How Young Urban Women Experience Menstruation

Menstruation is not simply a private, personal issue. Access to accurate and reliable menstrual health education depends on a lot of factors. That includes where we live, what information is available to us, and what systems exist to support us. Living in a city means having more resources and health programs around us than previous generations had anywhere. But that doesn’t always mean we get consistent access to care or even that we can get understandable information about menstruation.

A recent qualitative study from India explores how moving from rural areas to cities ends up affecting menstrual health. Community medicine researchers from the Maharaja Krishna Chandra Gajapati Medical College and Hospital in Berhampur and New Delhi, India and Jajati Keshari Medical College & Hospital in Jaipur, India, sought to understand how young people come to learn about menstruation, how they manage their periods and how public health initiatives and social change shape their experiences.

The study, “A Qualitative Analysis of Urbanization and Menstrual Health Among Young Women,” draws from focus group discussions and one-on-one interviews with girls and young women aged 10 to 25. It centers personal narratives of what it’s like to grow up menstruating in an urban environment, and what kinds of gaps remain even when services appear to be improving.

The researchers conducted this study in a single urban neighborhood in India and included 79 participants, 53 in focus groups and 26 in individual interviews. The researchers wanted a representative picture of menstruation in real life, so they included participants with different reproductive histories and health conditions. Thus the study encompasses girls and young women from a wide range of life situations: adolescents who had not yet had their first period, pregnant adolescents, young mothers and lactating mothers, adolescents who had dropped out of school, and participants with chronic or congenital health conditions.

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The study found that girls who were enrolled in school generally had more exposure to information about menstruation than those who were not. Their usual sources of knowledge included female family members, teachers, and increasingly, social media. However, much of the information they learned was fragmented or incorrect. Many participants believed menstruation was a way for the body to remove “impurities.” Most had little understanding of how the menstrual cycle works, fertility, or what symptoms beyond bleeding were considered normal.

Many had only limited knowledge of what to expect for their first period. As a result, they described their experiences of menarche as frightening or confusing, with several participants noting they thought they were injured or sick when they first bled. Some hid their blood-stained clothes or avoided telling anyone what was happening. Even in an urban area, menstruation still arrived as a shock.

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Most participants in the study used sanitary pads. There were marked differences in access to these materials between participants who were enrolled in school and those who were not. Those in school benefitted from free government-supplied pads. Those with more limited access to these resources, such as those who were of lower socioeconomic status or no longer in school, still used cloth or old clothes.

Across socioeconomic status and whether or not they went to school, it was a major challenge for the girls and young women to deal with menstrual products after using them. Participants described throwing used pads into open drains, hiding them in the garbage, burying them, or burning them in incinerators. Safe and private disposal was not consistently available, even when pads were.

While some traditional restrictions surrounding menstruation are weakening, there is still stigma around discussing and managing periods. Many participants reported that they still avoided temples or masjids during menstruation, that they made sure not to touch men or boys while on their period, and that they hid their menstrual products. Some felt uncomfortable discussing symptoms or bodily changes even with female family members. Periods also affected their school attendance. One participant explained: “I don’t go to school those days. If it happens at school, then I return home,” Her individual response shows how shame and discomfort continue to shape participation in education, even while attitudes about menstruation are changing.

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Government initiatives provided significantly greater access to menstrual resources, but there was often not enough accompanying education about those resources. For instance, free sanitary pad distribution and weekly iron-folic acid supplements in schools attempted to improve health outcomes and access to safe menstrual products. While these programs reached many young women, education about what they were or why they mattered were minimal. No one clearly explained what the tablets were for, how they worked, or whether they were safe. As a result, many students did not trust the supplies or feared their side effects. So they threw supplements away or simply avoided taking them. Health workers interviewed for the study reported that adherence was inconsistent, even when tablets were delivered door-to-door. This highlights a major gap in programs that focused on logistics and coverage but did not include education and failed to build trust.

Urbanization thus had both positive and negative impacts on menstrual health and knowledge. Participants in the study had better access to menstrual supplies, greater exposure to information via schools and social media, and improved sanitation infrastructure in some areas. However, not all issues are solved by increasing urbanization. Many participants in the study had access to pads but no easy way to dispose of them. They had information but it wasn’t all correct, and there was still stigma in discussing their questions with adults. They had school and government services but little understanding of how to use them.

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This study challenges the idea that improving menstrual health is simply a matter of providing products or increasing exposure to information. Urbanization creates new possibilities but also new contradictions: more information doesn’t automatically lead to increased health literacy, more products don’t guarantee safety or dignity, more services don’t build trust on their own. The findings reveal menstrual health to be a multi-system issue shaped by education, infrastructure, cultural norms, and institutional trust, all of which must move together to create real change.

Progress is happening, but not in a straight line. It is uneven and influenced by social inequality. Menstrual health isn’t just about access, but whether young people feel informed, supported and safe in their bodies, and whether the systems around them make that possible. Meaningful change will require moving beyond product distribution toward community-based education, trustworthy health systems, and cultural shifts that treat menstruation not as a problem to manage quietly, but as a normal and shared part of public health and gender justice.