A month of highs and lows: the impact of menstruation on HE

For many students today, navigating the academic landscape is complex and challenging, filled with unexpected difficulties that demand enormous support, resilience and adaptability. For many women in higher education, the journey is further complicated by the physiological and psychological reality they confront on a monthly basis. This essay argues that higher education institutions (HEIs) need to better accommodate the challenges faced by menstruating students to promote educational equity.

Each month, female university students endure an array of symptoms including cramping, heavy periods, mood swings, backaches, migraines, mental fogginess, bloating and more, which can vary in severity from person to person. Some might even experience debilitating symptoms that significantly affect their daily lives and activities. Despite grappling with these challenges, those students often persist in maintaining their academic responsibilities, from attending classes and completing homework to taking exams. Importantly, there is significant variation in how individuals experience menstruation due to intersecting factors such as race, socioeconomic status or disability.

• Breaking barriers for women: closing the gender health gap in academia
• Women in academia are doing too much non-promotable work – and that has to stop
• Breaking barriers for women: how to build effective parental leave

In the journey towards gender equity, the issue of women’s bodily autonomy and reproductive health has long been a knot, seemingly impossible to untangle due, in part, to deeply ingrained societal norms that impede progress. For centuries, women have been deprived of agency over their physical selves, their reproductive choices and their desired life paths. The world has slowly become more progressive, but the pace of societal change hasn’t come close to what it should be.

Take, for example, women’s menstruation. As women navigate hormonal and physiological changes, they are often pushed into silence, unable to discuss the challenges of menstruation, a cyclical process lasting approximately a week each month from puberty to menopause. This veil has perpetuated cultural taboo and stigma and caused societal misconceptions, linking women’s emotional expression to the ebb and flow of their menstrual cycles. Moreover, this lack of discourse has resulted in an alarming dearth of education surrounding the intricacies of the female body’s 28-day cycle, leaving women to grapple with the burden of purchasing costly, potentially harmful products to manage their menstruation.

Almost 90 per cent of women, during their reproductive years, have reported experiencing premenstrual physical and emotional symptoms at least once a week or two before they bleed and enter their menstrual phase. Of those, between 5 per cent and 8 per cent suffer more severe premenstrual conditions that can lead to severe depression, fatigue, trouble focusing, anxiety, panic attacks and difficulty controlling emotions. During the beginning of a woman’s cycle, the levels of the hormones progesterone and oestrogen drop and then begin to rise until they peak at ovulation. This fluctuation in hormone levels affects, among other things, emotional processing.

Whether thinking about premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD) or premenstrual exacerbation (PME), each of these conditions manifests with varying types of symptoms and degrees of severity. Yet women are expected to forge ahead in their academic pursuits, even when they aren’t being offered the help they need and deserve. 

What does this have to do with higher education?

Menstruation-related conditions can have a significant impact on a woman’s daily life, including her educational pursuits. Specifically in the context of higher education, these conditions can cause considerable challenges. For example, pain and discomfort related to dysmenorrhoea (painful periods) could cause a student to miss classes or be unable to focus on studying. Emotional and cognitive symptoms associated with these conditions, such as depression, anxiety and difficulty concentrating could similarly affect a student’s academic performance and engagement.

These issues can create an unequal playing field in higher education, with women potentially facing additional barriers to academic success. It emphasises the importance of universities and colleges providing resources and support to students dealing with these conditions.

In order to create a more equitable and empathic academic environment, our institutions must acknowledge that menstrual hygiene is a basic human need and address the unique issues presented by menstrual-related challenges. This necessitates the development of intentional and targeted support services, accommodations and educational resources, which empower students to manage their symptoms effectively while fulfilling their academic and professional roles.

1. At the very least, provide free menstrual products in all restrooms on campus, including those in libraries, recreational facilities and academic buildings.

2. Establish wellness centres that include menstrual health, providing access to medical professionals, mental health counsellors and support groups.

3. Research and implement policies to ensure that reasonable accommodations are made for students experiencing severe symptoms, such as flexible deadlines and inclusive sick leave policies.

(a) For example, include menstrual leave for employees who experience severe pain or discomfort during their menstrual cycle.

(b) Allow students experiencing menstrual discomfort to work remotely, adjust their own schedules or take short breaks as needed during the school day.

(c) Offer counselling services or employee assistance programmes that specifically address mental health concerns related to menstruation, such as premenstrual dysphoric disorder (PMDD) or other menstrual-related anxiety and depression.

4. Offer faculty and staff training programmes. These can focus on enhancing awareness and understanding of PMS, PMDD and PME, and can foster a more empathic approach to interacting with students and colleagues grappling with these disorders.

5. Integrate menstrual health education into the curriculum. HEIs can play a pivotal role in dismantling the stigma surrounding these conditions and fostering a more inclusive learning environment.

While this essay is focused on cisgender women, it is important to remember that the experience of menstruation isn’t exclusive to them. Many transgender men and non-binary individuals also navigate the challenges of menstruation in their academic journeys, further complicating an already complex landscape.

The mention of including menstruation issues in the UN’s sustainable development goals indicates a positive shift towards acknowledging these issues at a global level. However, translating this recognition into tangible actions, policies and support systems remains a crucial task.

HEIs, along with workplaces, can play an instrumental role in this. For a start, they can implement policies that are sensitive to the needs of menstruating students, creating a culture of understanding, dignity and empathy around menstrual challenges. By doing so, they can help to ensure that students do not have to compromise their education or careers due to unmanageable menstruation, moving us closer to a more equitable and inclusive society.

Mays Imad is an associate professor in the biology department at Connecticut College, US, and a senior STEM fellow with the AAC&U.

Kerri Maron is a recent biology graduate from Connecticut College.

If you would like advice and insight from academics and university staff delivered direct to your inbox each week, sign up for the THE Campus newsletter.