering menstrual health education. Second, toilet restrictions operated as institutional feeling rules, requiring menstruating students to suppress feelings, such as anxiety and discomfort, while maintaining composure in lessons, which often caused emotional strain and disrupted learning. Third, exceptions to toilet restrictions revealed ongoing emotion management by staff, who balanced care, authority, and regulations when responding to student requests. Inconsistent discretionary decisions created uncertainty and embarrassment for students, implicitly framing menstruation as a deviation from normal school conduct. Fourth, menstrual stigma was sustained through impression management strategies: students and staff concealed menstrual products, anticipated judgment from others, and avoided disclosure of their menstruation status, while teasing, particularly from male peers, reinforced gendered feeling rules.
Conclusion: We framed menstruation as a socially constructed experience shaped by stigma, restrictive policies, and expectations surrounding emotional regulation. Supporting menstrual health effectively in the daily high school routines, therefore, requires more than curriculum reform. Cultural and organisational changes are needed to validate student needs, reduce emotional strain, and equip staff to provide confident education and support.How do Autistic people manage menstruation? Findings from a UK-based longitudinal qualitative study.
Presenter: Rebecca Ellis
Affiliation: Swansea University
Menstruation is known to impact people negatively within a general population, including physically and emotionally. Our previous systematic review shows that Autistic people may face additional challenges, including increased sensory sensitivities, physical discomfort, overwhelm and meltdowns, and a reduced capacity to mask. Many of these reported experiences of menstruation were often internal experiences; therefore were understood less by others. Little is known about Autistic period pain management. The objective was to gain an understanding of how Autistic people (aged ≥16 years) manage menstruation, including the use of period products, and strategies to reduce pain and distress. The Autism from Menstruation to Menopause study is an on-going, qualitative, longitudinal study, which uses creative research methods to encourage participants to share their views and experiences of all aspects of reproductive health during interviews. 100 Autistic people who were assigned female at birth are interviewed at approximately six-monthly intervals (maximum of 10 interviews per participant). Data from 351 interviews conducted to date were analysed thematically. Participants described a range of social aspects that informed their menstrual product choice (in which pads were the most popular), including a hidden curriculum of knowledge, peer pressure to try new methods, and feeling the need to conceal their period (and period products) due to societal stigma. In addition, being Autistic informed their choice, including a preference for sameness, concerns about using products correctly, sensorily comfortable (or least uncomfortable) products, and frequency of changing period products. Executive functioning challenges created additional considerations for period product management. Participants reported a wide range of strategies to manage menstrual pain. This included a wide range of medication, both prescribed and not prescribed, to reduce pain and heaviness of bleeding. Heated products were also used to reduce pain. Participants also changed their daily routines, including what they ate and drank, allowing themselves more rest, the use of comforts, and increased stimming. Some relied on those with whom they lived for additional support. Our research provides an insight into Autistic adults’ menstrual management strategies, both in relation to managing menstrual flow, and menstrual symptoms, including pain and distress. To date, there are limited resources aimed at supporting Autistic people to manage menstruation, and many of these are aimed at children. In the future, we will co-develop resources with Autistic adults that provide Autism-friendly information on menstruation.
How to Flourish during the Menopausal Transition
Presenter: dr. Marijke Schotanus-Dijkstra
Affiliation: University of Twente, Psychology, Health and Technology department
Background: Each year, at least 25 million women worldwide experience menopause, yet the potential for flourishing during the menopausal transition period remains underexplored. To date, most studies in the climacteric field have focused on bio-physiological symptoms associated with the menopausal transition while mental health (both mental illness and mental wellbeing) is impacted by the menopausal transition as well. People who score high on emotional, social and psychological wellbeing across 14 dimensions, including happiness, life-satisfaction, social contribution, purpose in life and self-acceptance, are viewed as flourishing. The current scoping review aims to examine what is known about flourishing and its emotional, social and psychological wellbeing components throughout the menopausal transition.
Method: Almost 5.000 references were screened, and 461 full-text articles. This scoping review analyzed 181 articles from 158 longitudinal, experimental, cross-sectional and qualitative studies from four electronic databases up to 2026.
Results: Only 39 studies primarily addressed emotional, social or psychological wellbeing, with eight studies encompassing comprehensive measures of flourishing. A central finding of this review is that both longitudinal and cross-sectional studies consistently show that menopausal symptoms were negatively associated with flourishing, emotional and psychological wellbeing, while these variables did mainly not significantly differ between menopausal stages. In addition, the qualitative findings suggest that some women may experience growth and elements of flourishing during the menopausal transition.
Conclusion: More in-depth exploration of positive experiences throughout this challenging yet transformative period is needed as well as defining the menopausal stages more accurately.IMPACT OF RELIGIOUS AND CULTURAL PRACTICES ON MENSTRUAL HEALTH MANAGEMENT IN SOUTHERN AFRICA: A QUALITATIVE SYSTEMATIC REVIEW
Presenter: Esmie Lois Kachikuni
Affiliation: Independent Researcher
Co-authors: Tumeliwa Mphepo. Healthcare Outcomes Research Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland. Dr Anne Gatuguta. Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
Background: Global advocacy on menstrual health has mainly focused on equity issues, such as access to menstrual hygiene products and sanitation. In Southern Africa, a subregion comprising of 16 countries, menstrual health challenges extend beyond access to products and facilities to systems of belief that regulate behaviour, participation, and bodily autonomy. These norms influence how girls and women understand menstruation, navigate social expectations, and experience inclusion or exclusion within their communities. Aim: To explore how religious and cultural belief systems influence menstrual health management and experiences among girls and women in Southern Africa, to inform culturally sensitive policy and intervention development. Methods: The Sample, Phenomenon of Interest, Design, Evaluation and Research type framework (SPIDER) informed the inclusion and exclusion criteria. Peer-reviewed qualitative studies on religious and cultural norms surrounding menstruation as well as the knowledge and experience of girls and women who menstruate were analysed. Only studies conducted in English, from 2010 were included in the review. Data was analysed thematically, with descriptive codes refined into sub-themes and overarching themes, synthesized narratively to alignment with the study research questions. The Preferred Reporting Items for Systematic and Meta Analyses (PRISMA) guided the reporting of the findings. Results: Ten articles from South Africa, Zambia, Malawi and Zimbabwe were included in the study. Findings from a total of 200 girls and women indicate that menstrual stigma is sustained through narratives of impurity, secrecy, and restriction embedded within both religious teachings and cultural traditions. Menstruating girls and women reported exclusion from religious spaces, limitations in participation in community and household activities, and pressure to conceal menstruation. Despite the contextual differences in the expression of religious and cultural norms, the studies showed similar outcomes that reinforced stigma and restriction on participation. Conclusion: Menstrual inequality in Southern Africa is not solely driven by material deprivation but is also deeply embedded in socio-cultural and religious systems that shape dignity and agency. Addressing menstrual stigma requires culturally responsive approaches that centre on the lived experiences of girls and women and engage faith and community leaders.
Identifying Key Influencers and Relationship Characteristics Contributing to Menstrual Seclusion in Nepal: A Social Network Analysis Study
Presenter: Aubree E. McMahon
Affiliation: University of Pittsburgh - Department of Behavioral and Community Health Sciences
Co-authors: Puja Gartaula2, Kar Hai Chu1, Bhimsen Devkota1, 2, 3 , Sara E. Baumann1 Affiliations: 1 – Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh; Pittsburgh, PA, USA
2 - Bikash Shrot Kendra, Kathmandu, Nepal
3 – Tribhuvan University, Kirtipur, Nepal
Research Aim and Objective: Menstrual seclusion practices, which are socially and religiously rooted, are common in far-western and mid-western Nepal. Over 90% of menstruating individuals across Nepal practice some level of restriction, including many daily activities (e.g., avoiding touching food, religious activities). Some women reside in separate spaces (i.e., chhau goths, or menstrual sheds), for the duration of their menstrual cycle. Such restrictions pose health risks, with concerns including asphyxiation from heating chhau goths with fire, animal attacks, and lack of access to sanitation facilities. Despite significant health risks posed by menstrual seclusion, there is little known about who may influence key behaviors promoting health and safety during menstruation. We aim to identify1) key influencers of menstrual restrictions, and 2) associated relationship characteristics, which can be harnessed to effectively design menstrual health interventions focused on shifting social norms to improve health.
Methods: Social Network Analysis is an approach to analyzing social structures with particular interest in relational attributes. We surveyed 46 girls and women (ages 14-48) who practice menstrual seclusion in two Dailekh district villages, Karnali Province, which has a high prevalence of women practicing menstrual seclusion. We developed an ego-centric dataset by asking participants to name up to five individuals who influence their decision to practice menstrual seclusion. Participants then answered demographic questions about the influencers they nominated, as well as details about their relationship with each influencer (e.g., nature and length of relationship).
Results: On average, participants (mean age 27) were younger than influencers (mean age 52). Six caste/ethnic groups were represented among participants and influencers (chi-squared p-value=0.8542). All participants were Hindu and rated religion as important or very important in their life. All participants practiced at least two menstrual restrictions; no religious activities; avoiding the kitchen. 65.2% of participants reported sleeping outside the home during menstruation, and 37% reported sleeping separately inside the home. Most influencers of menstrual seclusion practices were family members (67.9%). Participants held long, close relationships with influencers, on average reporting relationships of 10+ years and contact at least once a week. Additional quantitative analyses are ongoing and will be available at the time of the conference.
Conclusions: This study identifies family members with long, high contact relationships as primary influencers of menstrual seclusion practices in mid-western Nepal. Menstrual health programs focused on behavior change should consider targeting these individuals, as they shape the social narrative, and practice of menstrual seclusion in their communities.Impact of providing free menstrual products on menstrual management and wellbeing at a large, U.S. midwestern university
Presenter: Kristen Upson
Affiliation: Michigan State University, College of Human Medicine, Department of Epidemiology and Biostatistics
Co-authors: Khushi Chhabra, Human Biology Program, College of Natural Science, Michigan State University. Harsna Chahal, Covenant HealthCare College of Medicine, Central Michigan University. Lucy Thompson, Department of Psychology, College of Social Science, Michigan State University
Research Aim: Access to menstrual products is vital for menstrual equity. A student-led advocacy group at a large, public university in the US Midwest, serving 51,838 students (80% undergraduate, 20% graduate) and 5,696 faculty/academic staff, worked with university leaders to adopt a policy to provide free menstrual products. The policy was implemented February 2023 with free pads and tampons provided in select women’s and gender-neutral bathrooms on the main university campus.
Objective: On a university campus, examine the impact of free menstrual products on menstrual management and wellbeing.
Methods: We conducted a cross-sectional study of current university students, staff, and faculty ages ≥18 years. A single, anonymous online survey with 40 questions was administered between November 2024 and March 2025. Survey questions focused on menstrual management on campus, including free product use and accessibility, and impact on campus-related activities and perceived support. Menstruators on campus both before and after February 2023 were asked about impact of free menstrual products on menstrual management.
Results: A total of 2,418 respondents experienced a menstrual period in the past year while on campus; 60%, 31%, and 9% were students, staff, and faculty, respectively, with a median age of 23 years (interquartile range 20-33 years). Over the prior year, 65% (n=1,467) reported not having any menstrual products with them to manage their menstrual period; 69% used the free menstrual products provided on campus, with more frequent use by students (74%) than non-students (62%). Furthermore, only 20% reported ever struggling in the past 12 months to obtain menstrual products, with the most common reasons being lack of store access to purchase menstrual products (62%) and financial struggles (52%). Most participants (77%) strongly agreed that having access to free menstrual products on campus made them feel supported. However, 43% reported needing menstrual products but none were available in the campus bathroom. Among individuals on campus both before and after February 2023 (n=1,244), many respondents agreed that free menstrual product availability helped with menstrual management (68%) and university attendance and participation (44%) and reduced the struggle to obtain menstrual products (57%).
Conclusion: In this university setting, experiencing a menstrual period and not having one’s own products on-hand is common, with free menstrual products being frequently used. While improvements are needed, including timely menstrual product restocking and expanding coverage to all campus bathrooms, free menstrual products helped with menstrual management, increased perceived community support, and promoted university engagement.Inclusive Period Care: Product Preferences for Young Autistic Menstruators
Presenter: Keely Lundy
Affiliation: University of New Mexico, Department of Pediatrics
Autism and periods. This intersection has fortunately been the focus of greater research and applied work, which have found that autistic persons are at a greater risk of early pubertal onset, menstrual disorders, and increased mood, behavioral, and other diagnostic-specific challenges while on their periods. Therefore, identifying appropriate supports for their menstrual care and well-being is imperative. This is what spurred an American study looking at the menstrual product preferences of autistic youth and the menstrual product choices of caregivers on their behalf. Youth participants were given popular menstrual products to try and completed surveys on their use and preference. Caregivers were asked about the importance of various menstrual product features and the degree to which these influenced the purchasing decisions they made for their children. Researchers found that youth most preferred period underwear and tried products requiring internal application the least out of fear of getting them stuck, incorrect use, and the potential for discomfort or pain. Caregivers considered the sensory impact and executive or motor functioning demands of menstrual products as most important in their buying decisions. Study results offer explicit recommendations on how to prepare autistic menstruators for their periods in advance of menarche, as well as to reduce financial burden and stress on families. Caregivers, service providers, and menstrual product companies may also utilize the information collected to better support the menstrual care and well-being of autistic persons.
Influence of Family and Culture at Menarche: A Qualitative Study.
Presenter: Dr Diana Manoshi
Affiliation: Martin Luther Christian University,Psychology
Co-authors: 1. Professor Ashok H.Shama, Chanakya University
- Dr. Ryntihlin Jennifer War Martin Luther Christian University
Background: Menstruation in India is steeped in taboos and societal restrictions, resulting in a challenging experience for young girls. A lack of understanding about menstruation’s role in sexual development and fertility contributes to feelings of shame and reluctance to discuss their experiences (Garg et al., 2001; Manoshi & Shailaja, 2019). Girls often face restrictions in interactions with men, religious practices, and societal participation, resulting in negative body image and resentment toward the physiological changes associated with their first period. The aim of this study is to examine the impact of family and culture on menarche from the perspective of a mother.
Method: A phenomenological research design using a focus group discussion technique was employed to procure data. 53 participants were recruited using the organisational and advertisement technique of purposive sampling. The groups displayed linguistic diversity, comprising Urdu, Kannada, Tamil, and English speakers. The first four groups included mothers with educational backgrounds of dropping out or studying up to the 10th grade, while the last two groups featured mothers with graduation or higher qualifications. Using Atlas.ti software, a qualitative research analyst performed thematic analysis on verbatim transcripts from discussions in six focus groups.
Outcome: the results of the study reveal mothers engaged in social and cultural practices related to food during menarche, which were shaped by their family traditions and cultural backgrounds, irrespective of their educational attainment, religion, or regional origins. These practices are viewed as beneficial for promoting health and mitigating complications in pregnancy. Some mothers wanted to follow rituals symbolically, while others felt compelled to do so as part of their cultural heritage, termed ‘sampradaya’. Those with negative menarche experiences, particularly well-educated mothers who could express their views confidently, often disagreed with various rituals. Parents cherished their children’s autonomy, evident in choices regarding clothing, sports, and manners. Some mothers of Islamic faith expressed significant concern that cultural norms might hinder their daughters’ education and lead to expectations for arranged marriages. Many wished to keep the cultural rites low-key to protect their daughters’ academic interests.
Recommendations: Developing an attitude scale for menstruation for Indian women is challenging due to the country’s diverse religions, regions, and cultures. A comprehensive scale is required to evaluate attitudes broadly, facilitating the provision of vital information and support to mothers, women, and girls in embracing their bodies.Informed and Empowered: Programmatic Lessons from an Informed Choice Assessment on Menstrual Product Use Among Adolescent Girls in Rural Nepal
Presenter: Sajani Limbu
Affiliation: WaterAid Nepal, Programmes Department
Research Background and Aim Promoting informed choice in menstrual health and hygiene (MHH) interventions enables menstruators to exercise bodily autonomy and manage their periods safely, comfortably, and with dignity. Without adequate information and access to a range of products, individuals cannot make decisions that best meet their specific needs and circumstances. WaterAid Nepal together with BASE Organisation, Nepal Fertility Care Centre and National Federation of the Disabled, implemented the WASH GAINS project in Bardiya District, western Nepal, to enhance the quality learning environment for adolescent girls and children with disabilities. While Nepal’s government ongoing pad programme represents a significant public investment in MHH, most school-going girls receive only disposable pads. This assessment examined whether offering adolescent girls menstrual product options alongside structured orientation and ongoing support enables informed product decision-making in rural school settings. Objectives To assess preferences, experiences, and ability to make informed choices regarding menstrual product; identify factors influencing product selection and recommendations for implementation. Methods A mixed-methods study was conducted across six schools in Bardiya between August 2025 and January 2026. One hundred adolescent girls aged 11–20 received a Menstrual Product Bag containing four product types: disposable pads, reusable cloth, reusable pads, and menstrual underwear. Orientation sessions engaged participants, parents, teachers, and school health nurses. Quantitative data were collected through pre/post questionnaires and three-monthly Menstrual Practice Needs Scale Short Form (MPNS-SF) assessments, supplemented by six Focus Group Discussions (FGDs). Results Orientation produced significant knowledge gains across all groups, most notably among parents (37% to 75%). Product usage shifted markedly over three months: menstrual underwear adoption grew from 53% to 86%, reusable pad use from 26% to 53%, and cloth from 5% to 57%, while disposable pads remained consistently high (~84%). MPNS-SF satisfaction scores improved from 2.84 to 2.93. FGDs identified comfort, absorbency, and ease of use at school as key drivers of preference, while inadequate washing, drying, and storage facilities were the primary barriers to reusable adoption. Most girls used two or more types of products within a single cycle depending on the menstrual flow and physical activity. Conclusion This assessment demonstrates that a structured, choice-driven MHH approach, combining product access, practical demonstrations, and multi-level stakeholder engagement can meaningfully shift adolescent girls’ knowledge, product confidence, and menstrual practices. However, product choice alone is insufficient without supportive infrastructure. Programming must invest equally in enabling school environments, including private washing, drying, and disposal facilities, alongside education and supply.
Investigating the Association between Polycystic Ovary Syndrome and Eating Disorder Symptoms
Presenter: Marie-Christine Opitz
Affiliation: University of Edinburgh, Clinical Psychology
Research Aims: Polycystic ovary syndrome (PCOS) is a common chronic endocrinological condition for which there is currently no known cause or cure. Thus, treatment options are limited to symptom management, commonly including weight loss as treatment goal. Preliminary evidence has identified an association between PCOS and eating disorder symptoms, which can be explained through hormonal imbalances, visible bodily differences, dysregulated mood, and weight loss treatment. However, no study so far has investigated the mechanisms linking PCOS and eating disorders through qualitative research. The present project aims to address this research gap by exploring the ways in which the two health conditions are linked.
Objectives: This study’s objective is to better understand the lived experiences of co-occurring PCOS and eating disorder symptoms, including the specific mechanisms involved. Both direct and indirect links are being explored.
Methods: UK-based adults with a PCOS diagnosis and self-identified eating disorders or disordered eating are invited for semi-structured online interviews. Interpretative Phenomenological Analysis (IPA) is used to gain a better understanding of individual lived experiences and contextual factors. Follow-up focus group discussions will be held to discuss first findings and common themes with interviewees.
Results: While the study is currently ongoing, preliminary findings indicate complex associations between the symptoms and treatment approaches of each condition. Thereby, links appear to be bi-directional and are amplified through a lack of health education and support in regards to both PCOS and eating disorder symptoms.
Conclusion: Co-occurring PCOS and eating disorder symptoms create a variety of short- and long-term health problems. A better understanding and increased awareness for the links between both conditions could improve the management of PCOS and eating disorder symptoms, as well as overall wellbeing for those affected.It’s About Bloody Time We Talk About This: A Qualitative Exploration of Menstrual Experiences and Interactions with the Period Products (Free Provision) (Scotland) Act 2021
Presenter: Vhairi Sophronia Wilde
Affiliation: University of Glasgow
Title: Materialising Menstruation
Aim: To provide a creative, interactive and inclusive workshop that invites participants to reflect on menstrual experiences, while fostering open and reflective conversation.
Content: This hands-on creative workshop offers a participatory, interactive and reflective approach to visualising the navigation of the menstrual cycle. During this workshop, participants will play, craft and create with diverse materials such as paper, fabrics, wool, beads, glitter, slime, wire and other textured and colourful materials. The purpose of the workshop is to feel and creatively explore how menstruation is experienced.
Through play and making, the participants will create a unique ‘menstrual object’ to visualise their experiences of menstruation. The act of crafting is both reflective and dialogic as participants are invited (though not required) to share stories, feelings and insights with others as they create.
The workshop foregrounds materiality and embodiment by offering an alternative method for exploring menstruation beyond verbal discussion alone. By using touch, texture and colour, the workshop encourages new ways of expressing and understanding menstrual experience.
Practicalities: I am a PhD researcher in Sociology at the University of Glasgow with an interest in creative and craft-based approaches. This workshop has been piloted, generating valuable insights that have informed its structure and facilitation. I will provide all materials required for the session, prioritising sustainably sourced, reused and repurposed materials wherever possible in order to minimise waste.Let’s talk cycles: Breaking Menstrual Health Silos Through Inclusive Education and Dialogue
Presenter: Davinny Sou
Affiliation: University of St.Gallen, ETH Zurich
Despite menstruation being a routine biological process and the menstrual cycle a vital marker of health, menstrual health remains surrounded by persistent stigma and substantial gaps in awareness and education. These gaps contribute to delayed or missed diagnoses, normalization of pain, and prolonged periods of reduced quality of life for many menstruating individuals. While there is a clear demand for better menstrual health education, existing approaches often fail to reach diverse populations, particularly individuals beyond academic contexts or with lower socio-economic backgrounds. Moreover, education frequently excludes non-menstruating individuals, despite their role in shaping public stigma and social support.
To address these challenges, we launched Let’s Talk Cycles, an in-person, inclusive, and dialogue-oriented educational initiative. The workshops combine evidence-based education with participatory exchange and consist of four core components: (1) a brief warm-up quiz assessing baseline menstrual health knowledge; (2) foundational education on menstrual cycle physiology, explicitly addressing inter-individual variability and reproductive life-stage differences; (3) thematic deep dives into specific life domains (e.g., work, sports, mental health) facilitated by invited experts; and (4) moderated group discussions designed to encourage experience sharing, question asking, and the critical examination of prevalent myths. Importantly, the initiative actively involves both menstruating and non-menstruating participants to address public stigma collectively.
Between October and December 2025, three workshops were conducted with a total of 60 participants. Qualitative insights were generated from facilitated group discussions, with participants’ reflections systematically captured on sticky notes and thematically analyzed. Three recurring patterns emerged: (i) non-menstruating participants reported strong interest in menstrual health but little to no formal education, often due to sex-segregated curricula; (ii) menstruating participants described their education as superficial and expressed frustration with medical dismissal of pain and symptoms, contributing to reduced trust in clinical expertise; and (iii) across groups, menstrual health knowledge was perceived as fragmented and siloed across healthcare providers’ domains, with limited integration into broader health care. Participants articulated a shared desire for more comprehensive, personalized menstrual health education, increased empathy and understanding across genders, and better support for individuals experiencing severe symptoms. These patterns highlight persistent educational gaps and suggest that inclusive, dialogue-based formats can help dismantle stigma and bridge silos between lived experience, medical knowledge, and social understanding.Leveraging longitudinal cohorts to understand menstrual health: challenges and opportunities
Presenter: Prof Gemma Sharp
Affiliation: Department of Psychology, University of Exeter
Co-authors: Sampurna Kundu, Gemma Sawyer, Panagiota Pagoni, Lachlan MacBean, Alice Brooks, Isabel Catling School of Psychology, University of Exeter
Introduction Menstrual health is increasingly recognised as a key indicator of overall health, yet it remains under-measured in population research. It is inherently multifaceted, shaped by dynamic, interacting biological, psychological, and social factors, and associated with a wide range of health and social outcomes. Large longitudinal cohort studies offer a powerful opportunity to capture these complexities across the life course, but important gaps in measurement limit their potential. We aimed to demonstrate the value and limitations of existing cohort data for understanding menstrual health, and to develop a new approach to address these challenges.
Methods We first established the MenstruLife study, in which we analysed data from seven longitudinal cohort studies to estimate the prevalence of heavy menstrual bleeding and menstrual pain, examine associated biological, psychological, and sociodemographic risk factors, and assess links with mental health outcomes. We then developed the CycleTrack study, embedded within two major UK cohorts (ALSPAC and Born in Bradford), combining existing longitudinal, genetic, and psychosocial data with new, detailed menstrual health measures. CycleTrack data collection includes an online questionnaire (~5,500 participants) and intensive longitudinal data in a subsample (~1,200 participants) across three menstrual cycles using daily smartphone-based symptom tracking, physiological data from wearable devices, and epigenetic data from menstrual fluid samples.
Results MenstruLife findings demonstrate that heavy menstrual bleeding and pain are common across the menstrual life course and are associated with a range of biological, psychological, and social risk factors, as well as poorer mental health outcomes. However, analyses also highlight key limitations of existing cohort data, including heterogeneity between studies, limited detail on symptoms, and a lack of prospective within-cycle data. These constraints restrict our ability to capture the dynamic and multidimensional nature of menstrual health and to disentangle underlying mechanisms. Early results from the CycleTrack pilot study show how we can address these gaps by integrating high-resolution, prospective menstrual health data into established cohort studies. This approach allows for detailed investigation of symptom trajectories, mechanisms, and impacts across the life course.
Conclusions Positioning menstrual health as a dynamic “vital sign”, our work provides a scalable framework for enhancing cohort studies and generating globally accessible data resources to advance menstrual health research and improve population health outcomes.Life Beyond Diagnosis: Case Studies of Women Living with Polycystic Ovary Syndrome
Presenter: Dr. Raminder Kaur
Affiliation: Panjab University, Department of Anthropology
Co-authors: Dr. Maninder Kaur, Associate Professor, Panjab University, Chandigarh
Research Aim: Polycystic Ovary syndrome (PCOS) being most common and underdiagnosed endocrinal and metabolic condition among reproductively active women. From an anthropological perspective, PCOS can be understood as a biocultural condition shaped by the interaction of biological predisposition, lifestyle behaviors, and socio-cultural contexts. Objective: The present study examines the lived experience and psychological health of PCOS women of Chandigarh, India using case study approach. Methods: A total of six case studies were examined in the present study using mixed method approach. The information was collected using detailed personal interviews, medical history and anthropometric assessment to explore participants reproductive health and lifestyle patterns. Results: The common symptoms reported by PCOS women were menstrual irregularity, weight gain, hirsutism and bilateral bulky ovaries. Family history of PCOS were also reported by participants. In addition to clinical factors, study examines lifestyle dimensions including dietary habits which exhibited higher processed and junk food intake, limited levels of physical activity, and irregular sleep patterns, which are recognized as significant contributors to the manifestation and progression of PCOS. The study emphasized particularly on the participant’s mental health. The finding highlights that PCOS symptoms predominantly hirsutism and infertility issue often results in increased emotional stress and compromised mental health among women. The study found that family perception and support appeared to play an important role in women’s well-being. In conclusion, the present study contributes to anthropological discussions on reproductive health by demonstrating how conditions such as PCOS are embedded within broader socio-cultural and behavioral contexts. Therefore, it underscores the importance of holistic and culturally sensitive health interventions that integrate medical treatment with sustainable lifestyle changes to improve women’s well-being.
Lived Experiences of Menstruation Among Transgender and Gender Diverse People: Intersectional Stigma and Calls for Resistance
Presenter: Amélie Pasmanns
Affiliation: Department of Health Promotion & Care, Public Health Research Institute, Faculty of Health, Medicine, and Life Sciences, Maastricht University
Co-authors: Lilith A. Whiley, Department of Management, University of Sussex Business School, University of Sussex; Latifa Abidi, and Sarah E. Stutterheim, Department of Health Promotion & Care, Public Health Research Institute, Faculty of Health, Medicine, and Life Sciences, Maastricht University
As menstruation is often framed as a feminine experience and transgender and gender diverse (TGD) people transgress cishegemony, TGD people navigate the complex intersection of two stigmas: menstrual stigma and transphobia. In this qualitative interview study with reflexive thematic analysis, we explored TGD people’s lived experiences of menstruating in a gender diverse body, paying particular attention to how TGD experience menstruation and navigate (intersectional) stigma. Findings revealed varied levels of internalized stigma, with some participants feeling ashamed or uncomfortable, and others perceiving menstruation neutrally. Anticipated stigma, stemming from societal views linking menstruation to femininity, led to fears of misgendering and medical discrimination. Enacted stigma included negative reactions and limited access to menstrual products and suitable restroom infrastructure. Participants resisted intersectional stigma by reframing menstruation positively or neutrally and urged for the promotion of inclusivity. Participants further recommended gender-neutral language, menstrual products and disposal bins in all restrooms, and increased representation in period advertising.
Lived experience of POI
Presenter: Naomi Alesworth
Affiliation: Premature Ovarian Insufficiency advocate
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Locally engineering sustainable, reusable sanitary pads from agricultural waste to overcome period poverty in Rwanda.
Presenter: Aakeen Parikh
Affiliation: The Minazi Impact
Period poverty is estimated to impact over 500 million people globally. Not only are sanitary pads prohibitively expensive in some communities, most are made with high amounts of plastic. Inadequate disposal facilities in agricultural towns mean that used pads and packaging are often burned, releasing toxic fumes, or buried with compost, which release microplastics into the soil. To bridge the period poverty gap, many government schemes or subsidies have been set up in villages and communities where these issues persist, however, funding dependency means they schemes cannot guarantee long term support.
This paper is based on the banana fibre sanitary pad project in Rwanda run jointly by The Minazi Impact and Dufatanye Organization. The project aims to address the above key interconnected issues through a systems change approach – the key research question is whether it is possible to systematically and sustainably eradicate period poverty by redesigning sanitary pads and increasing access to sanitary products through local agency. To do this, we have been developing a low cost, environmentally sustainable sanitary pad product, using local resources such as waste banana fibre.
We have also built a proof-of-concept production facility in Nyanza, to make and distribute reusable sanitary products locally, using local materials and local skill sets. This includes the installation of a banana fibre extraction machine, to make the absorbent core, and installation of sewing machines to stich pads in the village. In addition, we have delivered educational programmes and workshops, to break down stigmas and increase awareness of menstrual health and hygiene.
Our research programme shows that shifting away from the plastic based sanitary products, which have a high-cost barrier, by creating a sustainable reusable alternative in a localised production facility is advantageous and cost-effective in addressing period poverty. However, there are also difficulties which hinder the process, such as se curing capital investment or donations to build the facility, and the integration of a supply chain for critical components. This requires management and commitment, and a closed financial loop which can be realised by creating financial schemes. To date over 3000 pads have been produced and distributed, encouraging a systems change that moves away from subsidies and donations to sustained local production and supply, which is necessary for long term impact. Coupled with menstrual education and curriculum change, this project is helping to overcome the key social barrier for women and girls in communities where it is most needed.MENSTRUAL RIGHTS IN COLOMBIA: LEGAL CONSOLIDATION AND PUBLIC POLICY CHALLENGES
Presenter: Elizabeth Daza Reyes
Affiliation: UNIVERSIDAD MILITAR NUEVA GRANADA
Menstrual Rights in Colombia: Legal Consolidation and Public Policy Challenges
Menstruation is a natural physiological process experienced by women of reproductive age that, throughout history, has been subject to multiple interpretations and persistent stigmatization. Its psychosocial and cultural implications have driven regulatory developments at both international and national levels. In Colombia, these developments have progressively shaped what can be identified as the legal consolidation of menstrual rights, raising important public policy challenges that require systematic analysis within the Colombian legal framework.
Objective: To analyze the development of the Colombian legal system regarding menstrual rights and to identify the main public policy challenges associated with their consolidation.
Methodology: A qualitative study was conducted through a review of legal sources and a thematic bibliographic analysis.
Results: A total of 46 normative documents of different hierarchical levels were identified and analyzed alongside relevant international developments. Based on this analysis, six stages are proposed to reflect the evolution of menstrual rights within the Colombian legal context between 1991 and 2023.
Conclusion: Significant legal advances have been identified, particularly driven by constitutional jurisprudence, in the recognition of menstrual rights. However, these advances remain limited, as their formal legal recognition has not yet been explicitly consolidated within statutory regulation. Strengthening the protection and promotion of menstrual rights requires a comprehensive approach that addresses the menstrual experience of women and menstruating persons in Colombia, while also confronting pending regulatory challenges. The explicit incorporation of menstrual rights into Colombian regulation represents an innovative legal and public policy development.Making Menstrual Citizens: How Menstruators in Scotland conceptualise themselves through the Period Products (Free Provisions) (Scotland) Act 2021.
Presenter: Caroline Newton
Affiliation: Social Anthropology Student, The University of Edinburgh
This research introduces ‘menstrual citizenship’ by examining the Period Products (Free Provision) (Scotland) Act 2021. To be a menstrual citizen is to have a set of claims over state-provided menstrual products that create a sense of precarity and solidarity with other menstruators, based on perceptions of the self. Through three months of fieldwork made up of interviews and photo submissions, I explore the act through its impact on the everyday lives of menstruators.
‘Menstrual citizenship’ demonstrates how the Scottish state and menstruators co-produce norms of the moderate, educated bleeder and caring provision-user. A politics of unseen care for imagined menstruating others emerges as interlocutors respond to a scarcity paradigm in accessing products. This research offers new findings of menstruators seeing themselves as ‘thieves’ for using ‘universally accessible’ period products. The act evokes complex emotional responses for menstruators around their positions in the socioeconomic order as they construct themselves, emotionally and practically, into ‘menstrual citizens’. I use this as an entry point to address the unique categories of exclusion, not just inclusion, that come from progressive menstrual policy. Menstrual citizenship is a biopolitical category in which menstruators are mediated by the state, other menstruators, products and complex emotions with practical implications for product use.
My presentation will guide attendees through my research with the aim of highlighting the implications of the unseen political, category-making experiences on the practicality of product access in a way that has not been applied to the Scottish context before. Being physically able to access period products is still not the Scottish status-quo, yet when products are available access is personally complex beyond traditional discourses of period stigma. Learning from interlocutors that grew up, some from menarche, with access to period products in their schools provides insightful access as to how even the most progressive policies can be improved and learnt from in other contexts using a Scottish ‘menstrual citizenship’ framework to illuminate the traits of menstruation legislators were blind to that allow for inclusion, and exclusion, of product access.
Key themes: Menstrual product access, menstrual policy, menstrual citizenship, inequalities, ScottishMapping existing psychosocial interventions for menstrual distress across populations and settings: a systematic scoping review
Presenter: Kamilla Abdullayev
Affiliation: University College London; Clinical, Educational and Health Psychology Research Department & EGA Institute for Women’s Health
Co-authors: Samyuktha Balakrishnan, Professor Jennifer Hall, Professor Aimee Spector
Background and Aims: Menstrual distress, encompassing psychological and physical symptoms across the menstrual cycle, affects a substantial proportion of menstruating individuals and can significantly impair daily functioning, quality of life, and mental wellbeing. While pharmacological treatments remain the most commonly recommended approach, there is growing interest in psychosocial and psychological interventions targeting coping, pain perception, emotional regulation, and behavioural responses to menstrual symptoms. The breadth, characteristics, and methodological robustness of this evidence base, however, remain unclear. This scoping review aims to systematically map existing psychosocial interventions for menstrual distress, characterise intervention components and outcomes, and identify evidence gaps to inform future research and intervention development.
Methods: A scoping review is being conducted across MEDLINE, Embase, PsycINFO, CINAHL, and Web of Science using combined search terms related to menstrual distress, psychosocial factors, and interventions. Eligible studies included randomised controlled trials, quasi-experimental designs, and pre-post studies evaluating psychological or psychosocial interventions targeting menstrual-related distress (e.g., dysmenorrhea, PMS, PMDD) or associated wellbeing outcomes. Dual screening was conducted at title/abstract (5%) and full-text (10%) stages to ensure reliability, and 10% of data will be independently extracted to assess agreement. Data will be synthesised narratively using structured evidence mapping, categorising interventions by type, delivery mode, and population. Methodological quality will be assessed using the Downs and Black checklist.
Results: The initial search yielded 13,460 records; following deduplication, 7,465 abstracts were screened, 183 proceeded to full-text review, and 98 studies met inclusion criteria. Included studies encompassed a heterogeneous range of psychosocial and behavioural interventions, most commonly targeting dysmenorrhea and PMS. Identified approaches include cognitive behavioural therapy (CBT), mindfulness-based interventions, relaxation and breathing techniques, yoga, structured exercise, psychoeducation, emotion-focused therapies, and creativity-based approaches. Studies focused on dysmenorrhea most frequently examined education and mind-body techniques, whereas PMS and PMDD studies more commonly evaluated CBT and mindfulness-based therapies. Frequently reported secondary outcomes include quality of life, coping, anxiety, depression, stress, analgesic use, and health literacy.
Conclusion: Preliminary findings reveal a diverse but fragmented evidence base, characterised by considerable variation in intervention content and outcome measurement. Ongoing data extraction and quality appraisal will be completed by July 2026 to clarify the strength and consistency of the evidence and highlight priorities for rigorous future intervention development and evaluation.Measuring and Reducing Menstrual Self-Stigma: An Evaluation of a Community-Based Menstrual Dignity Intervention in Sindh, Pakistan
Presenter: Komal Qidwai
Affiliation: Research, Learning, and Evaluation Department at Aahung
Menstrual stigma is frequently cited as a challenge in socio-cultural and religiously conservative contexts such as Pakistan. However, in community settings it is not easily measurable as a social phenomenon. Self-stigma, or the internalisation of ideas of impurity, shame, and secrecy appears to be a key driver of everyday practices adolescent girls and women engage in, and is measurable in low-resource settings.
Aahung implemented and evaluated a community-based program with the aim of reducing self-stigma and improving self-care practices. To assess the effectiveness of the program – which employs a peer-to-peer education approach through youth health educators, alongside parental engagement – menstrual self-stigma was operationalised as a psychosocial construct. It was treated as both, a likely driver of menstrual health behaviours , and a proxy indicator for norm change in small community interventions, where social stigma is diffuse and difficult to quantify. This approach aligns with a self-care approach within sexual and reproductive health and rights – the right to menstruate with dignity in an environment where support from institutions such as the healthcare system, schools, and families is lacking.
Using a pre-post design, adolescent girls completed baseline and endline surveys covering menstrual knowledge, opinions (including stigma and restrictions), self-stigma/attitudes, and self-care/help-seeking behaviours. Of 147 girls surveyed at baseline, 78 completed endline. Early results show that knowledge increased by 34%, attitudes/self-stigma improved by 17%, and behaviours by 19%. Improvements were strongest for items tied to participation and dignity, for e.g., rejecting restrictions and feeling less “dirty/unclean” (a 53% improvement on this item). This suggests that targeting self-stigma may improve behavioural autonomy (asking for support from family, participating in sports at school) despite stigma in the broader social environment persisting.
At the same time, gaps persisted in biological knowledge on menstruation and communicating with boys and men regarding it – indicating persistent ideas of shame and secrecy, and menstruation being relegated as a phenomenon for women to deal with on their own. This was the case of male family members such as fathers and brothers as well – comfort discussing menstruation with male family members remained low.
These findings are preliminary; limitations include high attrition, the absence of a control group, and short follow-up. However, they suggest that measuring self-stigma can offer a feasible, locally relevant way to track norm-adjacent change in resource-constrained interventions. More importantly, they indicate how dignity can be embedded within community programs and how it can be shifted.Menarche, a trigger for: menstrual education, care and heteronormative gender norms in the Romanian context
Presenter: Anca Nita
Affiliation: Doctoral School of Sociology, University of Bucharest
An anthropological research regarding menstrual education and how gendered information on the topic during puberty participates in perpetuating and embodiment of heternormative roles. The research consists of 20 interviews with 10 cis-women and 10 cis-men (20-30 years old) on the topic of menstrual education and a netnography component that is still ongoing on Instagram. The initial goal of the research was to explore the perspectives of both women and men on menstrual education, knowing from previous research that boys are not part of the menstrual education during puberty/adolescence.
The interviews showed a more complex relation between menarche, menstrual education, care and heteronormative gender norms. After menarche, women are being taught that they have to be careful during menstruation, especially in the presence of male figures, from fathers, brothers or colleagues at schools. Men, by not receiving education on the subject, are indirectly thought that this is a matter that should not bother them.
For men one of the main sources of menstrual education are the sexual/romantic heterosexual encounters. For women, the embodied role of caring means being the educator in the relationship, explaining to their partners about menstruation and how it affects them. Men describe that during menstruation they are more careful with their partners and their needs, care being another form of the traditional role of provider: buying menstrual products, food or drugs. They expressed positive perceptions on menstruation and the menstrual blood, however stereotypes regarding the fragility and the emotional instability of women are present.
Another important finding is that a new form of masculinity emerges while taking care of your girlfriend during menstruation and it is socially appreciated as I saw in the interviews but also in the last 6 months of nethnography on instagram. In reels you are a better man based on the level of care and acts of kindness during the menstrual cycle, which are similar to the ones described by my respondents. Men acknowledging the menstrual experiences is important, however the interviews’ narratives and the social media videos are describing, disguised in a discourse about care, traditional heterosexual gender roles. The man is the provider and caretaker, while the woman’s body is controlled by her hormones, being unable to care for herself, maintaining an inequality of power specific to patriarchal heterosexual relationships.Menstrual Blood as a Biopsychosocial Phenomenon among Kukama-Kukamiria Women in the Peruvian Amazon
Presenter: Dr. Monica R. Ticlla
Affiliation: Swiss Tropical and Public Health Institute - Department of Research
Co-authors: Roxani Rivas-Ruiz1, Mari Dumbaugh2,3, Dayana Peña-Reyna1, Theresa J. Ochoa4, Sonja Merten2
1Facultad de Ciencias de la Educación y Humanidades (FCEH), Universidad Nacional de la Amazonia Peruana (UNAP), Iquitos, Peru. 2Department of Research, Swiss Tropical and Public Health Institute, University of Basel, Switzerland 3Insight Impact Consulting, LLC, Chicago, USA 4Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, PeruBackground: The Kukama-Kukamiria, one of the most representative Indigenous peoples of the Loreto Region, are known for their sociocultural mastery of floodplain life. Among Kukama-Kukamiria women, menstrual blood is understood as a biopsychosocial phenomenon linking embodied knowledge, gendered power relations, and local care practices. In local ontology, menstruation is associated with the moon and female vitality and conceived as a process of bodily renewal through the expulsion of “bad blood.” From a medical anthropological perspective, menstruation is not merely a physiological event, but a culturally shaped and socially situated lived experience. Following Kleinman’s framework, menstrual health must be understood not only within the biomedical domain, but at the intersection of illness and sickness. Understanding local interpretations of menstruation is therefore essential for analyzing menstrual experiences in Amazonian contexts and informing more equitable public health responses. Methods: A qualitative ethnographic study was conducted between December 2025 and February 2026 in three Kukama-Kukamiria communities in the Marañón region of the Peruvian Amazon. Community entry was coordinated with local authorities, and female facilitators supported recruitment of voluntary participants aged 18 years and older. Purposive sampling sought diversity in menstrual experiences. Data collection included semi-structured in-depth interviews, focus group discussions, body-mapping workshops, and participant observation. The analytical corpus addressed menarche, symptoms, care practices, menstrual material use, dietary practices, and meanings attributed to menstrual bleeding. Data were analysed through inductive thematic coding using iterative reading, constant comparison, and progressive category development. Triangulation of methods and regular team discussions enhanced qualitative rigour. Results: Menstruation was predominantly interpreted as a bodily cleansing mechanism that restores internal balance and was mainly situated within the register of illness as a culturally meaningful lived experience. Menarche emerged as a biographical milestone marked by fear, shame, and learning mediated by mothers and other women relatives. During menstruation, participants reported emotional changes and recurrent symptoms such as cramps, breast pain, and malaise. The menstruating body was considered vulnerable, leading to rest, mobility restrictions, and avoidance of physical exertion or river exposure. Dietary restrictions and phytotherapies were also common. Disposable pads and reusable cloths coexisted in practice. These findings reveal the coexistence and negotiation of biomedical and local care frameworks, while menstrual blood also functioned as a marker of gender and relational power. Conclusion: Menstruation among Kukama-Kukamiria women constitutes a complex biopsychosocial field in which physiology, lived experience, and sociocultural structures converge. The centrality of female intergenerational transmission and the tensions between protection, discomfort, and agency highlight the need for culturally appropriate menstrual health policies in Amazonian contexts.
