We all know that every life marked by female reproductive anatomy passes through three pivotal stages: menarche (the first period), menstruation (the recurring cycle of bleeding), and menopause (the end of menstruation). While much attention is given to the middle, the first and last stages are often ignored and rarely talked about. Yet dignity demands we see the full arc.
We should focus on menstruation, the stage where stigma, inequality, and silence are most deeply felt, but also recognize that this journey begins with menarche and concludes with menopause, reminding us that dignity must be upheld through every phase of this biological cycle.
Menarche: The Starting Line
Menarche marks the first time a person bleeds, and for many, it arrives without warning or guidance. In communities worldwide, it is often met with fear, shame, or expectation. Some are told that with blood comes adulthood, eligibility for marriage, or restrictions on daily life.
Yet biologically it is simply the beginning of reproductive function, not a license to assume maturity or responsibility. According to UNFPA Kenya’s Menstruation and Human Rights – Frequently Asked Questions, the onset of menstruation (menarche) does not signal a physical or psychological readiness for marriage or bearing children.
In neglecting to prepare and support young people at menarche, societies lay the groundwork for shame, misinformation, and exclusion in the years to come.
Menstruation: The Monthly Cycle
This is the heart of the menstrual journey. For many, menstruation becomes a monthly battleground of health, stigma, infrastructure, and rights.
Poor menstrual hygiene is not benign. It is linked to reproductive and urinary tract infections, especially when people use improvised or unhygienic materials. A PMC study on adolescent menstrual hygiene highlights this risk explicitly.
Additionally, menstruation can come with pain (dysmenorrhea), heavy bleeding (menorrhagia), irregular cycles, or underlying disorders like endometriosis or PCOS, conditions often dismissed because “periods are always painful.”
The struggle is not only medical. Many lack access to safe, affordable menstrual products, or have no private places to change or dispose of used materials. According to UNICEF, stigma, poverty, and missing WASH (water, sanitation, hygiene) infrastructure cause menstrual health and hygiene needs to go unmet for many.
A joint WHO/UNICEF report found that globally only 39% of schools provide menstrual health education, and even fewer have adequate disposal bins in girls’ toilets.
UNICEF’s program guidance stresses that addressing menstrual hygiene is not just about pads, it must also include knowledge, facilities, social support, and services.
Other resources similarly emphasize that menstrual health involves human rights, education, and stigma reduction.
Because menstruation is often framed as secret or shameful, many suffer in silence. Pain is endured, absence from school or work is hidden, and dignity is compromised month after month.
Menstrual dignity, therefore, requires that menstruating people not only have physical means to manage their cycles, but also the social respect and space to do so without shame or exclusion.
Menopause: The End That Is Overlooked
Where menstrual health is loudly advocated for, menopause on the other hand isn’t often spoken about. Once bleeding ends, many feel they leave the conversation altogether,as though their bodies and experiences no longer matter.
Yet menopause comes with real challenges: hot flashes, mood changes, sleep disruption, bone density loss, and cardiovascular risks. Despite its significance, menopause is rarely integrated into reproductive health discussions or programs.
WHO, in its Menopause fact sheet, calls for integrating menopause into sexual and reproductive health services and for breaking stigma so people receive the care they need.
On World Menopause Day, professional bodies and global networks highlight that supporting people through menopause (typically between ages 45–55) with policies such as flexible working and workplace resources is an equity issue and essential for productive societies.
Some employers are beginning to respond: for example, Bayer UK has announced workplace partnerships and programs to strengthen menopause support and awareness, showing how private companies can lead.
Yet such support remains rare. The continuity of dignity demands that menopause be part of the menstrual health agenda, because periods may stop, but the body’s needs and the person’s rights do not.
Why This Full-Circle Perspective Matters
When we talk only about menstruation, we risk neglecting the roots of stigma and the fate of those beyond bleeding.
- Menarche is crucial because early negative experiences shape how someone views their body and health practices forever.
- Menstruation is the daily battleground for dignity, health, and rights.
- Menopause is equally deserving of visibility, support, and respect.
Programs and advocacy must adopt a life-course approach: one that begins at menarche, supports through menstruation, and continues through menopause. FIGO, the International Federation of Gynecology and Obstetrics, underscores this by arguing we must refocus efforts “from menarche to menopause” in the context of universal health coverage.
By bridging these stages, we send a powerful message: dignity is not seasonal, and menstrual health is not just about bleeding, it is about humanity, equality, and respect across all phases.
What Must Change
To honor dignity across this full continuum:
- Integrate life-course menstrual and menopausal health into national policies and SRHR programs.
- Strengthen infrastructure (water, toilets, disposal) in schools, workplaces, and public spaces.
- Train healthcare workers to address menstrual and menopausal symptoms with sensitivity.
- Promote education starting before menarche and continuing into middle age, so people understand their bodies comprehensively.
- Encourage workplace reforms that support menstruating and menopausal employees alike (flexible hours, climate control, rest spaces).
- Break silence and stigma at every stage, through media, community dialogue, advocacy, and inclusion of gender-diverse voices.
Conclusion
Menarche, menstruation, and menopause are not separate, disconnected events, they are phases of a biological and human story. The dignity a person deserves should span the entire journey.
Menstruation demands our central focus because here the inequities multiply. But we cannot begin there without knowing where it began (menarche), and where it leads (menopause). Silence on either end diminishes the whole.
Let us commit to a menstrual health movement broad enough to hold every stage, from first bleed to final silence, with care, respect, and justice.
Written By: Victory Wekulom
Victory Wekulom is a writer and communications professional dedicated to using storytelling as a tool for visibility, advocacy, and social change. As the Media and Communications Assistant at IGE-SRH, they develop narrative-driven content, support community-focused campaigns, and help shape conversations around gender justice, the rights of marginalized communities, and sexual and reproductive health. Their work is grounded in clarity and a commitment to amplifying underrepresented voices and lived experiences.
