Women's menarche stories from a multicultural sample

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Abstract

This paper reports on the findings of a focus group study that examines how women have experienced menarche at the personal level and in relation to the larger cultural, religious, and societal environment. Fifty-three women from 34 different countries were recruited in 13 focus groups. On the one hand, at the personal level, menarche stories shared in this study revealed salient themes concerning feelings experienced at the time of menarche, the importance of mother's reactions to their daughter's first menstruation, difficulties around understanding the meanings attached to menarche by others, managing menstrual products, as well as making sense of formal education related to menstruation, and the age of menarche. On the other hand, the discussions concerning how women experienced menarche in relation to the larger cultural, religious, and societal environment revealed secrecy to be a defining feature of many stories. Cultural expectations of learning, and following the rules and regulations surrounding menstruation led to different reactions in women at the time of their menarche. Very few women mentioned a ritual or celebration at the time of their menarche. Findings are discussed in terms of similarities and differences in menarche stories of women from different cultural backgrounds. Limitations of the study are mentioned and suggestions for future research are provided.

Introduction

Menarche, the onset of the first menses, is a significant milestone in a woman's life and reproductive cycle. For the female adolescent, it is a sharply defined, sudden, and distinct biological event (Golub, 1992; Koff, Rierdan, & Silverstone, 1978). Menarche is also a socio-cultural event that is shaped and constructed by cultural institutions such as religion, science, and media (e.g., Chandra & Chaturvedi, 1992; Laws, 1990; Paige & Paige, 1981).

In psychology, menarche has attracted researchers’ attention, especially during 1970s and 1980s. Current studies on menarche are sparse, but a few recent publications on this topic may indicate re-emerging interest in this topic (e.g., Beausang & Razor, 2000; Chrisler & Zittel, 1998; Kissling, 2002). Menarche studies in psychology typically examined the experience among young female adolescents or college students in North America. Although a few studies have looked at cultural similarities or differences in women's menarche experiences, it is usually in the area of anthropology where we find cross-cultural studies. This particular study was designed to contribute to the slowly growing cross-cultural psychology literature on women's menarche experiences. The goal was to hear and record menarche stories of women from different cultural backgrounds, and thereby to explore salient themes that emerge in their menarche experiences. The study then draws upon these accounts to analyze the effects of the larger cultural, religious, and societal environment on personal experience.

It is important to look at how women experience their menarche in relation to the larger cultural, religious, and societal environment, especially as many cultures portray a negative image of menstruating women. For example, in most cultures menstruation is associated with physical discomfort, increased emotionality, and restriction of social and physical activities (e.g., Brooks-Gunn & Ruble, 1982; Clarke & Ruble, 1978). This image is further complicated by the various religious and cultural meanings that have been associated with menstruation (see Laws, 1985; Shuttle & Redgrove, 1980; Ussher, 1989). For example, menstruating women are excluded from religious activities and ceremonies in certain sects of Judaism, Christianity and Islam, and are considered dirty, sick, unbalanced, and ritually impure (Daly, 1984; Delaney, Lupton, & Toth, 1988). The media further reinforces this negative image by promoting the idea that menarche is a ‘hygienic crisis’ rather than a normal developmental event (Berg & Block Coutts, 1994; Morse & Doan, 1987), that menstruation is an illness causing physical discomfort that needs to be cured (Whisnant & Zegans, 1975), and that it is a problem for girls and their parents that needs to be ‘solved’ (Kissling, 2002).

Menarche studies in psychology have predominantly examined how girls experience menarche, and have shown that women typically have detailed memories of this event (Golub, 1992; Moore, 1995). In most studies, adolescent girls reported experiencing negative and sometimes mixed emotions (e.g., Koff, Rierdan, & Jacobson, 1981; Woods, Dery, & Most, 1982; Beausang & Razor, 2000). But it has been found that women tend to experience menarche as a shift to physical maturity (Koff, 1983). The experience of menarche is influenced by the girl's preparedness for this biological event and its timing (Koff, Rierdan, & Sheingold, 1982; Ruble & Brooks-Gun, 1982); and adolescent girls reported that mothers and schools were the primary source of information (e.g., Morse & Doan, 1987; Moore, 1995, Beausang & Razor, 2000).

While helpful to defining the individual girl's experience of menarche, most studies to date have been limited to specific populations, namely only girls or women in the western world. Moreover, most of these studies have not focussed on the social and cultural construction of menarche and how girls experience it in relation to the larger meaning of the event. A certain number of studies have been conducted with women from other parts of the world than North America or Western Europe, however, and the following section provides an overview of this research.

In their analysis of detailed menarche stories of women from Lithuania, United States, Malaysia, and Sudan, Chrisler and Zittel (1998) found some differences between these four groups. For example, the issue of timing of the first menstruation appeared to be more salient to the Americans than to the women from other countries. Also, although most women from Sudan, United States, and Malaysia reported that they were prepared for menstruation, only half of Lithuanian participants mentioned being prepared. Further, most American participants mentioned their mother as the person with whom they shared their first menstruation, whereas the percentage of the participants from the other three countries who did so was lower. The Americans and Malaysians were more likely than Sudanese and Lithuanians to express mixed feelings about their experience of menarche. Participants also recalled changes in body image. Lithuanians reported more philosophical meanings attached to their menarche than women in other groups, while Americans were more worried about daily issues such as playing sports. Americans also reported having started thinking more about sexuality related themes after their first menstruation.