Menstrual Dignity in Contexts of Internal Displacement: Health, Autonomy and Structural Inequality in Port-au-Prince, Haiti
Presenter: Magdalee Brunache
Affiliation: University of Toronto, Department of Political Science
Co-authors: Mialove BARTHELEMY, RÈG Ayiti Marie Michma EDME, RÈG Ayiti Mathania EDME, RÈG Ayiti Nathanaëlle PETIT-FRERE, RÈG Ayiti Sterline JANVIER, RÈG Ayiti
Haiti is experiencing an unprecedented internal displacement crisis driven by escalating armed violence and political instability. In 2025 alone, more than 1.4 million people were forced from their homes, leading to the rapid expansion of internally displaced persons (IDP) sites across the metropolitan area of Port-au-Prince, Haiti’s capital city. In these environments marked by limited access to water, sanitation, healthcare, and privacy, the everyday management of menstruation emerges as a critical yet often overlooked dimension of health and gender inequality.
Menstrual health in humanitarian settings is often reduced to product distribution, leaving unaddressed the structural conditions that shape menstrual dignity. This study evaluates the state of menstrual dignity among girls and women living in five IDP sites in Port-au-Prince. The objectives were to assess access to menstrual products and WASH infrastructure, examine menstrual management practices, analyze knowledge, attitudes, and stigma surrounding menstruation, and identify priority needs to inform gender-sensitive humanitarian responses.
A mixed-methods design was employed. Quantitative data were collected from 370 girls and women using a structured questionnaire with probability-based sampling. Data were analyzed using descriptive statistics to characterize access patterns, menstrual management practices, and priority needs. Qualitative data were generated through focus group discussions with girls and women (n=10) and boys and men (n=10), transcribed and analyzed using thematic analysis. Direct observation of WASH facilities complemented self-reported data.
Results indicate that menstrual dignity is significantly compromised in displacement settings. While 248 participants reported primarily using disposable pads, 23 relied on cloth or improvised materials due to financial constraints. Forty-three percent identified menstrual products as their most urgent unmet need, followed by medical consultations (22 percent) and pain management (16 percent). Access to water was inconsistent, toilets were often pay-per-use, and privacy for menstrual management was limited, with some women reporting changing in sleeping areas or other improvised spaces. Qualitative findings revealed persistent stigma and myths surrounding menstruation, including perceptions of impurity and social exclusion. Discussions with boys and men further highlighted limited knowledge but also expressed openness to participating in education and stigma reduction efforts.
The study concludes that menstrual dignity in humanitarian displacement contexts is a multidimensional issue shaped by infrastructure deficits, economic precarity, gender norms, and limited health services, constraining menstrual health, autonomy, and dignity. Integrated interventions combining access to menstrual products, improved WASH infrastructure, healthcare services, community education, and male engagement are essential to ensure safe and dignified menstrual management for displaced girls and women.Menstrual Education and Management in School Settings: Youth Voices from Chinese High School Students
Presenter: Sitian Chen
Affiliation: Instiute of Education, University College London
Research aim: This study explores how adolescents understand menstrual rights and menstrual education within school contexts and examines how institutional environments shape young people’s lived experiences of menstruation. It aims to reimagine menstrual education and rights by foregrounding youth voices and embodied experiences. Objectives: 1. To examine young people’s expectations of menstrual education in schools. 2. To explore how school environments and institutional regulations affect menstrual experiences. 3. To identify how youth perspectives can inform a whole-school approach to menstrual rights and education. Methods: This qualitative study was conducted with adolescents aged 16–17 in a high school setting in China. In total, 41 students (32 girls and 9 boys) participated in the study. Data were generated through focus groups, interviews, diary and participatory activities, and 37 instances of classroom and school observations. Thematic analysis and discourse analysis were used to identify recurring patterns in participants’ narratives concerning menstrual education, school environments, and institutional practices. Results: 1. Educational gaps and reliance on informal learning Participants reported learning about menstruation primarily through online platforms. While recognising the accessibility of online information, they expressed concerns about misinformation and emphasised that schools should provide earlier, practical, and credible menstrual education beyond biological explanations, including pain management, hygiene practices, and everyday coping strategies. 2. Structural exclusion of menstruating bodies in school settings Participants described school environments as designed around non-menstruating bodies. Limited access to menstrual products, inadequate toilet facilities, restrictive classroom rules, and inflexible leave policies often prevented timely menstrual care. These structural barriers contributed to embarrassment, discomfort, and, in some cases, health risks. 3. Youth voices and the need for dialogic education Students criticised existing sexuality education as didactic or moralistic and expressed a preference for respectful, equal, and problem-focused dialogue. Participatory research activities were described as supportive spaces that reduced shame and facilitated meaningful discussion. Conclusion: Findings suggest that menstrual rights in schools cannot be addressed solely through curriculum-based interventions or individual stigma reduction. Instead, a whole-school approach is needed, integrating menstrual education with structural changes to school environments, institutional policies, and communication practices. Meaningfully incorporating youth voices is essential for creating inclusive and effective menstrual education and support systems.
Menstrual Exclusion as a Lens for Understanding Systemic Oppression: Gender, Ethnic, and Socio-economic Inequality of Slovak Roma Menstruators
Presenter: Natália Blahová
Affiliation: (ngo) InTYMYta / Dôstojná menštruácia / Iniciatíva za dôstojnú menštruáciu / University of Amsterdam
The thesis investigates menstrual exclusion among Slovak Roma menstruators as a lens through which to examine the intersecting dynamics of gendered, ethnic, and socio-economic oppression in Slovakia. By situating menstruation within broader structures of racism, patriarchy, and class inequality, the study argues that menstrual exclusion is not only a symptom of marginalization but also a form of systemic oppression. Drawing on qualitative research conducted in April 2025 across six locations in the Prešov region, the research utilizes semi-structured, in-depth interviews with 24 respondents to highlight how menstruation functions as a site of both control and resistance. The research addresses three primary questions: (1) what indicates menstrual exclusion among Slovak Roma; (2) how limited WASH facilities access shapes their experiences; and (3) how they navigate stigma and build support networks. Findings show that menstrual exclusion manifests through inadequate or inaccessible menstrual products, unsafe or absent WASH facilities - with 22% of Slovak Roma lacking in-home running water (Atlas rómskych komunít, 2019) - and systemic barriers to healthcare and education. These challenges are compounded by structural racism and patriarchal gender norms that enforce gendered silences, rendering menstruation a site of layered oppression. Through the application of Achille Mbembe’s (2003, 2019) concept of necropolitics, the thesis conceptualizes the neglect of Slovak Roma menstruators as a form of necropolitical abandonment, wherein state and institutional failures effectively expose marginalized populations to premature suffering and symbolic death. The denial of essential infrastructures, such as clean water, demonstrates how Slovak Roma are deemed “disposable” within dominant structures of power. Crenshaw’s (1989) intersectionality, expanded within Collins’ (2000) framework of interlocking systems of oppression, provides the analytical basis for understanding how race, gender, and class interact simultaneously to shape these lived realities. The thesis also highlights resilience and solidarity. Despite silence in male-dominated family contexts, respondents described strong female networks - including mothers and aunts - that share knowledge and menstrual products. These practices reflect what Collins (2000) terms a “collective body of wisdom,” through which marginalized women challenge stigma and resist systemic neglect, cultivating dignity amid structural exclusion. The study concludes that menstrual justice is inseparable from systemic justice, requiring a fundamental shift in how institutional power regulates access to care.
Menstrual Health Care-Seeking, and Well-being in Early Adolescence: Insights from Wave 1 of a Longitudinal Qualitative Study
Presenter: Atiya Rahman
Affiliation: Humanitarian Hub, BRAC James P Grant School of Public Health, BRAC University
Co-authors: Ms. Arifa Bente Mohosin, Research Associate, BRAC JPGSPH, BRAC University, Bangladesh Heather Suttor, Research Officer, Global Adolescent Health (she/her), Burnet Institute Associate Professor Julie Hennegan, Associate Professor and Principal Research Fellow, Australian Women and Girls’ Health Research Centre, The University of Queensland Professor, Sabina F Rashid, BRAC JPGSPH, BRAC University, Bangladesh Dr. Elissa Kennedy, Co-Program Director, Women’s, Children’s and Adolescents’ Health Co-Head, Global Adolescent Health (she/her), Burnet Institute
Research Aim Menarche marks a critical transition in early adolescence, yet it is often experienced with limited knowledge, persistent socio-cultural taboos, inadequate support and limited care-seeking for menstrual concerns and related health needs We conceptualized menstrual care-seeking as one’s pursuit of further information social support such as communication family members, peers, teachers or health providers or services to manage menstruation, including accessing menstrual products and facilities. Despite increased attention to menstrual health, limited research has examines, how early menstrual experiences shape adolescent girls’ care-seeking behaviors and well-being.
Objective: In what ways do early menstrual experiences and surrounding social environment affect adolescent girl’s care-seeking behaviour well-being and shape their well-being?
Methods: This longitudinal qualitative sub-study of the AMEHC (Adolescent Menstrual Experiences and Health Cohort) study examines how early menstrual experiences shape subsequent sexual and reproductive health (SRH) outcomes. This analysis draws on first-round in-depth interviews with 40 girls aged 12–13 from eight schools and madrasas in Khulna Sadar and Dumuria. Interviews explored emotional responses to menarche, stigma, communication, care-seeking, school participation, and menstrual practices. Transcripts were translated and thematically analyzed using matrix-based coding to identify behavioral patterns in terms of care-seeking practices.
Results: Menstruation emerged as an emotional and social experience shaping girls’ well-being and care-seeking practices. Initial reactions to menarche, often marked by fear, confusion, anxiety, and embarrassment, were stronger among those with limited prior knowledge, reducing timely care-seeking and access to support. Socio-cultural norms framing menstruation as private or ‘impure’ reinforced shame and secrecy, constraining help-seeking from family, teachers, or health providers. Restrictions on mobility and social interaction reduced autonomy, while severe pain heightened distress and sometimes led to school withdrawal without appropriate care. Participants emphasized that supportive environments shaped how girls interpreted and managed early experiences. Open communication with family and teachers fostered reassurance and confidence. School education, peer discussions, awareness programs, menstrual materials, and digital media provided information that helped reduce stigma and improved girls preparedness, confidence and ability to seek care and support.
Conclusion: Findings position menstruation as an under-recognized determinant shaping adolescent girls care-seeking practices and well-being. Socio-cultural taboos fuel shame and anxiety, discouraging care-seeking and leaving concerns unaddressed. In contrast, supportive families, schools, and peer networks promote resilience and proactive help-seeking. Access to accurate information and adolescent-responsive care reduces stigma and distress while strengthening well-being and agency in resource-constrained settings.Menstrual Health Literacy: A Scoping Review and Mixed-Methods Exploration of Conceptualisations, Measurement, and Interventions
Presenter: Sophie Haas
Affiliation: ETH Zürich
Background: Menstrual health literacy (MHL) is fundamental to the physical, mental, and social well-being of menstruating individuals, yet significant knowledge gaps persist across the premenopausal life course. Menstruating individuals frequently lack accurate understanding of their menstrual physiology, cycle variability, and clinical warning signs – gaps shared, in different ways, by healthcare professionals and non-menstruating individuals. Existing educational systems and healthcare structures often fail to provide adequate support, contributing to misinterpretation of menstrual health experiences, delayed recognition of menstrual disorders, and substantial burdens related to chronic pain, fatigue, and emotional symptoms. Sociocultural stigma and inconsistent education further compound these challenges. Meanwhile, the rapid proliferation of digital menstrual health technologies, such as cycle-tracking applications, has introduced new but uneven opportunities for self-directed learning. Despite growing scholarly attention, research on MHL remains fragmented across disciplines, varies widely in conceptualisation and measurement, and lacks a unified, cross-contextual synthesis.
Objective: This study aims to systematically map how MHL has been defined, conceptualised, and measured to date, and to identify existing interventions designed to improve it. This study addresses four key questions: (1) How is MHL conceptualised in the current literature? (2) How has MHL been measured, and what opportunities exist for improved measurement? (3) How aware are healthcare professionals (specifically gynecologists) regarding menstrual health and where do gaps persist in menstrual health related consultation and patient guidance? (4) What interventions have been implemented to improve MHL among menstruating and non-menstruating individuals?
Methods: A scoping review will be conducted following JBI methodological guidance and reported in accordance with PRISMA-ScR standards. Three databases (PubMed, Scopus, and ACM Digital Library) will be searched using the key term “menstrual health literacy”. To contextualise and extend these findings, semi-structured interviews with gynaecologists and potentially an online survey with menstruating and non-menstruating individuals in German and English-speaking regions will be conducted.
Expected Results: We anticipate identifying substantial heterogeneity in how MHL is conceptualised and measured, limited evaluation of existing interventions, and significant unmet literacy needs among menstruating and non-menstruating individuals, as well as healthcare providers. These findings are expected to inform clearer conceptual foundations, improved measurement approaches, and more targeted strategies for strengthening menstrual health literacy across populations.Menstrual Health at the Intersection of Forced Displacement, Social Norms, and Adolescence: Evidence from Palestinian Refugee Camps
Presenter: Rula Ghandour
Affiliation: Institute of Community and Public Health - Birzeit University
Background: Menstrual health is increasingly recognized as a critical component of adolescent health and well-being. While global research on menstrual health has expanded rapidly in recent years, more structured and comprehensive evidence is still needed, particularly from humanitarian settings. In the Palestinian context, refugee camps represent a unique form of protracted displacement—originally established as temporary spaces following the 1948 displacement yet persisting for more than seven decades. This prolonged “temporary permanence” shapes the everyday lives and health experiences of adolescents growing up in refugee camps. Aim: This study examines menstrual health experiences, menstrual education, and menstrual-related health outcomes among adolescent girls living in Palestinian refugee camps and explores how prolonged displacement and social norms influence these experiences. Methods: A sequential exploratory mixed-methods design was used in Palestinian refugee camps in the West Bank and Jordan. Qualitative interviews and focus group discussions with adolescent girls and school staff informed the development of a cross-sectional household survey of 2,737 adolescent girls aged 15–18 years living in 29 refugee camps. Results: Findings reveal substantial gaps in menstrual preparedness and education. Many girls reported entering menarche with little prior knowledge, often describing fear, confusion, and embarrassment during their first menstrual experience. Mothers were the primary source of menstrual information, while schools played a limited role due to persistent social norms framing menstruation as a taboo topic and limited teacher preparation to address reproductive health education. Quantitative findings show a high burden of menstrual health problems. Dysmenorrhea was highly prevalent, with 41.5% of girls reporting severe menstrual pain. Menstrual pain was associated with reduced well-being and disruptions in education: 12% reported missing school, 16% difficulty concentrating, and 15% difficulty completing homework during menstruation. In related analyses, 92% of girls reported experiencing at least one premenstrual syndrome symptom, with severity associated with human insecurity and exposure to political violence. Conclusion: Menstrual health in Palestinian refugee camps is shaped by prolonged displacement, gender norms, and structural vulnerabilities. Addressing these challenges requires coordinated action at multiple levels, including strengthening school-based menstrual education, training teachers, engaging families and communities to address stigma, and integrating menstrual health into adolescent and community health programs to improve girls’ well-being, dignity, and educational participation.
Menstrual Justice in Action: A Taiwan Case Study of Period Poverty Intervention and Education Implementation
Presenter: Vivi Lin
Affiliation: Founder & Director, The Red House Period Museum
What does it actually take to move menstrual justice from principle to practice? And what happens when progress stalls at the edges of policy, culture, and institutional will? This presentation offers evidence-based answers from Taiwan, drawing on four recently released reports by With Red, the country’s first non-profit organisation dedicated to menstrual justice and the organisation behind the world’s only Period Museum. At a time when East and Southeast Asian perspectives remain critically underrepresented in global menstrual health discourse, Taiwan’s experience offers lessons that travel. The first section presents findings from With Red’s five-year period poverty initiative, The Red Box, which has delivered sustained, personalised menstrual product support to young people aged 18 and under across 21 counties and cities in Taiwan, through partnerships with 67 grassroots organisations. The initiative has operated in a context where policy remains insufficient and advocacy has significantly outpaced policymaking. The evaluation demonstrates that long-term, stable provision produces meaningful improvements in menstrual health, wellbeing, and stress reduction. Critically, it reveals that period poverty cuts across official welfare categories and frequently affects entire family units, challenging assumptions about who needs support and how to reach them. Capacity building for frontline social workers emerges as a necessity rather than an optional add-on. Yet a significant gap remains: once young people turn 18, there is currently no equivalent support structure in place, leaving those who experience period poverty highly vulnerable at precisely the moment they are expected to become self-sufficient.
The second section examines the impact and persistent barriers of menstrual education implementation through three complementary studies covering primary and secondary school educators (teachers, nurses, and administrative staff) and students. Training and resource provision significantly improve educator confidence, with trained educators collectively reaching thousands of students nationwide. Knowledge gains from even a single gender-inclusive session are measurable and significant. Yet structural barriers remain entrenched across all three studies: menstrual education is narrowly delivered, under-resourced, and constrained by cultural stigma and institutional hesitancy. Attitude change, the deeper goal, requires far more than a one-off intervention. These findings speak to challenges that are far from unique to Taiwan. They will be of relevance to anyone working at the intersection of menstrual health and justice, social welfare, and education. The presentation will be particularly valuable for researchers, practitioners, and policymakers, as it surfaces the shared challenges of translating menstrual justice into reality and explores how stakeholders can work more effectively together to drive meaningful change.Menstrual Pain, Mental Health, and School Attendance: Impacts on Adolescent Wellbeing in Coastal Kenya
Presenter: Salim Mwakidzuga
Affiliation: Vision Imaging & Medical Center
Menstrual health challenges are increasingly recognized as significant barriers to adolescent wellbeing and gender-equitable education. In low-resource settings, the intersection of menstrual pain, psychological distress, and stigma may restrict school attendance and compromise mental health. This study aimed to examine how menstrual pain and psychological distress affect school participation and wellbeing among adolescent girls in Coastal Kenya. The objective was to assess associations between menstrual pain, psychological distress, and school attendance, and to evaluate their combined impact on adolescent wellbeing during the 2025 academic year, across three school terms. A longitudinal, school-based observational study was conducted in public secondary schools, involving 360 adolescent girls aged 12–18. Participants were selected through stratified random sampling across different school types. Data were collected at three time points using validated instruments: a Visual Analog Scale for menstrual pain, the Kessler Psychological Distress Scale (K10), the WHO-5 Wellbeing Index, and school attendance logs. Multivariate regression analysis was conducted using R, controlling for age, socioeconomic status, and school type. Ethical approval was granted by the Kenya Medical Research Institute. Among the 352 participants who completed all three rounds of data collection, 72% reported moderate to severe menstrual pain. Higher pain scores were significantly associated with elevated psychological distress (p < 0.01) and lower school attendance (p < 0.05). On average, girls experiencing both high pain and distress missed 5.2 school days per term, compared to 1.7 days among their lower-distress peers (p < 0.001). Wellbeing scores were negatively correlated with both menstrual pain and psychological distress (p < 0.01). The study confirmed the hypothesis that menstrual pain and mental health challenges are key drivers of reduced school engagement and lower adolescent wellbeing. These findings emphasize the need for integrated school-based interventions that address both menstrual pain management and adolescent mental health. The study contributes to a growing body of evidence supporting menstrual health as a public health and education equity priority. Holistic, culturally sensitive approaches, combining menstrual literacy, psychosocial support, and policy engagement, are essential for advancing menstrual justice, improving educational outcomes, and promoting adolescent health and dignity.
Menstrual Practices at the Intersection of Media-Reproduced Individualisation and Communicative Socialisation
Presenter: Monika Dzialas
Affiliation: University of Münster, Department of Communication
Menstruation remains a taboo subject and a socially stigmatised bodily process, relegated to invisibility (Fadnis 2017). This marginalisation produces unequal treatment of menstruating people, limiting access to menstrual health care (Ford et al. 2021) and reinforcing gender-binary hierarchies (Amelang 2023). Within the processes of individualisation and the socially imposed construction of one’s life narrative (Beck 1993, 152), menstruation is framed as a matter of individual responsibility. Consequently, it is embedded in a wide array of menstrual‑management practices (Bauer 2022). These practices as “routinised type of behaviour” (Reckwitz 2003, 249) are constructed and reproduced as necessities, particularly through media representations (Holtz‑Bacha 2019).
Building on this, menstruation becomes commodified (van Dijck et al. 2018) through the purchase of menstrual products and the data that users transmit to menstrual technologies, a process that exploit menstruating individuals. Although the market for menstrual products and technologies has expanded to include alternative products that aim to reduce shame and insecurity surrounding the visibility of menstrual blood (Koskenniemi 2021, 13ff.), this diversification also intensifies the individualisation of choice, because the range of available management practices widens.
Rather than reinforcing these individualising tendencies, menstruation should be rendered more equitable and normalised. Instead of relegating it to private spheres, it is necessary to make menstruation visible by creating public spaces in which menstruation can be negotiated within community and network structures.
In my doctoral project, I will trace these structures through two case studies. For this purpose, I draw on Max Weber’s German term Vergemeinschaftung, which denotes the affective formation of communal belonging (Weber 2005, 29). Accordingly, I treat menstruation as a site of community building and will examine practices that shape it as a collective experience. In a mediatized world, communicative processes must be examined because they construct a communal identity around menstruation (Knoblauch 2008, 85). The project therefore asks: Which forms of communicative Vergemeinschaftung (as socialisation or community building) exist within contemporary menstrual practices, and how menstrual practices should be shaped to advance menstrual justice?
To answer this, I will identify the actors involved in menstrual practices of community building and map the networks that structure the collective (Latour 2022, 409). This approach enables a critical interrogation of individualisation tendencies and the construction of menstruation as collective care work.
The conference presentation will first introduce the theoretical framework of individualisation, Vergemeinschaftung, and networking. It will then demonstrate the relevance of these concepts through two exemplary artistic‑activist projects that foreground collective menstrual experience. The presentation will invite the audience to co‑produce the lecture space as a collective arena for sharing experiences.Menstrual Practices at the Intersection of Media-Reproduced Individualisation and Communicative Socialisation
Presenter: Monika Dzialas
Affiliation: University of Münster, Department of Communication
Menstruation remains a taboo subject and a socially stigmatised bodily process, relegated to invisibility (Fadnis 2017). This marginalisation produces unequal treatment of menstruating people, limiting access to menstrual health care (Ford et al. 2021) and reinforcing gender-binary hierarchies (Amelang 2023). Within the processes of individualisation and the socially imposed construction of one’s life narrative (Beck 1993, 152), menstruation is framed as a matter of individual responsibility. Consequently, it is embedded in a wide array of menstrual‑management practices (Bauer 2022). These practices as “routinised type of behaviour” (Reckwitz 2003, 249) are constructed and reproduced as necessities, particularly through media representations (Holtz‑Bacha 2019).
Building on this, menstruation becomes commodified (van Dijck et al. 2018) through the purchase of menstrual products and the data that users transmit to menstrual technologies, a process that exploit menstruating individuals. Although the market for menstrual products and technologies has expanded to include alternative products that aim to reduce shame and insecurity surrounding the visibility of menstrual blood (Koskenniemi 2021, 13ff.), this diversification also intensifies the individualisation of choice, because the range of available management practices widens.
Rather than reinforcing these individualising tendencies, menstruation should be rendered more equitable and normalised. Instead of relegating it to private spheres, it is necessary to make menstruation visible by creating public spaces in which menstruation can be negotiated within community and network structures.
In my doctoral project, I will trace these structures through two case studies. For this purpose, I draw on Max Weber’s German term Vergemeinschaftung, which denotes the affective formation of communal belonging (Weber 2005, 29). Accordingly, I treat menstruation as a site of community building and will examine practices that shape it as a collective experience. In a mediatized world, communicative processes must be examined because they construct a communal identity around menstruation (Knoblauch 2008, 85). The project therefore asks: Which forms of communicative Vergemeinschaftung (as socialisation or community building) exist within contemporary menstrual practices, and how menstrual practices should be shaped to advance menstrual justice?
To answer this, I will identify the actors involved in menstrual practices of community building and map the networks that structure the collective (Latour 2022, 409). This approach enables a critical interrogation of individualisation tendencies and the construction of menstruation as collective care work.
The conference presentation will first introduce the theoretical framework of individualisation, Vergemeinschaftung, and networking. It will then demonstrate the relevance of these concepts through two exemplary artistic‑activist projects that foreground collective menstrual experience. The presentation will invite the audience to co‑produce the lecture space as a collective arena for sharing experiences.Menstrual Wellbeing in the Workplace: Subjective Experiences, Coping Practices, and Organisational Gaps
Presenter: Christine Carolin Best
Affiliation: Social Research Center, TU Dortmund University
Around 47% of all employees in Germany were female in 2024, although female employment is likely to rise further in the coming years based on political demands to increase overall labor productivity. This means that around half of all employees are or were confronted with menstruation in the context of gainful employment. Women must position themselves and their physicality in an androcentric working world (Kurz-Scherf 2013), in which they often experience disadvantages and even discrimination (Kordsmeyer et al. 2022), particularly due to their physical reproductive capacity. Menstruation and associated symptoms – such as pain, fatigue, general discomfort and psychological impairment – remain largely invisible in the workplace, even though they can significantly reduce the wellbeing of those affected. The planned contribution will examine how women in Germany subjectively experience menstruation in the workplace, which contextual factors within their working environment influence these experiences, and how they manage menstruation in the context of their employment. The analysis is based on guided interviews conducted in 2025 with employed women aged 27 to 44. The interviewees work in a range of professional fields, including social work, education, public transportation, physiotherapy, and child and adolescent psychotherapy. Assuming that both menstruation and open discourse about it are still frequently associated with shame and taboo (Gottlieb 2020), the interviews are analysed using the (micro-)linguistic–descriptive analytic framework of the integrative basic procedure as outlined by Jan Kruse (2015). As it is unlikely that all interviews will have been fully evaluated by the time of the conference, the contribution will present preliminary findings. These findings indicate a marked discrepancy between menstruation-related complaints and restrictions in the workplace, on the one hand, and the lack of structural or organisational responses to these issues, on the other. In many cases, this absence of institutional support is compensated for at the individual level through the concealment of symptoms, self-discipline, and the use of hormonal contraceptives. Furthermore, the interviewees articulated a desire both to reduce the taboo surrounding menstruation and to receive greater support from employers.
Menstrual cycle phase and its association with COVID-19 vaccines side effects and subsequent infection: A study of period tracking app users.
Presenter: Poppy Cooper
Affiliation: London School of Hygiene and Tropical Medicine
Co-authors: Prof. Rebecca Sear, Brunel University of London, UK Dr. Sarah Walters, London School of Hygiene and Tropical Medicine, UK Dr. Alexandra Alvergne, CNRS, University of Montpellier, France
Objective: This study explores how adaptive trade-offs between fertility and immunity across the menstrual cycle affect Covid-19 vaccine outcomes. With estrogen’s immunoenhancing effects, it is hypothesised that immunity is prioritised during the estrogen-dominant follicular phase and fertility during the progesterone-dominant luteal phase. We will test these trade-offs by investigating whether a more vigorous immune response (indicated by greater side effects and lower risk of infection after vaccination) is observed if vaccination occurs during the follicular, compared with the luteal phase.
Methods: We conducted a retrospective cohort study using prospectively collected menstrual cycle data from the Clue period tracking app matched with an in-app vaccine survey (November 2021-February 2022). Among 1,474 regularly cycling women aged 18-44, we compared reported vaccine side effects and post-vaccination COVID-19 infection outcomes between those vaccinated during follicular versus luteal phases. Regression analyses tested associations between cycle phase and (1) side effect presence, severity and number, and (2) risk of COVID-19 infection over 67-372 days follow-up.
Results: Follicular-phase vaccination was associated with 35% higher odds of reporting any side effects (OR: 1.35, 95% CI: 1.05-1.66) compared to luteal-phase vaccination. Participants vaccinated during the follicular phase had a longer median time to infection (200 vs 165 days, p=0.05), though this trend was not maintained in adjusted survival analysis (n=82).
Conclusions: Menstrual cycle timing appears to influence COVID-19 vaccine outcomes, with follicular-phase vaccination associated with increased reactogenicity and potentially longer protection. These findings suggest cycle phase warrants consideration in vaccine research and may inform personalised vaccination strategies. Replication in larger cohorts with biological sampling is needed to confirm these associations.Menstrual cycle-related symptom management in elite female endurance athletes: a qualitative study of strategies, constraints, and support needs
Presenter: Prof Kerry McGawley
Affiliation: Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University
Co-authors: Dr. Natalie Brown, Department of Sport and Exercise Sciences, Swansea University Dr. Scott Swainston, Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University Dr. Kylie A. Steel, Faculty of Health, Western Sydney University Dr. Bryna C. R. Chrismas, National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University
Purpose: Menstrual cycle symptom prevalence in female athletes has been well documented in recent years, as has the perceived impact of symptoms in the context of sport. However, less is known about how symptoms are actively managed by athletes, coaches and support personnel within elite training and competition environments. The current study aimed to address this issue by describing menstrual cycle-related symptom management practices among elite female endurance athletes and examining the contextual factors shaping implementation of these practices in high-performance sport settings.
Methods: A qualitative descriptive approach was adopted to explore cycle-related symptom management. Participants were recruited globally to capture diverse perspectives, and only those rating at least two cycle-related symptoms as ‘severe’ in a pre-interview survey were included. Nine international female athletes (aged 28 ± 5 y), representing eight countries and six endurance sports, completed semi-structured interviews. Data were analysed using reflexive thematic analysis following the six iterative phases of familiarisation, coding, theme generation, review, definition and reporting.
Results: Eight of the nine athletes reported tracking cycle timings and at least one cycle-related symptom or physiological metric (e.g., body temperature, heart rate or recovery scores). Tracking was commonly used to anticipate bleeding and interpret changes in perceived readiness to train, but athletes described limited symptom-specific management options beyond pain-focused strategies (e.g., analgesics and heat application) and situational training modification. Athletes frequently described bloating and breast pain as difficult to manage, with few strategies to overcome these discomforts known about or perceived to be effective. Bleed management strategies and product choices were shaped by individual needs (i.e., heaviness of bleeding), sport demands, cultural norms, access during travel and competition, knowledge of options, and personal preference. Experiences of support from coaches, sport scientists and medical practitioners to help manage the menstrual cycle in sport varied, and some athletes reported uncertainty or dissatisfaction when receiving advice about hormonal contraception as a symptom management strategy.
Conclusions: In this sample of elite female endurance athletes experiencing severe cycle-related symptoms, cycle tracking was common but symptom management practices beyond this were often limited and highly individual, with variation in perceived support provided by coaches and support staff. These findings identify a need for applied, sport-relevant research on feasible cycle-related symptom management options and for improved application into practice within female athlete care systems.Menstrual health of adolescents with Down syndrome in the UK
Presenter: Katie Greenland
Affiliation: International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine
Limited available evidence indicates that people with Down syndrome faces unique challenges related to their menstrual health, including difficulties with self-care, the communication of needs, and access to appropriate menstrual materials and accessible information. The experiences of young people are significantly under-researched, yet an improved understanding of the menstrual health experiences of adolescents with Down syndrome is crucial for the development of tailored interventions to improve their wellbeing. This study aims to fill critical knowledge gaps, providing insights into the unique requirements and challenges faced by this population.
Guided by an Advisory Group of caregivers and young people with Down syndrome, this research employed a mixed-methods approach. A national online survey was conducted with 143 primary caregivers of adolescents aged 10–19 with DS to assess knowledge, preparedness, and concerns regarding menarche and ongoing menstrual management. In-depth interviews were held with six menstruating adolescents with DS (aged 13–19) using participatory methods to explore their personal knowledge, self-management, and emotional experiences. Interviews were also conducted with 11 mothers and 8 professionals, including teachers and healthcare providers, to contextualise adolescent perspectives and incorporate the experiences of those caring for young people with more complex needs. Data collection took place between September 2024 and July 2025.
Findings indicated that young people generally coped with the onset of periods better than their caregivers anticipated. However, the majority of survey respondents expressed ongoing concerns, particularly surrounding heavy periods (48%), management of period products and hygiene (45%), menstrual-related pain and discomfort (45%), and the communication of pain and discomfort (26%). The negative impact of periods on adolescent wellbeing was higher for those with greater support needs. Three-quarters of survey respondents whose daughters are menstruating expressed a need for further support, particularly resources designed for young people with DS, strategies to support independent management of periods, and information on managing pain. Interviews supported these quantitative findings, showing how the use of period underwear (or “magic pants”) simplified practical management and improved menstruation experiences for many young people. Interviews also reinforced the persistence and complexity of pain management and the need for accurate information to dispel myths and misinformation. The study identified significant unmet menstrual-related requirements and strategic opportunities for interventions.Menstrual rights and social justice: how climate change and Boko Haram attacks reinforce the stigmatization and vulnerability of women during their periods in migration and their consequences for their reproductive and mental health in the Far North region of Cameroon
Presenter: Falmata Oumar
Affiliation: UNOADD/GPGE/ ADECOPA
Co-authors: Ms MAGRA AVARAMLA Aissatou ADECOPA M ALIFA Mahamat Gender Partnership for Gender Equality
Our study focuses on menstrual rights, which are human rights. Our objective was to highlight the violations and abuses of women’s menstrual rights, particularly in crisis situations in the Far North region of Cameroon. Climate change, causing floods and droughts, is leading to internal migration. Women and girls are especially vulnerable during menstruation, which has numerous consequences for their reproductive and mental health.
Two scientific methods were used: the first, health history, allowed us to understand the perception of menstruation within communities, including the construction and evolution of beliefs about it. The second, qualitative method, was used for data collection and analysis. Our data collection tools included focus groups, individual interviews, and the collection of testimonies.
Our study underscores the inequalities in menstrual rights worldwide. Indeed, while the issue of menstrual leave is debated in developing countries, in sub-Saharan Africa, profound inequalities persist because women are still at the stage of recognition and acceptance. Women and girls are victims of stigmatization and violence for social, cultural, and religious reasons.
In our study area, menstruation is perceived as an evil, an impurity; a menstruating woman is often considered undesirable. Everything she touches is defiled. Isolated, these women resign themselves to and accept this situation. No claim for menstrual rights. A girl who has her first period is considered a woman and ready for marriage. For fear of an unwanted pregnancy, parents marry off their daughters or promise them marriage as soon as they begin menstruating. This situation worsens during times of crisis (abduction, conflict, floods, etc.). They do not have access to sanitary products. They use old clothes or pieces of fabric as sanitary pads. They are forced to tear their headscarves, loincloths, or other clothing. They scavenge for fabric in landfills, sometimes even stealing clothes to use as sanitary napkins. Similarly, they lack access to water to wash these napkins or use dirty water from ponds and rivers during their migrations. Added to this are menstrual pain, stress, and anxiety related to their menstrual cycle. This period poverty has direct consequences on their reproductive and mental health.Menstrual-related symptoms and absence from school among young people in Sweden: A stratified, randomized, population-based survey
Presenter: Klara Abrahamsson
Affiliation: Karolinska Institutet, Department of Women’s and Children’s Health
Background: Menstrual-related symptoms impact individuals’ health, quality of life and can limit the ability to engage in daily life activities, including school. Menstrual-related symptoms thus risk reinforcing existing gender inequalities in health, making it an issue of equal rights and public health concerns. No previous study has estimated the prevalence of menstrual-related symptoms and subsequent school absences in Sweden by using population-based data. Methods: The study aimed to estimate the prevalence of menstrual-related symptoms and school absence among young people aged 16–29 in Sweden, and to examine associations between symptoms, absence, and sociodemographic factors. A sample (n=5,483) of individuals aged 16-29 was drawn from a population-based cross-sectional study which used stratified random sampling. We used logistic regression to test sociodemographic factors associated with school absence. Results: Menstrual pain was reported by 76.59%, mood changes by 75.70%, ‘other’ menstrual complaints by half (57.88%) and heavy bleeding by 40.14%. Furthermore, 13.70% in total and 19.93% among those aged 16-19 reported school absence because of menstrual symptoms on every menstruation. Foreign-born individuals and Swedish-born individuals with two foreign-born parents had higher odds of school absence, as did those with parents with short education and those with long-term health issues. ‘Other’ menstrual complaints (such as headache, tiredness and concentration difficulties) had the greatest impact on school absence. Discussion: Menstrual-related symptoms are widespread among young people in Sweden. The subsequent absence from school is unevenly distributed according to the individual’s origin, parental education and long-term health issues and should be seen as an issue of gender equity and public health concern. Given the importance of schools for learning and development, student health services need to be equipped with screening methods and referral routines. Further studies should focus on socioeconomic inequities in menstrual health, with a particular focus on young migrants and second-generation immigrants.
Menstruating in Nepal: A Systematic Review of the Health Impacts of Restrictive Menstrual Practices and Key Factors for Effective Interventions
Presenter: Fiona Smith
Affiliation: London School of Hygiene and Tropical Medicine
Background: In parts of Nepal, restrictive menstrual practices persist. Inadequate menstrual hygiene management (MHM) threatens the physical and mental health of those who menstruate. Traditional practices such as Chhaupadi, where menstruating individuals are forced to stay in menstrual huts during their menstruation, further worsens the situation. These huts often expose individuals to numerous health risks, including infections due to unsanitary conditions and dangers such as animal attacks. The social and mental health consequences are equally concerning. Although both governmental and non-governmental organisations have made efforts to improve menstrual health in Nepal, significant barriers remain. Achieving the United Nation’s Sustainable Development Goals requires prioritising menstrual health.
Aim: This systematic review has two aims: 1) to assess the health impacts of restrictive menstrual practices on menstruators in Nepal, and 2) to identify the key elements of successful intervention strategies that mitigate any negative health impacts of these practices.
Objectives: Understand the various restrictive menstrual practices that exist in Nepal and the extent to which they are practised. Assess the impacts these practices have on the physical, mental, and social well-being of menstruators. Identify the key elements of successful interventions that effectively mitigate the negative health impacts of restrictive menstrual practices in Nepal. Highlight gaps in the current research in order to guide future studies on menstrual health and restrictive practices in Nepal.
Methods: Four databases were systematically searched for relevant literature. Results were screened using a defined inclusion and exclusion criteria. Depending on the study design, three different quality appraisal tools were used to determine the quality of the studies. Data was extracted and synthesised via a narrative synthesis approach.
Results: There were 30 studies which met the eligibility criteria and have been included. Studies were a mixture of different study designs. Participants were often adolescent or young adult girls. Different restrictive practices were reported with varying degrees of prevalence across the country. Restrictive practices impacted menstruators’ health via three dimensions, physical, mental and social wellbeing. Criminalisation has not eradicated Chhaupadi.
Conclusions: Menstrual restrictions persist, maintaining gender inequality and preventing menstrual health from being achieved. They are a multifaceted issue; change needs to be thought of in the short and long term. Policies should look towards implementing harm reduction measures whilst also working to achieve lasting change.Menstruation at Work and Tabooing of Women’s Bodies
Presenter: Danielle Markham
Affiliation: University of Sussex, Business School & School of Psychology
The tabooing of women’s bodies is among numerous ways in which female marginalisation and oppression continue to manifest. Discretion of menstruation fits under this misogynistic social standard. Owing to the pervasion of such issues within women’s lives, there is an unyielding constraint to women’s career successes which is sustaining inequality. This paper aims to confront these topics by challenging the misconceptions and misrepresentations of menstruation, and fundamentally relieve the embedded narrative of ‘other’. Through the philosophical lens of social constructionism, an iterative inductive thematic narrative analysis of interviews with twelve women was conducted to explore perceptions and encounters of menstrual stigma throughout their lives. Through the researcher’s reflexive interpretation, six core narratives reveal a basis for the development of menstrual shame. Applying feminist standpoint theory to contextualise and interpret the findings, it is proposed that a dominant, androcentric standpoint has linguistically framed the female-body and its by-products against a social norm, which creates and dictates reality. This paper takes a critical approach to social philosophy to reveal the extant power structures that perpetuate self-deprecation and the penalisation of female agency. The research contributes to and extends an understanding of women’s lived experiences of marginalisation in professional settings and the wider societal implications. Insights and recommendations are given to support policies and systems in dislodging negative representations of women and their bodies. This study champions the activism ideology to reclaim femininity in-and-for-itself.
Menstruation-Related School Absenteeism among Adolescent Girls in Ibadan, Nigeria: Individual and School-Level Drivers.
Presenter: Mojisola Alere
Affiliation: University of Ibadan, Nigeria
Research Aim: Menstrual health challenges remain a significant barrier to girls’ educational participation in many low- and middle-income countries. In Nigeria, limited access to menstrual hygiene products, inadequate water, sanitation and hygiene (WASH) facilities, menstrual pain, stigma, and insufficient menstrual health knowledge contribute to school absenteeism among adolescent girls. Despite increasing global advocacy for menstrual hygiene management (MHM), locally generated evidence in Oyo State, Nigeria remains limited. This ongoing study aimed to determine the prevalence, determinants, and school-level drivers of menstruation-related absenteeism among adolescent girls in Ibadan, Oyo State.
Objectives: 1. To estimate the prevalence and frequency of menstruation-related school absenteeism. 2. To identify individual-level determinants, including access to menstrual products, menstrual pain, and menstrual health knowledge. 3. To assess school-level factors such as WASH infrastructure, privacy, and availability of menstrual support systems. 4. To generate evidence to inform school health policy and gender-responsive educational programming in Oyo State.
Methods: A cross-sectional mixed-methods study was conducted among 620 adolescent girls aged 10–19 years in selected public and private secondary schools in Ibadan. Quantitative data were collected using structured questionnaire assessing menstrual experiences, school attendance patterns, pain severity, product use, and knowledge levels. School facility assessments were conducted to evaluate WASH conditions, privacy, and disposal systems. Multivariate logistic regression analysis identified predictors of absenteeism. Qualitative focus group discussions will explore lived experiences, stigma, coping strategies, and perceived school support.
Results: Preliminary findings indicate that approximately 28% of respondents reported missing at least one school day during their last menstrual period, with an average of 1–3 days lost per cycle. Key predictors of absenteeism included inconsistent access to sanitary pads (AOR >1.8), moderate-to-severe dysmenorrhea (AOR >2.3), and inadequate school WASH facilities. Schools lacking functional, gender-segregated toilets and private changing spaces demonstrated significantly higher absenteeism rates.
Conclusion: Menstruation-related absenteeism in Ibadan is driven by both individual and structural factors. Addressing product affordability, strengthening school WASH infrastructure, integrating menstrual health education into school curricula, and improving pain management support are critical to reducing absenteeism. These findings provide context-specific evidence to inform menstrual hygiene management policies, school health programming, and broader gender equity efforts in Oyo State and similar urban settings.Menstruation: Lived Experiences of Blind Adolescent Girls in Pakistan
Presenter: Sara Khalid
Affiliation: National University of Science and Technology (NUST), School of Art, Design and Architecture (SADA)
South Asia carries a high burden of visual impairment, with Pakistan ranking third in regional blindness prevalence (over 21 million people affected), disproportionately impacting women. Within this context, menstruation poses specific, unexplored challenges for blind adolescent girls. Existing evidence suggests that 48.7% of visually impaired women depend on caregivers to manage their menstrual cycle, and only 52.9% can manage menstruation independently, often relying on sensory cues such as the smell of blood or touch to track their cycles. In Pakistan, where studies on menstrual hygiene practices are already limited, work on disability-inclusive menstrual products is virtually non-existent. As a result, these girls resort to unhygienic, improvised methods, hindering their participation in school and social activities and affecting their overall mental well-being.
