You may sometimes hear the term “menstrual hygiene management.” But, because of the existing stigma surrounding periods and myths about cleanliness, we at Plan International USA often use the term “menstrual health.”

Here are the two main reasons why.

1. Plan, as a girls’ rights organization, is committed to dismantling the stereotypes and stigma surrounding periods around the world — and that starts with the words we use.

Many cultures consider menstruation to be a taboo topic of conversation. That silence sends a powerful message.

“Growing up, for some reason I was always ashamed of my period,” Abigail, a young woman in the U.S., says. “As young girls, we’re taught to hide it and that it is ‘gross’ and is that time whenever we act like complete ‘crazies.’ I was always embarrassed changing my pad at school and did everything to hide it.”

Yacira, a 16-year-old girl in Colombia, says girls in her community have similar experiences.

“For example, when we are in class and a girl has her period, she is told not to do sports,” she says. “Or if by accident, a girl’s clothes got stained by her period, people see it as something dirty, which disgusts them, and sometimes girls are mocked.”

Yacira, a 16-year-old from Colombia, reads information on menstrual health with her mother and younger sister.

In Malawi, 18-year-old Esnart says some girls are forced to stay home when they’re on their periods.

“Some people say during menstruation, you shouldn’t talk to anybody from the opposite sex, and you shouldn’t go anywhere but stay home,” she says. “They say that others may know you are menstruating and that is bad for you. But if you have a business, then you lose out on that day’s income because you have to stay home, which makes women struggle economically. It is almost as if we are dirty and need to wait until we are clean again.”

Esnart, an 18-year-old from Malawi, says that girls in her community are told to stay at home when they’re on their period.

These stereotypes come out in the language we use to describe period products. Signs in supermarket aisles list “feminine hygiene products,” but they’re not talking about deodorant. Menstrual pads are also known as “sanitary napkins.”

And, this isn’t only a problem in English — other languages follow suit. In Spanish, pads are often called “toallas sanitarias” (sanitary towels) or “compresas higénicas” (hygienic compresses). One of the most common French terms is “serviette hygiénique,” which literally translates to “hygienic napkin.”

When we use the words “sanitary” and “hygiene,” we reinforce the belief that periods are somehow unsanitary or unhygienic. And every time we avoid the words “period” or “menstrual,” we reinforce the message that this normal bodily function is shameful.

2. Our work goes beyond “menstrual hygiene.”

Plan’s work with girls, women and other people who menstruate involves more than just distributing period products. In addition, our staff members around the world are working to raise awareness about period health, not just among girls but also among their peers at school, teachers, and parents and caregivers. We’re also working with health care providers to make sure their services are adolescent-friendly, so that girls don’t feel ashamed to go to the doctor and talk about menstruation. Finally, our menstrual health work involves building safe bathrooms where students can manage their periods while at school. This means creating spaces that have locking doors for privacy, enough space to move around, access to clean running water, enough light to see and a spot to set down their personal items so they’re not on the floor.

For instance, Plan USA has partnered with Kimberly-Clark’s Kotex® brand, through its She Can Initiative, on a project spanning eight countries that supports menstrual health for girls in school and at home. From initial surveys in the program countries, it’s clear that period stigma is pervasive. Some of the findings include:

— Girls have inadequate knowledge about menstruation and menstrual health. Overall, younger girls and girls living in rural areas seem to be less knowledgeable about these topics.

— Many schools lack adequate girl-friendly bathroom facilities. These spaces are a critical component of girls’ menstrual health at school as they may be the only safe, private place where girls can change their pads or other period products.

— Overall, boys have even lower levels of menstrual education and knowledge than girls. When boys are ill-informed about menstruation, they may be more likely to tease girls or contribute to a negative social environment for menstruating girls.

— Parents have varying levels of knowledge and information about menstruation, and also have varying levels of comfort in talking to their children about this subject.

The Kotex® brand’s She Can Initiative helps girls to change these realities, so that periods don’t get in the way of their progress.

“Globally, we are witnessing the everyday impact felt by girls and women as they endure menstrual taboo and stigma,” Plan International USA Inclusive Quality Education Advisor Kevin Nascimento said. “Through the Kotex® project, we are working with girls and women to overcome pervasive barriers both in and out of school to ensure their access to quality education remains uninterrupted.”

In Brazil, the project has already reached more than 400,000 individuals through a campaign called “My Cycle, My Rules.” As part of the initiative, girls made bracelets with beads that represented stages in the menstrual cycle and distributed them to their communities, educating their peers and creating a movement to wear the bracelets as a symbol of breaking stigma around menstruation.

Chi, an 18-year old in Vietnam, explains how she joined a school club through the program. In it, she learned about menstruation and other important aspects of sexual and reproductive health.

“I joined the project when I experienced my first menstrual period with doubts and fears,” she says. “But I think with project activities at schools now, girls will be equipped with enough knowledge about reproductive health [and] the menstrual period so that they can confidently welcome puberty. With the knowledge and skills learned, I feel more confident, more mature and will bring the knowledge and skills learned to share and help other girls.”

Plan is also working with peer organizations throughout the sector to reframe menstrual health as a member of the Global Menstrual Collective. This group, which includes representatives from U.N. organizations, academia, government and more, published an official definition of “menstrual health” in the Sexual and Reproductive Health Matters journal in April 2021. This definition states that “Menstrual health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity, in relation to the menstrual cycle.”

The authors add that the new definition addresses a need to go “beyond the care of menstrual bleeding to include the many social and psychological components of menstrual experience, as well as needs related to health and social inclusion.”

For these reasons, Plan USA prefers to use the term “menstrual health” over “menstrual hygiene” when possible. Similarly, we prefer “period pads” or “menstrual pads” instead of “sanitary” napkins or towels.

Changing the words we use to describe menstruation won’t eliminate menstrual health problems everywhere, but it’s a start — and an important step toward achieving gender equality for everyone.

“Menstruation is normal and we must work to make everyone see it that way,” 16-year-old Yacira, from Colombia, says. “The task must not stop.”