Myths about menstrual medication: A global and local challenge

A myth is a traditional story or narrative, often involving supernatural beings, ancestors, or heroes, that conveys a culture's beliefs, values, or explanations about the natural world usually passed down through generations and serve various purposes in explaining natural phenomena (like why the sun rises and sets), teaching moral lessons, or preserving historical events in a legendary form. While myths are rooted in specific cultures or societies, they're often fictional and symbolic, blending elements of truth, imagination, and of cultural significance. For example, in Greek mythology, stories about gods like Zeus and Athena help explain aspects of nature, human behavior, and societal values

Menstruation is a natural biological process, yet it remains heavily stigmatized and shrouded in misinformation worldwide. In many communities, the use of medication to alleviate menstrual symptoms is viewed with suspicion and in some cases, strongly discouraged. This article explores some of the myths surrounding medication use during menstruation, focusing on their prevalence in various global communities highlighting the roots of these myths, their adverse effects, and strategies for overcoming this challenge.

Among different communities in parts of South Asia (India, Nepal & Bangladesh), Latin America (Mexico & Andean regions), it’s believed that painkillers are harmful to reproductive health. This myth suggests that taking pain relief medications, such as ibuprofen or paracetamol, for menstrual cramps can lead to infertility or other reproductive issues. These communities have a notion that menstrual blood needs to "flow naturally" without interruption from medications, which are thought to slow or suppress the process thus hindering their use.

In Western societies, there is a growing belief the "Detox" Mindset, a growing trend in wellness culture that menstruation is a time for “detoxing” the body, which can lead to recommendations to avoid medications, caffeine, certain foods, or other substances thought to “interfere” with the process. This idea aligns with myths about menstruation as a time for “cleansing,” despite lack of scientific basis. This is similar some low-income populations in Asia that believe medication intensifies menstrual bleeding as people believe it can increase the flow or prolong the period. This perception discourages many from seeking relief for cramps and other symptoms which is majorly wrong.

In Africa, these myths are widespread and often rooted in cultural or religious beliefs. Traditional healers sometimes discourage women from using pharmaceutical pain relief, instead suggesting herbal remedies or natural methods. In a study by Menstrual Hygiene Day (MHD), over 70% of women in Uganda reported experiencing menstrual pain, but only a small fraction sought medication for relief. According to the African Institute for Health, 60% of young girls in Uganda abstain from medication due to fear of infertility or other side effects. Another survey conducted by Water Aid found that 45% of Ugandan women and girls had been told not to use painkillers during menstruation due to myths about fertility and health. Commonly held belief about menstruation and medication in Uganda include the following;

• In the Buganda region, where traditional cultural practices still hold influence, menstruation is often seen as a time of impurity. Some community members believe that taking painkillers or other medications during menstruation might "corrupt" the body, preventing it from "purifying" itself naturally. This belief may lead individuals to avoid medications that could alleviate menstrual pain or discomfort, instead relying on traditional herbs or home remedies.

• In the pastoralist communities of Karamoja, myths around menstruation often prevent open discussion of menstrual health, including medication use. There is a belief in some areas that taking medication during menstruation can weaken the body or cause infertility. As a result, young women and girls might avoid taking painkillers or antibiotics even if they experience severe menstrual pain or infections related to menstruation. Traditional healers and herbal treatments are sometimes used instead.

• In the Busoga region, cultural taboos around menstruation persist, including beliefs that menstruating women are more vulnerable to illnesses or that medicines might cause "impurities" to stay in the body rather than be naturally released. Women and girls here might avoid painkillers for fear of disrupting their menstrual flow. In some rural areas, there is also limited information on safe menstrual hygiene practices, which may exacerbate discomfort during menstruation.

• Among some communities in the Ankole region, menstruation is viewed as a time for "natural cleansing," and there’s a belief that taking medication could interfere with this process. Some believe that if a girl takes pain relief medication regularly for menstrual cramps, she may become "too dependent" on them, weakening her body’s natural resilience thinking that its addictive. This can lead to girls suffering through pain without relief.

• In Acholi communities, myths about menstruation often discourage women from seeking medical interventions during their periods. Some believe that taking antibiotics or painkillers during menstruation could alter the reproductive organs or cause issues with fertility. This belief sometimes pushes menstruating women to bear discomfort and avoid helpful treatments.

Several factors contribute to the persistence of these myths in Uganda including;

Lack of menstrual health education. Schools and communities often lack resources to provide accurate information on menstrual health and medication, leading to reliance on word of mouth myths.

Deep-rooted cultural and religious beliefs shape community perceptions of menstruation. Traditional customs often view medication as unnatural, promoting herbal or non-medical remedies.

Stigma and secrecy around menstruation, the taboo nature of menstruation in Ugandan society often prevents open discussions about menstruation and menstrual pain, making it difficult for women to seek information on safe pain relief.

Influence of traditional healers in rural areas who hold substantial influence, often discouraging the use of modern medicine for menstrual pain in favor of herbal alternatives, citing cultural or spiritual reasons.

Strategies to Overcome Menstrual Medication Myths

Community education and awareness programs: Engaging community leaders, traditional healers, and religious leaders in educational programs can help counteract myths and promote evidence-based information on menstrual health by sharing accurate and clear information about the nature of menstruation, menstrual cramps, and how they can safely be managed with pain relief options. Remember acknowledging the importance of traditional practices but suggest integrating modern, safe pain management options as complementary.

School-based menstrual health education: Introducing menstrual health education in schools, including accurate information about safe pain relief and medical consultations can foster a culture of openness and reduce stigma among young people. Share stories of women who have benefitted from safe medication use during menstruation to dispel fears about infertility and addiction.

Health promotion campaigns: Public health campaigns can use local media, including radio and community events, to debunk myths, explain safe medication practices, and emphasize that menstrual pain is treatable. Encourage people to consult healthcare providers for advice on menstrual pain management rather than relying on myths or hearsay. Primary care physicians, thus are required to be acquainted with common myths related to menstruation prevalent in their communities and treat the individuals holistically by addressing them also.

Collaboration with NGOs and advocacy groups: Organizations such as Period Talk Uganda and other menstrual health advocates can play a significant role in challenging these myths by promoting positive menstrual health practices, providing information, and supporting access to safe medication.

In conclusion, myths about menstruation and medication, while rooted in cultural and historical beliefs, ultimately harm the health and well-being of women and girls. These misconceptions lead to unnecessary pain, mental health challenges, and reinforce stigma around a natural biological process. Without proper treatment, those affected by menstrual complications like dysmenorrhea, fibroids, endometriosis, menorrhagia etc. can suffer from anxiety, stress, reduced quality of life and in severe cases death if left untreated. Furthermore, myths discourage open dialogue, limiting healthcare-seeking behavior and reinforcing the notion that menstruation is shameful or secretive. By promoting accurate information and encouraging open conversations, communities in Uganda and beyond can dispel these myths, ensuring that women and girls have safe, effective options to manage menstrual health with dignity and support.

By Atwine Deras

Pharmacist, Period Talk Uganda