Objectives: To assess the behaviours’, practices, and autonomy levels of adolescent girls with complete blindness in managing menstruation, and to examine how disability-related barriers impact their menstrual independence.
Methodology: This qualitative study engaged ~50 adolescent girls with complete blindness across Pakistan from October to December 2025. In a context where the voices of blind menstruators are rarely heard, in-depth qualitative methods were deliberately chosen over surveys to honour their lived experiences and give space to their own words, emotions, and narratives. Data were collected through two structured focus groups (n=12 each) at a special school in Islamabad and 10 online/offline interviews with home-living teens nationwide, using non-probability sampling. This approach allowed voice to experiences that are typically silenced and poorly captured by quantitative tools. Thematic analysis identified recurring patterns, including skipping school on the first 2 days due to extreme caregiver reliance; delayed menarche recognition and identification issues, where girls failed to recognise their first period promptly, relying on external cues like visible, dried stains; basic hygiene and product confusion with fundamental gaps such as underwear orientation and terminology ignorance; extended pad use (changing every 10-12 hours); and skipping washing the lower body area or bathing entirely for 7 days.
Conclusion: As an ongoing study, these preliminary findings exhibit gaps in menstrual education among blind adolescent girls due to limited knowledge and awareness. Their menstrual hygiene practices were not at desired levels; almost half received support in menstrual hygiene management, and most used sensory indicators to determine the start/end of their menstrual period. These findings highlight the urgent need for awareness initiatives and accessible resources that allow discreet, safe, and independent menstrual management.Mental health and well-being impacts of discontinuation of HRT: preliminary findings from the TAPER Study qualitative work.
Presenter: El Molloy
Affiliation: University of Birmingham, Dept or Applied Health Sciences
Co-authors: Prof. Laura Jones, University of Birmingham Mrs Neelam Heera, Cysters Mrs Nina Kuypers, Black Women in Menopause Dr Sarah Hillman, University of Birmingham
Aim:
Research exploring how, when and why women attempt or wish to stop hormone replacement therapy (HRT) remains limited. Stopping HRT is commonly associated with recurrence of menopausal symptoms, creating uncertainty for women and healthcare professionals (HCPs). The TAPER study (NIHR Advanced Fellowship - NIHR 304353) comprises four work packages. Work package one is a qualitative descriptive study forming the preliminary phase of the TAPER study and aims to explore the experiences of women stopping or attempting to stop HRT and the views of HCPs supporting them.
Objectives:
To undertake interviews with women who have stopped or attempted to stop HRT in the previous 3 years.
To undertake interviews with HCPs who prescribe HRT and support women using HRT in primary care for menopausal symptoms.
Methods:
Semi-structured interviews were undertaken with women (target n=~20-30) and HCPs (target n=~20). Women were recruited through general practices in the West Midlands via the NIHR primary care research delivery network (RDN), with purposive sampling of practices serving socioeconomically and ethnically diverse populations. Additional targeted recruitment through community organisations (Cysters, Black women in menopause and South Asian health foundation) aimed to enhance inclusion of women from underserved groups. HCPs were recruited through the RDN, participating TAPER study practices, social media and personal networks.
All interviews were recorded, transcribed clean verbatim, anonymised, and managed in NVivo. Data collection and analysis were concurrent. Sampling for women and HCPs remained flexible to achieve information power and sample adequacy. Analysis followed a combined deductive/inductive thematic codebook approach, using interview guides as an initial coding framework.
Results:
Data collection and analysis are ongoing (6th March 2026) 24 interviews with women and 11 interviews with HCPs having been completed. Recruitment is anticipated to end in April 2026. Preliminary findings identify themes relating to decision making around stopping HRT, fears associated with continuation and discontinuation of HRT, recurrence of symptoms, communication with HCPs, and access to support. This presentation will focus on mental health and lifestyle impacts reported by women when starting and/or stopping HRT and why they may choose to stop or restart HRT.
Conclusions:
Stopping HRT is complex and highly individualised process, characterised by variable experiences and inconsistencies in clinical advice. Many women report multiple and mental health and lifestyle impacts associated with stopping and restarting HRT, for which clearer guidance and tailored support are needed. Findings will contribute to evidence-based strategies better equipping women and HCPs to navigate discontinuation decisions.More Than a Product Choice: Social Patterns in Menstrual Management.
Presenter: Sara Sánchez López
Affiliation: Universitat Politécnica de València
This study examines the social impact of menstrual stigma in Spain, based on the premise that while menstruation is a biological process, its meanings and consequences are largely shaped by cultural norms that influence how it is perceived, experienced, and managed in everyday life. The objective is to analyse how stigma and taboo affect participation, wellbeing, and interactions with institutions, and to identify social factors that may mitigate these effects.
A nationwide cross-sectional mixed-methods survey was conducted with 4,028 participants aged 14 years and older, residing in or born in Spain. The questionnaire included items on demographics, menstrual knowledge and practices, access to healthcare, and perceptions and experiences related to menstruation. Quantitative data were analysed using descriptive statistics to contextualise patterns of behaviour and participation, while qualitative open-ended responses were analysed thematically through an inductive and iterative process, guided by a constructivist approach that attends to the social meanings attached to menstruation.
The findings indicate that menstruation commonly influences everyday participation, particularly in activities involving bodily exposure or public visibility, such as wearing certain types of clothing, swimming, going to the beach, or practising sports. While some respondents described limiting their activities due to physical symptoms such as pain or fatigue, many also referred to anxiety, fear of leakage, and social discomfort, reflecting the internalisation of stigma and expectations of discretion. In educational and professional contexts, participants frequently reported attending classes or work despite discomfort, hesitating to take leave, and feeling pressure to minimise or conceal menstrual needs in order to meet productivity norms. Experiences of exclusion and judgement were also described in interpersonal and cultural settings, alongside accounts of being discredited through gendered stereotypes.
At the same time, the study highlights the importance of supportive social environments. Peer empathy, sorority, and institutional flexibility were identified as key protective factors that help reduce stress, enable participation, and promote more positive menstrual experiences. However, persistent gaps in menstrual education and the limited integration of menstrual health into clinical interactions continue to pose barriers to wellbeing and equity.Narratives of Sustainability in the Context of Reusable Menstrual Products
Presenter: Malissa Kay Shaw
Affiliation: Liberal Arts Department, University of Health Sciences and Pharmacy in St Louis
“I have been using menstrual cups for years. Psychologically, I feel I am doing something good for the planet.” Environmental movements have promoted the use of more eco-friendly menstrual care practices to reduce waste and resource use. This has led to menstruators adopting moralizing discourses of becoming more self-aware and environmentally conscious — creating a dual sense of personal and environmental sustainability. This paper focuses on the narratives of menstruators in Taiwan who have taken up the use of menstrual cups – a reusable menstrual technology – and how they, to varying degrees and in diverse ways, conceptualize and experience their use in relation to sustainability. These menstruators described menstrual sustainability in three distinct ways: through the lenses of reducing waste, adopting sustainable menstrual practices, and critical engagement. Narratives of reducing menstrual waste described serving a dual purpose: limiting plastic waste in landfills and reducing the burden of storing and disposing of used menstrual products in the unique Taiwanese waste-management context. Menstruators whose narratives illustrated a desire for adopting sustainable practices more broadly drew connections between their overall personal wellbeing and health and their concerns for the environment — recognizing that at times, they must place self-care (often expressed through using both single-use and reusable products) before environmental stewardship. The last narrative framing, critical engagement, was developed by only a few participants. These menstruators recognized the waste-reduction potential of menstrual cups but also questioned their larger environmental impact, considering factors such as production processes, transport, and disposal systems. The diversity of ways menstruators frame sustainability, combined with the fact that some engaged with more than one framing, show not only that sustainability in the context of menstruation is understood in a wide variety of ways, but that tensions between framings of sustainability as being a matter of either personal or environmental wellbeing have real impacts on menstrual practices. This has practical implications for menstruators’ wellbeing in regards to their menstrual health and the internalizations of pressures to be responsible environmental stewards. Moreover, this study reemphasizes the need to develop more diverse eco-friendly and healthy menstrual products that meet the unique needs of menstruators.
Obscured Rhythms, (Un)Anticipated Affects: Using Rhythmanalysis to Understand Movement through Menopause.
Presenter: Cassie Phoenix
Affiliation: Department of Sport & Exercise Sciences and Institute of Medical Humanities. Durham University.
Co-authors: Dr Meridith Griffin, McMaster University. Dr Erica Bennett, University of British Columbia.
Physical activity (PA) is frequently promoted as a means of managing symptoms associated with the menopause transition (MT), yet little is known of how the embodied, emotional, and temporal disruptions of menopause influence the possibilities for movement. In this presentation, we share findings from our research which aimed to understand the impact of MT symptoms on experiences of PA.
We draw on data generated from a qualitative survey, distributed from hubs in UK and Canada. Qualitative surveys involve participants responding in writing to a series of open-ended questions, affording them the autonomy to decide on the length, timing, and location of their contributions (Terry and Braun 2017). The survey was completed by 249 respondents spanning 10 countries, with the final sample being predominantly white/European, aged between 45-59 years. Over half were receiving treatment for menopause symptoms - largely Hormone Replacement Therapy.
In orienting ourselves to the analysis of the data, we were guided by facet methodology (Mason 2011). Rather than attempting to describe and document all dimensions of a problem in its entirety – a task that often proves unwieldy or overly general – facet methodology enables researchers to work through ‘flashes of insight’ generated via exploration of strategically and artfully constructed facets of a problem. To that end, we took inspiration from French sociologist Henri Lefebvre’s theory of ‘rhythmanalysis’ to develop new ways of thinking about movement through menopause in everyday life; reconceptualising and shifting prior assumptions about what makes PA possible or challenging during the MT through an intensive focus on the how and why of (moving) menopausal bodies in time and space.
Our findings highlight the varied ways in which symptoms intertwined with seasonal, hormonal and circadian cycles to reconfigure everyday tempos of energy, rest, and motivation. These shifting rhythms often constrained participation in PA, but also prompted creative adjustments including new pacing strategies, altered routines, and re-attunements to bodily fluctuation.
To conclude, we discuss how a rhythmanalytic approach challenges binary framings of PA as either hindered or facilitated, offering instead a textured account of how movement, stillness, and slowing are negotiated during the MT. Such insights contribute to feminist, embodied perspectives on health, demonstrating the value of more flexible, rhythmic, and context-sensitive approaches to promoting movement through the MT.Pad and Prejudice: An Intersectional Analysis of Period Poverty in Government Schools in Maheshtala, Kolkata
Presenter: Arhita Biswas
Affiliation: Co-Founder, Regent Park Spriha Society and PhD Scholar, Presidency University, Kolkata.
Co-authors: Dr. Sampriti Das, Dr. Anomitra Biswas. Dr. Das, Assistant Professor, GITAM Visakhapatnam, Member, Regent Park Spriha Society Dr. Biswas, Assistant Professor, GITAM Visakhapatnam, Member, Regent Park Spriha Society.
Abstract: This paper investigates MHH in two government-sponsored schools in a peri-urban municipality in West Bengal. It particularly investigates infrastructural deficits and socio-economic disparities in the schools and student bodies.
Methodology: Based on a self-reported survey of a sample of 300 young menstruators from different schools across the region, this study employs both quantitative tools and qualitative analysis to comprehend the association between institutional neglect, intersectional barriers and MHH practices, whilst contextualising the intrinsic disparities across religion, class and castes. Quantitative Tools: Summary Statistics Exploratory factor analysis (EFA) Structural Equation Model (SEM)
Relevance: Period poverty’s impact extends beyond menstruators, affecting institutions and ecosystems. The perception of menstruation as impure prompts concealment of menstruation, unsafe disposal mechanisms, and exclusion from education and workspaces. Limited access to WASH facilities and information impacts over-reliance on unsafe products and disposal techniques, further exacerbated by inadequate school facilities: absence of subsidised sanitary napkins, disposal bins, water supply, changing spaces and soap, leading to increased school absenteeism and dropouts. This paper highlights the perpetuation of cycles of female absenteeism due to institutional neglect and intersectional barriers.
Key Findings The study reveals knowledge gaps surrounding MHH, with 97% of the respondents reporting misinformation and associated myths and >5% managing to define menstruation. Product access and affordability is another concern: cost barriers (32%) and availability (15%) limit sanitary napkin usage; the former is exacerbated by religious and caste disparities: 53% of SC and 30% of OBC reported financial constraints compared to 26% of upper-caste respondents. Sanitary napkin usage remains markedly lower amongst Muslim students. Inadequate school facilities are also marked: 58% of respondents miss school during menstruation due to pain, fear of leaks, dirty toilets, inadequate disposal systems and changing space, with Muslim and SC/ST students reporting relatively higher rates of absenteeism. Adding to these are socio-cultural constraints as 63% of respondents face restrictions in their diet, mobility, socio-cultural activity and education during periods, besides battling shame and anxiety. Rates of negative emotions and restrictions are relatively higher among Muslim and SC/ST students than caste-Hindu students. As far as community support is concerned, students report availability of free sanitary napkins (43%), improved school WASH facilities (40%) and regular MHH education (38%). By centering a peri-urban municipality’s government-run schools, this paper further employs SEM technique to examine the convergent influence of policy implementation gaps, socio-economic disparities and cultural stigma on menstrual health experiences.
Keywords: period poverty, menstrual equity, MHM infrastructure, educational absenteeism, caste-religious nexus, menstrual stigmaPerceptions of normality: menstrual experiences and help-seeking behaviour
Presenter: Lisa Zuidema
Affiliation: Máxima MC, Gynaecology
ABSTRACT Background: Perceptions of “normal menstruation” influence how individuals interpret symptoms and decide whether to seek medical care. These perceptions are socially shaped and may not align with clinical definitions, potentially contributing to early or delayed presentation and diagnostic uncertainty in primary care. Aim: To explore how individuals construct and revise their understanding of normal menstruation, and how these perceptions shape help-seeking and diagnostic experiences. Design and setting: Qualitative exploratory design, with narrative, in-depth interviews conducted in the Netherlands. Methods: In-depth semi-structured interviews with individuals reporting a range of menstrual experiences were analysed thematically. This secondary analysis focused on perceptions of normality, uncertainty, threshold moments for help-seeking, and experiences with healthcare professionals. Results: Participants’ definitions of normal menstruation varied and were primarily shaped by personal experience, family narratives, and social comparison, rather than medical criteria. Uncertainty about what constituted normality—particularly regarding pain, bleeding, and changes over time—often delayed help-seeking. Medical consultation typically followed threshold moments, such as a worsening of symptoms or external encouragement. Healthcare responses strongly influenced subsequent engagement: being taken seriously legitimised concerns and facilitated further care, whereas dismissal reinforced self-doubt and postponement. Diagnosis retrospectively reframed earlier experiences as medically significant, while the absence of diagnosis prolonged uncertainty and frustration. Conclusion: Perceptions of normal menstruation play a central role in help-seeking trajectories in primary care. Actively eliciting patients’ beliefs about normality and communicating clearly about variation and warning signs may support earlier recognition and timely intervention of menstrual conditions.
Periods Should Not Cost the Planet: A Pilot Project on Sustainable and Affordable Menstrual Hygiene Products
Presenter: Dr Radhika Shrivastava
Affiliation: UNFPA
Menstrual hygiene management is a critical public health, social equity, and environmental concern. The widespread use of disposable menstrual products contributes significantly to plastic waste, greenhouse gas emissions, and long-term environmental pollution, while their recurring cost places a financial burden on menstruators, particularly in low-resource settings. Sustainable menstrual hygiene solutions, when locally produced and culturally appropriate, offer an opportunity to address environmental sustainability, economic empowerment, and menstrual equity simultaneously.
This pilot project, Periods Should Not Cost the Planet, explored whether a targeted behavioural change intervention, combined with the local production of reusable menstrual pads, could increase the adoption of sustainable and affordable menstrual hygiene practices. The project was implemented over six months in a community setting, with a dual focus on menstruators and local women trained to manufacture reusable cloth pads. These pads were produced using safe, absorbent, and washable materials and were designed to be affordable, durable, and environmentally friendly.
A mixed-methods approach was employed. Baseline assessments examined participants’ menstrual hygiene practices, awareness of environmental impacts, affordability concerns, and perceptions of reusable products. The intervention included training local community women in pad production and quality assurance, educational workshops for menstruators, product demonstrations, peer-led discussions, and the distribution of subsidized reusable pads manufactured within the community. Follow-up surveys and focus group discussions were conducted to assess behavioural change, user satisfaction, economic implications, and perceived health and environmental benefits.
Results indicated a marked improvement in knowledge and attitudes toward reusable menstrual hygiene solutions. A significant proportion of participants adopted reusable pads as their primary menstrual product by the end of the pilot. Users reported improved comfort, reduced monthly expenditure on menstrual products, and increased confidence in managing menstruation safely and discreetly. Environmental awareness also increased, with participants recognizing the role of reusable pads in reducing waste. Additionally, the initiative created income-generating opportunities for trained community women, strengthening local ownership and sustainability of the intervention. Initial concerns related to hygiene, washing, and social stigma decreased over time through peer support and continued engagement.
The pilot demonstrates that combining behavioural change communication with community-led production of reusable menstrual pads is a feasible and effective strategy for promoting sustainable menstrual hygiene. Such models have the potential to be scaled through integration into public health, livelihoods, and climate resilience programs, contributing to reduced environmental impact, improved menstrual health outcomes, and women’s economic empowermentPhysical and mental health comorbidities of premenstrual dysphoric disorder: Analysis of 4,475 participants in Our Future Health
Presenter: Christina Simoes Steyn
Affiliation: The University of Edinburgh, Institute of Neuroscience and Cardiovascular Research
Co-authors: Dr Arish Mudra Rakshasa-Loots[1], Dr Duncan Swiffen[1], Kelly Fleetwood[2], Dr Lynsay Matthews[3], Prof Daniel J Smith[1], Dr Katie FM Marwick[1]
1Institute of Neuroscience and Cardiovascular Research, University of Edinburgh, Edinburgh, United Kingdom
2Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
3Division of Biol4ogical Sciences and Health, School of Health and Life Sciences, University of the West of Scotland, United Kingdom
Background: Premenstrual dysphoric disorder (PMDD) is a prevalent but understudied psychiatric disorder affecting approximately 2% of females of reproductive age. In particular, the burden of physical and mental health comorbidities in PMDD remains poorly characterised, limiting clinical recognition and care.
Aim: To investigate the burden of physical and mental health comorbidities in premenstrual dysphoric disorder.
Objectives: To leverage the Our Future Health cohort to estimate, for the first time, the prevalence of comorbid mental and physical health conditions in females with PMDD compared to females with major depressive disorder (MDD) and females with no psychiatric history.
Methods: We examined comorbidity across 14 major diagnostic categories and 50 specific diagnoses in females aged ≥18 years with self-reported lifetime PMDD diagnosis (n=4,475). Reference groups comprised females with MDD but no PMDD (n=62,342) and a female comparator group with no psychiatric diagnosis (n=748,331). We estimated comorbidity prevalence in each group and used Poisson regression to identify conditions more strongly associated with PMDD than with each reference group, focusing on the PMDD vs. MDD comparison. Models were adjusted for a range of sociodemographic and lifestyle factors (including age, ethnicity, deprivation, body mass index, physical activity, and hormonal contraceptive use). We also compared multimorbidity across groups.
Results: Reproductive disorders showed the strongest association with PMDD versus MDD (endometriosis: PR 2·10 [95% CI: 1·90, 2·33]; polycystic ovary syndrome: PR 1·71 [95% CI: 1·55, 1·89]), followed by neurodevelopmental disorders (attention deficit hyperactivity disorder: PR 1·96 [95% CI: 1·79, 2·14]; autism spectrum disorder: PR 1·84 [95% CI: 1·64, 2·06]). Compared with MDD, PMDD was also associated with an increased prevalence of psychiatric comorbidities including body dysmorphia (PR 2·14 [95% CI: 1·89, 2·42]), perinatal depression (PR 1·58 [95% CI: 1·35, 1·85]), obsessive-compulsive disorder (PR 1·41 [95% CI: 1·28, 1·57]), postnatal depression (PR 1·39 [95% CI: 1·32, 1·47]), and post-traumatic stress disorder (PR 1·30 [95% CI: 1·22, 1·38]). Individuals with PMDD had greater comorbidity burden on average than those with MDD and comparators (mean: 2·6 vs. 2·1 vs. 1·2).
Conclusion: These findings highlight the high burden of physical and mental health comorbidity in PMDD, suggesting a need for systematic screening for common comorbidities. Different comorbidity patterns between PMDD and MDD – such as the higher prevalence of reproductive and neurodevelopmental disorders in PMDD – may reflect distinct pathophysiological processes, warranting further investigation.Potential Impacts of Menstrual Product Chemical Exposures on Vaginal Health
Presenter: Alexandra Scranton
Affiliation: Weaving Voices for Health & Justice (formerly Women’s Voices for the Earth)
In the last decade, chemical testing of menstrual products has been conducted, identifying numerous chemicals of concern including PFAS (forever chemicals), phthalates (reproductive toxins), heavy metals (lead, cadmium), fragrance allergens, antibacterial ingredients and more. Much of the time the potential health risks are assessed through estimations of how much of a toxic chemical found in a menstrual product might be absorbed systematically – thus having a health impact on the body generally. The often missing analysis is what impact these chemical exposures might have locally on vaginal and vulvar tissue, and the vaginal microbiome. This presentation will discuss the potential health impacts of the crucial but often overlooked vaginal route of exposure, and what these exposures can mean for our vaginal and reproductive health.
Predictors of menstrual product access: a longitudinal investigation among adolescent girls and young women in Nairobi, Kenya
Presenter: Nicole Stamas
Affiliation: Johns Hopkins Bloomberg School of Public Health Department of Population, Family, and Reproductive Health
Co-authors: Rashelle Jean Musci, PhD MS Johns Hopkins Bloomberg School of Public Health
Mary Thiong’o International Center for Reproductive Health - Kenya
Peter Gichangi Technical University of Mombasa
Michele R. Decker, ScD MPH Johns Hopkins Bloomberg School of Public Health
Dr. Shannon Wood, PhD MSc Johns Hopkins Bloomberg School of Public Health
Research Aim and Objectives: Access to menstrual products is fundamental to women’s sexual and reproductive health and global gender equity. Yet, over 500 million women and girls globally do not have access to menstrual products for adequate absorption, changing, and disposal or washing. While existing cross-sectional and qualitative studies suggest links between gender-based violence and menstrual product access, particularly among young women in sub-Saharan Africa, no existing studies have evaluated these associations longitudinally. This study aims to assess the longitudinal association of demographic characteristics and past-year relationship power imbalances on barriers to menstrual product access among adolescent girls and young women (AGYW) in Nairobi, Kenya.
Methods: Data were drawn from four semi-annual survey rounds (2020-2024) of a prospective cohort study among youth aged 15-24 in Nairobi, Kenya. Analyses included all women with complete outcome data for all four survey rounds and a replenishment sample who entered for survey rounds three and four and had complete outcome data (N=790). The primary outcome, any barrier to menstrual product access (binary), was measured at each survey round. Mixed effects logistic regression models assessed linear associations between demographic characteristics (age, marital status, household wealth, employment, currently in school) and relationship power imbalances (partner age disparity, reproductive coercion, intimate partner violence [IPV], transactional sex) with barriers to menstrual product access over survey rounds. Random intercepts for participant ID accounted for repeated observations.
Results: Mean age at entry among participants was 18.9 years. At study entry, 46.6% of AGYW completed a secondary education or higher, 33.2% self-reported household wealth in the lowest quantile, and 56.0% were married. Across survey rounds, 84.3% of women reported physical and/or sexual IPV, 84.2% reported engaging in transactional sex, and 63.1% reported reproductive coercion. In preliminary analyses, adjusted models demonstrated higher household wealth (OR=0.75; p<0.001), current employment (OR=0.65; p=0.003), and currently being in school (OR=0.66; p=0.02) were associated with significantly decreased odds of barriers to menstrual product access over survey rounds. Past-year physical and/or sexual IPV (OR=2.63; p<0.001) and engagement in past-year transactional sex (OR=1.36; p=0.03) were associated with significantly higher odds of barriers to menstrual product access over time.
Conclusions: After adjusting for demographics, physical and/or sexual IPV and transactional sex were associated with increased barriers to menstrual product access over survey rounds among AGYW in Nairobi. Ongoing analyses will examine nonlinear trajectories and time-varying violence exposures to inform targeted policies and programs for improving menstrual product access in Kenya.Premenstrual Dysphoric Disorder (PMDD) and Relationships: A Mixed-Methods Study of Experiences of People with PMDD and Their Partners
Presenter: Dr Sophie Hodgetts
Affiliation: Durham University, Psychology Department
Co-authors: Miss Aarushi Kalsi (Durham University) Dr Amy Pearson (Durham University) Dr Monique Botha (Durham University)
Aim: The androcentric bias in autism research has resulted in the experiences of autistic women and those assigned female at birth (AFAB) often going unexplored, particularly in areas like menstrual health. Sensory sensitivities, emotional dysregulation, and increased rates of conditions like premenstrual dysphoric disorder (PMDD) suggest that autistic individuals may experience menstruation differently from their non-autistic peers. However, research in this area remains limited, often relying on caregiver reports rather than self-reported experiences. Additionally, menstrual health education and healthcare services frequently fail to accommodate autistic needs, exacerbating distress. Objective: This study adopted a neurodiversity-affirming framework and a mixed-methods approach to explore the relationship between sensory processing, menstruation, and mental health in autistic individuals. We also considered the impact of PMDD in both autistic and non-autistic particants. We expected to find significant differences in the experiences of sensory sensitivities, mental health outcomes (such as anxiety, depression, and quality of life), and menstruation between autistic and non-autistic individuals. Method: The quantitative portion of our study used an online survey to measure sensory processing differences, premenstrual symptoms, mental health, and quality of life in autistic and non-autistic menstruators. Autistic participants for the qualitative phase were selected from the quantitative sample. The qualitiative portion of the study involved semi-structured interviews, analysed using Interpretative Phenomenological Analysis. Results: Quantitative results revealed that autistic participants experienced significantly higher sensory sensitivities, heightened emotional distress, and lower quality of life related to menstruation compared to their allistic peers. The qualitative study revealed key themes concerning the role of sensory overload, emotional dysregulation, and the struggle for control in shaping autistic menstrual experiences. Conclusion: These findings highlight the need to centre autistic voices in menstrual health education, support, and research. Prioritising lived experiences can lead to more inclusive healthcare practices and reduce disparities in care.
Prevalence of heavy menstrual bleeding and menstrual pain across the life course: findings from four population-based cohorts
Presenter: Dr Sampurna Kundu
Affiliation: Psychology, University of Exeter
Co-authors: Prof Gemma Sharp (University of Exeter), Prof Martha Hickey (University of Melbourne), Prof Abigail Fraser (University of Bristol), Prof Laura Howe (University of Bristol), Prof Healther O’Mahen (University of Exeter), Dr Maria Magnus (Norwegian Institute of Public Health), and Dr Jess Tyrrell (University of Exeter)
Background Menstrual health remains one of the most under-researched areas in women’s health. Heavy menstrual bleeding (HMB) and menstrual pain (MP) are among the most common menstrual symptoms, and have substantial impact on women’s quality of life, yet population-level evidence on their prevalence across the life course is scarce. Methods We conducted descriptive analyses separately on four longitudinal population cohorts: the Avon Longitudinal Study of Parents and Children (ALSPAC G0, ages 32-51, n= 11,494; ALSPAC G1, ages 10-17, n=4,289) and British Cohort Study 1970 (BCS70, ages 38-51, n=7,159) in the UK, the Raine Study (ages 14-28, n=1,414) in Australia, and the Adolescent Brain Cognitive Development Study (ABCD, ages 12-18, n=5,678) in the USA. We estimated cumulative prevalence (across all available timepoints) and age-specific point prevalence of HMB only, MP only, and co-occurring HMB and MP. Estimates were also stratified by socio-demographic factors (ethnicity and socioeconomic position indicated by household income, parental education, and occupational class), where data permitted. Results Many participants reported experiencing HMB and/or MP at least once across all available timepoints (90.3% ALSPAC G0, 76.6% in ALSPAC G1, 72.8% in Raine, 98.1% in ABCD, 966.3% in BCS70), with symptoms most commonly co-occurring. Age-specific patterns showed increasing prevalence across adolescence in ABCD and ALSPAC G1 specifically for MP and co-occurrence. In midlife (BCS70 and ALSPAC G0), HMB and co-occurring symptoms were highest in the late 30s to mid-40s and declined thereafter, consistent with perimenopausal changes. Ethnic differences were observed in ABCD, with Black adolescents reporting higher cumulative prevalence of MP only (48.1% vs 30.7%) and co-occurrence (20.4% vs 18.4%) compared to White adolescents. In BCS70 (midlife), co-occurring HMB and MP was more prevalent among women with lower educational status (low: 41.3% vs high: 35%) . Conclusion The vast majority of women experience heavy or painful periods at some point during their life, and these symptoms most commonly co-occur. Prevalence differs by life-course stage and ethnicity. Generating robust life-course evidence on menstrual symptom patterns is essential to inform clinical guidelines, reduce diagnostic delays, and address inequalities in menstrual health.
Psychological challenges and the relationship between menstrual pain severity and daily life interference in young adult women: A cross-sectional analysis of a population-based birth cohort
Presenter: Marlies Visser
Affiliation: 1. Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands, 2. Amsterdam Reproduction & Development research institute, Amsterdam, The Netherlands, 3. Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
Research aim. Menstrual complaints, including pain and heavy bleeding, affect millions of women worldwide. Evidence suggests ethnic differences in menstrual characteristics such as age at menarche, cycle length, pain intensity, and the prevalence of gynaecological conditions. However, evidence on the prevalence, determinants, and broader impacts of menstrual complaints remains limited, particularly in ethnically diverse populations. Previous research has largely relied on selected or clinical samples with limited ethnic diversity, and evidence from European contexts is scarce. This study will provide the first assessment of menstrual complaints across age, ethnic and clinical groups using a large dataset due to the unique ability of integrating data across multiple cohorts.
Objectives. This study aims to (1) estimate the prevalence and identify risk factors of key menstrual complaints across age, ethnic, and clinical groups in the Netherlands; (2) assess relationships with mental wellbeing and social participation (i.e., participation in school, work and daily activities) within and across the same groups.
Methods. Cross-sectional analyses will be conducted within and across three large Dutch cohorts – two population-based cohorts (ABCD; N=878, HELIUS; N~1,500), and one clinical cohort (OMEGA; N= 41,900) using a harmonised dataset. For Objective 1, crude prevalence estimates will be calculated for key menstrual complaints, including dysmenorrhoea, irregular cycles, and heavy bleeding. Associations between potential risk factors (e.g., age menarche, Body Mass Index, smoking, alcohol and physical activity) and menstrual complaints will be assessed using cohort-adjusted pooled regression analyses. Differences by age (<35/≥35 years), ethnicity (Dutch, Moroccan, Turkish, Surinamese, Ghanaian, or Other), and clinical status (presence of diagnosed menstrual disorders or reproductive concerns; yes/no) will be tested. For Objective 2, cohort-adjusted pooled regression analyses are conducted to examine associations between menstrual complaints and mental wellbeing and social participation outcomes. Adjusted models will account for relevant sociodemographic, lifestyle, and psychosocial covariates. Effect modification is tested here similarly to Objective 1.
Expected results. We expect to include about 44.259 respondents in our analyses. This will result in a unique large cohort study enabling the assessment of age, ethnic and clinical group differences across cohorts. Analyses for both objectives are ongoing, and results will be presented at the conference.
Conclusion. The findings are expected to contribute to a better and more inclusive understanding of menstrual health and related complaints, and their impact on mental wellbeing and social participation. The study will inform prevention strategies and policy efforts addressing menstrual challenges in diverse populations.Public Opinion & Knowledge on Period Product Safety
Presenter: Anushka Swannell
Affiliation: Manchester Community Central (Policy & Influence Team)
This study aims to assess the level of public knowledge, lived experience, and opinion regarding the safety, composition and regulation of menstrual products among women and people who menstruate nationwide.
Objectives
To identify gaps in public awareness of the ingredients and safety standards of commonly used menstrual products
To explore community attitudes towards current regulatory frameworks governing menstrual product safety
To capture the diversity of experiences across different demographics, including age, product preference and lived experience
To inform evidence-based recommendations and insights for menstrual product regulation and wider menstrual health legislative initiatives.
Methods
An anonymous online survey was developed and distributed by Manchester Community Central as part of an 18-month menstrual health project. The survey captures quantitative data on product usage and knowledge levels, alongside qualitative responses on lived experiences and policy opinions. Participation is open to all women and people who menstruate, with no requirement to answer every question, supporting inclusive and accessible data collection. To date, 248 responses have been collected, with data collection ongoing as of March 2026.
Results
Data collection is currently in progress. By the time of the conference, we would be ready to present findings from the survey, with analysis focusing on patterns in product safety awareness, areas of concern raised by respondents, and lived experience on menstrual health and period product safety.
Conclusion
This community-led research addresses a significant gap in public health knowledge. By centering the voices of those most directly affected, the findings will contribute to calls for greater transparency in product labelling, stronger legislation on period product regulation and the meaningful integration of lived experience into menstrual health policy. The study supports a growing evidence base for policy reform aligned with menstrual dignity and health equity.Qualitative study exploring the menstrual experiences of neurodivergent people.
Presenter: Mx Gabrielle Nwaordu
Affiliation: Goldsmiths University of London, Psychology Dept
Co-authors: Rebecca Charlton, PhD, supervisor and second author.
Aim: To understand the menstrual experiences of neurodivergent people. Research question: How do neurodivergent people experience their menstrual cycle? Is this different to the experiences of neurotypical people?
Objectives: (a) to consider the similarities and differences in the experiences of menstruation among people with different neurotypes. (b) to examine whether there are shared experiences that uniquely unify neurodivergent groups.
Methods Neurodivergent and neurotypical people were recruited online through social media platforms. Fourteen participants with experience of menstruation were recruited (age range 29-59 years). Most participants described being multiply neurodivergent (n=7), with the most common co-occurring conditions being autism and ADHD (n=6). Only two neurodivergent people did not identify co-occurring conditions (one autistic person, one person with ADHD). Five participants identified as neurotypical, although one suspected they may be autistic. Participants were interviewed using semi-structured interviews (11 online, 3 in person), asking about experiences of menstruation, symptoms, medical experiences, and treatments. Interviews were recorded and transcribed. Each transcript file was anonymised and uploaded to NVivo. The data is being analysed using thematic analysis (Braun & Clarke, 2006).
Results The analysis is in the end stages, and themes are being refined, defined and renamed. This will be completed before the conference. Four preliminary themes were described. (1) Barriers to accessing healthcare, which described the impact of feeling dismissed by healthcare professionals. (2) Confusion related to menstruation: which explored the ways people found menstruation confusing and how these created difficulties navigating menstruation. The theme explores confusion in social interactions, within one’s own bodily experiences, and in not knowing what is normal. (3) Secrets, which explored how ideas of privacy, hiding, stigma and taboo have impacted people’s experience and understanding of menstruation. (4) Social conversations about cycles, which illustrated the importance and usefulness of speaking about menstrual cycles, including when, with whom, and where people felt they could be more open about menstruation. This theme also explored the difficulties faced when trying to have conversations about menstruation, including reasons why some have felt they cannot talk about periods.
Conclusion At this stage of analysis, group differences have not yet been considered, but a preliminary examination suggests that some subthemes, such as confusion, are more potent among neurodivergent people compared to neurotypical people. This research shares some important insight into how neurodivergent people experience menstruation, whether different neurodivergent people experience similar challenges and whether these are similar or different to neurotypical menstruators.RETHINKING MENSTRUATION: A SOCIOLOGICAL NARRATIVE OF THE MISSING LINK IN PRODUCT DISPOSAL AND ENVIRONMENTAL CONCERNS
Presenter: Saheli Lye
Affiliation: The University of Burdwan
The occurrence of menstruation has always stigmatized women’s bodies and is thus considered to be shameful as well as dirty. The menstrual occurrence and practices are characterized by cultural stigma and tremendous taboos. Traditionally, the blood cycle occurrences are considered an impure notion for women. But in modern times, the idea of the menstruating body being too polluted and impure gradually changed and shifted to a neutral/pure body with the use of menstrual kits. Menstrual waste (used kits) and the environment are interconnected; however, this connection has not received proper attention, leading to various questions about the volume of menstrual waste generated, its disposal, and the resulting environmental pollution. Single-use plastic products have become a target. These products are often recognized as public hazards and one of the sources of biohazards. Therefore, the use of different menstrual kits and their sporadic disposal causes water, air, and soil pollution, which go unnoticed and are unexplored. The objective of this study is to explore how menstrual waste and its improper disposal resulted in environmental hazards and pollution of water, air and soil, and how proper management of menstrual kits and their disposal contributes to maintaining the health and hygiene of women and life of people in general on the one hand and environmental protection on the other hand. This eventually resulted in the females’ being unaware of the ecological consequences of commonly used menstrual products. The methodology adapted is based on qualitative approach combining lifecycle analysis (LCA) an attempt has been taken to uncover nature of water, air and soil pollution due to the uses of menstrual kits and its disposal and impacts therein on health and environment and how do (products) improvement and proper management of menstrual kits and its disposal help to maintain health, hygiene and people’s life as well as environmental protection. In-depth interviews with female students of school and college in Burdwan town, West Bengal, India, have been conducted to understand the female’s attitude and experience, which influence perceptions and on-ground disposal practices. Additionally, anticipated results indicate that entrenched gendered cultural norms—such as shame, secrecy, and domesticized responsibility—continue to regulate menstrual representation and disposal practices in everyday life. In conclusion, the study contributes to a more comprehensive understanding of menstrual health, promotes responsible product disposal through a sustainable approach, and advocates for integrating environmental awareness.
Resources for Menstrual Education - R4ME key insights from Nepal
Presenter: Sara Parker
Affiliation: Liverpool John Moores University Humanities Social Science
Menstrual stigma and discriminatory socio‑cultural practices continue to affect girls’ and women’s health, dignity, and educational participation in Nepal. This study evaluates the effectiveness and practical utility of the Resources for Menstrual Education (R4ME) toolkit, developed through the Dignity Without Danger (DWD) project, which aims to challenge menstrual stigma through creative, interdisciplinary, and educational interventions. The aim of this research is to assess how effectively the R4ME resource kit supports menstrual health education in Nepalese schools and contributes to developing menstrual knowledge in order to reduce menstrual discrimination in Nepal.
The study’s objectives were to: (1) review existing school curricula, textbooks, and reference materials related to menstrual hygiene education; (2) examine current pedagogical practices used to teach menstrual health; (3) critically evaluate the relevance and usability of the R4ME student resources and teacher guide; and (4) recommend evidence‑based improvements to strengthen menstrual health education across the school system.
A four‑phase methodology guided the research, involving (i) preparatory curriculum review and tool development; (ii) pilot testing of R4ME materials through student workshops and teacher feedback sessions; (iii) analysis and synthesis of findings across participating schools; and (iv) formulation of recommendations for resource revision and broader dissemination. Data were generated through surveys, workshops, document review, observation of teaching practices, and focus group discussions with teachers, students (including disabled students), and mothers
Results indicate that menstrual health content is formally included in the curriculum from Grades 4–12, but its delivery remains inconsistent. Many schools lack sufficient teaching guides, audio‑visual resources, and menstrual‑friendly facilities. Only a minority of teachers have received formal training, and teaching methods remain predominantly lecture‑based, with discussion used most frequently. Students reported learning about biological processes, hygiene practices, and cultural taboos, yet socio‑cultural restrictions persist. Disabled students highlighted the lack of braille materials and accessible resources. Mothers, who commonly serve as girls’ first source of menstrual information, reported adherence to cultural norms that reinforce restrictive practices. The R4ME toolkit was positively received for its clarity, creativity, and contextual relevance, though its reach and use varied across schools
Conclusion: The R4ME toolkit demonstrates strong potential to enhance menstrual health education through accessible and context‑appropriate materials. However, systemic barriers—including limited teacher training, insufficient resources, stigma among students, and infrastructural gaps—must be addressed to maximise its impact. Strengthening menstrual education in Nepal requires multisectoral collaboration, inclusive materials (including braille), improved facilities, and community engagement to dismantle deeply rooted menstrual stigmaReusable Menstrual Underwear: Use and Acceptability by Internally Displaced Women in Somalia
Presenter: Lauren D’Mello-Guyett
Affiliation: London School of Hygiene and Tropical Medicine
Background: Menstrual health and hygiene are often neglected in humanitarian crisis settings, where inadequate water and sanitation facilities, limited menstrual materials and information, restricted healthcare access, and unsupportive social environments undermine people’s ability to manage menstruation safely, with dignity, without harm. Reusable menstrual hygiene materials may help address some of these gaps, but more evidence on the acceptability and use in such settings is needed. This study examines factors associated with the use and acceptability of REEMI™ menstrual underwear distributed to internally displaced women and girls in the Banadir region, Somalia.
Methods: This study was a prospective longitudinal study among a random sample of 295 internally displaced women who received menstrual underwear with bags for washing and drying. Surveys were completed, at and within 12 months after the distribution, to capture demographics, menstrual practices, use of the menstrual materials, and acceptability or issues with the materials. Descriptive statistics summarised key variables, and logistic regression was used to examine factors associated with the use of the menstrual underwear.
Results: 12 months after distribution, 89% of women used the menstrual underwear during their most recent menstruation, 96% used the washing bag, and 95% used the drying bag. Participants found the menstrual underwear comfortable (100%), reliable for heavy bleeding (95%), and led to fewer infections (93%), with no reported leakage or odour (0%). Among reasons for using the washing and drying bags, privacy was the most common (86–89%), followed by convenience. The odds of using menstrual underwear were higher among participants who felt they received enough pairs for rotation. Compared to married participants, those divorced/separated or single had lower odds of using the menstrual underwear.
Conclusions: This study found high use and acceptability of menstrual underwear for displaced populations. These findings suggest that including long-lasting reusable menstrual materials in emergency humanitarian settings can have positive effect on menstrual health and hygiene, particularly when context-specific and addressing key factors such as privacy and hygiene, which strongly influence use and acceptability.
SOCIAL SECLUSION AND MENSTRUAL HYGIENE PRACTICES AMONG THE KUTIA KONDH IN KALAHANDI DISTRICT, ODISHA: A BIO-CULTURAL APPROACH
Presenter: Sanghamitra Bhoi
Affiliation: Department of Anthropology, Central University of Odisha
Co-authors: Co-author 1 Dr.B.K .Srinivas ,Assistant Professor and HoD Department of Anthropology , Central University of Odisha. Co-author 2 Dr. Madhulika Sahoo, Assistant Professor Department of Anthropology, Maa Manikeswari University, Bhawanipatna.
Menstruation is a natural biological process of women’s health, yet it remains surrounded by deep-rooted socio-cultural taboos that influenced the women’s physical and mental well-being. Among the marginalized tribal communities, the socio-cultural perceptions on menstruation often led to social scrutiny, social segregation and inadequate menstrual hygiene practices.It is not just about the individuals health and wellbeing but it also integrally related to some of UN Sustainable Development Goals such as Good Health and Wellbeing, Quality Education, Gender Equality, and Clean Water and Sanitation. This research illustrates the lived experience of Kutia Kondh tribal women addressing their prevalence of cultural taboos and menstrual hygiene practices in Batelima Panchayat of Lanjigarh block Kalahandi district, Odisha. This study adopts a mixed-method research design to achieve it’s objectives.The primary data were collected from 100 respondents during fieldwork through semi-structured interviews, Focus Group Discussions, and case studies.This research also employed survey questionnaire to collect quantitative data on their menstrual hygiene practices. To access the determinant of hygienic menstruation practices logit model was employed. The findings of the study reveals the prevalence of social isolation during menstruation which intern results in increase the social exclusion and gender disparities. The study also reveals a lack of access to menstrual hygienic products, with a significant proportion of women relying on reusable cloth rags as absorbent during their periods. The study observed that lack of education and inadequate awareness about government schemes are the major factors contributing to unhygienic menstrual practices among the Particularly Vulnerable Tribals Groups (PVTGs) women. The research demonstrates the needs for a culturally concerned interventions, community based awareness campaign and adequate education about menstrual hygiene management.
