Adolescent menstrual health must go beyond pads
BMJ 2025; 388 doi: https://doi.org/10.1136/bmj-2023-077515 (Published 28 January 2025) Cite this as: BMJ 2025;388:e077515
- Marni Sommer, professor of sociomedical sciences1,
- Julie Hennegan, co-head global adolescent health working group12,
- Arundati Muralidharan, coordinator3 4,
- Caroline W Kabiru, senior research scientist5,
- Therese Mahon, regional programme manager South Asia6,
- Penelope A Phillips-Howard, professor of public health epidemiology7
- 1Mailman School of Public Health, Columbia University, New York, USA
- 2Women’s, Children’s and Adolescents’ Health Program, Burnet Institute, Melbourne, Australia
- 3Global Menstrual Collective, London, UK
- 4Menstrual Health Action for Impact, New Delhi, India
- 5African Population and Health Research Center, Nairobi, Kenya
- 6WaterAid, London, UK
- 7Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Correspondence to: M Sommer ms2778{at}cumc.columbia.edu
Menstruation and the menstrual cycle affect female health and wellbeing from menarche, the first menstrual period, to menopause.123 Adolescent girls and women worldwide consistently report negative experiences with menstruation, including missed or delayed diagnosis of menstrual disorders. These issues have far reaching consequences for their wellbeing, education, livelihood opportunities, empowerment, and overall health.456 Investment in menstrual health (box 1) during adolescence is increasingly recognised as a pathway to mitigate these consequences and address gender inequality. This was emphasised in 2022 when the World Health Organization declared menstrual health as a health and human rights issue and not solely a hygiene issue.8 The emerging concept of menstrual justice highlights how harmful power structures and social norms result in menstrual related discrimination in many spheres of life that impede menstrual health.9
Main components of menstrual health7
Menstrual health is a state of complete physical, mental, and social wellbeing, not merely the absence of disease or infirmity, in relation to the menstrual cycle. Achieving menstrual health implies that women, girls, and all other people who experience a menstrual cycle can
Access accurate, timely, age appropriate information
Care for their bodies during menstruation, including access to water and sanitation facilities and menstrual materials
Access timely diagnosis, treatment, and care for menstrual related discomforts and disorders
Experience a positive and respectful environment
Decide whether and how to participate in all spheres of life during all phases of the menstrual cycle
Despite increased attention, insufficient data are available on adolescent girls’ menstrual health across countries. The absence of data on girls’ multidimensional requirements for menstrual health renders the challenges they experience invisible. Partly because of this, …
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