A study conducted by McMaster, Cormie, and Pitts (1997) in Zimbabwe revealed that most women discussed their menarche experience either with their mother or another female relative. Feelings concerning the onset of menstruation were fairly negative, with fear and worry being the most commonly reported emotions.

Logan (1980) looked at cultural variations of the menarche experience by interviewing 95 women from 23 nations. The interview questions focussed on how women prepared for menarche, the kinds of messages they received from others at the time of menarche, and their emotional reactions to the first menstrual period. Logan found the mother to be the most common source of information prior to the menarche, but in one-third of the cases, mothers did not assist the girl before the menarche. However, as in other studies, she found that girls preferred to discuss the matter with their mother. Only in Iran did an important number of women talk to their sisters. Preparation for menarche at school was reported by only 22% of the sample. Almost 30% of the women reported not having been adequately informed; some of them did so despite having received education about the matter at school. The messages women reported having received at the time of menarche concentrated on the hygienic routine, except in Iran where the girls were assured of the normality of the event. Another common response was that womanhood has begun. In terms of girls’ own reactions toward the menarche, Asian and Zambian women generally reported to have negative emotions, whereas Iranians expressed feeling “more grown up”. For other groups, generalizations were difficult to make because of the diversity of the responses.

Thuren (1994) examined the question of whether old Mediterranean ideas of sexuality as impure and shameful are still valid in an urban context in Spain. In her interviews with 36 working class women in Valencia, Spain, Thuren focused on women's first menstruation. She found that negative experiences dominated the women's stories, although some women reported neutral experiences. On the one hand, most women over 30 years of age reported not having received enough information at the time of their menarche. These women recalled that they preferred females of their own generation rather than their mothers to share the event believing that mothers communicated too much shame and too little of what they needed to know about menstruation. Most women reported feelings of shame and fear. These feelings seemed to go along with messages that conveyed a danger of sexuality and becoming pregnant.

On the other hand, women under 30 reported having more information about menstruation before the menarche and having more positive or neutral experiences. The girls were still be made to feel shame, however, in spite of the reported changes. The messages coming from older women, from religion, and form mass media still emphasized the negative rather than the positive consequences of starting to menstruate. Thuren concluded that despite the cultural changes occurred in Spain in the mid-1970s, menstruation has not been redefined as a positive event.

Amann-Gainotti (1986) interviewed 258 adolescents from Southern Italy on the kind of knowledge female and male adolescents have about menstruation as well as their sources of information. The results revealed that lack of accurate information about menstruation was common. Half of postmenarcheal girls expressed a negative evaluation of their menarche. Amann-Gainotti's study showed that a positive evaluation of menarche and the family's or cultural milieu's positive attitudes toward menstruation were positively related. Similarly, a positive relationship was also found between positive judgment of menarche and advance information.

These studies have shown that women from different cultural backgrounds experience menarche differently, as in the issues that become salient with menarche that were shown to vary from worrying about daily activities such as sports to interpretation of the event as a step to womanhood. There are some commonalities, however. For one thing, in most cases, negative emotions prevail, even though women who have had menarche more recently have tended to report more positive feelings. For another, most girls consulted either their mother or a close female relative at the time of menarche. Even so, a considerable percentage of the women mentioned not having been prepared for menarche, sometimes despite having received formal education about it.

The qualitative research reported here was designed to arrive at an in-depth understanding of women's menstrual experiences and particularly how they experienced menarche in relation to the larger cultural, religious, and societal environment. The present study differs from the existing studies in psychology that recruited women from different countries in the following ways. First, focus group methodology was used to elicit discussions among women from different countries in terms of how they experienced their menarche and what the similarities and differences in these experiences were. Second, menarche was examined not only in terms of how women experienced their menarche at the personal level, but also how they experienced it in relation to the broader cultural, religious, and societal environment primarily by encouraging women to talk about how they responded to the rules and regulations surrounding menstruation at the time of their menarche. Third, the sample is composed of women from a broad range of cultures. This will provide a variety of perspectives of women's adjustment to and coping with menarche as a culturally constructed event. At this point, it needs to be emphasized that the goal of the present study was not to make generalizations across countries. The goal was rather, to attempt to reveal salient differences between women's menarche experiences, while also looking for the underlying commonalties that may be predictors of some menarche-related attitudes, behaviors, or emotions.

Section snippets

Participants

Fifty-three women participated in focus group discussions about their menarche experiences.1 These women were recruited at an international women's summer school that was composed of 450 participants from 115 different countries. Recruitment was done by introducing the purpose and the methods of the study to the summer school attendants in social

Results

The following section describes the analysis of the qualitative data collected in the present study, along with the interpretation and discussion of the data, including how the findings relate to previous studies on menarche.

Conclusion

The present study represents an attempt to listen to women's menarche stories, to examine what women have experienced at a personal level, as well as to look at the ways in which the personal has interacted with the larger cultural, religious, and societal environment. At the personal level, menarche stories shared here reveal certain common and salient themes concerning the feelings experienced at the time of menarche, the importance of a mother's reactions to their daughter's first

Acknowledgements

This project was designed as the final requirement of the Project Area ‘Body’ at the International Women's University, Germany (2000) and started as a collaborative project with Sahar Sadjadi and Maggie Schmitt. Many thanks go to them as well as to Emily Martin who helped with the interview guide and to Michaela Hynie, Cynthia Chataway, Barbara Duden, Donna L. Stewart, Fataneh Farahani, and Janelle Jones who read different versions of the manuscript and provided valuable comments. Finally, many

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