Key Words: Social Isolation, Social Exclusion, Logit Model, Gender Disparities, Cultural Taboos & Menstrual HygieneSeeing Red: Visualising Menstruation Across Medicine and Art to Reimagine Menstrual Wellbeing
Presenter: Dr Camilla Mørk Røstvik
Affiliation: University of Agder
This paper explores how menstrual art and visual culture offer critical interventions into the histories of menstrual medicine and the impact these histories continue to have on menstrual health, mental health, and wellbeing. Across the period commonly referred to as “modern medicine,” menstruators have faced harmful and discriminatory practices: non-consensual hysterectomies and sterilisation; pharmaceutical pathologisation of PMS and PMDD; diagnostic neglect of conditions such as endometriosis; reliance on sanitised “blue liquid” testing; and persistent framings of menstruation as a hygiene crisis or emotional instability. These legacies continue to shape how menstruation is understood, visualised, and treated today. The aim of this research is to analyse how artists have responded to these medical paradigms and to consider what their work reveals about the possibilities for a more modern, equitable menstrual medicine. The study has three core objectives: (1) to map the gaps, distortions, and silences in medical visual archives; (2) to examine how menstrual artists address or reimagine these absences; and (3) to evaluate how artistic practices might contribute to improving menstrual health and wellbeing.
Using methods from visual analysis, medical humanities, and archival research, this paper focuses on three key case studies. Judy Chicago’s Red Flag brings into visibility the everyday acts that medical and commercial cultures have long hidden, exposing how menstrual products were framed as technologies of concealment rather than understanding. Jen Lewis’s If I Bled Blue critiques the advertising and laboratory conventions that replaced menstrual blood with blue liquid, revealing the cultural and scientific fears surrounding menstrual material. WhiteFeather Hunter’s Mooncalf goes further by bringing menstrual blood into biomedical research, highlighting how taboo and biohazard anxiety have impeded menstrual science, even as menstrual stem cell research becomes increasingly viable.
Preliminary findings from this ongoing project suggest that menstrual art does more than depict: it theorises. These works challenge medicalised shame, illuminate historical harms, and create new ways of thinking and feeling about menstrual embodiment. They foreground agency, critique commodification, and propose alternative knowledge systems rooted in lived experience. Significantly, they anticipate recent developments in menstrual health discourse, including the WHO’s recognition of menstruation as a vital sign and increasing clinical attention to menstrual pain and blood loss.
The paper concludes that artists have, in many ways, been curating menstrual modernism ahead of medicine. By engaging with the emotional, material, and political dimensions of the cycle, menstrual art offers a framework for reimagining menstrual health in ways that support dignity, mental wellbeing, and inclusive care.Silent Struggles at Work: Perimenopausal Women’s Lived Experiences in the Indian Workplace
Presenter: Dr. Sanchita Singh
Affiliation: Assistant Professor, Jindal School of Psychology and counselling, O. P. Jindal Global University, Sonipat, India
Background/ Aim: Perimenopause is a natural yet often overlooked phase of the menstrual life course, marked by physical, emotional, and psychological changes that can affect women’s mental health, well-being, and occupational functioning. Despite growing attention to menstrual health, perimenopausal experiences within workplace contexts remain underexplored in India. The study aims to understand the lived experiences of working women experiencing perimenopausal symptoms.
Methods: This qualitative exploratory study used Interpretative Phenomenological Analysis (IPA). Twelve perimenopausal women aged 40–55 years were recruited through purposive and snowball sampling across sectors, including education, information technology, healthcare, and administration. Participants were clinically diagnosed as being in perimenopause by a gynecologist, reported perimenopausal symptoms in the past six months, and had been employed in their current role for at least six months. Women with severe mental health conditions or disabilities were excluded. Data were collected through expert-validated semi-structured interviews, translated and transcribed into English, and analysed using IPA.
Results: The analysis yielded six overarching themes with related subthemes that captured the lived experiences of perimenopausal working women in India. The first theme, Lifelong Journey of Hormonal Burden, reflected participants’ narratives from their first experiences of periods and early encounters with womanhood, through the unexpected onset of perimenopause, and meanings associated with menopause. The second theme, Symptoms and impact of perimenopause, encompassed emotional, physical and behavioural, and cognitive changes that affected daily functioning. The third theme, Impact on work life, highlighted consequences such as reduced productivity, difficulties in concentration, strained workplace relationships, and concerns about professional competence. The fourth theme, Coping, included both adaptive coping strategies, such as self-care and seeking support, and maladaptive coping, such as symptom concealment and overcompensation. The fifth theme, Social-cultural expectations and gendered burden, captured cultural differences, taboos surrounding perimenopause in India, generational differences in disclosure, and the burden of multiple identities and roles. The sixth theme, Suggestions and strategies, reflected participants’ emphasis on the need for support systems, advice for women, and recommendations addressing policy gaps and workplace supports.
Conclusion: This study highlights the often “silent struggles” of perimenopausal women in the Indian workplace and underscores perimenopause as a critical yet neglected occupational health concern. The findings call for gender-sensitive, culturally informed workplace policies and practices that support women’s wellbeing across the life course.
Keywords: Perimenopause; Women’s Health; Workplace Experience; Lived Experiences; India
Supporting adolescent menstrual health to improve participation and performance in physical activity: rapid realist review to inform logic model for intervention development
Presenter: Alison Cooper
Affiliation: Cardiff University, Women’s Health Research Wales
Co-authors: Dr Ainah Mahaiyuddin, Cardiff University Dr Daniel Sim, Glamorgan Valleys Vocational Training Scheme Dr Freya Davies, Cardiff University Ms Elizabeth Gillen, Cardiff University Dr Natalie Brown, Swansea University Prof Adrian Edwards, Cardiff University Prof Jacky Boivin, Cardiff University
Background
Menstrual (period related) symptoms are a recognised barrier to adolescents engaging in physical activity. Insufficient physical activity is 5% higher among women than men globally associated with increased risk of non-communicable diseases such as diabetes, heart disease and cancer. The World Health Organization recommends that to improve global physical activity levels by 2030, one focus should be on women. However there is a lack of evidence-based guidance about how to address menstrual health barriers with physical activity. Our aim was to develop a set of programme theories to describe how menstrual health support interventions work, for whom and in what circumstances, to inform a logic model for intervention development.
Methods
We followed rapid realist review methodology incorporating stakeholder expertise. Formal, double screened, database and grey literature searches were conducted (Medline, AMED, Embase, Psycinfo, CINAHL, ERIC, SCOPUS) in line with abbreviated systematic review methodology. Articles were included that met inclusion criteria and contributed to the process of theory development. Explanatory statements were extracted and synthesised into programme theories (context-mechanism-outcome configurations) using Pawson’s reasoning processes, mapped onto Self -Determination theory concepts (autonomy, competency, relatedness).
Results
From 9585 database hits, 63 articles were included. Generated programme theories described how four intervention domains (education; practicalities including toilet facilities, period friendly clothing and free accessible period products; menstrual cycle tracking and screening tools; and medical support if needed) could support improving menstrual health confidence and understanding, communication, and trust. These could empower individuals to enhance their own menstrual health and potentially improve participation rates and performance in physical activity. However, adverse outcomes were described when processes were not in place to: signpost to medical support if needed; support users’ trust in how and why data were collected and used; and enable understanding of the limitations of menstrual health support tools.
Conclusion
The proposed programme theories and logic model can be used to inform and evaluate interventions aimed at overcoming menstrual health related barriers with physical activity. Future interventions developed from this model need robust evaluation.Suwahuwa vs Shakti: Ambivalence, Agency , and Negotiation in Assamese Brahmin Women’s Menstrual Identities
Presenter: Basudha Bhattacharya
Affiliation: Department of Social Work, Visva-Bharati University, Santiniketan
Background & Research Focus: This exploratory ethnography maps the Suwahuwa vs Shakti identity continuum among Assamese Brahmin women, capturing profound ambivalence between household suwa (temporary pollution) rituals and Kamakhya Devi’s sacralized menstruation. While Kamakhya Temple closes during Axar month—symbolizing divine menses—believers worldwide revere its red cloth and prasad as shakti embodiment. Yet Brahmin households enforce strict pollution: women isolate 3–9 days, their touch deemed contaminating. This study asks: Is suwa a sacred choice embodying devotion, or ritual imposition? How do women negotiate agency amid priests, male kin, and modernity’s pressures?
Research Aim and objectives: To explore menstrual identity ambivalence, negotiation dynamics across genders/religious authorities, and socio-economic shifts influencing ritual choices among Assamese Brahmin families.
Methods: Between November 2025 to March 2026, in depths interviews engaged 15 Assamese Brahmin women (aged 16–62, parts of upper and lower Assam), their 15 male kin (husbands/fathers/brothers), and 5 priests/ganaks (astrologers) from both lower and upper Assam. The analysis identified recurrent patterns: sacred choice vs. imposition; male/priestly gatekeeping; generational negotiation; modernity’s disruptions.
Key Findings: Three thematic clusters emerged:
Ambivalent Embodiment: Women described suwa as “Brahmin discipline” honoring Devi, yet confessed shame from touch-pollution fears—Kamakhya’s prasad acceptance contradicted home exclusion.
Negotiation Gatekeepers: Priests/Ganaks prescribed niyom or rules via horoscopes; husbands policed compliance as “family honour”.
Modernity’s Fractures: Professional women adapted rituals for jobs; daughters rejected maternal orthodoxy, citing Ambubachi’s shakti—yet feared caste family ostracism. Men split: traditionalists (60%)who believe in enforced rules; claim themselves as progressive (40%).
Conclusions & Implications: Suwahuwa-Shakti tension reveals menstrual identity as negotiated terrain. While priests/men historically gatekeep, educated women leverage Kamakhya’s global shakti symbolism for agency. Realistic recommendations include: school programs integrating Tuloni Biya celebration with Kamakhya’s positive menstrual symbolism; workplace flexibility for working women observing shorter niyom periods; family counseling addressing touch-pollution anxieties through temple prasad acceptance logic.The Development of Menstrual Literacy and Reproductive Health Understanding Among Young Adolescents in Bangladesh: A Longitudinal Qualitative Study
Presenter: Arifa Bente Mohosin
Affiliation: James P Grant School of Public Health, BRAC University
Co-authors: Ms Atiya Rahman, Assistant Scientist, BRAC James P Grant School of Public Health, BRAC University Ms Adiba Farha, MSc (Candidate), Health Economics, Deakin University Ms Heather Suttor, Research Officer, Global Adolescent Health, Burnet Institute Dr Elissa Kennedy, Co-Program Director, Women’s, Children’s and Adolescents’ Health and Co-Head, Global Adolescent Health, Burnet Institute A/Prof Julie Hennegan, DPhil, MSc, Associate Professor and Principal Research Fellow, University of Queensland; Honorary Principal Research Fellow, Burnet Institute; Honorary Fellow, University of Melbourne
Introduction
This study examines how menstrual health literacy and self-efficacy evolve during the first 2-3 years following menarche among adolescent girls in Bangladesh. Menstrual literacy involves the ability to access, understand, and apply information about menstruation and reproductive health to manage one’s body and make informed decisions. However, it is commonly framed as static hygiene knowledge and measured through cross-sectional designs. This study asks: how do menstrual literacy and confidence change over time, and how are they linked to broader body and reproductive literacy? Findings will inform responsive adolescent health interventions in Bangladesh.
Methods
We are conducting a qualitative longitudinal study with 40 adolescent girls in Khulna district, Bangladesh, over three years. Data collection involves four rounds of in-depth interviews and focus group discussions examining knowledge, bodily understanding, sources of information, confidence in menstrual management, and changes over time. Two rounds have been completed (2024 and 2025), with two remaining in 2026. Analysis follows a thematic approach using descriptive matrices to track change, guided by socioecological and self-efficacy frameworks.
Results
Preliminary findings show that early menstrual experiences were marked by fear, confusion, and limited prior knowledge, shaped by myths and maternal guidance. Over time, girls developed greater practical self-efficacy and confidence in managing menstruation, including anticipating periods, using products correctly, maintaining hygiene, managing leakage, and coping with pain. However, gaps in reproductive anatomy and biomedical understanding persisted, and shame and secrecy remained common. Social influences varied, with mothers emphasising hygiene, peers offering mixed support, and differences in school education and facilities, while limited facilities such as girls’ toilets, water, and disposal options reduced confidence and the application of menstrual knowledge. Girls described greater confidence managing menstruation at home, while management at school depended on facility availability, which varied widely. Social media also emerged as a source shaping girls’ understanding of menstruation. Longitudinal analysis indicates that practical self-efficacy improved faster than biological understanding, with learning occurring in non-linear, iterative cycles.
Conclusion
Menstrual literacy emerges as a gradual and non-linear process during early adolescence. Practical confidence developed faster than reproductive understanding, reinforcing menstruation as an ongoing learning process rather than a single event. These findings highlight the need for age-appropriate education that goes beyond hygiene to include anatomy and reproductive health. Strengthening caregiver engagement, school programmes, and digital information environments can address persistent myths and shame, positioning early adolescence as a critical window for interventions supporting informed decision-making and long-term empowerment.The Role of Literature and Literary Criticism in Menstrual Literacy and Education
Presenter: Lisa Tenderini
Affiliation: Rheinische Friedrich-Wilhelms-Universität Bonn
Menstrual literacy is shaped not only through formal education and healthcare systems, but also through cultural narratives that define how menstruation and the menstrual cycle are understood, perceived, and experienced. This paper examines literary representations of menstruation as a form of menstrual health education, asking whether and how literature may affect readers’ knowledge, expectations, and attitudes toward menstrual cycles, while also treating menstruation as a category of analysis within literary studies and criticism.
Building on the findings of my doctoral thesis on contemporary Italian literature (2025), the paper draws on the definition of Period Studies as a distinct, programmatic, transdisciplinary research field. Conceived as an extension of Critical Menstruation Studies, Period Studies systematically integrates literary analysis, cultural history, and intermedial studies to examine the menstrual cycle—i.e. menstruation, menarche, menopause, monthly cyclicity and its interruptions—as a cultural, symbolic, discursive, and narrative construct. Specifically, the paper seeks to (1) analyse how literary narratives shape menstrual literacy by conveying bodily knowledge, expectations, and social meanings; (2) identify dominant tropes and counter-narratives surrounding menstruation; and (3) raise scholarly awareness and articulate the need for transnational, transcultural, and historical approaches to the study of the menstrual cycle across literature, history, and the arts.
By compiling a corpus of literary works addressing menstruation—beyond the horror genre and young adult fiction—this research aims to uncover, analyse, and contextualise neglected texts and overlooked representations of the menstrual cycle, emphasizing the role of literature and literary studies in the production and circulation of menstrual knowledge. Drawing on ongoing pedagogical practice at the University of Bonn, where research on menstruation has been successfully integrated into the Romance Studies curriculum, the paper demonstrates how Period Studies can operate as a research framework and pedagogical approach, contributing to the dismantling of menstrual taboos at cultural and academic levels.
Literary and narrative representations constitute a crucial yet underexamined site of menstrual education: making these narratives visible can significantly shape readers’ understandings of menstruation—from menarche to menopause— and related health issues, helping to reduce stigma and challenge taboos. Establishing Period Studies as a research field within the humanities enables sustained, comparative, and transdisciplinary engagement with menstruation across cultures, media, and historical periods, thereby strengthening efforts to advance menstrual literacy, inclusive education, and social equity.The S.D.U. and Y.O.U. a design challenge to make the period bin better
Presenter: Chella Quint OBE
Affiliation: Sheffield Hallam University Lab4Living
Trauma-informed approaches to menstrual health recognise that menstrual memories can be emotionally loaded, unevenly accessible, and shaped by stigma, relationships, and the quality of information people had at the time. Across the menstrual span – from menarche through perimenopause, menopause and beyond – many people carry “menstrual span events” as isolated experiences rather than integrated parts of a life story. This paper presents findings from my PhD, Time Periods and Menstrual Time Travel, developed within Lab4Living (Sheffield Hallam University), a design-and-health research institute using art and design methods to address complex wellbeing challenges. Aim: To explore whether creating tangible menstrual timelines and integrating them with broader life-story timelines can support mental wellbeing during recall of past menstrual span events, and strengthen confidence, intergenerational empathy and agency when anticipating future transitions in multiple settings. Objectives: (1) Develop and refine a participatory, trauma-informed workshop method for “menstrual time travel” using material, creative timeline-making; (2) examine how participants narrate mood, wellbeing, stigma, support and agency around menstrual span events across life stages; (3) co-evaluate whether the method supports clearer communication and mutual support within families and communities. Methods: A series of facilitated workshops with intergenerational participants, including family/household groupings. Activities include constructing timeline sculptures using colour, texture and materiality; creating intertwined “life script” and menstrual timelines; and composing messages to past and future selves. As well as sitting within critical menstrual studies, the work is loosely informed by research on how humans emotionally relate to experience across time and memory, including Zimbardo’s Time Perspective Theory, Tulving’s mental time travel, the Remembering–Imagining System (Conway, Loveday & colleagues), and episodic future thinking (Atance & O’Neill). Trauma-informed practice is embedded throughout via opt-outs, non-verbal routes, pacing choices, accessibility adjustments, and careful closing/offboarding. Results: Participants co-designed the activity content by collaboratively selecting the menstrual span events to include and shaping the forms of creative response. This process generated community-facing outputs (reusable prompts, templates, and example artefacts) alongside research findings. Across life stages, participants prioritised specific menstrual span events and described how psychosocial and environmental contexts – stigma, education, relationships, and access to support – shaped menstrual and mental wellbeing. Post-workshop self-report measures indicated increased perceived menstrual literacy and communication confidence, stronger intergenerational understanding, and greater preparedness for future transitions. Outputs: The study produced a practical facilitation kit for community use, and a take-home family version designed for households to try the activity independently with other family members, supporting ongoing mutual support and conversation beyond the workshops.
The current context of psychosocial support for perimenopausal women in the UK and the experiences of these women: a scoping review and a case study
Presenter: Dot Ward
Affiliation: BSMS / Centre for Reproductive Health and Technologies (CORTH)
Co-authors: Ms Caroline Ackley, Brighton and Sussex Medical School/Centre for Reproductive Health and Technologies (CORTH)
Background Psychosocial support is an important but often overlooked aspect of care for perimenopausal women. This project aims to understand what psychosocial support is available for women in the United Kingdom (UK), how accessible it is, and to use these findings to inform recommendations for current and future services.
Methods This project comprised a scoping review and a case study involving an online questionnaire and two online focus group discussions (FGDs). The scoping review included UK literature from 2010-2025, identified through searches of four databases. The case study was conducted in Brighton and Hove, with a questionnaire open to all perimenopausal women, and two FGDs, one with service users of psychosocial support and one with service providers. Data were analysed thematically.
Results The scoping review included 72 articles. There were 37 questionnaire participants included, and 6 participants across the two FGDs. Themes that emerged from the scoping review include social support, further menopause education, easily accessible reliable information and cognitive behavioural therapy. Of the 37 questionnaire participants, 97% said that their perimenopause had affected their mental wellbeing, but only 30% had accessed a psychosocial support service. Of the participants who had accessed support, 80% said they would be ‘extremely likely’ to recommend the service to someone else. Additionally, 81% of those who hadn’t accessed psychosocial support said they would be interested in doing so. The FGDs revealed three themes: the positive impact of group psychosocial support, barriers to accessing support and challenges in providing support.
Discussion The scoping review highlighted a lack of necessary psychosocial support for perimenopausal women in the UK. Although specific interventions differed across studies, it was clear that women valued and sought more psychosocial support. The case study revealed perimenopause can have a significant impact on mental wellbeing and that psychosocial support was difficult to find but highly valued by those who accessed it. Additionally, it revealed that service providers faced practical challenges such as balancing limited time and navigating peer-led support.
Conclusion The two main themes throughout the study were the benefits of group psychosocial support, and the lack of current support available. It is clear that perimenopause can have a large impact on wellbeing, and psychosocial support can help with this. The scoping review highlighted different forms of psychosocial support, whilst the case study focused on group psychosocial support, the benefits of this, and challenges of running a psychosocial support service.The menstrual cycle as a lens to transform the system: data and observations from the Period Desk experience in Milan, Italy
Presenter: Veronica Corbellini
Affiliation: Eva in Rosso, association
The research presents the findings from a qualitative study based on the experience of the Period Desk (Sportello di Salute Mestruale e Ciclicità), a free menstrual health service active since January 2024 in Milan, Italy. Promoted by the association Eva in Rosso, the Period Desk was established to address significant educational, informational, and social-health gaps in the field of menstrual, sexual, and reproductive health through educational and informative consultations. Over time, it has also functioned as an “antenna,” revealing beneficiaries’ unmet needs, concerns, and the structural barriers they face within the healthcare system.
The four main objectives were: (1) analyzing the beneficiaries’ socio-demographic and health-related characteristics; (2) identifying their menstrual, sexual, and reproductive health needs; (3) examining challenges and barriers in accessing healthcare services; and (4) evaluating beneficiaries’ perceptions of the Period Desk. More broadly, the study aims to contribute in framing menstrual health as both a public health and social justice issue in Italy, and to explore the political and transformative potential of the menstrual cycle as an analytical lens.
Data on the beneficiaries were collected through a first-access form completed by the consultants. Additional information on the experience with the healthcare system and feedback on the Period Desk were gathered via an anonymous online questionnaire administered after the first consultation. A Additionally, semi-structured interviews and a focus group were also conducted with the consultants. The analysis combined descriptive quantitative methods with thematic qualitative analysis.
Between January and December 2025, 69 first-time users accessed the Period Desk and 12 of them returned for one or more consultations. Nearly all first-time users identified as women and heterogeneous by age. 57% reported experiencing menstrual-related disorders, and 70% of these did not have a gynecologist of reference. The primary reasons for accessing the service included: requesting support related to menopause and perimenopause (35%), understanding a diagnosed menstrual disorder (26%), improving knowledge of their menstrual cycle (16%), and managing menstrual pain (13%). Key themes emerged from consultations were: negative experiences within gynecological care, strong emotional responses to receiving accurate information, and expressions of gratitude towards the service. Indeed, in the feedback form, 84% reported being extremely satisfied with the service and 80% would recommend it.
To conclude, the findings highlight four interconnected areas for advocacy and policy intervention: transforming dominant approaches to menstrual health, establishing a menstrual health and body education, addressing gynecological violence, and rethinking the structure of healthcare services.The use of whole-body thermal therapies to support symptom management and wellbeing in people assigned female at birth with dysmenorrhea, pelvic pain, endometriosis, or adenomyosis: a scoping review
Presenter: Dr Laura Cowley
Affiliation: Population Data Science, Swansea University Medical School
Co-authors: Dr Mayara S. Bianchim, School of Psychology and Women’s Health Research Wales Centre, Cardiff University, Wales, UK Dr Kate Isherwood, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Wales, UK Dr Judith Roberts, Department of Psychology, Aberystwyth University, Wales, UK Dr April Rees, Biomedical Sciences, Swansea University Medical School Miss Rachel Joseph, School of Psychology and Women’s Health Research Wales Centre, Cardiff University, Wales, UK Dr Rebecca Anthony, DECIPHer, School of Social Sciences, Cardiff University, Wales, UK
Aim: This scoping review aims to systematically map and characterize the existing literature on the use of whole-body thermal therapies for symptom management and wellbeing among people assigned female at birth with dysmenorrhea, chronic pelvic pain, endometriosis, or adenomyosis.
Objectives: To describe the range and characteristics of included studies, the types and parameters of thermal interventions used, the outcomes assessed, and key findings including estimates of effect. To identify gaps in the evidence base and priorities for future research.
Methods: This work is led by members of the EMPOWER (Endometriosis Management and Promotion of Wellbeing using Evidence-based Research) Network. The review will be informed by the EMPOWER-VOICES patient and public involvement panel comprising people with lived experience of endometriosis. We followed the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) framework to structure the research question, eligibility criteria, search strategy, and data extraction form. We searched five electronic databases from 2000 to February 2026, including the Embase and Scopus databases, and the Medline, APA PsycINFO, and CINAHL Ultimate databases via the EBSCO platform. An abstract screening tool was developed to assist with the initial screening process. Both abstract and full-text screening will be conducted independently by two reviewers, with discrepancies resolved by a third reviewer or team discussion. All studies excluded at the full-text screening stage will be reported with reasons for exclusion provided. The principles of mixed-methods framework synthesis will be adopted to extract, map, chart, categorise and aggregate study findings. Data from each included study will be extracted by two reviewers independently and discrepancies resolved by a third reviewer. The review will be reported using the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analysis, Extension for Scoping Reviews) checklist.
Results: The search carried out in February 2026 identified 426 potentially relevant records. These were imported into the review management software Covidence. Screening and data extraction will be completed by April 2026, with full review findings expected by the end of June 2026. We will include a PRISMA flowchart in the results section of the review publication to describe the study selection process. Data will be synthesized descriptively in tabular and narrative format.
Conclusion: We will use the findings to inform a planned feasibility study on the use of contrast therapy to support symptom management and wellbeing among those with endometriosis, and to inform additional research projects to address any evidence gaps identified by the review.Time Periods and Menstrual Time Travel: Sculpting the menstrual life course – community arts research for menstrual wellbeing, mental wellbeing and agency
Presenter: Chella Quint OBE
Affiliation: Sheffield Hallam University Lab4Living
Trauma-informed approaches to menstrual health recognise that menstrual memories can be emotionally loaded, unevenly accessible, and shaped by stigma, relationships, and the quality of information people had at the time. Across the menstrual span – from menarche through perimenopause, menopause and beyond – many people carry “menstrual span events” as isolated experiences rather than integrated parts of a life story. This paper presents findings from my PhD, Time Periods and Menstrual Time Travel, developed within Lab4Living (Sheffield Hallam University), a design-and-health research institute using art and design methods to address complex wellbeing challenges. Aim: To explore whether creating tangible menstrual timelines and integrating them with broader life-story timelines can support mental wellbeing during recall of past menstrual span events, and strengthen confidence, intergenerational empathy and agency when anticipating future transitions in multiple settings. Objectives: (1) Develop and refine a participatory, trauma-informed workshop method for “menstrual time travel” using material, creative timeline-making; (2) examine how participants narrate mood, wellbeing, stigma, support and agency around menstrual span events across life stages; (3) co-evaluate whether the method supports clearer communication and mutual support within families and communities. Methods: A series of facilitated workshops with intergenerational participants, including family/household groupings. Activities include constructing timeline sculptures using colour, texture and materiality; creating intertwined “life script” and menstrual timelines; and composing messages to past and future selves. As well as sitting within critical menstrual studies, the work is loosely informed by research on how humans emotionally relate to experience across time and memory, including Zimbardo’s Time Perspective Theory, Tulving’s mental time travel, the Remembering–Imagining System (Conway, Loveday & colleagues), and episodic future thinking (Atance & O’Neill). Trauma-informed practice is embedded throughout via opt-outs, non-verbal routes, pacing choices, accessibility adjustments, and careful closing/offboarding. Results: Participants co-designed the activity content by collaboratively selecting the menstrual span events to include and shaping the forms of creative response. This process generated community-facing outputs (reusable prompts, templates, and example artefacts) alongside research findings. Across life stages, participants prioritised specific menstrual span events and described how psychosocial and environmental contexts – stigma, education, relationships, and access to support – shaped menstrual and mental wellbeing. Post-workshop self-report measures indicated increased perceived menstrual literacy and communication confidence, stronger intergenerational understanding, and greater preparedness for future transitions. Outputs: The study produced a practical facilitation kit for community use, and a take-home family version designed for households to try the activity independently with other family members, supporting ongoing mutual support and conversation beyond the workshops.
To enroll or not to enroll: Investigating menstrual attitudes in Pakistani diaspora via willingness to enroll in Sex Education at Schools.
Presenter: Urooba Fatima
Affiliation: Department of Anthropology, University of Illinois Urbana Champaign
This project investigates how menstrual attitudes are developed in young people and the impact of menstrual concealment ideals in British-Pakistani diaspora. By conducting ethnographic research in the community, I aim to understand the mechanisms of knowledge production on menstrual health. Most menstruators access information about menstrual health through informal and/or formal modes of communication. The informal mode is through kinship networks such as parents (mostly mothers), cousins, friends etc. while the formal mode is accessing information via menstrual health curriculum in educational settings such as at schools. My project analyses these knowledge production mechanisms through a critical lens, that is, the type of information circulated within the kinship networks and the curriculum choices made at schools. Both of these informal and formal modes of communication come at a meeting point when schools seek parental consent to educate students on menstruation-related components at schools. Menstrual concealment appears in the Pakistani diaspora through several ways such as avoiding menstrual conversations in public/private gatherings and developing menstrual attitudes through menstrual concealment ideals. This complicates the communicative methodologies as several religious, cultural and personal belief systems engage within the analytical field to make an informed decision about access to menstrual health.
Trajectories of Depressive Symptoms Across the Menopause Transition : Findings From The Avon Longitudinal Study of Parents and Children (ALSPAC)
Presenter: Rochelle Knight
Affiliation: University of Bristol - Population Health Science
Objectives: To examine changes in depressive symptoms across midlife, spanning the reproductive period to postmenopause, and to assess the association between menopausal stages (reproductive period, perimenopause and postmenopause) and depression.
Methods: We analysed data from 2,036 women from a UK community-based pregnancy cohort, followed over three decades from the early 1990’s to early 2020’s. Depressive symptoms were assessed at up to 11 timepoints using the Edinburgh Postnatal Depression Scale (EPDS). Depression was defined as EPDS score ≥ 13. Linear mixed effects models were used to characterise trajectories of depressive symptoms across reproductive and chronological age, and to estimate associations between menopausal stages and depression, accounting for ethnicity, social class, age at menarche, educational attainment, material hardship, social support, smoking status, body mass index (BMI), and alcohol intake.
Results: The burden of depressive symptoms increased gradually with both reproductive and chronological age; however, there was little evidence of a marked increase in levels of depressive symptoms during the peri- or postmenopausal stages. Compared with the reproductive period, perimenopause was associated with higher odds of depression (OR 1.19; 95% CI 1.03 to 1.39), whereas there was no evidence of increased odds during postmenopause (OR 0.99; 95% CI 0.83 to 1.19).
Conclusion: Overall, reproductive ageing appears to contribute relatively little to long-term changes in depressive symptoms beyond the broader effects of chronological ageing. Although risk of depression was highest in the perimenopause, this appears transient and does not persist into postmenopause. Future research should determine whether there are subgroups of women who may be particularly vulnerable to increases in depressive symptoms during the menopause transition to better inform targeted prevention and support strategies.Trajectories of Menopausal Symptoms Among Working Women: A Longitudinal Analysis of a Three-Wave Cohort Study
Presenter: Miho Iida
Affiliation: Keio University School of Medicine, Department of Preventive Medicine and Public Health
Background: Menopause is increasingly recognised as an important issue for workplace wellbeing as more women remain in the workforce during midlife. Menopausal symptoms can affect physical health, psychological wellbeing, and work participation. However, longitudinal evidence on how menopausal symptom fluctuations relate to workplace functioning and wellbeing remains limited. Understanding these relationships is essential for developing evidence-based workplace strategies to support women during the menopausal transition. Aim/Objectives: To examine how menopausal symptoms and their fluctuations influence wellbeing and work functioning among working women. Methods: We conducted a longitudinal survey study among employed women in Japan aged 40–60 years. Participants completed web-based questionnaires approximately every three months. The study is designed as a five-wave longitudinal survey; the present analysis focuses on data collected up to Wave 3. Menopausal symptoms were assessed using the Menopause Rating Scale (MRS). Key outcomes included work functioning measured by a single-item self-rated work performance question (SPQ; 0–100%), work engagement assessed by the Utrecht Work Engagement Scale (UWES), and overall life satisfaction rated on a 0–10 scale. Psychosocial work and home demands were also assessed, including effort–reward imbalance (ERI) and work–family conflict. Participant identifiers enabled linkage of repeated responses across waves. We will describe trajectories and within-person fluctuations in MRS across the first three waves and evaluate their associations with concurrent and subsequent changes in work functioning and wellbeing using longitudinal regression models that account for repeated measures over time. Results: Data collection has been completed (N=348), and analyses are currently ongoing. Planned analyses will report the distribution and within-person variability of menopausal symptoms across the first three waves and examine associations between MRS levels and changes in SPQ, UWES, and life satisfaction. We will also explore whether psychosocial work stress and work–family conflict modify these associations. Conclusion: This study will provide longitudinal evidence on how menopausal symptom burden and symptom fluctuations relate to workplace wellbeing and work functioning among working women in Japan. The findings are expected to inform workplace strategies and supportive policies to promote women’s health and wellbeing during the menopausal transition.
Turning the Monthly Bleeding into A Monthly Liquid Biopsy
Presenter: Hilla Shaviv
Affiliation: CEO & Founder, Gals Bio Ltd
Co-authors: Prof. Lee Shulman - Northwestern University Dr. Amos Ber - Maccabi health centers
Background and Aim: Despite growing interest in menstrual blood as a source of clinically relevant biomarkers, its diagnostic potential remains largely untapped. A key barrier is the absence of an accessible, standardized collection method that is easy to use, hygienic, and capable of preserving sample integrity with minimal loss or contamination. This study presents TulipDx, a novel at-home menstrual collection and transport platform designed to enable reliable biomarker analysis from menstrual fluid. The aim is to statistically evaluate the usability, acceptability, and analytical validity of this system as a foundation for routine menstrual-based diagnostics.
Methods: TulipDx consists of a proprietary vaginal collection device (TulipOn) and a dedicated handling and transport component. TulipOn is designed for insertion via an applicator, positioning the device within the vaginal cavity where it collects menstrual fluid for up to 12 hours without interfering with daily activities, including physical and aquatic activity. A one-way valve mechanism preserves collected fluid after removal, minimizing sample loss and contamination. Following use, the device is placed into a sealed handling compartment that enables safe extraction and mailing of the sample to a laboratory. Tulipon usability and acceptability were assessed in a clinical study involving 156 participants. In parallel, an ex vivo study evaluated sample integrity following simulated transport conditions of up to 48 hours.
Results: User acceptability was high, with 90% of participants reporting Tulipon device to be equal or superior to their current menstrual products. The system demonstrated ease of use, cleanliness, and minimal user interaction. Laboratory evaluation confirmed that samples collected using TulipOn maintained sufficient integrity for downstream biomarker analyses after simulated mailing conditions. These findings support the feasibility of standardized, at-home menstrual fluid collection suitable for diagnostic applications.
Conclusion: TulipDx addresses a critical unmet need in menstrual health by providing a practical, user-friendly, and analytically robust method for menstrual fluid collection and transport. By enabling reliable sampling outside clinical settings, this platform establishes the groundwork for transforming menstrual bleeding into a routine, longitudinal liquid biopsy. Ongoing and future studies will focus on large-scale clinical validation and statistical assessment of diagnostic performance across relevant biomarkers.Understanding Early Menstrual Pain Through Lived Experience: An Interpretative Phenomenological Analysis of 538 Narratives from Portsmouth and Their Translation Into System-Level Action
Presenter: Jodie Hughes
Affiliation: Endometriosis South Coast
Aim To explore how individuals make sense of severe menstrual pain in adolescence, how adults responded to these experiences, and what forms of support participants believe would have enabled earlier recognition and intervention.
Objectives
To examine lived experiences of early menstrual pain and associated meaning-making.
To identify responses from parents, teachers, and healthcare professionals.
To assess the adequacy of menstrual health education and healthcare pathways.
To translate experiential findings into applied, system-level recommendations for policy, education, healthcare, and families.
Methods A mixed-methods community consultation was conducted with 538 individuals who grew up in Portsmouth and surrounding areas. Quantitative data captured age of symptom onset, pain severity, help-seeking behaviours, and diagnostic timelines using descriptive statistics. Qualitative narrative responses were analysed using Interpretative Phenomenological Analysis (IPA) to explore lived experience, relational dynamics, and sense-making processes surrounding menstruation and pain. Findings were mapped to current system opportunities, including PSHE 2025 reforms and the NHS Women’s Health Strategy, to inform applied outputs.
Results Six interrelated experiential themes were identified. (1) Early menstrual experiences were characterised by shame, stigma, and silence. (2) Severe pain was consistently normalised rather than investigated; 86% of respondents reported that no adult suggested their pain could indicate a medical condition. (3) Menstrual health education was inconsistent, superficial, or absent, with only four respondents reporting any education on menstrual health conditions. (4) Participants described feeling unsupported and dismissed by parents, teachers, and GPs. (5) Healthcare responses were frequently slow and minimised symptoms, often limited to prescribing contraception without explanation or investigation. (6) Long-term consequences were substantial, affecting education, employment, mental health, relationships, and personal autonomy. These findings directly informed four applied outcome reports: a local government policy report, a school-facing educational guidance report, a clinical guidance report for healthcare professionals, and a parent guidance report.
Conclusion This study demonstrates how the normalisation and dismissal of severe menstrual pain in adolescence contribute to delayed recognition and long-term harm. IPA enabled identification of clear, actionable points for early intervention. Translating findings into multi-audience reports provides a scalable, policy-aligned model for improving menstrual health recognition and support at a system-wide level.Understanding Socioeconomic Inequality in Menstrual Hygiene Practices: A Comparative Study of Six Low- and Middle-Income Countries
Presenter: Swayamsiddha
Affiliation: International Institute for Population Sciences (IIPS), Mumbai, India
Background: Menstrual hygiene management (MHM) is a critical yet neglected component of reproductive health that significantly impacts the well-being and empowerment of women in low- and middle-income countries (LMICs). Despite global efforts, approximately 500 million women lack adequate facilities, facing barriers rooted in socioeconomic disparities and cultural taboos Objectives: This study aims to examine socioeconomic inequalities in menstrual hygiene practices (MHP) across six low- and middle-income countries (LMICs) in Asia and Africa. Methods Data were sourced from the most recent Demographic and Health Survey (DHS) datasets for India, Nepal, Cambodia, Philippines, Kenya, and Tanzania, comprising a total sample of 280,769 women. MHP was treated as a dichotomous variable (hygienic vs. unhygienic). Statistical techniques included bivariate analysis and logistic regression. The Erreygers Normalized Concentration Index and Wagstaff Decomposition Analysis were employed to measure and explain socioeconomic-related inequality. Results Findings show substantial cross-country variation in MHP. Cambodia (98.5%), Philippines (98.6%), and Kenya (96.9%) reported high prevalence, whereas Tanzania (58.9%), India (78.2%), and Nepal (82.3%) showed lower adoption. Urban residence, higher education (≥10 years), and mass media exposure were consistently associated with better hygiene. All countries exhibited pro-rich inequality, with the highest concentration in Tanzania (CI = 0.491), followed by India (CI = 0.328) and Nepal (CI = 0.309). Conversely, the Philippines (CI = 0.032) and Cambodia (CI = 0.052) displayed the most equitable distributions. Decomposition analysis revealed that wealth status and education were the most significant contributors to the explained inequality. In India, education contributed to 20% of the inequality reduction, while in Nepal, the wealthiest class had the highest contribution (70%) to mitigating hygiene disparities. Improved household sanitation and water access were also significant predictors of hygienic practice across all surveyed regions. Conclusion: The study concludes that national economic development is not a universal predictor of menstrual hygiene uptake. Despite the existence of menstrual related policies, there is a substantial need for targeted interventions to reduce the rural-urban gap and wealth-based inequalities. The findings emphasize that improvement in education and mass media exposure are major pathways for enhancing menstrual hygiene practices. To reach the standards of more equitable countries like the Philippines and Cambodia, countries with high inequality must focus on reducing socioeconomic barriers and integrating hygiene education into broader developmental frameworks to fulfill the Sustainable Development Goals.
Understanding fertility tracking: An investigation into digital and non-digital technology use
Presenter: Alina Geampana
Affiliation: Department of Sociology, Durham University
Context and aims: For millions of people trying to conceive or contracept, tracking menstruation and fertility biomarkers is a necessity, whether app-based digital methods are used or not. Despite recent interest in high-tech digital fertility tracking, new commercial technologies come with a slew of risks, including misinformation, inaccuracy, and personal data misuse. Nonetheless, we know very little about alternative non-digital solutions and how they might compare. We also lack sufficient information about which tools and technologies users choose and why. Thus, the main aim of the research presented here was to better understand how individuals make tracking product choices and for what reasons.
Methods: Data were collected through in-depth interviews with UK-based users of both digital and non-digital technologies (N=30). Participants were recruited between November 2024 and August 2025. Sampling followed a maximum variation logic whereby diversity was sought in relation to tracking purpose, race and ethnicity, age, and type of technologies used. Using grounded theory analysis techniques in conjunction with NVivo software, the study mapped the varied range of menstruation and fertility tracking practices.
Findings: The findings highlight different approaches to tracking depending on purpose, data engagement styles and attitudes towards predictive technology. Specifically, the study identified four approaches to identifying fertile windows and cycle patterns: 1) rule-based tracking, 2) tool-based tracking, 3) personalised cross-check tracking and 4) intuitive pattern tracking. Each type outlined represents a distinct approach respondents used to make sense of biomarker data and their cycles.
Conclusion: The research contributes to increased knowledge of user practices and choices in a world where commercialised tracking options are more abundant than ever. With ‘Femtech’ now being touted as key to solving issues in women’s health, the presentation will conclude by highlighting future implications for the development of ethical and user-centred reproductive tracking tools.Unmet needs of high school menstruators from the menstrual equity perspective
Presenter: Kristen Upson
Affiliation: Michigan State University, College of Human Medicine, Department of Epidemiology and Biostatistics
Co-authors: Khushi Chhabra, Human Biology Program, College of Natural Science, Michigan State University. Harsna Chahal, Covenant HealthCare College of Medicine, Central Michigan University. Lucy Thompson, Department of Psychology, College of Social Science, Michigan State University
Research Aim: Access to menstrual products is vital for menstrual equity. A student-led advocacy group at a large, public university in the US Midwest, serving 51,838 students (80% undergraduate, 20% graduate) and 5,696 faculty/academic staff, worked with university leaders to adopt a policy to provide free menstrual products. The policy was implemented February 2023 with free pads and tampons provided in select women’s and gender-neutral bathrooms on the main university campus.
Objective: On a university campus, examine the impact of free menstrual products on menstrual management and wellbeing.
Methods: We conducted a cross-sectional study of current university students, staff, and faculty ages ≥18 years. A single, anonymous online survey with 40 questions was administered between November 2024 and March 2025. Survey questions focused on menstrual management on campus, including free product use and accessibility, and impact on campus-related activities and perceived support. Menstruators on campus both before and after February 2023 were asked about impact of free menstrual products on menstrual management.
Results: A total of 2,418 respondents experienced a menstrual period in the past year while on campus; 60%, 31%, and 9% were students, staff, and faculty, respectively, with a median age of 23 years (interquartile range 20-33 years). Over the prior year, 65% (n=1,467) reported not having any menstrual products with them to manage their menstrual period; 69% used the free menstrual products provided on campus, with more frequent use by students (74%) than non-students (62%). Furthermore, only 20% reported ever struggling in the past 12 months to obtain menstrual products, with the most common reasons being lack of store access to purchase menstrual products (62%) and financial struggles (52%). Most participants (77%) strongly agreed that having access to free menstrual products on campus made them feel supported. However, 43% reported needing menstrual products but none were available in the campus bathroom. Among individuals on campus both before and after February 2023 (n=1,244), many respondents agreed that free menstrual product availability helped with menstrual management (68%) and university attendance and participation (44%) and reduced the struggle to obtain menstrual products (57%).
