April 2-4, 2020 • Hyatt Regency • Lexington, KY
Intersectionality and Interdisciplinarity in Health Communication Research
Abstract: “I did not want to talk about that with anyone:” Women’s Perception of Disclosure of Menarche in India
◆ Ashleigh N. Shields, Purdue University
◆ Meghana Rawat, Purdue University
◆ Maria K. Venetis , Purdue University
◆ Jyoti Seth, Government Girls College, Punjab University
One’s menarche (i.e., first menstrual experience) can represent many things in the life of a young woman. In cultures such as India, menarche can signal the transition into adulthood and change of status and behavioral expectations (i.e., changes in bathing, cooking, and rituals of worship). Globally, menstruation is a taboo topic, and this is particularly true within Indian society. Although menarche signals a significant disruption in the lives of young women, Indian women report receiving minimal if any communication with close others (i.e., mothers, sisters, and friends) in advance of menarche and limited information after menarche (i.e., about body changes). The lack of communication likely contributes to the stigmatized nature of menstruation-related communication and can shape their perceptions of menstruation and the likelihood of their comfort in disclosing any symptoms. Thus, the ability to seek information, support, or understanding from others is partially dependent on how young women experience and talk about menarche. To better understand this cultural proclivity to avoid menstruation-related communication, this study examines young women’s perceptions of their menarche and corresponding communication.
As part of a larger study, 8 focus groups and 600 paper-and-pencil surveys were collected in which participants responded to open-response items about menstrual experiences. Thematic analysis was conducted using an apriori selected framework, the Disclosure-Decision Making Model (DD-MM; Greene, 2009). Specifically, the information assessment component of the DD-MM assisted in conceptualizing themes. Themes identify how Indian women understand their menstrual experiences, particularly their menarche. The DD-MM describes five aspects of information assessment: (1) stigma (fear of judgment); (2) preparation (belief one may have the illness prior to diagnosis); (3) prognosis (particular health illness/disease implications); (4) symptoms (visible or nonvisible signs of health issue); (5) relevance to others (if health issue pertains to information recipients).
Thematic analysis revealed that during menarche, participants experienced stigma in the form of fear, shame, and embarrassment when they were uninformed about menstruation. Given the cultural climate toward menstruation, prior knowledge reduced but did not eliminate stigma. A majority of participants reported a complete lack of preparation for their menarche, particularly as mothers often did not educate daughters of their impending bodily changes. Participants reported that if they received any pre-menarche preparation, that preparation was limited to how to use sanitary napkins. Many participants experienced uncertainty concerning the severity (or prognosis) of their menarche, questioning if it was symptomatic of the disease. Although participants reported symptoms, or changes to their body, following menarche, it is unclear how symptoms influence disclosure. Finally, participants considered menarche-related information relevant to share with female family members and friends who were viewed as information recipients who could empathize and provide support.
This research provides an initial investigation surrounding menstrual disclosure in India. Study results and implications highlight barriers to menstruation-related disclosure. Future educational interventions may address how participants and members of their social network discuss menstruation, aiming to break the cycle that perpetuates the topic’s taboo nature.