By: Valentina Demarzo

Period. It’s not the end of a sentence but it should be the start of a conversation about human rights (because yes, women’s rights are human rights).

For many women around the world having their period can be cause of excruciating pain, diseases or affect if not seriously disrupt their lives. In developing countries even a regular period can dramatically change a woman’s life, and not for the best.

The UNFPA made a list of ways in which human rights can be hindered by menstruation. UNFPA highlighted how at least 5 basic human rights such as the right to dignity, the right to education, the right to work, the right to an adequate state of health and well being, and the right to non discrimination and gender equality can be undermined during a woman’s life because of period-related issues.

The main problem is the lack of supplies and facilities to manage menstrual health, which prevents the attendance of school or work, and in certain cultures, can even lead to the segregation of women because of their “impurity”. 

Speaking of the lack or difficulty to manage supplies such as tampons and sanitary pads, in the last decade, menstrual cups have often been hailed as the final solution to change women’s lives (and the world, potentially). And as much as I might agree on the overall positive impact cultural and physical barriers need to be taken into account before assuming that menstrual cups can solve all period-related issues.

It’s worth mentioning the latest review of scientific studies on the use of the cups which has been recently published in The Lancet.  The study assessed the experiences of leakage, accessibility and safety of the cups. Among the 43 countries where the studies took place, there are several African countries such as Ghana, Kenya, South Africa, Tanzania, Uganda, and Zimbabwe. The outcome of this study is that menstrual cups are safe and comfortable to use even in low-income countries and can also be a good alternative to single-use product in conditions of scarce access to clean water and poor sanitation facilities. Besides suggesting further studies on the environmental impact of the cups and whether they are cost-effective, the authors of the review also highlight the need for training and education to encourage the use of the cups.

UNICEF estimates that 1 in 10 school-age African girls do not attend school

during menstruation. Although it’s hard to measure whether there is a positive correlation between absenteeism and period for the lack of comprehensive studies on the phenomenon, in different small scale studies both parents and girls confirm that the beginning of menstruation coincides with the habit for girls to start skipping school.

A booklet published by UNESCO confirms the negative effect of period on school attendance. According to this document, many girls report dropping out of school because of the lack of menstrual hygiene materials and sanitation facilities. They also mention the discomfort of participating in normal school activities such as standing up and writing on the blackboard or answering the teacher’s questions for fear of smelling or leaking. Furthermore, studies in South Africa have reported incidents of sexual harassment in toilets and latrines. The inadequate structures and facilities plus the risk of violence constitute an obstacle, almost a literal barrier, for girls who want to go to school during their period. And it’s worth mentioning that many girls cannot  afford to buy pads and tampons, which makes it harder for them to manage their periods in a safe and dignified manner.

Menstrual cups could actually be a solution to some of these issues, as a matter of fact,  the study on The Lancet mentioned above concluded that: “reported leakage was similar or lower for menstrual cups than for disposable pads or tampons” and, on the financial side, the study also reported a significant  decrease in costs since the cups can be used for years. The lack of facilities, though, represent a problem anyway. Despite the fact that women don’t need to change the cups as often as any other pads or tampons, these still need to be emptied and washed which implies having access to water and soap and some privacy in a safe environment.

The use of cups can also face some barriers, especially cultural ones, by being perceived as responsible for breaking the hymen, and thus taking away a girl’s virginity. In many African countries, virginity is still a value to uphold, especially for girls. Virginity testing is still a reality in many African countries. In reality the hymen can break for many reasons which have nothing to do with the use of the cups,  including physical activities and/or just the fact that its tissue tends to wear down when a girl reaches puberty.

Ways to handle period poverty could be a way to increase the discussion around virginity and menstruation. For instance, a well - known manufacturer of menstrual cups, Ruby cups, who launched a campaign to distribute menstrual cups in East Africa had to consider the possible reaction of girls to the use of the cups as many would think that the hymen could be broken by the use of the devices. So, in a blog they addressed this question saying that they would not distribute the cups where girls could face adverse consequences because of their use. But most importantly, they said, the cups are never handed to the girls without an adequate explanation of how they are supposed to be used. They run workshops in which besides the “instructions” for the cups they also discuss virginity and particularly the hymen and its anatomy, and they explain that the hymen can be broken by several other activities but a broken hymen does not imply the loss of virginity.

Although the outcomes of the  studies and experiences of charities and NGOs working to distribute menstrual cups in Africa are relatively  positive, there is still a lot to do in terms of education and training before crowning these devices as “the” life changing tool for African women. Also,there are probably more factors to include in the analysis  before concluding that even once facilities have been improved and cups and training provided, the menstrual cups can easily replace other menstrual hygiene products.

One particular practice comes to my mind,  in the many articles, blogs and advertising about Menstrual Cups and their revolutionary effect on African women’s lives, I have never encountered any mention on a particular kind of barrier which could be classified as physical and cultural at the same time: FGM/C. If up to 98% of women in some African countries undergo a practice which totally or partially closes the vaginal opening, it seems very unlikely that they will be able/willing to use an internal device.  

This means that in countries like Somalia or Sudan menstrual cups might not be a viable solution to period poverty, but with the due improvements and training programme they might make period more manageable for the many other women in Africa.