Conclusion: In this university setting, experiencing a menstrual period and not having one’s own products on-hand is common, with free menstrual products being frequently used. While improvements are needed, including timely menstrual product restocking and expanding coverage to all campus bathrooms, free menstrual products helped with menstrual management, increased perceived community support, and promoted university engagement.Visual Representations of Menstruation in Contemporary India: Exploring Menstrual Stigma Across Media
Presenter: Valeria Giampietri
Affiliation: Sapienza University of Rome / Antwerpen University
In contemporary India, menstruation remains widely framed as impure and polluting, leading to the systemic exclusion of menstruating bodies from religious, social, and domestic spheres. This study investigates how such stigma is represented and reinforced through visual culture, focusing on contemporary art, short films, social media content, and materials produced and used in activist contexts. The research examines the mechanisms through which visual media perpetuate menstrual stigma, with particular emphasis on how prescriptive religious texts are reinterpreted to validate modern restrictions. Objectives include identifying recurring themes and symbols, analyzing their manifestation across media, and exploring the historical, cultural, and socio-religious contexts that inform these representations.
Drawing on qualitative methods, including ethnography and the visual analysis of selected materials, the research shows that menstrual stigma is reinforced through symbolism, narrative framing, ritualized depictions of impurity, and culturally coded textual references. The analysis also considers how social media amplifies traditional taboos and how activist interventions seek to challenge these narratives through creative visual strategies.
The findings demonstrate that stigma persists across both institutional and everyday visual cultures, often subtly reinforced through aesthetic, narrative, and textual mechanisms that marginalize menstruating bodies. By integrating visual, textual, and ethnographic perspectives, this study contributes to a broader understanding of how visuality shapes bodily experience, thereby offering a critical framework with which to analyze the intersection of media, gender, and the body in the Indian context.What if Ambivalence Towards Religion Prevents Learning from Alternative Menstrual Healths? Considering Menstrual Practices of Hindu Women
Presenter: Daphnée Dion-Carrier
Affiliation: Faculté de théologie et de sciences religieuses, Université Laval
As part of a Ph.D. in Religious Studies at the Faculté de théologie et de sciences religieuses, at the Université Laval (Quebec), two research trips were carried out in South Asia (2024, 2025) to gather information on women’s menstrual practices. The project involves more than 75 Indian Hindu women aged 18 to over 90, mostly from Varanasi in northeastern India, many of whom come from underprivileged backgrounds. Meeting additional Hindu women in Bajura—in the far northwest of Nepal—also enriched the research materials. These field sites will serve as the groundwork for discussing the consequences of the ambivalence towards religion as exemplified through normative definition of menstrual health from global and developmental perspectives (i.e., McAllister and al. 2025; Hennegan and al. 2021).
This communication argues that the reduction of menstrual stigma and taboos will remain inefficient if this effort, often implicitly, is a battle against religious tradition. In an article published in 2025, social and policy science scholars, Mcallister and al. ask where menstruation fits into global health policy. The silence surrounding menstrual disorders and menopausal women, gender non-conforming people, and the lack of discussion on environmental concerns are deplored, but religion as a structuring value system for some people is nowhere to be found in this international relations’ approach. When religion is included in the discussion, such as social and health scientists Ottsen and al. (2026) are doing when considering menstrual stigma and intervention for combatting it in India, for a religious studies scholar, some problems are clear; a) religion is brought into the discussion because it is “India,” which is seen as a country imbued with religion, meaning some intersectional bias and coloniality remain embedded in research patterns b) cultural representation and practices around menstruation are attributed to Hinduism with little regard for the religious diversity b) religious norms are seen as perpetuating cycles of inequality regardless of how persons, mostly women, make sense and choices from them c) data remain sparse and misunderstood. Bringing these normative attempts around menstruation in relation with lived experiences of the research participants demonstrates how the blind spot around religion does not allow for the inclusion of locally produced knowledge on menstrual health.
Hennegan, J., I. T. Winkler, C. Bobel, D. Keiser, J. Hampton, G. Larsson, V. Chandra-Mouli, M. Plesons, and T. Mahon. 2021. ‘Menstrual Health: A Definition for Policy, Practice, and Research.’ Sexual and Reproductive Health Matters 29(1):31–38. McAllister, J., Amery, F., Channon, M., and Thomson, J. 2025. ‘Where Is Menstruation in Global Health Policy? The Need for a Collective Understanding.’ Global Public Health 20(1):1–15. Ottsen, P., A. Mellor, C. Benoit, and Z. Premji. 2026. ‘Addressing Menstrual Stigma: A Scoping Review on Menstrual Health Interventions in India.’ Social Sciences 15(96):25 pages.When the Researcher Feels: Reflexivity and Menstrual Taboos in Rural India
Presenter: Debashree Tripathy
Affiliation: Indian Institute of Technology Roorkee and Department of Humanities and Social Sciences
Menstruation and menstrual taboos among reproductive-age women have been studied in various contexts across the globe. The experience of menstruation is considered personal and embodied, and menstrual-related symptoms (MRSs), even today is expected to be kept concealed. The menstrual taboos influence the way menstrual-related symptoms (MRSs) are managed in a rural context and are a public issue that needs academic attention. As a female researcher, conducting field research in the study area poses challenges because of societal expectations to conceal the phenomena rather than discuss them in a rural location. In a field situation, the researcher’s perception, positionality, and the researcher-respondent relationship shape the quality of field research. The researcher’s field encounters are intertwined with the respondent’s life experiences, which they communicate through emotions, making this researcher-respondent binary blurred. The emotions that a respondent conveys and a researcher feels are shaped by the intersubjectivity between them. As a researcher, I highlight the social construction and lived realities of differences, as they manifest in the researcher’s body. It is to be noted that no study can be absolutely free of bias and will be affected by the researcher’s own experiences and personality. However, these impacts can be carefully addressed by using reflexivity as a research vehicle to navigate the issue of the researcher’s and the respondent’s involvement and detachment. The literature has consistently focused on patients’ illness experiences and has paid less attention to how researchers with morbidities understand their own bodies in health research. Therefore, the present study through a qualitative in-depth semi-structured interview attempts to study the dual influence a researcher deals by confirming to the (mis) recognized identity and in turn the impact that the field experiences which shaped the researcher’s experiences while conducting interviews with the young adult women who attempt to negotiate the menstrual taboos and access the healthcare facilities for managing their menstrual-related symptoms (MRSs) in a village in Uttarakhand, India. Keywords: (mis)recognized identity; researcher positionality; reflexivity; menstrual taboos; menstrual-related symptoms (MRSs)
Where Mental and Hormonal Health Meet: Improving Women’s Health Care in Psychiatric Inpatients
Presenter: Hannah Kelso
Affiliation: Avon & Wiltshire Mental Health Partnership NHS Trust
Co-authors: Dr Grace Denton; Dr Alexandra Thatcher; Dr Bridget Martin; Dr Sophie Hickling (all Avon & Wiltshire Mental Health Partnership NHS Trust)
Aims There is growing awareness of the complex bidirectional interactions between hormonal and mental health, with fluctuations across the menstrual cycle, perimenopause and menopause influencing the onset, severity and course of psychiatric illness. Despite this, reproductive health is often poorly assessed and documented in psychiatric inpatient settings. An initial audit across multiple inpatient wards across the trust demonstrated a substantial deficit in the identification and documentation of reproductive health information. Our trust policy recommends that women are asked within 24 hours of admission about menstrual problems, menopause and breastfeeding; however, discussing these sensitive issues is often inappropriate or overlooked during acute psychiatric admissions. In this ongoing quality improvement project (QIP) we aim to increase awareness and detection of women’s health problems in female psychiatric inpatients using a trauma-informed approach led by trained nursing staff. We hypothesised that shifting responsibility from early medical clerking to appropriately timed nurse-led conversations would be more acceptable and feasible, while improving identification of clinically relevant issues.
Methods The QIP intervention was initiated on a single 15-bed female acute psychiatric ward. Nurses with additional training in women’s health were designated as Women’s Health Champions (WHCs). Their role included offering one-to-one conversations with service users when clinically appropriate, running twice-monthly educational groups, providing written information on the ward and escalating concerns to the medical team. The first Plan-Do-Study-Act (PDSA) cycle focused on assessing feasibility and uptake of one-to-one conversations over a three-week period, alongside qualitative identification of implementation challenges.
Results During the first QIP cycle, 7 of 15 service users were deemed well enough to participate in a one-to-one women’s health conversation. Three service users were offered a conversation over three weeks; two engaged in brief discussions. Barriers identified included limited nursing time, fluctuating mental state of service users and uncertainty around documentation and information-sharing. Key process issues to be addressed in future cycles: the need for thorough documentation to avoid missing ‘red flags’; obtaining explicit consent to share information with the medical team, and documenting whether a service user is well enough to participate.
Conclusions Early findings suggest that a nurse-led, trauma-informed model for addressing women’s health in psychiatric inpatients is feasible but constrained by acuity and resource limitations. While uptake was limited, the project identified clear, actionable system changes to support safer and more consistent practice. These results support revising existing policy to prioritise timing, consent and documentation rather than rigid early-admission targets.Working through Menopause: Time-Poverty and Workplaces as ‘Masculine’
Presenter: Anjali Kurup
Working Through Menopause: Time-Poverty and Workplaces as ‘Masculine’ Anjali Kurup
Aim
This paper aims to examine how the nature of work and socio-economic background shape the menopause experience of working women. The study investigates how the demands of paid employment, domestic labour, and workplace expectations influence women’s abilities to navigate menopause in their everyday lives. The paper seeks to situate menopause within the broader intersection of gender, work, and health, highlighting it as a socially embedded experience rather than solely a biological transition.
Objectives
The objectives of this paper are to:
Examine how time-poverty structures the everyday experiences of menopause and work. Analyse how socio-economic backgrounds shape access to rest and care during menopause. Explore how workplace environments and gendered expectations influence the visibility or invisibility of menopausal bodies at work.
Methods
The paper draws on qualitative research conducted in Delhi, India, using in-depth, semi-structured interviews to explore women’s lived experiences of menopause in relation to work. A total of 20 women aged 47-56 were interviewed across formal and informal work sectors, including domestic workers, vegetable vendors, childcare workers, NGO employees, corporate workers, and government employees. Participants were recruited through snowball sampling and an NGO network. The interviews were between 30-60 minutes, and were conducted in Hindi and English in participants’ workplaces, homes, or by phone, and were supplemented with observations and post-interview reflections.
Results
The findings of the study show that time-poverty is a key factor shaping women’s experiences of menopause. Women across socio-economic groups balance paid employment and unpaid domestic responsibilities; however, their economic status mediates their capacity to manage menopausal symptoms at work. Women from higher socio-economic backgrounds often relied on domestic workers to share the household responsibilities. In contrast, women working in informal sectors faced long working hours and limited flexibility, leaving little time for rest, nutrition, or medical care despite experiencing difficulties such as fatigue, joint pain, and other symptoms. The findings also revealed how workplaces operate through masculine norms of productivity that render bodily needs invisible. As a result, women often manage symptoms privately and avoid discussing them or showing any discomfort at work.
Conclusion
The study highlights menopause as a socially structured experience, and demonstrates how it is co-produced through the interaction of biological and social forces.‘It’s Not Just Part of Being a Woman’: Developing Tools to Transform Family Conversations About Menstrual Health
Presenter: Rebecca Anthony
Affiliation: Cardiff University
Co-authors: Robyn Jackowich Cardiff University Hayley Reed Cardiff University Jacky Boivin Cardiff University Richard Morey Cardiff University Honor Young Cardiff University
Menstrual health disorders, including dysmenorrhea, endometriosis and polycystic ovary syndrome, affect a large proportion of adolescents, yet help‑seeking remains extremely low. Only around 11% of young people experiencing severe period pain consult healthcare services, with evidence suggesting that poor family communication, symptom normalisation and limited health literacy contribute to delayed diagnosis and unmet need. Existing interventions largely target young people alone, leaving a significant gap in family‑centred approaches that could support earlier recognition of symptoms and timely access to care.
Our study aims to co‑develop an evidence‑based, culturally responsive intervention to improve communication about menstrual health within families and with healthcare professionals.
The objectives are to: (1) understand the extent and patterning of help‑seeking for severe period pain among young people; (2) test hypotheses regarding how household menstrual health history influences help‑seeking behaviours; (3) identify modifiable familial, cultural and systemic barriers and facilitators to support‑seeking; (4) co‑design the intervention through participatory engagement with young people, families, healthcare professionals and community organisations; (5) develop a prototype intervention including content, format and delivery model; and (6) refine and prioritise components using stakeholder feedback.
This mixed‑methods study follows the INDEX and 6SQuID intervention development frameworks. Quantitative analyses will use the School Health and Wellbeing (SHW) survey linked to healthcare records via the SAIL databank to examine who seeks help, outcomes of consultations and disparities by ethnicity, socioeconomic status and gender diversity. Additional linkage with household data will allow exploration of whether familial menstrual health history influences help‑seeking. Secondary qualitative analysis of 150+ interviews from the Severe Period Pain Is Not Normal (SPPINN) study, alongside a rapid review of the literature, will identify modifiable social and familial mechanisms influencing support‑seeking. Two rounds of participatory focus groups will support co‑design and refinement of the intervention. Results are forthcoming as analyses and focus groups are ongoing.
The anticipated outcome is a co‑produced, theory‑informed intervention addressing modifiable barriers such as stigma, communication gaps, lack of knowledge and challenges navigating healthcare. The project will generate a fully specified prototype ready for feasibility testing and aligned with Welsh Government and UK priorities on menstrual health and period dignity. Ultimately, the intervention aims to support earlier diagnosis, reduce unmet need and improve wellbeing among young people experiencing menstrual health issues.‘Painful Menstruation isn’t Okay’: Narratives of Women with Endometriosis from Urban India
Presenter: Dr Bijoya Roy
Affiliation: Centre for Women’s Development Studies, New Delhi
Co-authors: Deepika Pandey, Research Consultant, Centre for Women’s Development Studies, New Delhi; Dr Sreeparna Chattopadhyay, Associate Professor at the Manipal Law School (India) & Senior Fellow, College for Social Sciences And Humanities, UA Ruhr; and Sayanti Majumdar, Research Consultant, Centre for Women’s Development Studies, New Delhi
Painful menstruation/ dysmenorrhea affects a significant proportion of adolescent girls and women of reproductive age, coinciding with their educational and working years. Despite its prevalence, menstrual pain is often considered normal and inevitable. Menstrual health history is increasingly recognised as a significant factor in women’s health assessment and disease research (McCartney 2016). However, routine dismissal of painful menstruation warrants analysis as it significantly impacts the lives of adolescent girls and women by invisibilising suffering. This paper aims to recognise painful menstruation as a legitimate health concern and push the discourse beyond menstrual hygiene to include physical care and psychosocial support.
Research questions: How does the persistent trivialization of menstrual pain contribute to the invisibility of dysmenorrhea? What impact does it have on menstruating bodies and mental and emotional health? How can families, educational institutions, and medical communities better understand and provide care?
Method: This paper draws on the narratives of 24 women whose painful menstruation in adolescence remained unheard, unattended and dismissed before their diagnosis of endometriosis across cities in India. We have used snowball sampling and feminist interviewing techniques. Their early experiences of dysmenorrhea were trivialised by their social milieu – families, schools and healthcare providers.
Findings: Women as young adolescents had to conceal their painful menstruation due to shame, stigma and the widespread belief that everyone experiences it and must simply be endured till menopause. Marriage and pregnancy are frequently suggested as cures. As adolescents, respondents describe their menstruation as difficult, physically draining, emotionally isolating and yet consistently normalised.
Medical consultation during the adolescent years was far and few. Those who consulted were either not believed or labelled as “attention-seekers”. This neglect of menstrual pain indicates the medical community’s normalization of period pain, their lack of knowledge and understanding of dysmenorrhea and endometriosis. Overall, menstrual care was limited, and adolescents were gaslighted by their doctors. Schools also considered pain as an inevitable part of menstruation and lacked the capacity to provide psychosocial support.
Conclusion: These narratives highlight the need to prioritise adolescent experiences of severe menstrual pain. They reveal how patriarchal norms, discrimination and institutional neglect control menstruating bodies and demonstrate that families, schools and the medical community need a better understanding of menstruation and dysmenorrhea. The paper argues for better menstrual education and recognising dysmenorrhea as a serious health concern so that painful menstruation is acknowledged as ‘real’ and not trivialized and overlooked.“Advancing Menstrual Equity in Cameroon and beyond: Expanding Access to Reusable and Disposable Pads and a Stigma-Reducing Digital Platform”
Presenter: Mandenge Nchang Glenys
Affiliation: Institution: EveryLady Initiative, Cameroon Department: Menstrual Health Research & Social Entrepreneurship
Menstrual health inequity continues to limit the educational participation, health, and dignity of adolescent girls and young women in Cameroon and beyond, particularly in low-resource communities. Barriers like the high cost of menstrual products, limited menstrual health management (MHM) education, and persistent stigma and cultural taboos contribute to unsafe menstrual practices causing infections, school absenteeism, and reduced self-confidence. Despite growing global attention to menstrual equity, locally driven and context-specific solutions in underrepresented regions such as Cameroon remain insufficiently documented.
This community-based research project aims to evaluate an integrated menstrual health intervention combining access to reusable and disposable sanitary pads, menstrual health education, and a stigma-reduction digital platform. The objectives are: (1) to identify structural and economic barriers to menstrual product accessibility; (2) to assess the acceptability and usability of reusable and disposable menstrual products among adolescent girls and young women; and (3) to examine the potential of digital peer support in reducing menstrual stigma and improving menstrual confidence and health management.
Using a mixed-methods approach, data were collected through structured questionnaires, focus group discussions, and participant observation during menstrual care pack distribution and educational outreach in Buea, Cameroon. In parallel, I am working on introducing a pilot digital platform to enable sharing of menstrual experiences, peer support, and access to accurate menstrual health information. Preliminary findings suggest that affordability and stigma remain the most significant barriers to safe menstrual health management. Participants reported increased confidence, improved menstrual preparedness, and reduced feelings of isolation when provided with both product options and access to supportive peer dialogue through the digital platform. Data collection and expanded platform testing are ongoing.
This research highlights the critical importance of integrated, locally led menstrual health solutions that combine product accessibility, education, and safe digital spaces. By presenting evidence from an underrepresented low-resource context, this study contributes to global menstrual health research and demonstrates the potential for scalable, community-driven interventions to advance menstrual equity. Participation in this conference will enable further knowledge exchange, strengthen research capacity, and support the development of sustainable menstrual health solutions in Cameroon and similar settings.“Don’t be scared.” How community clubs could better support adolescent menstrual health with physical activity: realist inquiry
Presenter: Dr Cara Thomas
Affiliation: Division of Population Medicine, Cardiff University
Co-authors: Dr Alison Cooper - first author - Division of Population Health, Cardiff University Dr Ainah Mahaiyuddin - Division of Population Health, Cardiff University Professor Jacky Boivin -Women’s Health Research Wales and School of Psychology, Cardiff University Professor Adrian Edwards - Division of Population Health, Cardiff University
Aim/Objectives Menstrual (period related) symptoms are a known barrier to adolescents engaging in physical activity. Our aim was to refine initial programme theories developed from a rapid realist review describing how menstrual health support interventions (education; facilities, clothing and free accessible period products; menstrual cycle tracking and screening tools; and medical support if needed) could improve menstrual health confidence and understanding, communication and trust - to empower individuals to enhance their own menstrual health and potentially improve participation rates and performance in physical activity.
Methods Realist methodology was used to test and refine initial programme theories (context-mechanism-outcome configurations, CMOs) structured within self-determination theory constructs (competence, relatedness, autonomy) with qualitative data. Cardiff University gave ethical approval. Interview participants were recruited from a short qualitative online survey targeted at adult leaders from community clubs involving physical activity (September–November 2025). Young people were recruited through the adult leaders. Semi-structured realist interviews were conducted online or in person individually or in small groups (n=2/3) according to preference, and by visiting a community centre in a diverse community. Interviews were conducted October 2025-January 2026 and transcribed, anonymised and imported into NVIVO15 for analysis. Explanatory data accounts were extracted as ‘if-then-because’ statements for CMO refining. 53% (8/15) transcripts were double-coded with findings discussed in weekly team meetings February–March 2026.
Results (analysis to be completed May 2026) There were 21 survey respondents (n=20 female, n=1 male; n=20 White Caucasian, n=1 Asian; n=10 water sports activities, n=5 outdoor activities) with rich data and 19 participants interviewed (n=9 adults, n=10 adolescents; n= 10 diverse communities, n=9 White Caucasian). Preliminary results describe how tailored menstrual health education and support resources are needed in different settings (land-based activity, water-based activity, remote outdoor activities) and for different population groups (e.g. diverse communities, performance athletes). Context specific advice is needed on how menstrual health education is delivered within clubs including boys, men and wider families and how to encourage role models and peer support to enable communication in safe spaces. Programme theories describe how these and menstrual health support tools can improve individuals’ self-awareness, allow them to understand options, and empower adolescents to make individual decisions about how best to manage their own menstrual health with physical activity.
Conclusion Our refined programme theories describe how community clubs could adapt existing interventions to their context to better support menstrual health. Interventions developed from these programme theories need robust evaluation.“Don’t be scared.” How community clubs could better support adolescent menstrual health with physical activity: realist inquiry.
Presenter: Cara Thomas
Affiliation: Division of Population Medicine, Cardiff University
Co-authors: Dr Alison Cooper - first author - Division of Population Health, Cardiff University Dr Ainah Mahaiyuddin - Division of Population Health, Cardiff University Professor Jacky Boivin -Women’s Health Research Wales and School of Psychology, Cardiff University Professor Adrian Edwards - Division of Population Health, Cardiff University
Aim/Objectives Menstrual (period related) symptoms are a known barrier to adolescents engaging in physical activity. Our aim was to refine initial programme theories developed from a rapid realist review describing how menstrual health support interventions (education; facilities, clothing and free accessible period products; menstrual cycle tracking and screening tools; and medical support if needed) could improve menstrual health confidence and understanding, communication and trust - to empower individuals to enhance their own menstrual health and potentially improve participation rates and performance in physical activity.
Methods Realist methodology was used to test and refine initial programme theories (context-mechanism-outcome configurations, CMOs) structured within self-determination theory constructs (competence, relatedness, autonomy) with qualitative data. Cardiff University gave ethical approval. Interview participants were recruited from a short qualitative online survey targeted at adult leaders from community clubs involving physical activity (September–November 2025). Young people were recruited through the adult leaders. Semi-structured realist interviews were conducted online or in person individually or in small groups (n=2/3) according to preference, and by visiting a community centre in a diverse community. Interviews were conducted October 2025-January 2026 and transcribed, anonymised and imported into NVIVO15 for analysis. Explanatory data accounts were extracted as ‘if-then-because’ statements for CMO refining. 53% (8/15) transcripts were double-coded with findings discussed in weekly team meetings February–March 2026.
Results (analysis to be completed May 2026) There were 21 survey respondents (n=20 female, n=1 male; n=20 White Caucasian, n=1 Asian; n=10 water sports activities, n=5 outdoor activities) with rich data and 19 participants interviewed (n=9 adults, n=10 adolescents; n= 10 diverse communities, n=9 White Caucasian). Preliminary results describe how tailored menstrual health education and support resources are needed in different settings (land-based activity, water-based activity, remote outdoor activities) and for different population groups (e.g. diverse communities, performance athletes). Context specific advice is needed on how menstrual health education is delivered within clubs including boys, men and wider families and how to encourage role models and peer support to enable communication in safe spaces. Programme theories describe how these and menstrual health support tools can improve individuals’ self-awareness, allow them to understand options, and empower adolescents to make individual decisions about how best to manage their own menstrual health with physical activity.
Conclusion Our refined programme theories describe how community clubs could adapt existing interventions to their context to better support menstrual health. Interventions developed from these programme theories need robust evaluation.“During a pandemic, my concerns about my periods seemed frivolous”: seeking menstrual health support during the pandemic
Presenter: Dr Gemma Williams
Affiliation: Birmingham City University, School of Life & Health Sciences
Aims: The Covid-19 pandemic exacerbated existing gendered health inequalities, including menstrual inequality. Using critical and feminist theories, this study seeks to understand the how the pandemic influenced menstrual management decisions and menstrual health support-seeking behaviours during lockdown in the UK.
Methods: A mixed methods design was utilised to gather data on the experiences of those needing menstrual health support during the pandemic in the UK, employing an open-ended online survey (n=240) and semi-structured telephone interviews (n=4). Data was collected in 2021, covering several different pandemic lockdown periods across the UK.
Results: Reflexive thematic analysis and descriptive statistics were combined to provide insight to menstrual health experiences during the pandemic, with participants seeking to understand their menstrual cycle changes and how best to manage menstruation during lockdown. Menstrual management and help-seeking decisions were influenced by menstrual cycle changes, menstrual stigma, and Covid-19 disease-prevention measures which impacted the accessibility of menstrual products and menstrual healthcare.
Conclusion: The findings illustrates how existing pre-pandemic inequalities, including poverty, gender and menstrual stigma, intersect with pandemic-related factors to further increase menstrual inequality across the UK.“I Feel Everything All of the Time”: A Mixed-Methods Analysis of Autistic Menstrual Experiences
Presenter: Dr Sophie Hodgetts
Affiliation: Durham University, Psychology Department
Co-authors: Miss Aarushi Kalsi (Durham University) Dr Amy Pearson (Durham University) Dr Monique Botha (Durham University)
Aim: The androcentric bias in autism research has resulted in the experiences of autistic women and those assigned female at birth (AFAB) often going unexplored, particularly in areas like menstrual health. Sensory sensitivities, emotional dysregulation, and increased rates of conditions like premenstrual dysphoric disorder (PMDD) suggest that autistic individuals may experience menstruation differently from their non-autistic peers. However, research in this area remains limited, often relying on caregiver reports rather than self-reported experiences. Additionally, menstrual health education and healthcare services frequently fail to accommodate autistic needs, exacerbating distress. Objective: This study adopted a neurodiversity-affirming framework and a mixed-methods approach to explore the relationship between sensory processing, menstruation, and mental health in autistic individuals. We also considered the impact of PMDD in both autistic and non-autistic particants. We expected to find significant differences in the experiences of sensory sensitivities, mental health outcomes (such as anxiety, depression, and quality of life), and menstruation between autistic and non-autistic individuals. Method: The quantitative portion of our study used an online survey to measure sensory processing differences, premenstrual symptoms, mental health, and quality of life in autistic and non-autistic menstruators. Autistic participants for the qualitative phase were selected from the quantitative sample. The qualitiative portion of the study involved semi-structured interviews, analysed using Interpretative Phenomenological Analysis. Results: Quantitative results revealed that autistic participants experienced significantly higher sensory sensitivities, heightened emotional distress, and lower quality of life related to menstruation compared to their allistic peers. The qualitative study revealed key themes concerning the role of sensory overload, emotional dysregulation, and the struggle for control in shaping autistic menstrual experiences. Conclusion: These findings highlight the need to centre autistic voices in menstrual health education, support, and research. Prioritising lived experiences can lead to more inclusive healthcare practices and reduce disparities in care.
“If we raise our voice, society will get angry”: Adolescent Boys’ Understanding and Perceptions of menstruation in Nepal
Presenter: Minakshi Dahal
Affiliation: University of Bath
Background: Menstruation is rarely discussed with men and boys, particularly in LMICs, where it is surrounded by socio-cultural taboos. Adolescent boys can be an important stakeholder in dismantling discriminatory menstrual practices and making menstrual experiences of adolescent girls better. This study aims to explore adolescent boys’ current understanding and perception of menstruation in Nepal and explore their potential roles in supporting adolescent girls. Methods: A qualitative exploratory study was conducted in two municipalities in Surkhet district in Nepal. Six focus group discussions were carried out with 51 boys aged 13-18 years. Data were analysed using reflexive thematic analysis. Results: Three key themes were generated. 1) Fragmented and stigmatised knowledge- Boys’ understanding of menstruation was inadequate and fragmented, shaped by systemic ignorance. Their first information about menstruation at home centred on restrictions. School further reinforced stigma where lessons were either skipped or taught superficially. 2) At the crossroads: Negotiating traditions and fears- Boys expressed a mixed reaction towards menstrual restrictions. A minority accepted these restrictions, some seemed to struggle to decide their position, while others explicitly rejected them. Boys were thinking critically about these restrictions and even questioning the rationales provided. 3) Empowered in words, paralyzed in actions- Adolescent boys were conscious of the effects of menstrual practices in girls and were empathetic towards them, and wanted to help. However, almost none had raised a voice against these. They were scared of the elders’ reactions and also considered that individual voices don’t matter. Conclusion: Adolescent boys’ awareness of the impacts of menstrual restrictions and their desire to support suggest they can be agents for transforming menstrual norms. Targeted interventions such as accurate, inclusive menstrual education and creation of supportive spaces and role models for open dialogue would help them to engage actively in dismantling harmful menstrual norms in Nepal.
“Our Voice - Transforming Lives through Chhaupadi (Menstrual Seclusion) Ending”: Integrating Human-Centered Design, Arts-Based Research, and Intervention Mapping to Co-design an Intervention to Reduce Menstrual Harms in Nepal
Presenter: Sara E. Baumann
Affiliation: University of Pittsburgh, Department of Behavioral and Community Health Sciences
Background Menstrual stigma and inequalities continue to undermine menstrual dignity in many parts of Nepal, particularly through the persistence of chhaupadi—a menstrual seclusion practice rooted in social and religious norms. Despite policies criminalizing the practice and multiple programmatic interventions, chhaupadi remains, exposing menstruators to significant physical, psychological, and social harms. To date, no study has systematically examined which intervention components are most effective in addressing menstrual stigma and advancing dignity. This study aims to synthesize programmatic evidence to understand how chhaupadi interventions work, for whom, in which contexts, and why.
Objectives 1. To identify the contextual factors influencing menstrual seclusion intervention success; 2. To examine the mechanisms through which programs address menstrual stigma and inequality; 3. To generate actionable insights to strengthen menstrual dignity–focused programming.
Methods Using a Realist Synthesis (RS) approach, we analyzed scientific and grey literature alongside program documents, multimedia materials, and interview transcripts from consultations with program experts, implementers, and community members in Nepal. Data were examined through context–mechanism–outcome (CMO) configurations to identify how interventions produce change under specific social, cultural, and structural conditions.
Results: Three key preliminary findings emerged. First, multi-level stakeholder engagement—combining policy enforcement with grassroots and household-level dialogue—was critical to shifting deeply embedded stigma. Second, knowledge and behavior change strategies varied in effectiveness by context; while external messengers sometimes disrupted entrenched norms, trusted insiders were essential for sustained shifts in beliefs and practices. Importantly, education alone was insufficient without addressing social power dynamics and structural inequality. Third, male engagement and inclusive approaches were pivotal for advancing menstrual dignity, with experts highlighting the need to better integrate people with disabilities and LGBTIQ+ individuals into programming.
Conclusion: Advancing menstrual dignity in Nepal requires interventions that move beyond criminalization and awareness-raising to address stigma, gendered power relations, and structural inequalities. The findings are expected to provide program planners, researchers, and policy makers a strong conceptual grounding to design subsequent, contextually appropriate and evidence-informed menstrual health programs in a range of settings across Nepal.“Society will scold her”: Perceived consequences for refusing to comply with menstrual restrictions in Mugu District, Nepal
Presenter: Josephine McAllister
Affiliation: Department of Social & Policy Sciences, University of Bath
Menstrual restrictions in Nepal are associated with long held religious and cultural beliefs of menstrual impurity and can have serious negative impacts on the health and wellbeing of those who menstruate. Restrictions include the dangerous chhaupadi practice where menstruators are forced to sleep away from home in a menstrual hut or outside. Forcing someone to practice chhaupadi became punishable by law in 2017 and drives have taken place to destroy menstrual huts. However, in some contexts, this has resulted in adverse effects as poorer quality menstrual huts have been reintroduced increasing menstruators’ vulnerability.
To better understand the factors that sustain menstrual restrictions, we conducted focus group discussions with adolescent girls and adult women in Mugu District, a rural, mountainous area in Nepal’s Mid-Western Region. We asked participants about their experiences of menstrual restrictions and what they thought would happen if girls decided to stop practising them.
Initial analysis indicates that menstrual restrictions including chhaupadi are prevalent in Mugu and negative impact girls’ health and rights. Many girls want restrictions to end, highlighting how personal attitudes conflict with socials norms. We found that the threat of sanctions from family members, the community and the Gods contribute to ensuring that girls continue following menstrual restrictions. Participants believe that they will be publicly cursed and shamed by community members if girls stopped complying with them. Furthermore, they believe that Gods will become angry, and this could be detrimental to girls’ health, as well as the wellbeing of their families and community.
Participants indicated that girls with support from their family members to stop restrictions may face fewer sanctions from the community. However, community members may blame girls’ parents for teaching their daughters incorrectly and sanction them by refusing to visit them or share their food. This could discourage family members from supporting girls to disrupt harmful social norms. Consequently, girls continue practising menstrual restrictions to avoid shame, to protect their family’s reputation and to minimise misfortune.
This research illustrates how perceived consequences for refusing to follow menstrual restrictions contribute to sustaining harmful social norms, even when personal attitudes are in opposition. The threat of sanctions for both girls and their families prevents them from complying with chhaupadi law and illustrates the need for interventions that go beyond blanket bans to effectively address social norms. It also highlights how the involvement and support of influential people in the community could encourage change and support girls have safe and positive menstrual experiences.“The algorithm determines my fertility status”: The language of algorithmic authority on digital contraceptive apps
Presenter: Hannah Westwood
Affiliation: University of Glasgow, School of Critical Studies
This presentation investigates the language used to characterise “the algorithm” on the digital contraceptive app Natural Cycles and its social media advertisements. I contend that it is necessary to pay attention to how algorithms are characterised in reproductive tracking apps, as these technologies intervene on how we manage and view a ‘healthy’ reproductive body. I ask: (1) how does the Natural Cycles app use AI?; and (2) how does the Natural Cycles app and marketing position “the algorithm”, and to what effect? To answer these questions, I draw on data collected from a year-long walkthrough (Light et al., 2018) of the Natural Cycles app, and an analysis of its influencer advertisements on Instagram. Overall, I show how the characterisation of the algorithm is used to lend the product legitimacy and scientific authority.
Natural Cycles harnesses AI in the form of a machine-learning algorithm that uses temperature data from previous menstrual cycles to predict ovulation. However, the Natural Cycles algorithm is proprietary, and therefore it remains unclear exactly how fertility status is calculated (Freis et al., 2018). Its website claims that the app is between 93% and 98% effective, and that “the algorithm” does not produce outputs it is not confident in. Nonetheless, there have been several reports and countless personal testimonies of the app failing (e.g. Sudjic, 2018; McEvinney, 2023).
Both the influencer advertisements and Natural Cycles app use the language of “the algorithm” to lend legitimacy and authority to its fertility outputs. In the 46 adverts analysed, messaging about the algorithm remained similar, with each caption sharing a variation on the following: ‘the algorithm analyses hormone-driven temperature fluctuations in order to confirm fertility status’. Some posts took this a step further, claiming that the algorithm ‘determines’ their fertility status. Meanwhile, daily use of the app during the walkthrough revealed continual messaging about the algorithm. This included encouraging the user to add more data so the algorithm can ‘get to know you’, not confirming ovulation when ‘the algorithm needs more data’ and motivating sharing of past health history ‘to help the algorithm adapt to you’.
This framing forefronts “the algorithm” as the scientific authority behind the fertility predictions, lending them authenticity, despite concealing exactly how it works. Natural Cycles thus positions the algorithm as an authority on the reproductive body, constructing the fallacy that it is only through these technologies that users can understand their reproductive health and fertility.
Freis, A., Freundl-Schutt, T., Wallwiener, L., Baur, S., Strowitzki, T., Freundl, G., Frank-Hermann, P. (2018). Plausibility of menstrual cycle apps claiming to support conception. Frontiers in Public Health, 6, 98. https://doi.org/10.3389/fpubh.2018.00098
Light, B., Burgess, J., & Duguay, S. (2018). The walkthrough method: An approach to the study of apps. New Media & Society, 20(3), 881-900. https://doi.org/10.1177/1461444816675438
McEvinney, K. (2023, September 6). Doctors warn about social media link to abortion rise. BBC News. https://www.bbc.co.uk/news/uk-scotland-66671765
Sudjic, O. (2018, July 21). ‘I felt colossally naive’: The backlash against the birth control app. The Guardian. https://www.theguardian.com/society/2018/jul/21/colossally-naive-backlash-birth-control-appPoster
“It’s all about profiting” A Critical Content Analysis of AI-integrated Menstrual Tracking Apps
Presenter: Faye Louise Doughty
Affiliation: Northumbria University, School of Computer Science
In menstrual healthcare, people often experience dismissal and normalisation of pain, leaving people with undiagnosed conditions for months or years. Meanwhile, Artificial Intelligence (AI)-integrated menstrual tracking apps are becoming increasingly popular, promising personalised insights and predictions. These technologies could be used to evidence menstrual symptoms in clinical settings. However, limited research explores how current menstrual tracking apps use AI, and whether these systems challenge or reinforce medical biases. In this study, a critical content analysis of AI in five menstrual tracking apps was conducted using the critical app-walkthrough method. Reflective notes and structured exploration guides were complied to explore how current AI-integrated menstrual tracking apps frame and market AI, and represent conditions affecting menstruation. User reviews for each app were also collected to investigate user-reported views of AI integration. Data analysis is in progress, but early findings have revealed stigmatising language use for heavy menstrual flow and algorithmic inaccuracies, including AI-generated health insights citing unverifiable academic sources. This raises concerns around AI-integrated menstrual tracking apps stigmatising heavy menstrual bleeding, and misrepresenting menstrual experiences through quantification. Future research is needed to explore whether AI-integrated menstrual tracking apps shift reproductive labor to those with conditions affecting menstruation, and develop a framework for designers to evaluate how these technologies might perpetuate or challenge medical biases.
A computational approach to understanding motivational decision-making across the menstrual cycle
Presenter: Annalise Whines
Affiliation: MRC Cognition and Brain Sciences Unit, University of Cambridge
Co-authors: Dr Sara Z. Mehrhof - MRC Cognition and Brain Sciences Unit, University of Cambridge Professor Camilla L. Nord - MRC Cognition and Brain Sciences Unit, University of Cambridge and Department of Psychiatry, University of Cambridge
The menstrual cycle involves hormonal fluctuations that can impact mental health. For instance, some women experience the onset or exacerbation of low mood, anxiety, anhedonia, and somatic symptoms during the premenstrual phase. One neurocognitive mechanism driving these symptoms may be oestrogen’s influence on motivational decision-making. This study investigated effort-based decision-making across the menstrual cycle using a well-validated physical effort-reward task. Two hundred naturally cycling women from a general population sample completed the task and psychiatric measures during two phases in a counterbalanced order: the periovulatory phase (high oestrogen, low progesterone) and the perimenstrual phase (low oestrogen, low progesterone). Computational modelling revealed that participants’ choices in both cycle phases were best explained by models incorporating parabolic effort costs, reward sensitivity (the influence of reward value on choice), and acceptance bias (a person’s general willingness to exert effort for reward). The effect of cycle phase on psychiatric measures and these motivational parameters were explored using Bayesian multilevel models, controlling for age and counterbalancing order, with random intercepts for participants. As expected, psychiatric symptoms worsened perimenstrually across measures of depression, anxiety, anhedonia, and premenstrual syndrome. The perimenstrual phase was also characterised by increased reward sensitivity and decreased acceptance bias. Interestingly, Bayesian general linear models on residualised change scores revealed that greater increases in reward sensitivity predicted lower perimenstrual depression. These findings suggest that shifts in reward sensitivity may reflect a compensatory neurocognitive response to falling oestrogen that could buffer against perimenstrual low mood.
A qualitative exploration of the lived experience of “brain fog” during menopause in neurodivergent and neurotypical people
Presenter: Martha Ann Piper
Affiliation: Psychology, School of Mind Body & Society, Goldsmiths University of London
Co-authors: Professor Rebecca Ann Charlton, Psychology, School of Mind Body & Society, Goldsmiths University of London
Background: Cognitive symptoms (often referred to as “brain fog”) are common in menopause and can involve difficulties with memory, word-finding and concentration. Recent reports suggest that cognitive symptoms are experienced by up to three quarters of people during menopause, with some studies finding they are more frequently experienced than more well-known symptoms such as hot flashes. Furthermore, neurodivergent people may experience cognitive symptoms to a greater degree due to pre-existing cognitive differences, increased stigma and barriers to healthcare. Existing findings are mixed as to which cognitive domains are impacted during peri- and post-menopause and results of cognitive testing do not always reflect self-reported difficulties. Understanding the lived experience of cognitive menopause symptoms is critical to increase awareness and mitigate the impacts of these symptoms, and to create support options which meet the needs of all menopausal people.
Aims: This study aims to explore how people experience cognitive symptoms during menopause, including the types of symptoms, how people perceive and interpret those symptoms and the impact symptoms have on daily life. It will also explore how the experience and impact of cognitive symptoms may be different for neurodivergent people, such those who are autistic or ADHD.
Methods: Semi-structured interviews will be carried out with neurotypical and neurodivergent participants who have experienced cognitive changes during menopause. The interview guide will include questions about participants’ interpretation of the term “brain fog” and experiences of cognitive changes during menopause. Interview transcripts will be analysed through inductive reflexive thematic analysis to find patterns in the data. Interviews are expected to take place in March-April 2026 with initial results expected in time for the 4M conference in July.
Expected results and implications: Our findings will shed light on neurodiverse conceptualisations and experiences of “brain fog” during menopause. We expect to report on aspects such as how cognitive symptoms impact participants’ daily lives and participants’ attitudes towards managing and seeking support for symptoms. We also hope to make novel insights into how cognitive symptoms of menopause may relate to or interact with existing neurodivergent traits. We hope that better understanding the lived-experience of “brain fog” will contribute towards developments in policy and healthcare practice to support people through the menopause transition.Acceptability of Reusable Menstrual Products in Nepal among school-age girls
Presenter: Ignacio Franco Vega
Affiliation: University of Bath
Co-authors: Melanie Channon. University of Bath Mahesh Puri. Center for Research on Environment Health and Population Activities
Aim: Municipal governments in Nepal implement successful single-use disposable pad distribution programmes in schools to improve girls’ attendance and reduce drop out. However, policymakers are concerned about the policy’s environmental impact. We investigate the feasibility of switching from single-use disposable pads to reusable menstrual products among school-aged girls in the municipalities of Kaski and Surkhet. The research aims to identify barriers and facilitators influencing adoption and to inform the development of sustainable menstrual health interventions. Objectives: The primary objectives are to assess knowledge, attitudes, and practices regarding menstrual product use; examine emotional and logistical factors influencing use; evaluate previous intervention programmes; and explore potential strategies to promote the uptake of reusable pads. Methods: We conducted 53 interviews and focus groups with four stakeholder groups: school-attending girls, teachers, adult men, and community leaders. A four-level coding structure with 88 codes was created based on salient topics. Results: Disposable pads are widely regarded as the superior menstrual management product, associated with convenience, hygiene, and educational attainment. Cloths, the predominant reusable product, are consistently linked to negative emotions (embarrassment, disgust), logistical challenges (worsened by menstrual restrictions), a stigma of poverty, and a negative assessment of the previous generation (seen as backwards and uneducated). Reusable pads are recognised but rarely used, with environmental concerns only influencing attitudes when prompted. Previous interventions promoting reusable products had limited impact, with uptake declining after the distribution of disposable pads increased. Waste management primarily involves burying or open-burning garbage. Both methods are considered problematic given their perceived impacts on health and the environment. Several programmes have attempted to provide infrastructure for burning pads. These appear to have been mostly unsuccessful due to a lack of maintenance and inconsistent training of users and managers. Conclusions: The evidence does not support replacing disposable pads with reusable alternatives in schools. While environmental and financial arguments exist, they are outweighed by social, emotional, and logistical barriers, all of which are worsened by persistent menstrual restrictions. Recommendations include offering reusable pads as complementary options, continuing to reduce menstrual restrictions, improving waste management, and implementing long-term pilot programmes. Future interventions should carefully frame reusable pads as modern and desirable, leveraging environmental awareness and curiosity, while avoiding associations with poverty or outdated practices. Finally, it is also important to question why the focus of an environmental policy is placed on pads rather than on any other single-use products or on waste management improvement in general.
