Menstrual Health – Explained Pointwise

Recently, the Supreme Court in a landmark judgment has declared the right to menstrual health & access to menstrual hygiene management (MHM) measures in educational institutions is a part of the fundamental right to life & dignity under Article 21 of the Constitution.

What is Menstrual Health?

• Menstrual health is a state of complete physical, mental, and social well-being in relation to the menstrual cycle.
• It goes beyond just having a period to encompass everything needed for a person to manage their menstrual cycle with dignity, safety, and good health.
  

  Physical & Biological Well-being	Regular, predictable cycles Access to safe, effective menstrual products
  Mental & Emotional Well-being	Freedom from stigma, shame, and psychological distress associated with menstruation.
  Social & Cultural Well-being	Participation in all aspects of life—education, work, sports, social, and religious activities—without restriction or exclusion due to menstruation. Freedom from harmful cultural practices (e.g., segregation, restrictions on food or movement).
  Access to Information & Healthcare	Accurate, timely, and age-appropriate education about the menstrual cycle, before the first period (menarche) and throughout life. Understanding the link between the menstrual cycle and other aspects of reproductive and overall health (e.g., fertility, bone health, iron levels).The World Health Organization (WHO) defines it with four key dimensions:

What is the significance of Menstrual Health?

1. A Fundamental Human Right & Matter of Dignity: Managing menstruation safely, comfortably, and without shame is a basic necessity for half the global population. The inability to do so infringes on fundamental rights to health, education, work, non-discrimination, and human dignity. Recognizing menstrual health is a step toward gender equity.
2. School Attendance & Performance: Lack of products, pain management, and poor sanitation facilities are leading causes of school absenteeism for girls. This disrupts education, lowers academic performance, and increases dropout rates, limiting future economic and social opportunities.
3. Essential for Economic Participation & Productivity: Menstrual health is a major driver of economic participation. Lack of menstrual health support leads to “presenteeism” (working while unwell) or absenteeism, reducing productivity and career advancement. Supportive policies (like sick leave for severe pain) and workplace facilities are key to an inclusive economy.
4. Foundation for Reproductive Autonomy: Understanding one’s cycle is foundational for reproductive health literacy. It empowers individuals to make informed choices about their bodies, recognize fertile windows for pregnancy or contraception, and understand changes throughout life (puberty, postpartum, perimenopause).
5. Core to Mental Well-being: Breaking stigma and shame fosters positive body image, self-confidence, and reduces anxiety and depression linked to menstrual distress.

What are the challenges to Menstrual Health?

1. Deep-Rooted Stigma & Taboos:
   • Menstruation is often shrouded in secrecy, considered “impure” or “dirty,” leading to restrictions on mobility, food, religious participation, and social interaction.
   • In some communities, practices like isolation (e.g., staying in menstrual huts) persist, though declining, perpetuating shame and risk.
2. Limited Access to Affordable Menstrual Products:
   • Period Poverty: Many cannot afford commercial pads, tampons, or reusable options, leading to use of unsanitary materials like old cloth, ash, or leaves. These materials are difficult to clean and significantly increase the risk of Reproductive Tract Infections (RTIs).
   • Taxation: Until recently, menstrual products were taxed as “luxury items” (GST reduced to 0% on some products in 2018, but affordability remains uneven).
   • Supply Chain Gaps: Rural and remote areas often lack consistent availability of quality products.
3. Lack of Private, Safe Toilets: Many schools, workplaces, and homes lack functional toilets with water, locking doors, and disposal systems, making menstruation management difficult and unsafe.
4. Disposal Challenges: Even in areas with product access, there is often no way to discreetly or safely dispose of used materials, leading to unhygienic environments.
5. Lack of Medical Attention: Menstrual disorders (e.g., PCOS, endometriosis, dysmenorrhea) are often dismissed as “normal pain,” leading to underdiagnosis and suffering.

What the SC said in the recent ruling on Menstrual Health?

1. Fundamental Right:
   1. The Court declared that the right to menstrual health is part of the “Right to Life” under Article 21 of the Constitution. Lack of menstrual hygiene management undermines the dignity, privacy & bodily autonomy of a girl child. 
   2. The right to free & compulsory education under Article 21A includes supply of free sanitary napkins in schools.
2. Mandatory Provisions: It directed all states and Union Territories to provide free biodegradable sanitary napkins and functional, separate toilets in all schools (government and private).
3. Menstruation is not a “Gender-specific” Issue: The judgment clarified that menstruation is not just a “women’s issue” but a human rights issue affecting all genders, including transgender persons and non-binary individuals.
4. Binding Directions for All Schools: The Court issued several mandatory directives for all schools (both government and private) across India, with a three-month deadline for compliance such as:
   • Providing free oxo-biodegradable sanitary napkins to all girl students in Classes 6–12.
   • Ensure functional, gender-segregated toilets with usable water connectivity.
   • Establish “Menstrual Hygiene Management Corners” equipped with, spare innerwear, spare uniforms etc for menstruation related emergencies.
   • Installing safe disposable facilities.

What have been the various initiatives to improve the Menstrual Health?

1. PMBJP (Suvidha Pads): Perhaps the most visible success, the Pradhan Mantri Bhartiya Janaushadhi Pariyojana provides “Suvidha” pads (which are oxo-biodegradable )for just ₹1 per pad at over 16,000 Jan Aushadhi Kendras.
2. National Menstrual Hygiene Scheme (MHS): Run by the Ministry of Health, this targets adolescent girls (10–19 years). It uses ASHA workers to distribute subsidized pads in rural areas and hold community meetings to break taboos.
3. State govt initiatives:
   • Kerala – Menstrual Cup Revolution: First state to actively promote menstrual cups as a sustainable alternative.
   • Maharashtra – Asmita Yojana: Uses Women’s Self-Help Groups (SHGs) to manufacture and distribute pads, creating local livelihoods while solving the supply chain issue.
   • Rajasthan – Udaan Scheme: Provides free sanitary napkins to all women and girls in the state, not just those in schools.
   • Andhra Pradesh – Swechha: Focuses on providing branded, high-quality napkins to school and college students to ensure comfort and dignity.
4. Initiatives by NGOs:
   • Goonj (NJPC): Their “Not Just a Piece of Cloth” campaign transforms old clothes into hygienic cloth pads, treating menstruation as a tool for rural development.
   • Pinkishe Foundation: Runs “Pad Banks” where urban donors can sponsor “hygiene kits” for girls in slums and rural areas, combined with “Pink Talks” to educate families. 
   • Social enterprises like Saathi (biodegradable pads), Aakar Innovations (compostable pads), and Jaipur Cups (menstrual cups) provide eco-friendly and affordable options.

Conclusion: In essence, menstrual health is not just a “women’s issue.” It is a public health imperative, an economic necessity, and a social justice benchmark. Thus, investing in it creates ripple effects – creating more equitable & resilient societies that uphold the dignity & rights of all people who menstruate.