Do you spend the time with your patients talking and explaining about menstrual health? Family physicians are the first point of contact for many patients and hence have a unique opportunity to help the patients select the appropriate options to safeguard their menstrual health.Do you spend the time with your patients talking and explaining about menstrual health?

There exist many social constraints about menstrual etiquttes and it is well understood that this plays a huge role in women NOT discussing menstrual issues in open, even with their family physician. By putting away this topic,family physicians contribute to the many barriers that accompany this topic.

The incident of suicide of a 12-year old girl from Tamilnadu because of an alleged shaming by her teacher for menstrual stain highlights the role of healthcare providers in communicating awareness regarding menstrual health not just with adolescents but also to key adults such as teachers and parents (Kokra, 2017).

Several cross-sectional studies in India suggest that adolescent girls from all socioeconomic settings suffer from various menstruation-related illnesses. These include problems such as dysmenorrhea, menorrhagia, amenorrhea, excessive white discharge and problems associated with menstrual hygiene issues such as endogenous reproductive tract infections.

Studies point out that these preventable menstrual health disorders need a shift in attitudes, beliefs, and perceptions regarding menstruation, not only among adolescents but also among key adults such as parents and teachers (Bhilwar, Lal, Sharma, Bhalla, & Kumar, 2015; Mollins, 2013; Patil et al., 2011).

The role of healthcare providers seems to be crucial in bringing about this shift and in starting a dialogue about menstruation with adolescents and key adults.

3 Key points for effective communication about menstruation

1. Explain the anatomy and physiology in simple words

Studies indicate that adolescents lack information on the very anatomy of their bodies and also on the physiology of menstruation. Instead of only diagnosing and prescribing, even if doctors can spend 5-7 minutes per patient in explaining the basics of menstruation to adolescents who are diagnosed with menstrual health disorders, it would help alleviate misconceptions regarding menstruation and reduce the taboos and fears regarding menstrual health disorders.

2. Include the adults in the discussion

It is essential to include the key adults (parents, guardians) in menstruation-related discussions both in clinics/health camps. If adults are excluded and adolescents are only given prescriptions for their ailments, illnesses associated with menstrual hygiene and negative perceptions will be difficult to deal with.

Commnicating about prescriptions

If patients are prescribed hormonal pills, it is necessary to give some time to explaining the role of this medication, why it is necessary to take it, and more importantly, why it is important to consume it as directed to avoid any side effects or recurrences.

3. Ask adults to be open for discussions

Parents, guardians, and teachers are usually the first source of information for any adolescent. If they are turned away or silenced by them, only then do they turn towards other, possibly unscientific sources. It is best to talk to parents and guardians and ask them to be open to questions about sexuality and menstruation. Providing necessary, scientific information can build trust between the parents and children and help solve their queries and possibly avoid unhygienic behaviors and illnesses.

Implementing such health communication practices is important to build trust between healthcare providers, patients, and care-givers as menstruation is a sensitive topic surrounded by stigma and taboos. Proactive, positive and open dialogue with healthcare providers may be a small step in breaking the culture of silence around menstruation.

The writer is pursuing a doctorate in Social epidemiology at the Indian Institute of Technology, Gandhinagar working on adolescent and menstrual health.