Age at Menarche and Adverse Pregnancy and Perinatal Outcomes: triangulating evidence from multivariable and Mendelian randomization analyses
Presenter: Elisabeth Aiton
Affiliation: MRC Integrative Epidemiology Unit at the University of Bristol
Background Observational studies have suggested that a younger age at menarche is associated with increased risks of adverse pregnancy and perinatal outcomes. However, it is unclear whether these relationships are causal.
Methods We estimated associations between age at menarche and thirteen pre-specified pregnancy outcomes using two approaches. We estimated observational associations in the Avon Longitudinal Study of Parents and Children (N=9,441) using multivariable regression accounting for educational attainment, ethnicity, age at delivery, parity, offspring sex, and adiposity. We conducted two-sample Mendelian Randomization using MR-PREG collaboration data (77,683-707,797 pregnancies), and multivariable MR (MVMR) accounting for genetically-proxied adiposity.
Results Older age at menarche was associated with lower risks of hypertensive disorders of pregnancy, gestational hypertension, and preeclampsia, but accounting for adiposity attenuated these effects across approaches. For example, per 1-year older age at menarche the OR for hypertensive disorders of pregnancy was 0.88 (95%CI:0.84, 0.93) in inverse variance weighted MR and 0.95 (0.90, 1.01) in MVMR, while the observational association attenuated from OR=0.91 (0.87, 0.94) to OR=0.97 (0.93, 1.01).
We found no clear evidence for effects of age at menarche on small-for-gestational-age, low birthweight, post-term birth, or perinatal depression from either approach. For other outcomes evidence was limited due to imprecision (very preterm birth, gestational diabetes), or inconsistent effects in sensitivity analyses (offspring birthweight, large-for-gestational-age, high birthweight, preterm birth).
Conclusions We find little robust evidence for causal effects of age at menarche on pregnancy outcomes. Effects of younger menarche on increased risks of hypertensive disorders of pregnancy may be driven by adiposity.An Exploration of Institutional Barriers Hindering the Adoption of Reusable Period Products in Youth Settings in Scotland
Presenter: Dominique Haig
Affiliation: Institute for Global Health and Development, Queen Margaret University
Despite Scotland’s global leadership in menstrual equity, uptake of reusable menstrual products remains low, revealing a gap between progressive policy intent and institutional implementation. While the Period Products (Free Provision) (Scotland) Act 2021 mandates free access to both disposable and reusable menstrual products, little is known about how institutions interpret and operationalise this responsibility in practice, particularly within educational and youth settings where early product preferences are shaped.
This study aimed to examine how institutional practices within educational and youth settings in Scotland influence the visibility, accessibility, and uptake of reusable menstrual products following the implementation of the Period Products (Free Provision) (Scotland) Act 2021.
The study sought to: (1) explore how institutional actors understand and implement the Act; (2) identify institutional, educational, and infrastructural barriers to the provision and promotion of reusable menstrual products; and (3) examine how awareness, accessibility, and affordability of reusables are shaped for different user groups.
This qualitative study used semi-structured interviews with 24 educators, youth workers, procurement staff, and local authority representatives across 21 institutions. Data were analysed thematically using Braun and Clarke’s approach, informed by an adapted Social Ecological Model and an intersectional feminist lens to capture how structural, organisational, and social factors intersect to shape menstrual experiences.
Findings reveal a persistent institutional preference for single-use products, driven by perceived demand, perceived budgetary constraints, infrastructural limitations, and limited staff training. Reusable products were frequently stored in less visible locations, rationed, or excluded entirely, reinforcing disposables as the default option. Participants highlighted limited consultation with young people, inconsistent menstrual education, and significant gaps in awareness among both staff and users regarding the availability and use of reusable products. These barriers disproportionately affected students experiencing poverty, disability, or gender-based stigma. Inadequate private washing facilities and fears of misuse further constrained access, while non-mandatory menstrual education limited opportunities to normalise reusable options.
The study demonstrates that menstrual equity cannot be achieved through policy or institutional action alone. The interaction between policy design, national guidance, and institutional norms shapes access to and uptake of reusable menstrual products. The findings underscore the need for clearer national guidance, strengthened monitoring, and sustained funding, alongside institutional-level changes including staff training, inclusive menstrual education, and participatory provision models, to support the normalisation of reusable menstrual products and advance equitable menstrual health outcomes.Are hypertensive disorders of pregnancy associated with placental weight? A systematic review and meta-analysis
Presenter: Genevieve Monaghan
Affiliation: Department of Population Health, University of Bristol
Background: Hypertensive disorders of pregnancy (HDP) e.g. gestational hypertension (GH) and preeclampsia (PE) are adverse pregnancy outcomes with a severe effect on both maternal and fetal health. The pathogenesis of HDP is complex but the placenta is implicated. Research Aim: To review the evidence describing the associations of placental weight (an easily obtained placental measure) with any HDP, GH, and PE. Objectives: To characterise how HDP are associated with placental weight Methods: PUBMED, Cochrane Library, and EMBASE were searched for studies reporting placental weight at delivery in pregnancies with and without any HDP. A random effects meta-analysis was conducted pooling: all studies and, separately, studies matched for gestational age (GA). To examine how GA influenced study results, we conducted three meta-regression analyses: all studies by GA of cases, all studies by the difference in GA between cases and controls, and only studies where cases and controls were GA matched. We performed post-hoc analyses looking at early onset (diagnosed at <34 weeks’ gestation) and late onset (diagnosed at >34 weeks’ gestation) PE separately as there was a sufficient number of studies to do so. Results: 122 studies were included with data from a total of ~695,000 pregnancies. The mean difference [95%CI] in placental weight between cases and controls for any HDP (-55g [-84g, -26g]) was lower than for any PE (-114g [-130g, -98g]). The difference for early onset PE was larger than all other outcomes (-181g [-226g, -135g]) whilst the difference in placental weight for late onset PE (-50g [-80g, -19g]) was the second smallest. The mean difference in placental weight for GH was minimal (-9g [-15g, -2g]). When restricted to GA matched studies only, the estimates for any HDP (-36g [-68g, -5g]), any PE (-77g [-106g, -48g]), and early onset PE (-72g [-91g, -53g]) were somewhat attenuated, but completely attenuated for GH and late onset PE. The meta regression results confirmed that the difference in GA between cases and controls was driving part of the difference in placental weight between cases and controls for any HDP, any PE, early onset PE, and late onset PE. Conclusion: Early onset PE results in a smaller placenta independently of gestational age, but late onset PE and GH do not. This likely reflects the severity of the insult on placental growth in early onset PE compared with late onset PE and GH which aligns with current research linking early onset PE to abnormal placentation.
Breaking the Cycle: Worker Perceptions and Business Implications of Menstrual Leave Policies in the UK
Presenter: Afnan Gohar
Affiliation: University of Central Lancashire
Co-authors: Dr. Giamene Odom, Associate Lecturer UCL
Aim Menstrual health issues are often overlooked and excluded from the UK’s prioritisation of world-class Diversity, Equity, and Inclusion (DEI) policies. Even though 96% of women report period pain and 51% are impacted every cycle (Wellbeing of Women, 2023), workplace settings remain inflexible, clinging to the male 24-hour diurnal cycle, failing to consider and accommodate the 28-day female infradian cycle. This research aims to examine this marginalisation by exploring employee perceptions of menstrual leave and the subsequent business implications in order to develop a practical, analytical framework for struggling menstruators in workplaces while maximising corporate satisfaction at the same time.
Objectives To identify barriers to implementing menstrual leave within UK workplace settings. To analyse the outcome of normalised menstrual support on employee satisfaction. To develop a flexible and adaptable framework for HR professionals and policymakers to fight workplace menstrual stigma and empower working women to pursue their professional dreams.
Methods This study adopted a qualitative methods approach within a Manchester-based technology firm. By using anonymous online open-ended surveys (n = 21), employees’ real life experiences and perceptions of menstrual leave were collected. This pilot study served as the primary evidence base for a published submission to the UK Parliament (https://committees.parliament.uk/writtenevidence/148687/pdf/) and informed the company’s strategic commitment to develop a formal menstrual policy backed by the C-suite.
Results Results revealed widespread support for formal intervention; participants linking such policies to increased staff retention and psychological safety. Critical barriers such as having to ‘work with a brave face’ and fears of career-limiting gender discrimination emerged. While male perceptions were mixed, they emphasised the need for managerial training to deconstruct stigma. The study demonstrated that successful implementation is dependent on changing the organisational culture from ‘suffering in silence’ to becoming menstrual-friendly.
Conclusion This research ultimately shows that the idea of data-driven menstrual policies can influence both corporate leadership and national governance to consider implementation. This study strongly advocates for workplace policies to treat menstrual health as a DEI requirement rather than a personal weakness wrongfully attributed to menstruators and it serves as a blueprint for HR leaders to become champions of health equity by recognising cyclical conditions, starting with the normalisation of menstruation.Breaking the Silence about Uterine Fibroids: A Pathway to Legislation Change
Presenter: Jemima Bittor
Affiliation: University of Cambridge, Department of Obstetrics and Gynaecology
Co-authors: Dr Priscilla Day-Walsh1,2,3* , Dr Francesca Gaccioli1,2, Dr Dafina Angelova1,2, Dr Giulia Avellino1,2, Jasmine Kiley1, Dr Gioia Canciani
1Department of Obstetrics and Gynaecology, University of Cambridge, Cambridge, UK
2Loke Centre for Trophoblast Research (Loke CTR), Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
3Homerton College, University of Cambridge, Cambridge, UK 4Cambridge University Hospitals NHS Foundation TrustUterine fibroids are benign tumours affecting approximately 80% of women globally and are associated with serious debilitating symptoms such as infertility, miscarriage, chronic pain and anaemia. In the UK, menstrual and gynaecological conditions such as fibroids, contribute to an estimated £11 billion annual economic burden due to work absenteeism. Despite their prevalence, fibroids still remain under-recognised in research, policy and clinical education with no preventative measures minimising the extent of the tumour currently available and most treatments not preserving fertility. To address gaps in awareness, research prioritisation and policy engagement surrounding uterine fibroids, we established FibroidsFree (Fibroid Focus on Research, Empowerment and Healthcare Equity), a multidisciplinary initiative aimed at integrating scientific research, community advocacy, clinical expertise and legislative dialogue. Through the Breaking the Silence symposium series, we convened researchers, clinicians, policy makers, patient advocates and organisations to stimulate a conversation on the topic and advance uterine fibroids as a national and reproductive health priority. During our November 2024 conference, we highlighted urgent needs including education, early diagnosis, equity in treatment access and culturally competent care. Thus, our current work focuses on 3 main priorities: 1) Increasing patient awareness and empowerment: 2) Enhancing early diagnosis through improved education and clinical practice: 3) Establishing a pathway to legislation change, drawing influence from the US Fibroid Bill in partnership with the All-Party Parliamentary group (APPG) on Black Health, the Caribbean & African Health Network, Cambridge Centre for Science and Policy, Fibroids Forum UK, Fibroids Foundation USA and Homerton College (Cambridge). Leveraging on these collaborations, the FibroidsFREE initiative aims to break longstanding silence around uterine fibroids and drive actionable steps towards equitable reproductive care.
Building Male Allyship to Foster Safe Spaces and Promote Dignity in Menstruation through Culturally-Responsive Education
Presenter: Margaret Bolaji (originally submitted by Maureen Torkula)
Affiliation: Stand With A Girl (SWAG) Initiative
Co-authors: Maureen Torkula
NA
Caste and Menstruation: An Inquiry on Inclusive Menstrual Health Policies In India, A Qualitative Study of The Arunthathiyar Community in Salem
Presenter: Chandlee Crawford
Affiliation: Baala Action Lab
Co-authors: Dr. Ankita Gupta, Research and Communications Specialist, Baala. Shiwani Agrawal, Implementation and Research Team Lead, Baala.
NA
Comparing a smart ring vs a vaginal sensor for measuring temperature across the menstrual cycle
Presenter: Sarah Koerner
Affiliation: University of Bristol
Co-authors: Sarah Koerner 1,2, Robyn E Wootton2,3,4,5, Kayleigh E Easey 2,3, Jon Heron2,6, Tom R Gaunt2, Louise AC Millard2
- equal contribution 1 ESPRC Centre for Doctoral Training in Digital
Health and Care, University of Bristol, Bristol, UK 2 MRC Integrative
Epidemiology Unit, University of Bristol, Bristol, UK, 3 School of
Psychological Science, University of Bristol 4 Psychiatric Genetic
Epidemiology Group, Research Department, Lovisenberg Diaconal Hospital,
Oslo, Norway | 5 PsychGen Centre for Genetic Epidemiology and Mental
Health, Norwegian Institute of Public Health, Oslo, Norway 6 Centre for
Academic Mental Health, Population Health Sciences, Bristol Medical
School, University of Bristol, Bristol, United Kingdom
Background: The menstrual cycle is characterised by cyclical hormonal fluctuations reflected in changes in body temperature. Wearable technologies enable nightly, passive temperature monitoring to track fertility for personal use or to collect high frequency menstrual data for research. This study aimed to compare the collected temperature data and acceptability of two wearable devices that measure overnight temperature: a vaginal sensor (OvuSense) and a finger-worn smart ring (Oura), within a research context.
Methods: We recruited 15 participants via email lists at the University of Bristol. Eligible participants were aged 18–40 years, experienced menstrual bleeding, and were not pregnant or using hormonal contraception. At baseline, participants completed a questionnaire on menstrual and fertility history and prior experience with wearable devices. Both OvuSense and Oura were worn concurrently for 40 nights (except that OvuSense could not be worn during menstruation). Participants recorded menstrual start and end dates. Following the wear period, participants used visual analogue scales (0-100) to rate device comfort and the maximum duration they would be willing to wear each device under three conditions: OvuSense with data access, Oura without data access (study conditions), and Oura with data access (it is not currently possible to use OvuSense without participant data access). We used repeated measures correlation to assess the within-person correlation of the temperature readings between the devices. Acceptability ratings were compared using t-tests and Wilcoxon signed-rank tests.
Results: Preliminary results showed a strong positive repeated measures correlation of temperature measurements between devices (r=0.72; p<0.001). However, individual correlations (Pearson’s r) ranged from 0.41 [95% confidence interval (CI): -0.09, 0.75] to 0.95 [95% CI: 0.82, 0.98] indicating some variability across participants. Comfort ratings did not differ substantially between devices (meanOura=73.93 [SD=17.58]; meanOvuSense=77.00, [SD=17.58]; paired t-test p=0.26). Pairwise comparisons indicated longer willingness to wear for Oura with data access (median 92 days) than for Oura without data access (median 50 days; p=0.007) or OvuSense (median 68 days; p=0.004), with no difference between Oura without data access and OvuSense (p=0.17).
Conclusion: While temperature readings were strongly correlated overall, there was some evidence of variability across participants and further research is needed to replicate this finding and investigate which individual-level factors drive variation across participants. As comfort did not differ substantially between devices, other considerations may guide device selection in cohort studies, including access to personal health data, which increased intended wear duration. These findings may inform methodological decision-making in future epidemiological research.Conceptualizing and Visualizing Menstrual Cycle Experiences in Workplace Contexts: Strengthening Awareness of Both Challenges and Strengths
Presenter: Marcia Nißen or Davinny Sou (originally submitted by Debra Soth)
Affiliation: Berlin School of Economics and Law, ETH Zurich, University of St. Gallen, University of Zurich, Eastern Switzerland University of Applied Sciences
Co-authors: Prof. Dr. Heike Wiesner Prof. Dr. Tobias Kowatsch Prof. Dr. Marcia Nießen Davinny Sou MSc
Background: Menstrual health remains structurally under-addressed in workplace research and organizational practice, despite growing recognition that cycle-related physiological changes may coincide with fluctuations in concentration, energy, mood, and perceived task performance. Moreover, recent research suggests that menstruating individuals tend to focus predominantly on negative aspects of menstrual health, particularly symptom coping, while paying little attention to potential cycle-related strengths (e.g., phases of heightened focus). To date, limited work has explored how menstrual cycle data and work-related experiences can be integrated and visualized to support individual awareness, reveal potential patterns, and highlight both the challenges and strengths associated with menstrual health in relation to work performance.
Objective: This Bachelor’s thesis investigates how menstrual cycle characteristics and self-reported work-related indicators can be visually represented to enable reflective insight at the individual level.
Methods: A focused literature review synthesizes research on menstrual cycle physiology, (work) performance self-assessment, and digital self-tracking practices. Based on this synthesis, a conceptual framework is developed to organize cycle-related variables (e.g., phase, symptom intensity, variability) alongside perceived performance indicators (e.g., concentration, fatigue, productivity, affect). Using publicly available or synthesized data, personalized cycle–performance visualization prototypes are designed to illustrate intra-individual temporal patterns and potential co-occurrences. The emphasis lies on visualization design and interpretability rather than statistical generalization.
Expected Contribution: This thesis contributes a conceptual framework for integrating menstrual health and work-related self-assessments, along with an exploratory evaluation of whether data visualization linking work performance and menstrual cycle patterns can function as a low-threshold awareness intervention in organizational contexts. As a proof of concept, the approach represents a first step toward applying cycle-aware reflective visualization frameworks to other domains in which physiological and performance-related self-tracking data intersect.CyMe- A Digital Women’s Health Research Initiative and Platform
Presenter: Marinja Principe
Affiliation: Department of Informatics, University of Zurich
Co-authors: Elia Stebler, University of Zurich Davinny Sou, ETH Zurich Elaine M. Huang, University of Zurich Tobias Kowatsch, University of St. Gallen Marcia Nißen, Eastern Switzerland University of Applied Science (OST)
Menstrual health technologies (MHTs) can support users in tracking symptoms, identifying patterns, and better understanding their bodies. However, many existing applications provide limited customization, require effortful self-reporting, and often embed narrow assumptions about their users, such as focusing primarily on cisgender women and fixed tracking practices. These limitations can reduce user agency and fail to accommodate the diverse and evolving needs of people across their life course.
To address these challenges, we present CyMe, a customizable MHT designed to place user agency at the center of the system’s design. CyMe enables users to adapt the application to their individual needs, life stages, and identities by allowing them to decide what data they track, how they track it, and which data sources they want to integrate. The system supports both self-reported and passively collected data from external health platforms (e.g. Apple Health) while allowing users to control how their data is stored and shared. Users can choose to integrate external services such as wearable sensors or keep all data locally on their device, enabling privacy-preserving use without mandatory data sharing.
CyMe further adopts an open-source approach as a core principle, recognizing that research and development in menstrual health often face limited funding and fragmented efforts. By making the platform openly available, CyMe aims to foster collaboration, transparency, and shared development, enabling researchers and developers to build upon existing work and contribute new solutions to the field.
Finally, CyMe is developed as a collaborative research platform that allows multiple research groups to use and extend the system for their own research questions and contexts. A distinctive aspect of the project is the involvement of students, who contribute through individual research projects during their studies. By enabling students to bring their own interests and perspectives into the project, CyMe fosters intrinsic motivation while supporting the long-term sustainability and continuous evolution of the platform.Developing a Menstrual Hygiene Module for Teachers and Caregivers of Girls with Special Needs in India
Presenter: Nevita Saha
Affiliation: Department of Occupational Therapy, Yenepya (Deemed to be University)
Background: Menstrual health and hygiene (MHH) remains an important component of adolescent health education. In India, caregivers, parents, and teachers, are the primary sources of menstruation information for adolescent girls with special needs. However, limited knowledge, low awareness and confidence, socio-cultural taboos, and lack of training may hinder their ability to provide appropriate guidance. There is a need for structured educational interventions targeting these individuals to improve their capacity. Aim: To develop and evaluate feedback of a MHH module for teachers, parents, and caregivers of girls with special needs. Methods: A menstrual hygiene session was conducted for teachers, parents, and caregivers of girls aged 12 years and above. The session included information on body understanding, emotional safety, hygiene skills, and pain or discomfort management. The module also included discussions on preparing girls for menarche and fostering appropriate attitudes towards menstruation, demonstrations on teaching correct use and disposal of sanitary pads, and the provision of menstrual support kits. Following the session, feedback was collected from participants using a structured feedback form to assess the clarity, usefulness, and perceived applicability of the training. Results: A total of 13 participants completed the feedback survey. Among them, 38.5% had no prior exposure to menstrual hygiene sessions and had not previously taught a girl to manage menstruation. All participants reported improved understanding of menstrual challenges faced by girls with special needs and increased confidence in supporting them. Most participants agreed that the program provided feasible strategies, emphasized dignity and privacy, was sensitive to the needs of girls with disabilities, and could help reduce stigma. Practical demonstrations were identified as the most useful component of the module and participants recommended conducting similar programs in local languages. Anticipated challenges reported were overdependence on caregivers, limited awareness among girl with special needs, and physical limitations associated with their disabilities. Conclusion: An MHH training program for caregivers and teachers could be a feasible and effective approach to support girls with special needs in India. The study highlights the importance of educational programs in special school settings.
Differential Associations Between Sexual Activity Types and Age at Natural Menopause: A SWAN Study Analysis
Presenter: Pei Qi Tea
Affiliation: University of California, San Francisco
PURPOSE: Menopause is characterized by declining levels of progesterone and estrogen. Earlier or premature decline of estrogen, however, has been associated with increased risk of cardiovascular disease and cognitive disorders like Alzheimer’s disease. Prior analyses using data from the US-based Study of Women’s Health Across the Nation (SWAN) have demonstrated that higher “sexual frequency” is associated with later age of natural menopause (ANM), with sexual frequency defined as the maximum frequency across all types of sexual activity. Thus, one participant’s sexual frequency score could reflect masturbation frequency while another’s reflect intercourse frequency, potentially obscuring activity-specific effects. Considering evidence that different types of sexual activity have distinct health effects (e.g., intercourse being most beneficial), the current study reanalyzed SWAN data to examine links between specific activities—masturbation, touching, intercourse, and oral sex—and ANM.
METHODS: Following prior work, sexual frequency was coded as less than monthly (reference), monthly, or weekly for each activity type. We analyzed data from 3016 SWAN participants using Cox proportional hazards models that adjusted for covariates.
RESULTS: Our results revealed heterogeneous associations between sexual activity type and ANM. Monthly touching showed the strongest association with later ANM (HR=0.65, 95% CI: 0.47–0.91, p=0.006) while weekly touching showed an attenuated association (HR=0.73, 95% CI: 0.53–1.00, p=0.034). Weekly oral sex was also associated with later ANM (HR=0.82, 95% CI: 0.67–0.99, p=0.047), whereas monthly oral sex showed no significant association. Masturbation frequency demonstrated a consistent protective association, with both monthly (HR=0.85, 95% CI: 0.72–0.99, p=0.031) and weekly engagement (HR=0.77, 95% CI: 0.63–0.95, p=0.010) linked to later ANM. In contrast, neither monthly nor weekly intercourse was significantly associated with ANM. Sensitivity analyses examining additional lifestyle covariates (e.g., physical activity and relationship satisfaction) are ongoing.
CONCLUSIONS: Associations between sexual activity and menopausal timing varied by sexual activity type and did not demonstrate a clear dose–response pattern, warranting further investigation into how various sexual activity types may differentially influence reproductive aging and health.Do period products cause menstrual disorders?
Presenter: Dr Rebecca Evans
Affiliation: Department of Social and Policy Science, University of Bath
Co-authors: Ms Rosie Barber, University of Oxford (UG) Ms Gwennan Evans, University of Newcastle (UG)
Background Stories of the dangers of using certain menstrual products abound in many cultures. Is this just scare-mongering or a justified concern? In many LMICs certain menstrual products are shunned due to concerns about them interfering with fertility. Here in the UK, a HIC, attitudes are rather more blasé. But that might be because it seems unthinkable that period products can be as unregulated as they are. Currently there is no law requiring manufacturers of period products to list their ingredients, and research by WEN has found tampons, pads and period pants to contain heavy metals, among other chemical residues. Aim We conducted a systematic review of the literature to collect observational and experimental data on the effects of lead and cadmium exposure on the uterus, in order to gain an understanding of the aetiology of adverse effects on the female reproductive system. Method The study was registered on PROSPERO 2026 CRD420251246022. We searched PubMed, Springer Nature and Web of Science publications for observational or experimental studies on female mammals from January 1st 2015 until December 31 2025. We included experimental studies on primary cells or cell lines from female mammals or humans in vitro. Database returns were screened independently by two researchers (RB and GE) for inclusion in the review. Any conflicts in the decisions were resolved by a third reviewer (RE). A data extraction table was prepared in Excel and completed by RB. Effects were grouped both deductively and iteratively (augmented by AI analysis (Co-pilot)), into themes.
Results The search returned 1247 articles of which 40 met the inclusion criteria. The themes that emerged were that lead and cadmium were associated, in a dose dependent manner, with 1) reduction in uterine size and weight, 2) structural and histological damage to uterine tissue 3) changes to endometrial thickness and glandular tissue 4) oxidative stress and biochemical damage to uterine cells, 5) reduction in cellular viability and increased cell death 6) hormonal (oestrogen and progesterone) signalling disruption.
Conclusion Cadmium and lead exert a wide range of toxic effects on the uterus. The structural changes provide an insight into the aetiology of menstrual disorders, and the changes in oestrogen and progesterone signalling support the common theory that heavy metals serve a metalloestrogenic role within the uterus, thus disrupting the menstrual cycle and subsequent fertility. This work highlights the dangers of exposure to Lead and Cadmium on the reproductive system and users of period products should be aware of what is in them.Effects of climate change on menstrual health and hygiene: a global mixed-methods systematic review
Presenter: Lauren D’Mello-Guyett
Affiliation: London School of Hygiene and Tropical Medicine
Background: Menstrual health and hygiene are often neglected in humanitarian crisis settings, where inadequate water and sanitation facilities, limited menstrual materials and information, restricted healthcare access, and unsupportive social environments undermine people’s ability to manage menstruation safely, with dignity, without harm. Reusable menstrual hygiene materials may help address some of these gaps, but more evidence on the acceptability and use in such settings is needed. This study examines factors associated with the use and acceptability of REEMI™ menstrual underwear distributed to internally displaced women and girls in the Banadir region, Somalia.
Methods: This study was a prospective longitudinal study among a random sample of 295 internally displaced women who received menstrual underwear with bags for washing and drying. Surveys were completed, at and within 12 months after the distribution, to capture demographics, menstrual practices, use of the menstrual materials, and acceptability or issues with the materials. Descriptive statistics summarised key variables, and logistic regression was used to examine factors associated with the use of the menstrual underwear.
Results: 12 months after distribution, 89% of women used the menstrual underwear during their most recent menstruation, 96% used the washing bag, and 95% used the drying bag. Participants found the menstrual underwear comfortable (100%), reliable for heavy bleeding (95%), and led to fewer infections (93%), with no reported leakage or odour (0%). Among reasons for using the washing and drying bags, privacy was the most common (86–89%), followed by convenience. The odds of using menstrual underwear were higher among participants who felt they received enough pairs for rotation. Compared to married participants, those divorced/separated or single had lower odds of using the menstrual underwear.
Conclusions: This study found high use and acceptability of menstrual underwear for displaced populations. These findings suggest that including long-lasting reusable menstrual materials in emergency humanitarian settings can have positive effect on menstrual health and hygiene, particularly when context-specific and addressing key factors such as privacy and hygiene, which strongly influence use and acceptability.
Endometriosis at work: Rethinking wellbeing and workplace policy in the UK
Presenter: Aishwarya Viswamitra
Affiliation: Centre for Reproduction Research, De Montfort University
Endometriosis is a chronic, inflammatory condition affecting approximately 1 in 10 women and people assigned female at birth in the UK. While menstrual health has gained increased visibility, workplace responses to endometriosis remain inconsistent and frequently situated within individualised “wellbeing” initiatives, if recognised at all. Drawing on sociological theories of the “ideal worker”, a norm privileging constant availability, productivity and bodily reliability, this study examines how a chronic, fluctuating condition is negotiated within rigid organisational structures. The presentation focuses on the qualitative interview phase of a mixed methods PhD exploring endometriosis and employment in the UK.
The research aims to improve understanding of how endometriosis intersects with labour market engagement and lived experiences of work. It seeks to understand how workplace management policies and procedures, and organisational framings of endometriosis, operate, are organised and impact on lived experiences. The study also aims to identify how endometriosis is understood and managed by employers, and to contribute to theoretical models of gender, illness, disability, embodiment, impairment and the labour market.
Semi-structured interviews are being conducted with UK-based participants with a diagnosis or clinical history consistent with endometriosis. Data is being analysed using reflexive thematic analysis to examine how participants interpret and navigate workplace expectations. Existing research suggest a tension between the episodic, unpredictable nature of endometriosis symptoms and workplace systems structured around linear time, attendance metrics and performance continuity. Participants describe negotiating disclosure, anticipating disbelief, and encountering support that is often discretionary rather than embedded within policy.
We know that endometriosis disrupts dominant assumptions embedded within workplace policy about what a “normal” worker body can do. Rethinking menstrual health as a structural employment issue, rather than solely a matter of individual wellbeing, may be necessary to develop more consistent and equitable forms of support. This research contributes to debates in menstrual health and workplace sociology by situating endometriosis within broader questions of embodiment, productivity and organisational power in the UK.Exploring the Awareness and Use of Menstrual Cycle Tracking Applications Among Learning-Disabled Women: a literature review and interview with 3 learning disabled women.
Presenter: Katarina McVann
Affiliation: Medical School, Kings Collage London, Portsmouth Branch
In 2023, NHS England created a framework for inclusive digital healthcare and improving health inequalities in this area. Menstrual Cycle Tracking Applications (MCTAs) allow women to record and track their menstrual health, and studies demonstrate the benefit of such apps (1). Irregular bleeding, dysmenorrhea and menorrhagia occur at a similar incidence in learning-disabled women (LDW) and the general female population (2). However, communication difficulties, a lack of learning-disability training and (often unconscious) discrimination may contribute toward pathologies being missed and menstruation being experienced more negatively by LDW. (2, 3)
This project aimed to investigate whether there had been any research around LDW using MCTAs and if LDW were aware of this technology. Following a literature search, three women from a local social group were recruited for interviews. Thematic analysis was used to analyse the subsequent semi-structured interviews.
All women had smartphones but were unaware of period-tracking apps. However, they would be interested in using an MCTA if it were simple and easy to use. They heavily relied on others to manage their menstruation and associated symptoms, and to keep track of their periods (for example, their mother marking them on a calendar). All participants reported medical issues with their periods, with one having been offered contraception as a form of management without investigation. Discussing periods was felt to be an embarrassing topic and the interviewees were all very keen for privacy. The cohort was small but demonstrated the need for further research into how to provide equitable access to MCTAs. No studies were found to include LDW within their research around MCTAs, although one study included multiple disabled women (4).
LDW may be reliant on older family members who will not be aware of such technology or no longer need period-tracking apps. MCTAs could provide these women with privacy and independence and remove the embarrassment of discussing periods, as demonstrated in the interviews. MCTAs could help healthcare professionals identify potential pathology at an earlier stage, or provide education around women’s health and screening programs, since uptake is lower in the LD population (5).
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- Adnan T, Coull BA, Jukic AM, Mahalingaiah S. The real-world applications of the symptom tracking functionality available to menstrual health tracking apps. Curr Opin Endocrinol Diabetes Obes. 2021;28(6):574-86.
- Rodgers J, Lipscombe J, Santer M. Menstrual Problems Experienced by Women with Learning Disabilities. Journal of Applied Research in Intellectual Disabilities. 2006;19(4):364-73.
- Badcock E, Sakellariou D. “Treating him…like a piece of meat”: Poor communication as a barrier to care for people with learning disabilities. Disability Studies Quarterly. 2021;42.
- Patel U, Broad A, Biswakarma R, Harper JC. Experiences of users of period tracking apps: which app, frequency of use, data input and output and attitudes. Reproductive BioMedicine Online. 2024;48(3):103599.
- Ward LM, Cooper S-A, Sosenko F, Morrison D, Fleming M, McCowan C, et al. Population-based cancer incidence and mortality rates and ratios among adults with intellectual disabilities in Scotland: a retrospective cohort study with record linkage. BMJ Open. 2024;14(8):e084421.
Exploring the Relationship Between Violence and Menstrual Health in Adult Menstruators: A Mixed-Methods Systematic Review
Presenter: Elesha Foord
Affiliation: Brighton and Sussex Medical School
Objectives There is growing evidence that menstrual health inequalities negatively affect adolescents’ physical and psychosocial health. However, little is known about the relationship between violence and menstrual health among adult menstruators aged 18 years and above. Existing research has largely focused on younger populations, leaving a critical gap in understanding how experiences of violence intersect with menstrual health across adulthood. To ensure inclusivity, this review uses the term menstruators to encompass individuals who menstruate but may not identify as women. This systematic review aims to synthesise evidence on the bidirectional relationship between violence and menstrual health, examining how menstrual health challenges may increase vulnerability to violence and how exposure to violence may affect menstrual, physical, and psychosocial health outcomes.
Methods A systematic search of PubMed, CINAHL, MEDLINE, Embase, the Cochrane Library, and Taylor & Francis Global Health was conducted, alongside searches of grey literature sources including WHO, UNFPA, UNICEF, UN Women, and WaterAid. Two reviewers independently screened titles and abstracts, with full-text screening currently underway. The review follows PRISMA 2020 guidelines and has been registered with PROSPERO. Data extraction captures study characteristics, types of violence, prevalence estimates, associated risk factors, and impacts on menstrual, physical, mental, and psychosocial health. Data synthesis follows a convergent integrated mixed-methods approach, with qualitative findings synthesised thematically and quantitative data transformed to enable integration. Methodological quality is assessed using Joanna Briggs Institute (JBI) Critical Appraisal tools, certainty of evidence using the GRADE approach, while reporting quality of qualitative studies using COREQ, and grey literature using the AACODS checklist.
Results The search identified 3,094 records. After removal of duplicates, 1,519 records were screened at title and abstract level, of which 131 studies were included for full-text review. Full-text screening and data synthesis will be complete in February 2026. Preliminary screening indicates substantial heterogeneity in study design, settings, and outcome measures.
Conclusions By synthesising evidence on the intersections between violence and menstrual health among adult menstruators, this review aims to inform policy, programming, and preventive strategies across health and social sectors and identify critical gaps to guide future research.Exploring the impact of Premenstrual Dysphoric Disorder (PMDD) on reproductive decision-making
Presenter: Jessica Davies
Affiliation: Department of Psychological Medicine, IoPPN, King’s College London
Aim: This study explores whether and how Premenstrual Dysphoric Disorder (PMDD) influences reproductive decision-making, such as decisions around becoming pregnant or having children. PMDD is a hormone-related mood disorder characterised by severe emotional and physical symptoms in the luteal phase of the menstrual cycle, however little is known about how it shapes reproductive decision-making.
Objectives: To understand how individuals with PMDD experience and
reflect on decisions about pregnancy and parenthood.
To explore the perceived roles of healthcare professionals, partners,
family and social networks in shaping these decisions. To identify key
concerns, needs and barriers people with PMDD face when considering
pregnancy or parenting.
Methods: Approximately 20 semi-structured interviews were conducted with people who self-identified as having PMDD and lived in the UK and had a diverse range of parenting intentions and reproductive choices. Interviews explored experiences of PMDD, views on pregnancy and parenthood, within the context of PMDD, and interactions with healthcare and support systems. Data were analysed using Braun and Clarke’s (2006) reflexive thematic analysis. A feminist and critical realist framework informed interpretation, allowing consideration of both the gendered context of reproductive mental health and the structural, institutional and cultural factors shaping decision-making.
Results: Themes pertaining to fear and uncertainty around symptom exacerbation following pregnancy, risk of offspring inheriting PMDD, worries around parenting while symptomatic and limited support from healthcare professionals will be presented and discussed.
Conclusion: This study will generate new insight on how PMDD shapes reproductive decision-making, an area that remains under-researched despite its clinical and social relevance. Findings will inform future research, support the development of more holistic preconception and perinatal care, and highlight the need for clearer guidance and support for individuals with PMDD considering pregnancy or parenthood.Feasibility and Acceptability of an Online Questionnaire and Cognitive Tasks in Midlife Women for Research on Menopause-Related Cognitive Changes
Presenter: Emily Budden
Affiliation: University of Sussex
Co-authors: “Alice Stanton, University of Sussex Dr Sam Berens, University of Sussex Professor Michael Hornberger, University of Southampton Professor Anne-Marie Minihane, University of East Anglia Professor Dorina Cadar, Brighton & Sussex Medical School Professor Naji Tabet, Brighton & Sussex Medical School Dr Claire Lancaster, Brighton & Sussex Medical School”
“Background Over two-thirds of women report cognitive symptoms during menopause, often called ‘brain fog’, including forgetfulness and difficulty concentrating, which can significantly impact quality of life. Midlife represents an important window for promoting cognitive wellbeing into older age; however, the influence of menopause and Menopause Hormone Therapy (MHT) use during this time is not fully understood. To better characterise menopause-related cognitive changes, research must adequately capture reproductive health factors, use cognitive measures sensitive to midlife variability, and be scalable to include larger and more diverse samples. Remote, online methods can facilitate this research, but their feasibility and acceptability must first be established in this population.
Study Objectives To assess the feasibility, acceptability and relevance of an online questionnaire and cognitive task battery in midlife women who started MHT in the previous 18 months, and to refine methods for use in future research.
Methods Women (n = 31) were recruited from the general population across the UK. Participants completed online questionnaires capturing menopause symptoms, health (reproductive, general and mental), and lifestyle, followed by domain-specific cognitive tasks that reflect subjective menopause complaints and are sensitive to vulnerability in ageing (e.g., verbal memory, executive attention). All participants provided written feedback, and a subset (n = 6) was interviewed to explore experiences. Quantitative feedback and task data were analysed descriptively, and interviews and qualitative feedback were analysed thematically.
Results Participants (mean age 47.58 years, SD = 4.01) found the methods feasible and acceptable to complete independently at home. High average ratings (0-10 scale) were given for question acceptability (M = 9, SD = 1.9) and comfort (M = 9.16, SD = 2.11). Thirty participants completed all cognitive tasks, with minimal missing data or evidence of technical issues, and 93% agreed that they were possible to complete. Ongoing analysis indicates that the tasks appear sensitive to performance differences in this population, with no evidence of overall floor or ceiling effects. Qualitative analysis highlighted the perceived value and relevance of the research, and participants described a range of menopause experiences, including cognitive and mental health challenges, and suggested improvements to better capture these.
Conclusion The online questionnaire and cognitive tasks were feasible and acceptable for midlife women using MHT. Participant feedback provided insights to improve relevance and representation of menopause experiences, and refinements have been implemented in consultation with participants and menopause-specialist healthcare professionals. These methods will now be used in larger studies investigating how menopause and MHT influence cognitive health in midlife.”Foundations for Co‑Designing Culturally Responsive Menopause Technologies: An Integrative Review of South Asian Women’s Experiences and Health Technology Use During Menopause.
Presenter: Helen Ryder
Affiliation: Coventry University Centre for Arts and Creative Cultures
Background: Health technologies are increasingly promoted as tools for improving access to personalised support in women’s health, yet many are designed around assumptions of white, middle class, digitally literate users. South Asian women remain underrepresented in menopause research, with limited understanding of how cultural, social, linguistic and structural inequalities shape their experiences and engagement with health technology tools. As the women’s health technology market expands at rapid pace, growing evidence calls for culturally informed, co designed health technologies. Such approaches depend on a clear needs analysis, underscoring the importance of reviewing existing evidence on South Asian women’s menopause experiences and their engagement with health technologies.
Aims: This review synthesises current evidence on the support needs of South Asian women during menopause and evaluates how health technologies are used to navigate this transition. It identifies barriers and facilitators influencing help seeking behaviours and examines factors shaping engagement with existing health technology tools. The review aims to highlight gaps in access, design and user experience to inform further research in culturally competent health technology design frameworks.
Methods: A systematic search was conducted using Boolean operators, truncation and wildcards to identify relevant studies across health, design and social science disciplines. Searches were limited to English language human research published between 2000 and 2026. Following integrative review methodology, the search incorporates empirical and theoretical literature and grey literature from organisations including WHO, NICE and NHS Digital. A PICO framework guided screening. Eligible studies will be appraised using the Mixed Methods Appraisal Tool (MMAT), with selection documented via PRISMA. Data will be synthesised thematically using Whittemore and Knafl’s (2005) framework.
Anticipated findings: Preliminary thematic patterns indicate that South Asian women’s menopause support needs are shaped by intersecting cultural, social, economic, linguistic and structural factors. Barriers to using health technologies include stigma, limited culturally relevant information, language constraints, reduced access and trust, and the influence of family norms on help seeking choices. Facilitators include discreet information sources, peer support and tools that acknowledge cultural values. Existing technologies show mixed alignment with lived experience, with notable gaps in culturally grounded design principles and representation in development processes.
Implications: Findings are expected to underscore the need for participatory, culturally nuanced approaches to health technology design and for equity focused frameworks that recognise diverse menopause experiences and avoid reinforcing disparities.From Data to Insight: The Role of AI-based Textual Summaries and Visualization in Menstrual Health
Presenter: Marcia Nißen (originally submitted by Elia Stebler)
Affiliation: University of Zurich, Institute for Informatics
Co-authors: Marinja Principe (University of Zurich) Prof. Dr. Elaine Huang (University of Zurich) Prof. Dr. Marcia Nißen (OST)
Many menstruating individuals are only partially aware of how their menstrual cycle (MC) affects their physical and mental well-being. Providing accessible insights into potential cyclical patterns can enhance bodily self-awareness, support reflection, and empower individuals to make more informed decisions. This work aims to investigate how different modes of presenting self-tracked MC data influence users’ ability to derive insights, their menstrual health awareness, and potential behaviour change.
To track their period and menstrual cycle-related changes, many menstruating people use smartphone-based menstrual cycle tracking applications (MCTAs). Prior work recommends that MCTAs should support users in identifying connections between their MC and related experiences, while other studies also show user dissatisfaction with existing applications in this area. Our own analysis of MCTAs (n=16) concluded that most applications rely on simple circular or calendar-based graphics and do not allow users to compare more than one MC.
This online study employs a 3×3 between-participant experimental design to compare how three different presentation modes (visualization only, AI-generated textual summary only, and the combination of both) and three ways of highlighting MC key dates (MC start only, MC phase only, and a combination of both) influence users’ ability to derive meaningful insights from their data. One novelty of this work is the use of a spiral timeline design (for the MC phase only condition) which avoids placing artificial emphasis on a single MC phase transition and adapts a visualization that has proven effective for visualizing periodical data but has not yet been applied to MC visualization.
While the data analysis is still ongoing, first results (n=279 participants) suggest a preference for visual presentations of MC data with both visual-only and combined visual-text conditions consistently preferred over text-only presentations. Furthermore, participants reported feeling better informed about their menstrual health after viewing the presentations, although their perceived awareness of bodily changes throughout the MC decreased slightly. This might imply that engaging with their data in these novel ways revealed gaps in their knowledge which is further highlighted by participants reporting intentions to track their MC more thoroughly in the future (n=159), investigate their symptoms further (n=48) or consult healthcare professionals (n=37).
