By Samikchhya Gurung, Rahul Aryal, and Yadav Singh Dhami 
Kathmandu. Just sixty-five kilometers from Kathmandu, in the heart of Makwanpur district, women quietly endure what can only be described as a monthly health emergency not due to a lack of awareness, but because society continues to treat menstruation as a taboo rather than a biological reality.
The research was conducted in Thaha Municipality of Makwanpur district among eighty-two women aged 15 to 49. The researchers firsthand witnessed how deeply entrenched myths, poverty, and social restrictions continue to affect the menstrual health and dignity of women. While global discussions around menstruation are gaining momentum, in places like Thaha, periods remain shrouded in silence and shame.This silence is not just a culture; it is systemic and is harming lives.
The Paradox of Awareness and Access
It would be a mistake to assume that Nepali women are unaware of menstruation or menstrual hygiene. The data from the onsite research revealed that 81.7% of the women who participated in the survey knew about commercial sanitary pads. However, understanding is not the same as using. Only forty-four out of eighty-two respondents said they used sanitary pads, which is nearly half of the respondents. But why?
The reasons were disheartening yet familiar: high cost, limited availability, and a lack of freedom to make sanitation-related purchases. Most women still rely on old clothes or reused materials because menstrual products are considered luxuries in low-income households. Compounding the problem is the lack of education about alternatives. Tampons and menstrual cups were unknown. Only one circumstance of the respondents had even heard of them, let alone used them. This is unsurprising given the absence of structured health education programs that address menstrual health in public schools or community outreach initiatives.
Stigma in the Home and Beyond
One of the most unsettling revelations from this research study was that 67% of the women reported facing social restrictions during menstruation. These restrictions range from being restricted from entering kitchens or temples to being excluded from family gatherings. While some restrictions may appear “soft” or “symbolic,” they leave lasting psychological scars and reinforce the idea that women are impure or unclean during their periods.
The most common restrictions noted were:
- Prohibition from participating in religious activities (37.1%).
- Ban on cooking food (29.8%).
- Restriction from social events (30.5%).
Even more revealing is the identity of those who enforce these rules. Surprisingly, it is not always men. In 37.8% of cases, restrictions were imposed by elderly family members, often women. Another 31.7% cited parents again, often mothers. These are not just family traditions; they are mechanisms of internalized patriarchy passed from one generation to the next. The saddest element of the story is the internalized control, where women monitor and judge one another.The menstrual taboo is not a shadow cast solely by religion or patriarchy. It is now rooted in the social fabric of homes, whispered into the ears of young girls by mothers and grandmothers who were once victims themselves.
What Hygiene Means
Menstrual hygiene is about far more than the product you use. It is about how often you change it, whether you clean your hands, where you dispose of the waste, and how you clean your body. There was also a major gap in these factors.
While 70.7% of respondents said they cleaned their hands every time after changing menstrual medium, a significant 29.3% did not. Moreover, 13.4% said they never cleaned their internal organs during menstruation. These are not minor oversights. Poor menstrual sanitation can lead to severe infections, reproductive tract diseases and germs, and long-term health problems.
Ironically, several women believe they are managing their periods hygienically, but without proper guidance, harmful practices persist. For example, while 82.9% said they dry menstrual cloths in the sun (a healthy practice), a notable 17.1% still dry them in damp, dark spaces, increasing the risk of bacterial growth.
The Psychological Weight of a Natural Process
During theinteractions with participants, the most striking part was not just the practical challenge, but the emotional toll. Women spoke of hiding their pads, skipping social events, or feeling “less than” during their periods. One young respondent said, “I hate those days and times. I feel like I do not belong and be in my own places or home.”
This is not merely a health issue, it is an identity crisis. When a woman is made to feel ashamed of something as natural as menstruation, it gradually erodes her sense of self-worth. Over time, this silent suffering turns into a burden she carries not just for a few days each month, but throughout her life.
This internalization of shame leads girls to avoid school, especially in adolescence. Research across South Asia shows a direct link between poor menstrual management and school dropout rates. How can we expect girls to reach their full potential when society tells them their biology is a barrier?
Toward a More Just and Dignified Future
It is easy to feel overwhelmed by these findings. But the truth is that solutions are within reach if we act with urgency and clarity. Nepal must prioritize menstrual health with bold initiatives rather than ignoring its importance.This begins with normalizing the conversation around menstruation and removing the stain that silences women and girls. Schools, families, and local governments must work together to bring this natural process out of the shadows and into everyday discourse.
One of the powerful methods and techniques we have is educational knowledge. Menstrual health education should be incorporated into the national curriculum by Grade 5, and teachers, regardless of gender, should be trained to speak about it with accuracy and without shame. In addition, the use of menstrual products and items must be ensured and available for all the women.Municipalities should allocate budgets to distribute free or subsidized sanitary pads in public schools and health centers, particularly in economically disadvantaged communities.
Awareness is equally critical. Using radio programs, social media platforms, and local community events, Nepal must dismantle centuries-old myths and promote accurate, culturally sensitive knowledge about menstruation. These campaigns should target not only girls and women, but also fathers, brothers, teachers, and elders, because societal change requires collective understanding.
Infrastructure, too, must be addressed. Safe, clean, and private toilets equipped with disposal bins should be constructed in schools, marketplaces, and workplaces to give women and girls the dignity they deserve. Furthermore, ensuring menstrual health should be seen as a vital aspect of public health justice.Legal frameworks should enforce product safety standards, ban discriminatory practices, and promote private-public partnerships to ensure the affordable, ethical production and distribution of menstrual materials.
We can no longer afford to wait for international NGOs to fix what we can solve ourselves. Local leadership is key. Community health volunteers, school principals, mothers’ groups, and local elected representatives must take the initiative. The future of menstrual dignity in Nepal depends on what we do nowand on our willingness to speak, act, and lead without shame.
Final Thoughts: Let Women Bleed Without Guilt
A society that cannot talk about periods is a society that is not ready for progress. If we continue to frame menstruation as something unclean or shameful, we will keep half our population hidden and half our potential wasted.But there is hope. The same women who suffer in silence are also the ones who, when asked, say they want to break the silence. 73.7% of women surveyed said menstruation should be talked about openly.
That is a revolution waiting to happen.Let us be clear: menstrual health is not a niche issue. It is not a woman’s problem. It is human rights and equality, a priority for development, and a matter and importance of national dignity.Nepal cannot move forward while its women are forced to move backward five days each month.
