A review covering over 20 years of global research on the menstrual experiences of university students highlights a need for greater understanding of how menstruation impacts education in high-income countries.
There were no published research studies recorded in Australia for the entire review period from 1990 to mid 2020.
"We just don’t know," says PhD candidate Alana Munro when asked how periods affect Australia’s university students. Her goal is to address that knowledge gap in her ongoing research.
Her review, recently published in PLOS One , showed that globally period pain contributed to university absenteeism, and declining academic performance and it impaired participation and concentration.
While there has been increased awareness and support for menstruating high school students in Australia, the review highlights insufficient research into the impact on Australia’s university students.
"Uni is very different from high school. The way that learning and attendance are structured means students have less contact with teaching staff and more opportunity to fall through the cracks," said Ms Munro, lead author and a PhD candidate in the Faculty of Medicine and Health at the University of Sydney.
"We know that menstrual cycle-related discomforts are common among university students, but there is more to the story that we must uncover."
The global review, looking at the impacts of menstruation on university students’ experience and education found:
- Only 83 available studies, with most conducted in lower to middle-income countries.
- Studies in high-income countries included Saudi Arabia, Spain, England and the United States but mainly focussed on the prevalence of menstrual pain.
- Painful periods (known as dysmenorrhea) negatively impacted students’ ability to attend university, complete assignments, study for exams and participate in class activities. However, these impacts were unnoticed by university teaching staff.
- ·Students were generally dismissed by health professionals when seeking help for pain.
- Poor university sanitation facilities made it difficult for students to manage their menstrual periods, and led to fears of staining their clothes and being ridiculed by peers at university.
- Little research on other aspects of the menstrual experience such as students’ knowledge of menstrual biology and their confidence to manage menstruation.
- No studies were conducted with trans and gender diverse students, and only one study explored international students’ experiences of menstruation.
An Australian study published post-review also focused exclusively on menstrual pain.
Asking the right questions
Early in her research, Ms Munro undertook an Instagram survey to see what kind of engagement she’d get on the topic and was shocked to receive over 240 responses in just 24 hours.
"It showed me that many people wanted to share their experiences of menstruation despite it being a generally taboo topic," said Ms Munro.
Of the 240 respondents (not exclusively university students):
- 33% felt anxious managing their period outside the home
- 70% said their period impacted their school, university or work attendance
- 28% told their teacher, lecturer or employer that they absented because of their period
- 82% would like access to menstrual leave at school, university or work.
Ms Munro suggests research needs to start addressing questions such as how period stigma affects students’ time at university and how teaching staff can create an environment where students feel comfortable discussing menstrual-related impacts on their education.
"There is this common discourse in the media and community that periods hold students back from their education and that there isn’t much they can do about it because it’s out of their control," said Ms Munro.
"However, we are hearing students can be very resourceful. For example, they might rearrange study schedules or assignment preparation to fit their menstrual cycle or they’ll wear double protection on days they have heavy bleeding so they don’t miss out on university or work.
"They are creative in overcoming these challenges, but we need to do more to support them. A critical part of that is actually asking them about their needs."
Meeting the needs of students
The review also showed that research to date has failed to understand how campus bathroom facilities could be improved so students can manage their menstruation using their preferred methods and products - from pads to menstrual cups.
Earlier this year Ms Munro worked with Share the Dignity to install a vending machine for free period products in the University of Sydney’s Carslaw bathrooms. This followed a survey of over 300 students (conducted as part of her studies) that showed around a quarter of students have left campus to purchase products instead of attending class. Ninety-two percent also indicated reasonably priced products in student bathrooms would help them manage menstruation.
The University of Sydney Union (USU) also secured Student Services and Amenities fee (SSAF) funding this year to install free PIIXI menstrual products in bathrooms across USU facilities in the Holme, Wentworth and Manning buildings as a 12-month pilot program.
However, Ms Munro and co-author Dr Erin Hunter caution that meeting the needs of students is about more than pads and tampons.
"While ensuring students have access to menstrual materials is important, menstrual needs don’t end there," said Dr Hunter from the Sydney School of Public Health.
"Here in Australia, better understanding the needs and preferences of university students is an important first step in working toward policies or programs that can help ensure university campuses are conducive to the needs of students who are menstruating."
The findings of the PLOS One review have informed Ms Munro’s latest study on the menstrual needs of over 400 students attending an Australian university, with findings expected to be published next year.
Declaration: The authors declare no competing interests.
Header image: Shutterstock/ Elizaveta Galitckaia
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