Menstruating people often track MC-related experiences in MCTAs that provide limited support for deeper exploration of the collected data. While the study has not concluded, initial findings suggest that improved presentation of self-tracked menstrual data may support deeper engagement with menstrual health.Hormonal Contraceptive Use in Physically Active Women: Evidence Gaps Between Sport Science Research and Clinical Guidance
Presenter: Katrina Taylor
Affiliation: University of Kent -Sport, Exercise and Rehabilitation Sciences
Co-authors: Fadah Khalfa, Kent and Medway Medical School
Introduction: Hormonal Contraceptive (HC) use among women in sport and physical activity is common. Whilst frequently prescribed for pregnancy prevention, many athletes and physically active women use HC to manage menstrual symptoms and reduce disruption to training and competition (Schaumberg et al., 2013). Representation of HC use in sport science research is reliant on small studies, inconsistencies in methodologies and reporting, unreflective of real-world practice (Flood et al. 2024). For those prescribing HC, current frameworks and clinical guidelines (NICE & British National Formulary [BNF]) provide limited guidance regarding how different contraceptive formulations may interact with training load, competition schedules or recovery demand. As such, limited guidance on potential performance implications is available to both physically active women and prescribers. Methods: A scoping review was conducted to examine representation of HC use and impact in physical activity and sports performance research. In addition to outcomes previously derived by (Flood et al. 2024) (contraceptive type, formulation and brand, athlete calibre, performance outcome), this review sought to establish participants’ reasons for contraceptive use, and references to physician/coach/athlete discussions regarding performance considerations. In addition, a narrative review of the BNF was conducted to ascertain if information on physical activity prescription or training are detailed in HC user or prescriber guidelines. Results: In total, 101 studies met the scoping review inclusion criteria. The majority of studies involved oral HC (n=76 monophasic combined oral contraceptives; n= 13 triphasic formulations). Non-oral methods were scarcely represented in the literature (n=3 hormonal intrauterine devices; n=3 implants; n=2 progesterone-only pills; n=1 vaginal ring; n=2 injectable contraceptives). Inconsistencies were noted in reporting of contraceptive characteristics (n=37 brand; n=67 formulation, n=29 neither). Most studies presented findings of different formulations/brands grouped together. Only 5 studies reported reasons for contraceptive use. None reported whether contraceptive choice had been discussed with physicians or coaches in relation to exercise or performance. The narrative review charted a total of 32 UK licenced HC prescription formulations, unique side effect profiles and indications for use. There was no mention of physical activity guidance or contraindications with any formulation. Conclusion: Research investigating contraceptive use and exercise performance has largely focused on oral HCs, leaving other methods underrepresented. Inconsistent reporting of contraceptive formulations and the reasons for their use complicates the interpretation of their effects on physical activity performance. Ultimately, athletes and prescribers continue to face challenges when selecting contraceptive options that best support individual training demands and symptom management.
Hormone linked fluctuations in episodic recollection: A psychophysiological study across the menstrual cycle
Presenter: Angharad Williams
Affiliation: Nottingham Trent University, Psychology
Co-authors: Ms Alisa Yusufova (Nottingham Trent University), Dr Jessica Piasecki (Nottingham Trent University)
Many individuals who menstruate report changes in memory, clarity of thought, or cognitive “sharpness” across the menstrual cycle, yet scientific evidence for such fluctuations remains inconsistent. One reason may be that most studies focus on overall behavioural performance, which can mask differences in specific memory processes. In particular, familiarity‑based responding often remains stable, even when recollection (the form of memory that supports retrieval of vivid, contextual details) varies. This project investigates whether endogenous fluctuations in ovarian hormones influence recollection‑related neural activity, and whether such changes occur independently of overt behavioural performance. Thirty menstruating women (aged 18-35) will complete three laboratory sessions timed to hormonally distinct phases of the cycle. At each session, participants will provide a venous blood sample for quantification of oestradiol, progesterone and cortisol, and will complete an episodic memory task while electroencephalography (EEG) is recorded. This approach allows us to examine recollection‑sensitive neural signatures, such as the late parietal old/new event-related potential (ERP) effect and theta‑band increases, which provide temporally precise indicators of hippocampal‑dependent retrieval processes. Recent ultra-high resolution magnetic resonance imaging (MRI) work shows that menstrual‑cycle hormone fluctuations modulate the structure of medial temporal lobe subregions, including CA1, subiculum and perirhinal Area 35. The hippocampal subfields supporting recollection show particularly strong hormone‑linked plasticity, thus these findings raise the possibility that endocrine variation may influence recollection‑related processes more than familiarity‑based ones. Despite clear evidence that menstrual‑cycle hormones modulate recollection‑related hippocampal subfields, the functional impact on recollection‑specific neural activity has never been tested. Findings will advance understanding of how menstrual‑cycle physiology shapes cognitive experiences, contributing to broader discussions of menstrual wellbeing, neuroendocrine health and lived cognitive variability.
Investigating patterns in menstrual symptom management: Findings from a UK pilot study
Presenter: Poppy Taylor
Affiliation: University of Bristol
Background Whilst several tools exist to assess menstrual symptom severity in clinical and research settings, these fail to consider relevant management behaviours. This study aims to develop a modern survey tool for assessing the use of self-care strategies and related shopping habits in managing menstrual symptoms. Here we present findings from a pilot study.
Objectives The core objectives for this research are to develop a tool and provide novel insights into menstrual symptom experiences, self-care strategies and related products which will help to inform future research involving linkage with shopping data. We evaluate the appropriateness of the survey questions to ensure data captures a range of symptoms and reflects current self-care practice. The tool will be refined accordingly.
Methods In October 2025, 150 female participants aged 18-55 completed an online survey. The survey consisted of four sections: 1) Demographic background; 2) Menstrual experiences; 3) Managing menstrual symptoms; 4) Shopping habits. Recruitment was managed through Prolific with pre-set screening criteria to target participants who were paid for their participation. A range of statistical methods were deployed in data analysis.
Results 99.33% of participants reported at least one menstrual symptom (median = 5). The most common symptoms were period pain (93.33%), mood changes (92.00%), tiredness (91.33%), bloating (82.67%) and heavy menstrual bleeding (75.33%). 72.67% of participants reported use of self-care strategies for managing menstrual symptoms. For example, the most common strategies for managing pain were paracetamol (68.00%), ibuprofen (53.33%), hot water bottle (50.00%) and herbal tea (26.67%). The mean self-reported monthly spending on managing menstruation was £11.49±£8.60.
Conclusion Such self-reported behaviours can indicate likely shopping patterns to study further using shopping data and help to track management strategies on a large scale. Additional symptoms and strategies have been identified and, following this pilot, the tool has been revised in preparation for upcoming studies.Leveraging Digital Health Technologies to Support Detection and Management of Menstrual Cycle–Related Disorders: A Scoping Review
Presenter: Marcia Nißen or Davinny Sou (originally submitted by Cassandra Chapi-Nitcheu )
Affiliation: CDHI
Co-authors: Tobias Kowatsch, Marcia Nißen, Davinny Sou
Background: Menstrual cycle–related disorders include abnormalities in menstrual frequency, regularity, duration, or bleeding volume, such as intermenstrual bleeding, heavy menstrual bleeding, or unscheduled bleeding. They also include ovulatory abnormalities, such as anovulation or infrequent ovulation, and can substantially impair health-related quality of life while imposing significant economic costs on society. These conditions are frequently associated with underlying hormonal and endocrine disorders such as polycystic ovary syndrome. Although global prevalence among reproductive-aged individuals is estimated between 3% and 30%, inconsistencies in classification systems, widespread underreporting, and clinical underdiagnosis suggest that the true burden is considerably higher. Diagnostic delays and the persistent normalisation of menstrual symptoms continue to contribute to fragmented care and unmet health needs. Digital health technologies including mobile applications, wearable devices, and remote monitoring platforms, are increasingly used to track menstrual cycles and related physiological parameters. Advances in sensor precision and data analytics have strengthened the recognition of menstrual cycle data as a valuable component of reproductive health monitoring. These tools enable the collection of longitudinal, non-invasive digital biomarkers such as heart rate, sleep metrics, basal body temperature, and physical activity levels, which may support earlier identification of cycle abnormalities and improved symptom monitoring. However, the evidence supporting their clinical utility remains fragmented and unevenly evaluated, particularly in the context of menstrual cycle–related disorders. Objective: This scoping review examines how digital health technologies are being used to support the detection, monitoring, and self-management of International Federation of Gynaecology and Obstetrics (FIGO)-defined menstrual cycle-related disorders across menstrual phases. Methods: Five databases will be searched for peer-reviewed literature published between 2015 and 2026. Findings will be synthesised to identify the types of technologies employed, the menstrual cycle-related disorders addressed, the digital biomarkers reported, and the outcomes supported, as well as existing gaps in validation and equitable integration into clinical care pathways. Expected Contribution: By mapping the current evidence landscape, this review aims to contribute to ongoing discussions on how digital innovation can strengthen menstrual health research, improve individual well-being, and inform future policy and technology development.
Menstrual Change: The Movement Toward Menstrual Equality
Presenter: Emma Griffin
Affiliation: University of San Diego, Engineering, Sustainability, and Health
This study analyzed differing sources of data, ranging from general public comment regarding menstruation and key informant data from the non-profit organization Period. The central question was “How are menstrual equality organizations changing societal narratives surrounding menstruation?” Through data interpretation and analysis, this research uncovered that these organizations are affecting teens much more dominantly than older generations and are therefore changing societal narratives for the incoming generations. The future of our societal notions about menstruation are being changed from the work of menstrual equality groups through the current school aged generation, allowing more education to reduce stigma and access issues, therefore reducing menstrual inequality in the long term.
Menstrual Health in the Workplace: Perspectives from Managers
Presenter: Marcia Nißen or Davinny Sou (originally submitted by Vassilka Kavassakali)
Affiliation: University of Applied Sciences Karlsruhe (HKA)
Co-authors: Prof. Dr. Tobias Kowatsch, ETH Zurich, University of St.Gallen, University of Zurich; Prof. Dr. Marcia Nißen, ETH Zurich, University of Zurich Eastern Switzerland University of Applied Sciences; Davinny Sou (Phd), ETH Zurich, University of St.Gallen
Background: Although nearly half of the world’s population menstruates, menstrual health remains a seriously underrepresented topic, particularly in the workplace context. Despite its importance, the topic is still marginalized due to stigma, cultural taboos, and a persistent lack of awareness and education. Research on menstrual health in the workplace has predominantly examined (menstruating) employees’ perceptions and experiences, while often overlooking the role of organizational leaders, particularly those without lived menstrual health experience. Yet, leadership perspectives are critical for shaping workplace cultures, policies, and practices around reproductive health, particularly menstrual health.
Objective: To address this gap, this study explores how leaders in a large German corporate organization (~30,000 employees) perceive menstrual health in the workplace, whether they consider it a taboo topic, and how these perceptions vary by role, personal menstrual health experience (i.e., whether the participant has or had menstruation themselves), team composition (e.g., size, gender distribution), and leadership experience. Specifically, this study addresses the following research questions: (1) How do organizational leaders perceive and communicate about menstrual health in the workplace? (2) How do these perceptions vary across organizational leaders with different roles, menstruation experience, leadership tenure, and team characteristics? and (3) What barriers and opportunities do leaders identify for reducing stigma and normalizing menstrual health in organizations?
Methods: Semi-structured interviews with n = 15 leaders from diverse departments were conducted, including participants with and without personal menstruation experience. Recruitment was carried out through targeted email invitations. The interviews were audio-recorded, transcribed, and analyzed using thematic analysis.
Preliminary Results: The preliminary results highlight both persistent stigma and emerging openness. While some leaders adopt a pragmatic approach that equates menstrual health with other common health concerns, others remain uncertain or uncomfortable. These insights provide an important lens on organizational inequities, highlighting the critical role of leaders as both drivers of structural change and role models in normalizing menstrual health. The findings offer implications for designing stigma-reducing workplace practices and fostering inclusive environments that acknowledge reproductive bodies at work.Menstrual Rights and Menstrual Dignity: Living conditions and menstrual hygiene of women incarcerated in Mokolo prison in the Far North region of Cameroon
Presenter: Falmata Oumar
Affiliation: UNOADD/GPGE/ ADECOPA
Co-authors: Ms MAGRA AVARAMLA Aissatou ADECOPA M ALIFA Mahamat Gender Partnership for Gender Equality
Our study focuses on menstrual rights, which are human rights. Our objective was to highlight the violations and abuses of women’s menstrual rights, particularly in crisis situations in the Far North region of Cameroon. Climate change, causing floods and droughts, is leading to internal migration. Women and girls are especially vulnerable during menstruation, which has numerous consequences for their reproductive and mental health.
Two scientific methods were used: the first, health history, allowed us to understand the perception of menstruation within communities, including the construction and evolution of beliefs about it. The second, qualitative method, was used for data collection and analysis. Our data collection tools included focus groups, individual interviews, and the collection of testimonies.
Our study underscores the inequalities in menstrual rights worldwide. Indeed, while the issue of menstrual leave is debated in developing countries, in sub-Saharan Africa, profound inequalities persist because women are still at the stage of recognition and acceptance. Women and girls are victims of stigmatization and violence for social, cultural, and religious reasons.
In our study area, menstruation is perceived as an evil, an impurity; a menstruating woman is often considered undesirable. Everything she touches is defiled. Isolated, these women resign themselves to and accept this situation. No claim for menstrual rights. A girl who has her first period is considered a woman and ready for marriage. For fear of an unwanted pregnancy, parents marry off their daughters or promise them marriage as soon as they begin menstruating. This situation worsens during times of crisis (abduction, conflict, floods, etc.). They do not have access to sanitary products. They use old clothes or pieces of fabric as sanitary pads. They are forced to tear their headscarves, loincloths, or other clothing. They scavenge for fabric in landfills, sometimes even stealing clothes to use as sanitary napkins. Similarly, they lack access to water to wash these napkins or use dirty water from ponds and rivers during their migrations. Added to this are menstrual pain, stress, and anxiety related to their menstrual cycle. This period poverty has direct consequences on their reproductive and mental health.Menstrual health across the lifespan in a multi-ethnic population: Evidence from a multi-cohort study
Presenter: Marlies Visser
Affiliation: 1. Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands, 2. Amsterdam Reproduction & Development research institute, Amsterdam, The Netherlands, 3. Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
Research aim. Menstrual complaints, including pain and heavy bleeding, affect millions of women worldwide. Evidence suggests ethnic differences in menstrual characteristics such as age at menarche, cycle length, pain intensity, and the prevalence of gynaecological conditions. However, evidence on the prevalence, determinants, and broader impacts of menstrual complaints remains limited, particularly in ethnically diverse populations. Previous research has largely relied on selected or clinical samples with limited ethnic diversity, and evidence from European contexts is scarce. This study will provide the first assessment of menstrual complaints across age, ethnic and clinical groups using a large dataset due to the unique ability of integrating data across multiple cohorts.
Objectives. This study aims to (1) estimate the prevalence and identify risk factors of key menstrual complaints across age, ethnic, and clinical groups in the Netherlands; (2) assess relationships with mental wellbeing and social participation (i.e., participation in school, work and daily activities) within and across the same groups.
Methods. Cross-sectional analyses will be conducted within and across three large Dutch cohorts – two population-based cohorts (ABCD; N=878, HELIUS; N~1,500), and one clinical cohort (OMEGA; N= 41,900) using a harmonised dataset. For Objective 1, crude prevalence estimates will be calculated for key menstrual complaints, including dysmenorrhoea, irregular cycles, and heavy bleeding. Associations between potential risk factors (e.g., age menarche, Body Mass Index, smoking, alcohol and physical activity) and menstrual complaints will be assessed using cohort-adjusted pooled regression analyses. Differences by age (<35/≥35 years), ethnicity (Dutch, Moroccan, Turkish, Surinamese, Ghanaian, or Other), and clinical status (presence of diagnosed menstrual disorders or reproductive concerns; yes/no) will be tested. For Objective 2, cohort-adjusted pooled regression analyses are conducted to examine associations between menstrual complaints and mental wellbeing and social participation outcomes. Adjusted models will account for relevant sociodemographic, lifestyle, and psychosocial covariates. Effect modification is tested here similarly to Objective 1.
Expected results. We expect to include about 44.259 respondents in our analyses. This will result in a unique large cohort study enabling the assessment of age, ethnic and clinical group differences across cohorts. Analyses for both objectives are ongoing, and results will be presented at the conference.
Conclusion. The findings are expected to contribute to a better and more inclusive understanding of menstrual health and related complaints, and their impact on mental wellbeing and social participation. The study will inform prevention strategies and policy efforts addressing menstrual challenges in diverse populations.Money and Shame: Leaving Menstruators at Risk
Presenter: Melissa Bosley
Affiliation: University of Baltimore School of Law, Student
American menstruators use a variety of menstrual products throughout their lives, using more than 7,400 tampons throughout their lives. Yet, menstrual product companies and the federal government make little effort to identify the health consequences incurred by menstruators who use these products. Throughout history, the United States and menstrual product companies economically benefitted from menstruators’ menstruating because menstruators contributed to the labor force and bought menstrual products. Despite this history of economic benefit, shame surrounds menstruation. This shame and continued usage of menstrual products culminates in menstruators continuing to use menstrual products without knowing what negative health effects they may face. Scientific research studies show that menstrual products contain known harmful materials, but the U.S. Food and Drug Administration (FDA) admits that there is little literature to determine what ramifications the presence of these materials have on menstruators’ health and bodies. Most recently, research revealed that tampons contain metals, including lead and arsenic, which are known to be harmful to the human body. With an ongoing history of known dangerous materials being found in menstrual products, the FDA lacks adequate regulations to protect menstruators. This paper explores the history of menstrual products and focuses on the dangers to tampon users and then analyzes the FDA’s current regulations of tampons and calls for change to the regulations to protect menstruators’ lives. For a copy of the paper, please visit: https://scholarworks.law.ubalt.edu/ublr/vol55/iss1/9/
Navigating menstruation in the street: A qualitative study among the female adolescents in Dhaka, Bangladesh
Presenter: Faria Binte Arif
Affiliation: Lecturer, Department of Anthropology, Shahjalal University of Science and Technoogy, Sylhet- Bangladesh
The country like Bangladesh is grappling with the overpopulation, resource scarcity and limited social safety services. Among the categories of our population, the adolescent group specially who lives in the street is more marginalized regarding their basic rights and services. Organizations like United Nation and UNICEF defined street children with the three components, including the time spend on the street, earn livelihood from the street and not having any support from NGOS, adult groups or any kind of external help. However, the female street adolescents are more uniquely vulnerable regarding their gender and age. Growing up in the street, these females face challenges to meet their basic health and hygiene, especially during the menstruation. This study aims to uncover the realities of how the street adolescents navigate and negotiate their menstrual experiences being on the street. This would be exploratory research following In-depth Interviews with adolescents (n= 15), KII with caregivers (n=3), and community-based service providers (n= 4). The findings show there is a robust correlation between the knowledge and menstrual practices among these females. However, the interviews reveal the reluctancy of mothers to share menstruation related information due to SRH stigma and shame. Lack of proper source mislead them and their practices. Being on the street, they usually use public toilets which limits their time to take proper bath, sometimes they have to pay to take shower in these toilets. As a material they use old clothes and re-use this for a time being by washing and drying them in a secret place. This piece of cloth is perceived as a symbol of shame to these females. Moreover, lack of washroom facilities in the street, lack of accessibility of the sanitary products and lack of knowledge as they do not have any schooling from the any educational institution, their life ended up in the misinformation and stigma regarding the menstruation. However, the street connected females perceived menstruation as an embarrassment, a taboo, a lost opportunity and a troubling situation. These kinds of practices make them susceptible to the vaginal infection and reproductive health risks also. This paper makes a strong case that ignorance, false perceptions, and unsafe practices regarding menstruation are not uncommon among female street adolescents, which directly impacted their reproductive and sexual health. This study would shed lights on the struggles of these females which need institutional support to empower themselves to live with dignity.
Perimenopausal Onsets of Bipolar Disorder
Presenter: Lisa Shitomi-Jones
Affiliation: Cardiff University, Division of Psychological Medicine and Clinical Neurosciences
Co-authors: Dr Clare Dolman, Bipolar UK and King’s College London Dr Katherine Gordon-Smith, University of Worcester Prof Ian Jones, Cardiff University Prof Valentina Escott-Price, Cardiff University Prof Arianna Di Florio, Cardiff University
Background and aim: Although over half of the population experience menopause during their lifetime, the effects of the menopausal transition on mental health remain critically understudied. Our previous research demonstrated that perimenopause is associated with an increased rate of first-onset bipolar disorder relative to the late reproductive stage (Shitomi-Jones et al. 2024). Building on these findings, the present study aimed to explore whether perimenopausal-onset bipolar disorder represents a clinically and biologically distinct phenotype compared to premenopausal onsets. To meet this aim, we investigated differences between pre- and peri-menopausal onset groups in bipolar subtype proportions, parity, symptom dimensions, and polygenic risk.
Methods: Utilising data from the Bipolar Disorder Research Network (BDRN), we selected 2,423 participants for whom we had sufficiently complete data for analyses. Perimenopausal onset was defined as a first episode of mania or hypomania occurring within a window spanning four years before to two years after the final menstrual period. Premenopausal onset was defined as a first episode occurring at least eight years prior to menopause, or before 35 years-of-age. Differences in bipolar subtype proportions between onset groups were examined using logistic regression, adjusted for age at interview. Logistic and linear regression models were used to compare parity, Bipolar Affective Disorder Dimension Scale (BADDS) scores, and polygenic risk scores (PRSs) between onset groups.
Results: Participants with a perimenopausal onset of bipolar disorder had two times the odds of having bipolar II disorder when compared to those with a premenopausal onset (odds ratio = 2.12; 95% confidence interval: 1.13-3.87), though bipolar I disorder remained the most prevalent subtype in both onset groups. No statistically significant differences were observed between onset groups in number of pregnancies, number of deliveries, or parity. Analyses of BADDS scores and PRSs are ongoing.
Conclusion: First onsets of bipolar disorder that occur during the perimenopause may be more likely to be bipolar II disorder than those that occur before menopause, though bipolar I disorder remained the more prevalent subtype in both onset groups. Parity did not appear to differ between pre- and perimenopausal onsets, suggesting that oestrogen changes alone do not explain the aetiology of perimenopausal onsets.Perimenopause as a Transitional Phase Beyond Menstruation: Identifying Unmet Needs Through Co-Creation and Expert Knowledge
Presenter: Henrike Langer
Affiliation: Ruhr University Bochum, Faculty of Medicine
Co-authors: Henrike Langer, Ruhr-University Bochum, Faculty of Medicine: henrike.langer@ruhr-uni-bochum.de Christine Best, Social Research Centre of TU Dortmund University: christine.best@tu-dortmund.de Prof. Dr. Sebastian Merkel, Ruhr-University Bochum, Faculty of Medicine: sebastian.merkel@ruhr-uni-bochum.de
Perimenopause marks a significant yet underrecognized phase in the menstrual life course – a gradual transition away from often regular menstruation characterized by hormonal fluctuations, cycle irregularities, and a wide range of somatic and psychological symptoms. Despite its profound impact on women’s daily lives, perimenopause remains poorly understood both among affected women and within healthcare systems. Women frequently lack adequate knowledge about perimenopausal changes, often misattributing symptoms to other causes and therefore delaying help-seeking if necessary. At the same time, healthcare provision fails to adequately address perimenopausal needs: consultations are short, information materials are scarce, and digital health tools designed specifically for this transitional phase are largely absent. This gap is particularly pressing given that perimenopause sits at the intersection of menstrual health and menopause care – and is too often overlooked by both fields. This paper presents findings from an ongoing participatory research project, named “PETRA – AI-Based Educational Therapy Guidance for Perimenopause”“, developing a digital health application for women in perimenopause. To identify unmet needs and inform user-centered design, we conduct co-creation workshops with perimenopausal women and semi-structured expert interviews with gynecologists. The workshops use participatory methods to elicit women’s experiences, knowledge gaps, and expectations regarding perimenopausal health information and self-management support. Expert interviews explore clinical perspectives on current care shortcomings and the potential role of digital tools in bridging them. Preliminary findings seem to confirm that women in perimenopause frequently experience a lack of reliable, accessible health information tailored to their specific situation. Many participants reported wishing they had received more support and not knowing where to find reliable information. Gynecologists confirmed a structural gap in care, noting that perimenopausal women are often insufficiently informed and that existing resources do not reflect the heterogeneity of perimenopausal experiences. Both groups emphasized the need for clear, inclusive, and evidence-based digital information tools. These findings underscore the importance of recognizing perimenopause as a distinct and critical stage within the broader menstrual life course. Addressing the informational and care needs of perimenopausal women requires interdisciplinary approaches that center user experience and integrate clinical expertise – as a step towards more equitable menstrual and reproductive health provision across the life course.
Periods Abroad: Menstrual Health Among International Students in Taiwan
Presenter: Olivia Schneider
Affiliation: University of Oslo, Department of Community Medicine and Global Health
Background: Menstrual health literacy and product access are increasingly recognised as critical components of reproductive health equity. Taiwan has made significant progress in menstrual policy, including the 2023 Ministry of Education policy providing diverse menstrual products across school campuses. However, this policy was designed primarily for Taiwanese students. With over 80,000 international students currently enrolled in Taiwanese universities, a significant population gap exists. International students face unique challenges including language barriers, unfamiliarity with local healthcare systems, and culturally distinct menstrual norms. Yet no research has examined their menstrual health experiences in Taiwan.
Objectives: This collaborative project between the researcher and With Red (Taiwan’s leading menstrual equity NGO) aims to: (1) assess menstrual health literacy and access barriers among international students in Taiwan, (2) explore how cultural background shapes menstrual management in a new context, and (3) co-design service improvements with international students themselves, ensuring solutions are shaped by their lived experience.
Methods: This mixed-methods study employs an anthropological perspective within a service design approach. Phase one involves a cross-sectional online survey distributed through international student associations at Taiwanese universities (target n=150). The survey assesses knowledge of campus menstrual policies, healthcare-seeking behaviours, experiences of period poverty, and cross-cultural challenges discussing menstruation. Phase two consists of co-creation workshops with 15-20 international students, facilitated in partnership with With Red. These workshops will use participatory methods to collectively interpret survey findings, identify priority pain points, and generate student-led service solutions.
Expected Outcomes: This research will generate the first empirical data on international students’ menstrual health experiences in Taiwan, also revealing broader insights about migrant health. Apart from the master’s thesis, a report will be created for With Red, including recommendations for possible opportunities for intervention by the organisation. Additionally, there will be a co-created service design output. The precise form and function will be determined collaboratively with international students during the co-creation process, ensuring the final deliverable addresses their needs.
Conclusions: Understanding the menstrual health needs of international students is essential for creating truly equitable learning opportunities for university students. This study places international students at the centre of menstrual health research, not as subjects, but as co-designers of solutions. By partnering with With Red, the study moves beyond documenting barriers to actively shaping more inclusive campus environments. The co-created outputs will offer practical tools for universities while advancing With Red’s mission of making menstrual equity accessible to everyone in Taiwan.Physical Activity Interventions Impact on Quality of Life within Endometriosis Populations: A Systematic Review.
Presenter: Kate Day
Affiliation: University of Kent, CHSS
Co-authors: Sharon Manship, University of Kent Dr Caroline Flurry, University of West England
Background: Endometriosis, a chronic, multisystem condition affecting 10% of people assigned female at birth. Associated with chronic pelvic pain, fatigue, cognitive symptoms, and impaired quality of life. Conventional management relies on pharmacological therapies and invasive surgery, which pose challenges in navigating pathways, waitlists, and variable efficacy. Overlooking wider wellbeing, increasing interest in holistic approaches to support symptom management.
Objectives: To evaluate the efficacy of physical activity–based interventions and manual muscle stimulation on pain severity and quality of life outcomes among individuals diagnosed with endometriosis.
Methods: This systematic review followed PRISMA guidance and was registered on PROSPERO. Six databases were searched for published intervention studies between 2020-2025. Eligible studies included endometriosis-diagnosed samples (laparoscopy, ultrasound, or MRI), interventions ≥4 weeks involving physical activity/exercise or manual muscle stimulation, and primary outcomes including pain and/or quality of life. Two reviewers independently screened titles/abstracts and full texts using Rayyan, resolving conflicts by consensus. Data extraction and quality assessment (PICO, TIDieR-informed, EPHPP, MMAT, RoB-2/ ROBINS-I). Narrative synthesis summarised findings.
Results: Eight publications (six studies) were included out of 5,655; two supervised exercise RCTs, one quasi-experimental strength training study, one virtual reality–based relaxation/physical activity intervention, and two RCTs evaluating massage/manual therapy protocols. Supervised multimodal exercise programmes (including pelvic floor muscle training and combined resistance stretches) demonstrated consistent improvements in current pain and quality of life. Qualitative evidence highlighting the importance of expert supervision, safety, and empowerment for adherence. Manual therapy and massage interventions were suggested to reduce dysmenorrhoea and dyspareunia, but heterogeneity and confounding factors limit conclusions.
Conclusions: Structured, supervised physical activity with multiple longitudinal intervention sessions appears beneficial for reducing pain and improving quality of life in endometriosis. Evidence for manual muscle stimulation is promising but less robust, warranting larger, well-controlled longitudinal trials reporting standardised outcomes.The influence of menopause symptoms on workplace mental health among Irish women: A preliminary study
Presenter: Wendyrose Smith (originally submitted by Akansha Naraindas)
Affiliation: Dublin Business School, Dublin Ireland
Co-authors: Akansha Naraindas, University of Exeter, School of Psychology Sarah M. Cooney, University College Dublin, Dublin, Ireland
Introduction Women’s experiences of menopause are shaped not only by biological changes but also by the social contexts in which they occur, such as the workplace. The objective of this study was to explore how psychological, somatic and urogenital menopause symptoms affect occupational self-efficacy, work ability, perceived health and work quality, and perceived workplace support among Irish women. Methods A total of 121 participants (Mage = 49.9, SD = 4.9, Range = 37–62) experiencing perimenopausal or postmenopausal symptoms participated in an online survey. Participants completed validated measures assessing menopause symptom severity, occupational self-efficacy, work ability, health and work quality, perceived workplace support, and menopause-related absenteeism. Results Psychological symptoms were significantly associated with lower occupational self-efficacy and work ability, whilst somatic and urogenital symptoms were not. Higher psychological, somatic and urogenital symptoms were correlated with multiple health and work quality measures. Organisational support was significantly associated with lower symptom severity. No significant relationships were found between symptom severity and absenteeism or reduced working hours. Conclusion Psychological menopause symptoms impact key workplace outcomes, while organisational support appears protective. These findings underscore the importance of menopause-informed policies in promoting the well-being, confidence, and retention of the workforce.
Understanding Experiences of Menopausal Healthcare: A Cross-National Mixed-Methods Study
Presenter: Kathryn Babbitt
Affiliation: Cambridge Centre for Neuropsychiatric Research, University of Cambridge
Research aim Self-reported positive and negative experiences of menopausal healthcare have been explored in specific healthcare systems, however, there is a lack of cross-national comparison of these experiences.
Objectives To evaluate and compare self-reported positive and negative experiences of menopausal healthcare provisions in five countries: Australia, Canada, New Zealand, the UK, and the US.
Methods The current analysis focused on two open-ended questions about positive and negative experiences of care from a healthcare professional (HCP) for the menopause. Data were analysed using thematic analysis. The negative dataset included data from 1896 respondents, while the positive dataset included data from 1515 respondents.
Results The most prevalent theme identified in the negative experiences was HCP attitudes and approach (51.11%, n = 969) followed by barriers with assessment and formulation of appropriate symptom treatment (38.08%, n = 722). The most prevalent theme identified in the positive experiences was positive interpersonal relationships, interactions with HCP, and HCP approach to care (68.78%, n = 1042). The next most common theme was access and positive experiences with suggested interventions (36.24%, n = 549). Between group comparisons revealed that participants from the US referenced barriers with assessment and formulation of appropriate symptom treatment more than the UK. The UK referenced challenges with appointment access, structure, or timing more than all other countries. For positive experiences, the UK and US respondents described access to HCPs more than respondents in Australia and New Zealand. The US referenced positive digital experiences of support more than all other countries.
Conclusion Healthcare experiences were primarily shaped by HCP attitudes, clinical approach, and access to care. While assessment and treatment barriers were central to negative accounts, positive experiences were driven by supportive interpersonal interactions. Cross-national differences highlight the influence of healthcare system structures on patient experience. These findings highlight the need for interventions that strengthen clinician communication, improve diagnostic processes, and address system-level access barriers across healthcare settings.Understanding the global prevalence of heavy menstrual bleeding among women of reproductive age
Presenter: Asia Bile
Affiliation: London School of Hygiene and Tropical Medicine
Abstract Background
Heavy menstrual bleeding (HMB) is a common gynecological condition with substantial health and social impacts, yet global prevalence remains poorly quantified due to inconsistent definitions and measurement tools.
Objective To systematically review and synthesize the global prevalence of HMB and examine variation by region, population, and method of assessment.
Methods A systematic search of MEDLINE, Embase, and Global Health identified studies reporting prevalence of HMB among women of reproductive age. Eligible studies used clear, reproducible definitions and provided prevalence estimates with denominators. Methodological quality was assessed using the Joanna Briggs Institute (JBI) Checklist for Prevalence Studies. Random-effects meta-analysis was performed for nationally representative studies and for those using validated questionnaires; other data were summarized descriptively.
Results Twenty-five studies, representing 32,910 participants across all six WHO regions, met inclusion criteria. Reported prevalence ranged from 2% (Iran) to 78% (Nepal). The pooled global prevalence from five nationally representative studies (16 countries) was 38% (95% CI: 31–45%), confirming that more than one in three women experience HMB. Prevalence varied by methodology: validated questionnaires yielded a pooled prevalence of 38%, subjective self-reports ranged from 18–52%, and symptom-based criteria from 2–65%. Population and setting influenced estimates, with adolescent and school-based surveys typically reporting lower prevalence (2–15%) and community-based adult cohorts or clinic-linked samples reporting higher figures (>35%).
Conclusion HMB affects a substantial proportion of women globally, with prevalence strongly influenced by measurement tools, population characteristics, and cultural context. Standardized definitions and validated tools are urgently needed to enable comparable estimates. Greater awareness, routine screening, and policy recognition are essential to reduce the burden of HMB and its related consequences, particularly in low- and middle-income countries.YOGA PRACTICE AND FUCTIONAL NUTRITION IN MENSTRUAL DISORDERS: A CONCEPTUAL FRAMEWORK FOCUSING ON HPA AXIS, OXIDATIVE STRESS AND GUT MICROBIOTA
Presenter: Vijayarani Mani
Affiliation: The Gandhigram Rural Institute (DBTU) Department of Home Science, India
Abstract: Menstrual disorders are increasingly prevalent among young women and are strongly associated with stress dysregulation, hormonal imbalance, and lifestyle-related factors. Emerging evidence highlights the role of hypothalamic–pituitary–adrenal (HPA) axis dysfunction, oxidative stress, and gut microbiota alterations in the pathophysiology of menstrual irregularities. However, these mechanisms are often studied independently, with limited integrative models linking them to combined lifestyle interventions. Aim: To develop a conceptual framework integrating yoga practice and functional nutrition in the management of menstrual disorders through the interconnected pathways of the HPA axis, oxidative stress, and gut microbiota. Objectives: 1. To examine the role of HPA axis dysregulation in menstrual disorders. 2. To explore the contribution of oxidative stress and gut microbiota imbalance to menstrual health. 3. To conceptualize the combined effects of yoga practice and functional nutrition on these mechanisms. Methods: This study adopts a conceptual and integrative approach based on an extensive review of existing literature on yoga interventions, nutritional modulation, and physiological mechanisms related to menstrual health. A theoretical framework is developed linking neuroendocrine regulation, redox balance, and gut microbial dynamics with lifestyle-based interventions. Results: As a conceptual study, no primary experimental data are presented. The proposed framework suggests that yoga practice may regulate the HPA axis and autonomic function, thereby reducing stress-induced hormonal disturbances, while functional nutrition—comprising antioxidant-rich and gut-supportive components—may attenuate oxidative stress and promote a healthy gut microbiota. The integration of these approaches is expected to produce synergistic effects on hormonal regulation and overall menstrual health. Conclusion: The proposed framework provides a comprehensive understanding of the interconnected mechanisms underlying menstrual disorders and highlights the potential of combined, non-pharmacological interventions. This integrative model may guide future empirical research and contribute to the development of holistic, accessible strategies for improving women’s reproductive health. Keywords: Menstrual disorders; Yoga practice; Functional nutrition; HPA axis; Oxidative stress; Gut microbiota
Workshop
(Digital) Women’s Health Across the Life Course in 2050 – A Future Back Workshop
Presenter: Marcia Nißen, Marinja Principe, Davinny Sou, Maximilian Bley
Affiliation: Eastern Switzerland University of Applied Science (OST) University of Zurich ETH Zurich
NA
A Community Conversation: Policy, Practice, and Culture for Workplace Menstrual Health Support
Presenter: Anushka Swannell
Affiliation: Manchester Community Central (Policy & Influence Team)
This study aims to assess the level of public knowledge, lived experience, and opinion regarding the safety, composition and regulation of menstrual products among women and people who menstruate nationwide.
Objectives
To identify gaps in public awareness of the ingredients and safety standards of commonly used menstrual products
To explore community attitudes towards current regulatory frameworks governing menstrual product safety
To capture the diversity of experiences across different demographics, including age, product preference and lived experience
To inform evidence-based recommendations and insights for menstrual product regulation and wider menstrual health legislative initiatives.
Methods
An anonymous online survey was developed and distributed by Manchester Community Central as part of an 18-month menstrual health project. The survey captures quantitative data on product usage and knowledge levels, alongside qualitative responses on lived experiences and policy opinions. Participation is open to all women and people who menstruate, with no requirement to answer every question, supporting inclusive and accessible data collection. To date, 248 responses have been collected, with data collection ongoing as of March 2026.
Results
Data collection is currently in progress. By the time of the conference, we would be ready to present findings from the survey, with analysis focusing on patterns in product safety awareness, areas of concern raised by respondents, and lived experience on menstrual health and period product safety.
Conclusion
This community-led research addresses a significant gap in public health knowledge. By centering the voices of those most directly affected, the findings will contribute to calls for greater transparency in product labelling, stronger legislation on period product regulation and the meaningful integration of lived experience into menstrual health policy. The study supports a growing evidence base for policy reform aligned with menstrual dignity and health equity.Capturing Complexity: New Directions for Defining and Measuring the Menopausal Transition
Presenter: Marijke Schotanus-Dijkstra
Affiliation: University of Twente, Psychology, Health and Technology department
Background: Each year, at least 25 million women worldwide experience menopause, yet the potential for flourishing during the menopausal transition period remains underexplored. To date, most studies in the climacteric field have focused on bio-physiological symptoms associated with the menopausal transition while mental health (both mental illness and mental wellbeing) is impacted by the menopausal transition as well. People who score high on emotional, social and psychological wellbeing across 14 dimensions, including happiness, life-satisfaction, social contribution, purpose in life and self-acceptance, are viewed as flourishing. The current scoping review aims to examine what is known about flourishing and its emotional, social and psychological wellbeing components throughout the menopausal transition.
Method: Almost 5.000 references were screened, and 461 full-text articles. This scoping review analyzed 181 articles from 158 longitudinal, experimental, cross-sectional and qualitative studies from four electronic databases up to 2026.
Results: Only 39 studies primarily addressed emotional, social or psychological wellbeing, with eight studies encompassing comprehensive measures of flourishing. A central finding of this review is that both longitudinal and cross-sectional studies consistently show that menopausal symptoms were negatively associated with flourishing, emotional and psychological wellbeing, while these variables did mainly not significantly differ between menopausal stages. In addition, the qualitative findings suggest that some women may experience growth and elements of flourishing during the menopausal transition.
Conclusion: More in-depth exploration of positive experiences throughout this challenging yet transformative period is needed as well as defining the menopausal stages more accurately.Changing Cycles, Changing Lives: Mental Health and Wellbeing in Perimenopause
Presenter: Elaine Rose Leela
Affiliation: Women’s Inner Wellness
Perimenopause is a psycho-neuro-immunological life transition of the female life cycle that continues to be under-recognised, with important consequences for mental health and wellbeing. Although menstruation research has expanded in recent years, perimenopause often remains at the margins of these conversations, despite the fact that changes to hormones and periods may coincide with anxiety, low mood, irritability, sleep disruption, cognitive changes and reduced confidence. For many, this life stage also brings wider questions about identity, changing family roles, grief and loss and life disappointments, ageing, and shifting expectations. These experiences are frequently misunderstood, dismissed or fragmented across healthcare, workplaces and communities.
The workshop has four aims: to deepen understanding of where in the menstrual cycle perimenopause begins to recognise how perimenopause affects mental health, wellbeing and identity to explore how stigma, gendered expectations shape lived experience to strengthen confidence in discussing perimenopause across research, education, advocacy and practice
The session uses Integral Theory and Mindfulness principles and practices, for a clear and accessible framework to understanding perimenopause across four connected dimensions: inner experience, including emotion, meaning and identity; physical experience, including menstrual changes, sleep, symptoms and cognitive functioning; relationships and culture, including stigma, family roles and shared beliefs; and systems and structures, including healthcare, workplaces, policy and access to support. This approach enables participants to move beyond narrow biomedical accounts and engage with perimenopause as an embodied, relational and structural experience that can change lives.
Activities will include a short framing presentation, individual reflection, paired or small-group discussion, and a guided mapping exercise using the four connected dimensions above. Participants will reflect on common symptoms, emotional changes, identity shifts, support needs, stigma and help-seeking and share discourse and lived experience of perimenopause. The session will close with a discussion that draws together practical insights, critical questions and hopeful reframings for research, policy and practice.
Participants will leave with stronger understanding, greater confidence and a renewed sense of possibility. Able to respond thoughtfully to perimenopause and to recognise this transition as one that can hold meaning, agency, growth in the cyclical life experiences.
Although a 90-minute workshop would be preferred, it can be adapted to a time length given. If possible, a space for participants to gather into a circle.Cycling Beyond the Binary: A Workshop on Cyclical Wellbeing, Menstrual Dignity and Literacy for LGBTQ+ Menstruators
Presenter: Mati Ray Marlowe
Affiliation: Stakeholder - Cycling with my Cycle project
Menstruation and the whole cycle experience is still widely framed as an exclusively women’s experience — yet many trans, non-binary, intersex, queer people menstruate and live with a cycle often without enough or any education, supportive healthcare or community spaces that reflect their realities and that are open to discussing said realities. This erasure and taboo can deepen gender dysphoria, fuel health anxiety/mental health issues, and leave LGBTQ+ menstruators navigating our bodies largely in silence and alone. For many LGBTQ+ menstruators, menstruation intersects painfully with gender identity. This thread opens honest conversation about dysphoria, body image and the psychological weight of menstruating in a world that misgenders the experience.
Aims This interactive workshop aims to create a brave, affirming space to change that. We aim to provide: an introduction to elements of gender-affirming cyclical health education; honest conversations about dysphoria, identity and cycle phases; and some practical tools for managing menstrual wellbeing with self-compassion. The session is offered to LGBTQ+ menstruators, advocates, educators and health practitioners. No prior knowledge is required — only a willingness to explore menstrual health through a lens that centres gender diversity and inclusivity. The workshop blends some facilitated input with peer reflection and small group discussion. It is grounded in community voices and shaped by the understanding of the LGBTQ+ menstruators.
Activities The workshop is structured around three facilitated threads, blending brief accessible input with peer reflection and small group discussion:
Know your cycle — exploring cycle phases and the relationship between hormones, mood, energy and cognition, using inclusive, gender-neutral language throughout. The goal is to offer knowledge as a tool for autonomy and self-understanding.
Dysphoria and cyclical living —a collective exploration of what it entails and what challenges are faced, lived, embodied to be people who menstruate and be part of a wider spectrum of identities outside and/or inclusive of ““womanhood”“? If time, a menstrual dignity practice — examining what dignity looks like in clinical settings, everyday life and community spaces, and how we can better aid LGBTQ+ people
Learning Outcomes By the end of the session, participants will be able to: describe the menstrual cycle using inclusive, non-gendered frameworks; identify the intersections between menstruation, gender identity and mental health; and apply at least two self-care strategies to support cyclical wellbeing.
