Researcher Laura Medina Perucha, from the Jordi Gol i Gurina Primary Care Research Institute (IDIAPJGol), coordinated the Equity and Menstrual Health in Spain study, funded by the European Society of Contraception and Reproductive Health. The aim of the study was to describe and understand menstrual inequities and menstrual health among women and people who menstruate (PM) aged between 18 and 55 in Spain. To obtain the results, the research team conducted studies with three population groups: women and PM, men, and experts in equity and menstrual health. The study lasted two years, from November 2020 to December 2022.
Highlighting menstrual inequity and menstrual health characteristics in Spain
The study found that menstrual characteristics in women and PM vary according to sociodemographic factors, such as age. It identified an earlier age of menarche (first menstrual bleeding) in younger generations. The likelihood of experiencing more menstrual pain and premenstrual symptoms was also higher among younger participants. A relationship was also found between economic difficulties and experiences of menstrual pain and heavy bleeding.
The study concludes that menstrual inequity affects all women and PM transversally, given its roots in patriarchal social and political systems, and that menstrual inequity is a form of gender inequity. However, menstrual inequities seem to particularly affect women and PM with greater socioeconomic difficulties, certain migrant groups, and non-binary and trans people who menstruate.
On the other hand, healthcare professionals’ responses, often limited to a biomedical perspective and oriented toward the medicalization of menstruation and the menstrual cycle, as well as the normalization of menstrual pain and other related symptoms, appear to constitute a barrier to accessing health services for issues related to menstruation and the menstrual cycle. For this reason, both women and PM and experts in equity and menstrual health emphasized the need to promote menstrual education among practicing health professionals and to strengthen menstrual education in university curricula. In addition, experts advocate for the creation of multidisciplinary teams to take population heterogeneity into account during consultations. It would also be necessary to strengthen the role of community agents to build links between health services and women and PM who do not usually access them.
Measures to improve menstrual health and reduce menstrual inequities
The study also includes a set of recommendations to reduce menstrual inequities and improve menstrual health among women and PM. These focus on the need to target political and community strategies and interventions toward addressing the structural factors that contribute to menstrual inequity. In this regard, menstrual policies should be implemented comprehensively (rather than in a fragmented way). Furthermore, it is necessary to develop specific policies according to the needs of different groups (LGTBIQ+, people with disabilities, migrant groups in vulnerable situations, among others). These measures should aim to address menstrual taboo, stigma, and discrimination, strengthen menstrual education and quality healthcare in public services, and ensure access to menstrual products and spaces for healthy menstrual management, including the adaptation of workplaces and educational environments. The researchers also emphasize the need to promote research on equity and menstrual health.