Experience Outcomes Participants can expect to leave feeling more informed, less isolated and more confident discussing menstrual health on their own terms. Practitioners and educators will have a possibility to develop language, awareness and practical approaches to better support LGBTQ+ menstruators in their work. All genders welcome. All experiences valid.Defining Our Impact: A Collaborative Workshop on creating a UK Menstrual Health Framework and Evaluation Toolkit
Presenter: Annalise Weckesser
Affiliation: Birmingham City University/Social SciencEs Endometriosis Network
Aim: Menstrual inequality is a significant public health issue in the UK, yet the community-led organisations at the forefront of addressing this issue have informed us that they are unsure how to define impact and that they often lack standardised tools to meaningfully measure the impact of their initiatives. To address this gap in knowledge and practice, a new NIHR-funded research project, developed in partnership with the Period Equity Alliance (PEA), aims to co-design the UK’s first Menstrual Health Framework and Evaluation Toolkit. This workshop is designed to bring together menstrual health community practitioners, individuals with lived experience, and academic researchers to inform this vital initiative.
Activities: Following a brief presentation of the project’s aims, participants will engage in small-group, facilitated discussions and collaborative mapping activities. These exercises will be designed to capture diverse perspectives on evaluation needs (including any evaluations that organisations have already undertaken), potential indicators to measure impact, and the practical realities of data collection in community settings. The 60-minute session will conclude with a large-group feedback and synthesis of key themes.
Expected Outcomes: Workshop participants will gain an understanding of the current gaps in UK menstrual health data. The workshop fosters networking, bridging the gap between grassroots practitioners and academic researchers to start a dialogue around which menstrual health factors—such as psychological well-being, social participation, and symptom management—are most critical to measure and how best to measure them. Feedback gathered via the workshop will inform the NIHR project’s planned rapid systematic review and future stakeholder workshops planned as part of the main research project. The insights gathered will also be used to shape the co-design elements of the project, ensuring that the stakeholder engagement strategy is genuinely inclusive and representative of the UK menstrual health and period poverty sector.
Logistical details: 60-minute session, cabaret style room layout, PowerPoint access and flipcharts.Designing Accountable Participation: A Transformative Learning Pathway for Male-Identified Actors in Menstrual Research
Presenter: Peter Hochenauer
Affiliation: University of Vienna, Faculty of Philosophy and Education, Department of Philosophy
This workshop proposal addresses the persistent gender imbalance in menstrual research and advocacy — not by advocating for greater male recruitment, but by asking what conditions would make male participation genuinely accountable and epistemically prepared. The aim is to present and collectively refine a conceptual framework for a pre- and post-conference workshop model designed to support male-identified researchers, practitioners, and policy-makers in developing critical menstrual literacy around their participation in feminist-led research spaces.
The proposal is motivated by participant observation and personal reflection at the 2025 Menstruation Research Conference, where even well-intentioned male attendance revealed a recurring friction: professional socialization that has not yet adapted to the epistemological and relational norms of feminist-led inquiry. Rather than placing the burden of men’s sensitization on women, the proposed model is designed to be facilitated by male peers, deliberately redistributing the emotional and pedagogical labor this transition requires.
The conceptual framework draws on three interlocking bodies of work: transformative learning theory, enactive cognitive science, and Joint Problem Framing (JPF). Transformative learning provides the architecture for understanding how structured reflection — before, during, and after a disorienting encounter — can catalyze a shift in professional habitus, regardless of whether that disorientation is anticipated or only recognized in retrospect. Enactive cognitive science frames the observed friction not as ideological conflict but as an embodied and relational failure to attune to a different epistemic environment. JPF offers participatory practices through which technical expertise can be realigned with the situated knowledge of those whose lives the research concerns.
The proposal is at a conceptual stage. Workshop activities will include guided reflection on scenario vignettes and collective mapping of design principles, supported by a visual framework derived from the theoretical synthesis. This session therefore invites critical engagement from conference participants — particularly regarding design principles, potential risks, and the conditions under which such a model could support rather than appropriate feminist research culture. Expected outcomes include a shared articulation of what accountable male participation could look like, and initial co-design input for a workshop framework that may be piloted at a future conference. A session duration of 90 minutes is proposed.Holding Space: Doing Emotionally Challenging Research — An Occupational Therapy Perspective on Researcher Wellbeing.
Presenter: Samantha Tavender
Affiliation: University of Huddersfield
NA
How to avoid reproducing societal myths in menstrual policy and campaigns work
Presenter: Sally King
Affiliation: Menstrual Matters & King’s College London, Dept of Women’s Health
Overview: The menstrual health & rights movement must proactively identify, expose, and challenge inaccurate and oppressive beliefs about periods and the people and practices associated with them, or we risk unintentionally perpetuating harmful social stereotypes. This workshop will outline a few key examples of the way in which we may internalize social norms, and how menstrual health and rights work has sometimes done this in the past, despite having the best of intentions. Topics covered: Menstrual leave, tampon tax, period poverty, menstrual health, environmental sustainability, & menstrual education.
Aims: To highlight the need for reflexive and evidence-based practices within the menstrual health & rights movement, especially when it comes to influencing policy and campaigns work. To provide participants with some knowledge and tools to avoid reproducing social myths in their own activities.
Activities: Interactive PowerPoint presentation (30 mins), group discussions by theme (different tables/ areas of the room) (20 mins), feedback as a whole group (nominated speaker per group- 10 mins).
Learning outcomes: Understanding the ease with which we may all unintentionally ‘blame periods or those who have them’ while trying to improve menstrual health and rights. Understanding the need for and how to check for social myths in our work activities and policy/ campaigns work. Knowing some common pitfalls and previous problems within the movement.
Resources: Take-away document (4 pages A4)- adapted from Encyclopaedia entry (will check copyright issues with Kay Standing/ Bee Hughes).
Logistics: Screen for PowerPoint, possibly tables, or at least some means of splitting the audience into discussion groups by theme? Could be different areas of the room?Irise International - Period Confident Schools: Lessons from Translating Youth-Led Research into a Whole-School Approach to Menstrual Justice
Presenter: Chrissy Cattle, Sara Newton
Affiliation: Irise
NA
Mapping the Pelvis. An Embodied experiential approach to Pelvic awareness and connection for physical and emotional health and wellbeing.
Presenter: Jane Dancey
Affiliation: Freelance
My work has been honed from 20 years of working with females and the positive outcomes from working through an embodied approach.
AIM To take you on an embodied anatomical journey with the female pelvis, to befriend and map this part of the body that is so often overlooked, unknown and shrouded in taboo and pain. To go beyond the one dimensional anatomical diagram into the multidimensional living body.
Many females suffer from menstrual pain and discomfort and most are not initiated into their own embodied anatomy. When problems arise they don’t have a relationship within which to explore the problems, they might not be familiar with the anatomical terminology to describe what is happening for them, and they might not have access to a felt sense of the sensations within their pelvis nor be able to describe how they are and where they are. This might even result in them putting off going to a doctor.
Female genitalia are within the body and therefore are not acknowledged, known or mapped in the same way as the external male genitalia. The neuro-registery of this region of the female body will not be so pronounced as within a male body therefore it will be more un-known. It’s much harder to talk about something that is unknown and this can lead to consigning what should be personal knowledge over to the white-coated man to tell us what is ok or is not ok. We know that increased proprioception and interoception is incredibly beneficial to health outcomes, and it makes sense that this would be incredibly useful for pelvic health as well.
It’s time for this to change and for a reclamation of the feminine pelvic terrain, so that we become the experts on our own pelvises and cultivate the power and creativity that comes with this.
OUTCOME For attendee’s to experience an embodied approach to pelvic connection and relationship through mapping the bones and organs using external touch, posture and movement.
METHOD Somatic movement, embodied pelvic mapping, breath and visualisation.
DURATION - 90 MINS WORKSHOP REQUIREMENTS - chairs to sit on. Does not need specific clothing.Menstrual Knowledges: Interdisciplinary Approaches to Understanding and Valuing Menstruation
Presenter: Ainhoa Rodriguez Muguruza
Affiliation: University of the Basque Country
NA
Supporting menstrual health with physical activity
Presenter: Alison Cooper, Natalie Brown, Sophie Harrison
Affiliation: Cardiff University, Women’s Health Research Wales Swansea University Bangor University
Background
Menstrual (period related) symptoms are a recognised barrier to adolescents engaging in physical activity. Insufficient physical activity is 5% higher among women than men globally associated with increased risk of non-communicable diseases such as diabetes, heart disease and cancer. The World Health Organization recommends that to improve global physical activity levels by 2030, one focus should be on women. However there is a lack of evidence-based guidance about how to address menstrual health barriers with physical activity. Our aim was to develop a set of programme theories to describe how menstrual health support interventions work, for whom and in what circumstances, to inform a logic model for intervention development.
Methods
We followed rapid realist review methodology incorporating stakeholder expertise. Formal, double screened, database and grey literature searches were conducted (Medline, AMED, Embase, Psycinfo, CINAHL, ERIC, SCOPUS) in line with abbreviated systematic review methodology. Articles were included that met inclusion criteria and contributed to the process of theory development. Explanatory statements were extracted and synthesised into programme theories (context-mechanism-outcome configurations) using Pawson’s reasoning processes, mapped onto Self -Determination theory concepts (autonomy, competency, relatedness).
Results
From 9585 database hits, 63 articles were included. Generated programme theories described how four intervention domains (education; practicalities including toilet facilities, period friendly clothing and free accessible period products; menstrual cycle tracking and screening tools; and medical support if needed) could support improving menstrual health confidence and understanding, communication, and trust. These could empower individuals to enhance their own menstrual health and potentially improve participation rates and performance in physical activity. However, adverse outcomes were described when processes were not in place to: signpost to medical support if needed; support users’ trust in how and why data were collected and used; and enable understanding of the limitations of menstrual health support tools.
Conclusion
The proposed programme theories and logic model can be used to inform and evaluate interventions aimed at overcoming menstrual health related barriers with physical activity. Future interventions developed from this model need robust evaluation.Threads of Menstruation
Presenter: Bushra Mahnoor
Affiliation: Mahwari Justice
Women had historically limited access to formal education but they were often taught embroidery from a very young age. Textile work became one of the few mediums available to women for recording everyday life. Women have used embroidery as political commentary during South African Apartheid and under the dictatorship of Augusto Pinochet in Chile to record state violence. Even today, women in Balochistan, Pakistan use embroidery to fight against forced disappearances. Embroidery has often been used to express experiences when other forms of communication are restricted or censored. Menstruation has long been one of them.
This workshop explores embroidery as a way of engaging with menstruation through textile work. Participants will sit together in a circle and embroider small fabric squares using thread and needle. The session will begin with a short demonstration of basic stitches so that participants can work with the material. Participants will then embroider symbols or phrases (in their language of choice) that reflect their experiences and feelings related to menstruation. At the end of the session, the individual squares will be stitched together to form a collective cloth. The piece will remain at the conference as a shared artwork created during the workshop. The cloth will be assembled during the final part of the session so that participants can see the work come together. The workshop sees embroidery as a creative and political practice that creates space for participants to reflect on menstruation in a medium that does not rely solely on speech.What about a 5th ‘M’? Movement within the 4M’s: a life course approach to embedding physical activity.
Presenter: Katrina Taylor & Hannah Hersant
Affiliation: University of Kent
NA
Women’s health research through an intersectional and interdisciplinary lens: Spotlight on the biopsychosocial model of PCOS
Presenter: Kate Day, PCOS Research Network
Affiliation: University of Kent, Centre for Health Services Studies
Research Aim: To explore the diagnosis experiences and support needs of individuals living with Polycystic Ovary Syndrome (PCOS)
Objective: To understand the lived experiences of individuals living with PCOS in Kent, Surrey and Sussex and to co-develop with those living with the condition a set of recommendations to address issues around diagnosis and improve ongoing support
Methods: An evidence synthesis of the existing literature was conducted via a systemised scoping review. Additionally, semi-structured one-to-one interviews with a sample of 12 participants living with PCOS were undertake to further explore individual experiences
Results: The scoping review search strategy produced 1786 results and 213 potentially relevant papers, which were screened and resulted in the final papers selected for inclusion (n=16). The review of the literature uncovered a number of challenges and negative experiences of diagnosis PCOS, including time delays, lack of knowledge of healthcare professionals (HCPs), gatekeeping of referrals, feeling stigma and shame and limited provision for mental health support. The interviews uncovered that despite experiences being nuanced, they were broadly similar to the literature, and these and additional issues were experienced both pre and post-diagnosis. Challenges included a lack of knowledge of HCPs and patients, lack of support systems, unclear care pathways and wide misinformation about the condition, which impacted on the quality of life and wellbeing of individuals. The needs of those living with PCOS included better support from HCPs, more training and education, better recognition of all aspects of the syndrome, a person-centred and empathetic approach, more focus on the mental health aspects of the condition, accessible and evidence-based information and peer support.
Conclusion: The illness burden of those living PCOS is experienced variety of ways, including biophysically, psychologically and socially. Diagnostic experiences and support needs are varied and nuanced, and should therefore be addressed using a person-centred, empathetic and holistic approach, which treats the whole person instead of targeting individual symptoms. The findings indicate the need for a improved health literacy for both professionals and patients and multidisciplinary care which goes beyond the clinical approach, as well as wider societal supportRoundtable
Dignity in Menstrual Health: Concept, Definition, and Practice
Presenter: Abigail Lennox, Meera Tiwari, BINTI, Katie Nearly, Freedom4girls, Inga Winkler
Affiliation: University of East London BINTI Liverpool John Moores University/ Liverpool Council/Newham Council Freedom4girls
Within the menstrual health discourse, dignity is frequently invoked yet rarely interrogated. The term circulates widely across research, policy, and practice (Bobel and Fahs, 2020), yet without a shared or stable definition. Raising a foundational question that this panel takes as its starting point: what does dignity actually mean in the context of menstruation, and for whom? The urgency of this question is well established. Reports from Plan International (2018) and UNICEF (2019) document that millions of girls and women remain unable to menstruate safely and with dignity, facing stigma, restricted mobility, school absenteeism, and exclusion from social and religious life. Yet as Wein (2022) observes across the broader development literature, dignity is consistently invoked without being defined, assumed to be selfevident while remaining, in practice, contested and unstable. In menstrual health specifically, as Bobel (2019) has shown, the term has quietly come to function as a proxy for concealment, with dignity-preserving interventions prioritising discretion over the dismantling of stigma. This panel brings together academic experts from Liverpool John Moores, and East London with collaborators from the BINTI and Freedom4girls, to address this gap directly. It is structured around three interconnected questions: what is dignity, how is the term used, and what does it mean to enact it? The first part asks what dignity actually means in the context of menstruation. Drawing on Tiwari’s (2022) work, which locates dignity in the self, in selfrespect, self-esteem, and self-worth, while recognising how deeply those qualities are shaped by social norms, the panel explores how the concept has been understood across philosophy, policy, and practice. Rather than imposing a fixed definition, the panel invites critical dialogue about what dignity should mean for those who menstruate, drawing on Sennett (2003), Sen (1999), and Alkire (2007) as conceptual anchors. The second part examines how the term is used - and misused. When dignity remains undefined, dominant norms fill the gap, reinforcing silence and the expectation of concealment rather than challenging the stigma that underpins poor menstrual health outcomes.
Exploring Menstrual Cup Awareness, Perceptions, and Use Among Adolescent Girls in Bugiri District Secondary Schools
Presenter: Namulwana Florence
Affiliation: Couldyou.org
Menstrual health remains a critical public health issue affecting the wellbeing, dignity, and educational participation of adolescent girls in low- and middle-income countries. In Uganda, menstrual hygiene management is constrained by socio-cultural taboos, limited access to accurate information, and inadequate availability of sustainable menstrual products. Menstrual cups present a cost-effective and environmentally friendly alternative; however, their acceptability and use among adolescents remain insufficiently understood.
This study aimed to assess the knowledge, attitudes, and use of menstrual cups among adolescent girls attending selected secondary schools in Bugiri District, Eastern Uganda. The specific objectives were to determine the prevalence of menstrual cup use, assess levels of knowledge regarding menstrual cups, and explore attitudes toward their use.
A field-based cross-sectional survey was conducted among 50 adolescent girls aged 13–18 years. Data were collected using a structured questionnaire covering sociodemographic characteristics, knowledge, attitudes, and practices related to menstrual cup use. Descriptive statistics were used to analyze the data, and results were presented in tables and narrative form.
Findings showed that 70% of participants had heard about menstrual cups, with media and schools being the most common sources of information. Despite this awareness, only 10% reported having comprehensive knowledge of menstrual cup benefits. Attitudes toward menstrual cups were mixed, with 46% expressing positive perceptions, while concerns related to hygiene (44%) and lack of knowledge on proper use (50%) were prominent. Notably, 76% of respondents reported having used a menstrual cup, with peer and family recommendations emerging as key influences for adoption. Among non-users, fear of insertion and inadequate knowledge were the main barriers.
In conclusion, while awareness and reported use of menstrual cups among adolescent girls in Bugiri District were relatively high, significant gaps in detailed knowledge and confidence remain. Strengthening school-based menstrual health education, incorporating practical demonstrations, and leveraging peer support systems may enhance informed uptake and sustained use of menstrual cups. These interventions could contribute to improved menstrual health management and empowerment of adolescent girls.From Product Provision to Menstrual Literacy: Integrating Menstrual Health into Sexual and Reproductive Health Consultations in Primary Care through Brazil’s National Menstrual Dignity Programme
Presenter: Ursula Maschette Santos & Mariana Seabra Souza Pereira
Affiliation: Ministry of Health, General Coordination of Women’s Health, Brazil
Across many countries, menstrual health policies remain largely centred on product distribution, with limited investment in education, stigma reduction and integration into health systems. Brazil’s National Menstrual Dignity Programme, led by the Ministry of Health, presents an innovative policy approach that combines access to menstrual products with a structured educational strategy embedded within primary health care (PHC) and broader sexual and reproductive health services.
This panel will present a national good practice focused on scaling menstrual literacy through public policy while addressing menstrual stigma and inequalities. Since 2024, the Programme has expanded free access to menstrual products nationwide while simultaneously developing an educational axis aimed at strengthening professional training, community dialogue and rights-based care. In parallel, Brazil incorporated the etonogestrel subdermal contraceptive implant into the public health system (SUS) in 2025, supported by a national investment of approximately BRL 224 million. The implementation included large-scale territorial workshops conducted between late 2025 and early 2026, qualifying more than 12,000 health professionals in menstrual health, sexual and reproductive health, and contraceptive counselling.
These training experiences revealed that menstrual health education functions as a key entry point for reducing stigma, improving clinical listening and strengthening shared decision-making in reproductive health consultations. Insights gathered from territories demonstrated how integrating menstrual cycle discussions, from menarche to menopause, enhances autonomy, expands access to information and supports more comprehensive care pathways within PHC.
The panel will explore how menstrual literacy can move beyond individual behaviour change to become a structural component of menstrual policy, highlighting lessons learned from implementing educational strategies in a large and socially unequal country. Particular attention will be given to how menstrual health education intersects with contraceptive access, professional training and gender equity within a universal health system.
By sharing Brazil’s experience, this session contributes to global discussions on menstrual policy innovation, demonstrating how combining education, clinical training and public investment can transform menstrual dignity initiatives from product-based interventions into integrated, life-course health strategies. Participants will gain practical insights into scaling menstrual health education through policy design, workforce development and intersectoral collaboration.Intersectionality Beyond This Buzz
Presenter: Inga Winkler, Andrea Ford, Paula Blancarte Jaber, Erica Selznick, Janice Lazarus, Samantha Schwickert
Affiliation: Wageningen University Edinburgh University BTU Cottbus
Menstrual research, policy and advocacy often commit to diversity and inclusiveness. Yet, all too often this commitment remains tokenistic, reduced to inclusive language, while much of the actual work remains centred on a ‘default’ menstruator, usually an adolescent girl. In this panel, we will discuss intersectionality as more than a buzzword to critically interrogate gender, compounded stigma and intersecting power structures. The four papers provide conceptual, empirical and policy analysis perspectives examining menstrual stigma, menstrual discourse in popular media, and menstrual health concerning the self-management of endometriosis.
My contribution is the paper: What is the difference between intersectionality and diversity of experiences?
I draw on a critique of endometriosis policy environments and processes, combining policy analysis and key informant interviews to assert that diversity of endometriosis experiences does not translate to intersectionality unless allied institutionalized structural injustices are interrogated and challenged.
I analyze governmental documents on endometriosis, as well as NGO policy proposals. Key informant interview participants include policymakers and policy advocates across Europe involved in developing endometriosis policy.
Adopting an intersectional feminist approach, I examine the interplay between people living with endometriosis’ lived experiences self-managing and the structural conditions that facilitate or impede these. I explore how framing and prioritization in endometriosis policy and advocacy contribute to shifting care responsibilities from the state to individuals and communities, influencing lived experiences. I recognize how overlapping systems of oppression influence how individuals encounter empowerment, through autonomy and control, and abandonment, through structural neglect.
Particular attention is given to the intermediary role of endometriosis advocates. Advocates operate between people living with endometriosis (representing their needs and validating experiences) and institutions (framing issues strategically to appeal to policymakers). Advocacy often aims to ‘represent the majority’ when petitioning, yet advocates simultaneously recognize the vast diversity in endometriosis lived experiences. This is complicated by the positionality of many advocates who have endometriosis themselves, navigating their own experiences while engaging with others and communicating this to policymakers in ways that represent people’s needs and inform policy.
I interrogate whether advocacy and policy processes engage beyond recognizing diversity of lived experiences and whether they incorporate intersectional approaches. While acknowledging diverse experiences can inform policymaking, it can lead to significant shortfalls and overlook systemic inequalities if it conflates this with intersectionality and fails to address the systemic forces shaping health and care that may require wider structural questioning and reorganizing.Menstrual Discrimination: constructs inequality from Kitchen to Parlimanet
Presenter: Radha Paudel
Affiliation: Global South Coalition for Dignified Menstruation
Panel The aim of the panel is to unpack the nature of menstrual discrimination and its role in construction of inequality and its systemic impact in all aspects of society or menstruators. There will be three speakers and one moderator from global south. It needs 90 minutes to conclude the panel. We have done such virtual panels and one to three days international conference several times including UN NGO CSW therefore will not be any issue from our side. We can share our zoom link if required. We will proceed with guided meditation, use of mentimeter, panel discussion and question answer mode. Understanding on urgency of dignified menstruation as a decolonial and holistic approach will be the outcome of this panel.
Menstrual Policy Priorities
Presenter: Bettina Bildhauer, Helen Lynn, Inga Winkler, Hilary Critchley, Sophie Collins, Tigist Grieve
Affiliation: University of St Andrews University of Exeter Women’s Environmental Network Wageningen University University of Edinburgh Technopolis UK University of Bristol
Academics from the Menstruation Research Network have identified five ‘hot topics’ for current policy intervention: (1) medical care, (2) menstruation in the workplace, (3) menstrual product safety, (4) education, (5) stigma. The roundtable aims to share recent research findings, explore gaps in menstrual policy, identify practical policy changes and build collaboration among menstrual academics, activists and policymakers. Policies often unintentionally replicate the stigma they seek to dismantle, “resulting in hesitancy and missed opportunities” (Olson et al, 2022; cf. Bildhauer Røstvik and Vostral 2022). How can we as policymakers, academics and activists learn from each other’s experience and research in menstrual policymaking in the UK and internationally to create effective interventions?
Leading policymakers, academics and activists will contribute a 5-minute presentation (one powerpoint slide or simply an oral statement) to this roundtable, followed by a Q&A.
In my contribution, I will speak on the role of policy in unsettling menstrual stigma. I will share lessons from policy-making in various parts of the world. What role can policy play in tackling pervasive stigma surrounding menstruation? And what are the challenges and limitations of existing policies, and how can we best overcome these by complementing policy-making with other measures? How can we best make use of the signaling function of policies that turns something perceived as private into a matter of public policy and ultimately a societal responsibility? To achieve this, policies need to combine measures that accommodate the needs of menstruators while simultaneously enhancing their societal recognition.
Period politics and menstrual justice
Presenter: Fran Amery, Melanie Channon, Jennifer Thomson, Minakshi Dahal
Affiliation: University of Bath
Join us for a roundtable to discuss the forthcoming book Period Politics (2027; Policy Press). Periods are now finally enjoying political attention after years of stigma and silence. Campaigns for ‘menstrual equity’ or against ‘period poverty’ have taken off in many countries. ‘Tampon taxes’ have been culled around the world. Getting period products to those who can’t afford them has also become a major focus. Yet, as the book aims to show, governments are also getting periods wrong: too often, they are simply throwing pads at the problem while leaving stigma and inequality intact.
In this roundtable we will ask, why has providing period products come to dominate menstrual policy agendas? And what’s being left behind in the rush to provide products? What’s going wrong in policy around menstruation around the world and what (more rarely) are governments getting right? We will discuss specific areas that are often neglected in policy discourse on menstruation, including menstrual pain, the safety of menstruating people, and the impact of (menstrual) capitalism.
This roundtable will also consider the book’s call for menstrual justice. In an already-crowded field of menstrual concepts (menstrual health, period poverty, menstrual equity, period dignity, and so on), why call for ‘justice’? We argue for menstrual justice as a holistic framework within the broader reproductive justice tradition, connecting menstruation to other social justice issues. Menstrual justice emphasises the fundamentally political nature of menstruation-related disadvantages and the relational character of menstruation itself: we always experience menstruation in relation to others.
Duration: 1 hour (or 1h30). No AV equipment needed.Tampons as a source of chemical exposure: Novel research and its impact on policy
Presenter: Jenni A. Shearston, Kristen Upson, Kathrin Schilling
Affiliation: University of Colorado Boulder Michigan State University Columbia University
For half the population who experiences menstrual bleeding, tampons are a vital option for menstrual management. Tampons are the only disposable product that retains menstrual fluid within the vagina and that has substantial contact with the vaginal wall – which is highly permeable, vascularized, and allows absorbed chemicals to directly enter systemic circulation. Several studies have detected a range of toxic chemicals in tampons, including metals and chemicals that can disrupt the endocrine system. Furthermore, the menstrual Toxic Shock Syndrome epidemic of the early 1980s provided evidence that tampons are not inert cotton plugs; rather tampons are classified as Class II medical devices in the United States that can interact with the vaginal environment to produce adverse health. Thus, toxicants in tampons – from toxic shock syndrome toxin-1 to dioxins to metals – have sparked concern among scientists and the public for decades. Yet, little is publicly known about the manufacture of tampons - which are highly-engineered to minimize menstrual leakage and maximize user comfort - and whether users can absorb chemicals present in tampons.
In this panel, we will describe: (1) the design of tampons and features of the vaginal environment that allow for efficient chemical absorption; (2) our review of the scientific literature on the detection of chemicals in tampons together with new findings from our research on the presence and potential release of metals from tampon materials; (3) experimental studies examining whether metals can be released from tampons under conditions that reflect typical use; (4) characterization of the structure and components of multi-layered tampon materials and how product design may influence metal retention or release; (5) emerging evidence from vaginal tissue models that explores how metals may be taken up and move across epithelial barriers; and (6) our recommendations for next steps to ensuring safety with tampon use in the US and globally.
Through our experience as scientists detecting toxic metals in tampons and moving forward the science in parallel with advocacy, this panel highlights the importance of the science-public continuum and using science to support policy change. This panel will include a 45-minute presentation of scientific research, followed by 15 minutes of audience questions and answers. Logistical details include use of sound/visual technology, including microphones for audience questions.Performance/ art
Code Red - A short comedy film about the stigma of menstruation
Presenter: Jessica McGaugh
Affiliation: San Diego State University, Department of Television, Film, and New Media
Code Red is a short comedy film about a professor who bleeds through her pants on the way to teach a class. It was written as part of an episodic film project titled Womanhood: The Series, which is a collection of original short comedy films designed to shed light on issues of womanhood; the embarrassing, awkward, disgusting, beautiful, and extraordinary moments women experience. To date, Code Red has screened at eleven film festivals around the U.S., including the competitive San Diego Film Festival. It won the Professional Dramatic Short Award at the Raw Science Film Festival and is nominated for best Live Action Short at the upcoming Nevada Women’s Film Festival. Through Code Red, our goal is to use the film as a tool to begin discussions that can lead to social change. We hope to contribute to reducing menstrual stigma by fostering open dialogue, advancing research on menstrual health, and building a coalition of advocates for menstrual equity. Comedy, an enthusiastically consumed and widely shared cultural form, is uniquely positioned to confront injustice and reimagine social reality in ways that engage, disarm, and inspire. Code Red is not simply about a professor bleeding through her pants. It examines the cultural positioning of women’s bodies, the institutional neglect of menstruator’s needs, the interpersonal silencing of menstrual experiences, generational shifts in how periods are discussed, and the power of storytelling to reshape cultural norms. However, this message will only be impactful if I am able to get buy-in and support for those already working within this research area. I believe that screening the film at the Menstruation Research Conference, I will be able to connect with researchers who can help be build an audience of educators, community partners, and legislators who can use this film as a tool for change. To screen the film at the conference, I will need a screening room space with a quality projector and sound system. The screening event at the conference could include myself, plus additional panelists to discuss how media can be used for education and community impact.
Stall
Grace and Green
Presenter: Kathryn King
Affiliation: Grace and Green
Menstrual health educator, advocate, and Pelvic Health and Educational Lead at Grace & Green - a Bristol-based B-corp committed to providing ethical period care for all who bleed, and educate on menstrual wellbeing; empowering people to better understand their bodies, make informed health choices, and challenge long-standing myths
Making Lived Experience Visible: A Tool for Visualising Qualitative Health Data for PCOS Self-Management Care
Presenter: Hilary Wray
Affiliation: Centre for Arts and Creative Cultures
My core research explores how women with Polycystic Ovary Syndrome use FemTech apps alongside NHS care to answer key questions about what supports or hinders PCOS self-management. These insights will inform co-designed UX/UI guidelines grounded in lived experience. As part of this, I am developing a novel digital tool that lets people with PCOS visually map their full care journey, capturing clinical touchpoints alongside self-care and digital condition management activities both as actions and emotions. Bringing clinical and digital touchpoints together reveals patterns that are otherwise hard to see. PCOS participants capture key moments of interventions, delays, frustrations, and changes in their motivation and view on their experience. This creates an interactive visual map. This helps them understand how their experience develops and identify where needs aren’t being met.
Designed for both reflection and communication, it allows participants to share their map with clinicians to support more personalised, empathetic care. Anonymised aggregated maps can also highlight common pinch points, informing better digital health design. Overall, the tool makes invisible labour visible by turning a complex hybrid care journey into something visual, understandable, navigable, and genuinely useful.
Stall Set Up
The stall will feature a screen showing a short video introducing the digital pathway mapping tool, and a poster will be provided to explain the research approach and the design process.
Visitors to the stall can try the beta version on a laptop or tablet at the stall, exploring how the tool captures appointments, symptoms, app use, and other touchpoints. A QR code will also let people test it on their own device or later at home. This demo is purely for interaction and feedback; no data is saved.
Aim
The aim is to give visitors a quick, hands-on sense of how the tool works, what the mapping experience is and what it looks like. It provides the opportunity to learn more about PCOS and its management, and to share experiences with others. It also looks at how this type of mapping can promote the framework for holistic care in the NHS and its trend toward digital self-care. Although currently being developed for PCOS, it can be adapted for other long-term conditions where people navigate complex mixtures of clinical care and digital self-management, such as endometriosis, PMS, and infertility. Additionally, the stall will help to gather impressions to refine the next version of the tool.Menstrual Literacy in Action - Menstrual Cycle Support (MCS) and a Whole-School Approach
Presenter: Kate Shepherd Cohen
Affiliation: Menstrual Cycle Support
Menstrual literacy is foundational to health, equity and educational participation - yet many students and adults still lack a clear, cyclical understanding of the menstrual cycle beyond basic biology or product management.
Menstrual Cycle Support (MCS) exists to ease menstrual suffering through menstrual education, reconnecting individuals with their embodied cyclicity and the inherent intelligence of the menstrual rhythm.
Our stall will offer an interactive introduction to the MCS model, which adapts the NHS social prescribing and personalised care framework into digital courses and an emerging School Accreditation approach, enabling delegates to explore how menstrual literacy can move from theory into practice.
MCS provides a clinically reviewed, biopsychosocial menstrual literacy course available through primary care and social prescribing in more than 500 GP surgeries across the UK.
Independent evaluation demonstrates statistically significant improvements in participants’ relationship with their menstrual cycle and confidence to speak with health professionals. Participants also report increased knowledge, practical charting skills and greater acceptance of cyclical changes - core elements of meaningful menstrual literacy.
At the stall, delegates can explore the six bite-sized digital modules, review headline evaluation findings, and engage with practical tools such as the cycle wheel and symptom charting framework. We will demonstrate how MCS integrates NHS pain management principles, mindfulness-informed strategies and NICE-aligned guidance within an accessible educational format. The stall will also introduce our whole-school model, designed to embed menstrual literacy within pastoral systems, attendance frameworks and staff confidence.
The stall format enables conversation, demonstration and critical dialogue. Delegates can discuss implementation challenges, intersections with mental health and safeguarding, and the gap between reproductive education and lived cyclical experience.
MCS takes an inclusive approach - supporting anyone with a menstrual cycle and those who care for or work alongside them. By reframing menstruation as a predictable biopsychosocial rhythm rather than a monthly disruption, MCS seeks to strengthen confidence, reduce stigma and improve communication across educational and clinical settings.
We welcome researchers, educators, clinicians and policymakers to engage with us in refining scalable, evidence-informed approaches to menstrual literacy.Menstrual Literacy in Action - Menstrual Cycle Support (MCS) and a Whole-School Approach
Presenter: Kate Shepherd-Cohen
Affiliation: Menstrual Cycle Support
Menstrual literacy is foundational to health, equity and educational participation - yet many students and adults still lack a clear, cyclical understanding of the menstrual cycle beyond basic biology or product management.
Menstrual Cycle Support (MCS) exists to ease menstrual suffering through menstrual education, reconnecting individuals with their embodied cyclicity and the inherent intelligence of the menstrual rhythm.
Our stall will offer an interactive introduction to the MCS model, which adapts the NHS social prescribing and personalised care framework into digital courses and an emerging School Accreditation approach, enabling delegates to explore how menstrual literacy can move from theory into practice.
MCS provides a clinically reviewed, biopsychosocial menstrual literacy course available through primary care and social prescribing in more than 500 GP surgeries across the UK.
Independent evaluation demonstrates statistically significant improvements in participants’ relationship with their menstrual cycle and confidence to speak with health professionals. Participants also report increased knowledge, practical charting skills and greater acceptance of cyclical changes - core elements of meaningful menstrual literacy.
At the stall, delegates can explore the six bite-sized digital modules, review headline evaluation findings, and engage with practical tools such as the cycle wheel and symptom charting framework. We will demonstrate how MCS integrates NHS pain management principles, mindfulness-informed strategies and NICE-aligned guidance within an accessible educational format. The stall will also introduce our whole-school model, designed to embed menstrual literacy within pastoral systems, attendance frameworks and staff confidence.
The stall format enables conversation, demonstration and critical dialogue. Delegates can discuss implementation challenges, intersections with mental health and safeguarding, and the gap between reproductive education and lived cyclical experience.
MCS takes an inclusive approach - supporting anyone with a menstrual cycle and those who care for or work alongside them. By reframing menstruation as a predictable biopsychosocial rhythm rather than a monthly disruption, MCS seeks to strengthen confidence, reduce stigma and improve communication across educational and clinical settings.
We welcome researchers, educators, clinicians and policymakers to engage with us in refining scalable, evidence-informed approaches to menstrual literacy.Million Moons: One Moon a Million Menstrual Experiences, Storytelling for Social Change
Presenter: Nikki Berridge
Affiliation: Howami
Menstrual health education remains inconsistent and often inadequate worldwide. Many young people reach puberty without the knowledge or language to understand their changing bodies, while stigma surrounding menstruation continues to affect confidence, mental wellbeing, and open communication within families and schools. Addressing this gap requires not only better education, but also cultural change that normalises conversations about menstrual and emotional health. Million Moons is a global, community-driven campaign designed to build awareness, participation, and support for the development of Howami — a youth-first digital ecosystem that helps young people understand their menstrual cycle, emotional landscape, and inner experience. The campaign aims to create a shared cultural shift by inviting people to contribute their stories, reflections, and experiences of early menstruation as part of a collective digital archive.
Rather than functioning as a traditional fundraising campaign, Million Moons is intentionally participatory and story-led. Individuals are invited to contribute £1 (or more) and add their “light” to a shared digital moon while sharing a personal reflection or story about menstruation. Together, these contributions form a living record of diverse experiences across cultures, generations, and communities, helping to build a collective language around menstrual and emotional health.
At our conference stall, visitors will be introduced to the vision behind Million Moons and the wider Howami initiative. Interactive elements will invite participants to reflect on their own experiences and perspectives around early menstrual education and communication. Visitors will be encouraged to contribute thoughts, insights, or messages that will weave into the growing Million Moons initiative and community. Through storytelling, dialogue, and shared reflection, the stall aims to demonstrate how collective participation can help shift stigma, strengthen understanding between generations, and support young people in navigating puberty and adolescence with confidence. Million Moons ultimately seeks to illuminate a simple but powerful idea: when stories are shared and communities come together, meaningful cultural change becomes possible.Missing Words for Periods: Understanding Menstruation Through Language
Presenter: Tilyan Aslam
Affiliation: Mahwari Justice
In Pakistan, like many cultures around the world, menstruation does not have a clear name. Instead, people rely on euphemisms, coded phrases, or silence to replace words to denote menstruation in their everyday lives. What can be said about periods and what cannot, is largely shaped by patriarchy, shame, class difference, and the long history of colonialism in South Asia broadly. The lack of language creates a vacuum on how menstruation is understood, limiting the way menstruators understand their own body anatomy. This installation begins from that observation and asks what the absence of direct naming does to our relationship with menstruation. In many families, young menstruators hear vague terms such as that time of the month or chutiyan referring to periods instead of directly naming it. In schools, biology chapters on reproduction are either entirely skipped or taught very superficially that leaves students with no formal menstrual language. This gap in vocabulary is a cyclical medium to perpetuate stigma and shame. In this installation, we look closely at how language has been used as a tool for menstrual stigma. This installation is an interactive work built around engaging with words. It uses simple materials such as cardboard panels, handwritten notes, visuals to create a setting where visitors can sit and engage with language. Across the space, there will be a display of words for menstruation in different languages along with blank spaces and ellipses reflecting how menstruation is spoken about in everyday life. In addition to this there will be a couple of connected activities: Letter to My Period; in which visitors are invited to write letters addressed to their periods; these letters could be filled with apology, grief, anger, tenderness, or gratitude. There is no fixed format and no required language for this activity. We will collect these letters and read them aloud on the final day; either anonymously or with names, with consents from the participants. A Word Map on the wall will be held, where visitors write what periods are called in their own languages. Our period rap song, sung by a local Pakistani artist, will be played bringing voices that are usually kept private into public space . Language, for centuries, has been used as a tool of scrutiny to control menstruating bodies. This installation tries to reclaim that language and redefine it.
Visualising Menstruation in Nepal - creative outputs from Dignity Without Danger
Presenter: Sara Parker
Affiliation: Liverpool John Moores University Humanities Social Science
Menstrual stigma and discriminatory socio‑cultural practices continue to affect girls’ and women’s health, dignity, and educational participation in Nepal. This study evaluates the effectiveness and practical utility of the Resources for Menstrual Education (R4ME) toolkit, developed through the Dignity Without Danger (DWD) project, which aims to challenge menstrual stigma through creative, interdisciplinary, and educational interventions. The aim of this research is to assess how effectively the R4ME resource kit supports menstrual health education in Nepalese schools and contributes to developing menstrual knowledge in order to reduce menstrual discrimination in Nepal.
The study’s objectives were to: (1) review existing school curricula, textbooks, and reference materials related to menstrual hygiene education; (2) examine current pedagogical practices used to teach menstrual health; (3) critically evaluate the relevance and usability of the R4ME student resources and teacher guide; and (4) recommend evidence‑based improvements to strengthen menstrual health education across the school system.
A four‑phase methodology guided the research, involving (i) preparatory curriculum review and tool development; (ii) pilot testing of R4ME materials through student workshops and teacher feedback sessions; (iii) analysis and synthesis of findings across participating schools; and (iv) formulation of recommendations for resource revision and broader dissemination. Data were generated through surveys, workshops, document review, observation of teaching practices, and focus group discussions with teachers, students (including disabled students), and mothers
Results indicate that menstrual health content is formally included in the curriculum from Grades 4–12, but its delivery remains inconsistent. Many schools lack sufficient teaching guides, audio‑visual resources, and menstrual‑friendly facilities. Only a minority of teachers have received formal training, and teaching methods remain predominantly lecture‑based, with discussion used most frequently. Students reported learning about biological processes, hygiene practices, and cultural taboos, yet socio‑cultural restrictions persist. Disabled students highlighted the lack of braille materials and accessible resources. Mothers, who commonly serve as girls’ first source of menstrual information, reported adherence to cultural norms that reinforce restrictive practices. The R4ME toolkit was positively received for its clarity, creativity, and contextual relevance, though its reach and use varied across schools
Conclusion: The R4ME toolkit demonstrates strong potential to enhance menstrual health education through accessible and context‑appropriate materials. However, systemic barriers—including limited teacher training, insufficient resources, stigma among students, and infrastructural gaps—must be addressed to maximise its impact. Strengthening menstrual education in Nepal requires multisectoral collaboration, inclusive materials (including braille), improved facilities, and community engagement to dismantle deeply rooted menstrual stigmaVisualising Menstruation: What do you know about menstrual art?
Presenter: Bee Hughes
Affiliation: Media, Culture, Communication at Liverpool John Moores University
The stall will facilitate conversations about my academic research project Visualising Menstruation: Art, Blood and the Liminal Body. The project outputs are a podcast, an Open Access academic monograph published by Liverpool University Press (forthcoming 2028), and an open access data resource on menstrual art.
The project aims to expand knowledge about the history of menstrual art by producing a range of outputs that situate menstrual art within socio-cultural contexts and alongside/against traditional art histories. It also challenges narratives that downplay the significance of art about menstruation within contemporary art histories, and the idea that art is a panacea to address menstrual stigma.
The stall will feature information about the podcast (leaflets / flyers), a listening station, a suggestion box where conference attendees can share their favourite examples of menstrual art, menstrual art database in-progress examples, and conversation prompts. If logistically possible, we could look at recording brief interviews with attendees throughout the conference to feature in a podcast bonus episode.
Find out more about Visualising Menstruation podcast here: https://linktr.ee/visualisingmenstruationPre-recorded
Narratives of Surgical menopause and rare cancer
Presenter: Kay Standing
Affiliation: Liverpool John Moores University, Sociology
There has been a recent increase in interest and awareness around the menopause, focussing on removing the stigma and silence, however, whilst there may be a ‘’menopausal turn’ in popular culture, discussions often centre white, cisgendered, middle-aged, middle-class women. There is little discussion of surgical menopause, which can leave people feeling isolated and excluded from the menopause narratives. This is a short film which paper explores initial finding from research into the experiences of people with rare cancers who have experienced surgical menopause, and argues more support and information is needed.
The research aims to explore the lived experiences of people who had undergone surgical menopause as a result of treatment for cancer. It’s objectives are to move beyond the biomedical approach to examine a more holistic and people centred approach to surgical menopause.
The film is based on autoethnography as a rare cancer survivor, and initial interviews with Pseudomyxoma peritonea (a rare form of appendix cancer) patients/survivors. Findings to date highlight a lack of information on, and post-surgery support for, surgical menopause. The research showed a lack of understanding of, and support for, the emotional and psychological long-term impact of surgical menopause, and the impact on family and social relations. This can have the negative impact this can have on patients’ mental health, self-esteem and body image. It highlights the inconsistency of access to, and quality of, counselling, which leaves people outside of both the existing support systems for both cancer and menopause.Release Therapy for women
Presenter: Jackie Kopelman
Affiliation: Release for women
Release is the only women-led Sussex-based charity specialising in supporting the mental and physical health of women during their most challenging life transitions: becoming a teenager, becoming a parent and during perimenopause; when women are at their highest risk of suicide. We do this through nationwide 1-1 online counselling and menopause coaching. We also have group therapy courses for first and second + time mums as well as those going through perimenopause, as well as Wellbeing Days within Sussex.