From September to December 2020, a young womxn-led team sought to break this silence. We conducted Periods During a Pandemic, the UK’s first ever youth-led study on the experiences of young adults aged 18-35 managing their menstrual health during the Covid-19 pandemic, funded by youth rights INGO Restless Development. A total of 615 young menstruators from across the country shared their experiences, challenges and resilience during the pandemic in an online mixed methods survey. Herein we present the quantitative data to highlight an unprecedented and precarious environment, in which young people, already marginalised due to intersectional factors of gender, race, age, class and citizenship, were pushed further from public focus.
Our research shows that menstrual health is an important Covid-19 consideration, with far-reaching implications for young people’s physical and psychosocial wellbeing. Widespread barriers emerged in our data, with nearly 1 in 3 young people having less or much less access to period products than before lockdown. Given that 2 in 3 respondents also reported significant and sometimes severe changes in their menstrual health symptoms, it is clear the pandemic has been damaging for many menstruators. Common changes included periods being longer, heavier and more painful, triggered by isolation, anxiety and even Covid-19 infection. Fewer outlets for self-care and coping mechanisms, as well as professional healthcare available due to the pandemic, meant that even severe medical conditions were treated at home as many felt that their menstrual health issues were not a priority. While there is growing research on period poverty in the UK, such as Plan International UK’s recent study on adolescent girls, the experiences of young menstruating adults remain largely unreported - even as they become increasingly adverse and so merit further attention.
It is also clear that young menstruators’ adverse menstrual health experiences are not uniform. We found evidence of significant, and again overlooked, inequalities in our study. Nearly 40% of respondents who self-identified as Mixed and Black experienced less or much less access to menstrual health resources than before the pandemic. Additionally, 50% of respondents from Black, Asian, mixed and other minority ethnic backgrounds who had changed period products did so because previous products were inaccessible, unavailable and unaffordable, compared to 34% of white respondents. Data like this demonstrates that race, ethnicity and socioeconomic class, not just gender, are vital for understanding the true range of young adults’ experiences of period (in)justice and dismantling white supremacist narratives of menstrual health. Yet, without intersectional data and analysis like ours, these inequalities will continue to be neglected in public health planning and policy.
And our study is just the start. Perhaps our most important research finding is that far more work is needed to understand and address the varied challenges facing young menstruators - both during the pandemic and into the future. Feminist theories of knowledge production argue that research gaps are not only caused by, but also cause, ignorance of social inequalities. This ignorance is often neither neutral nor accidental: it perpetuates the sense that an issue is simply not worth recognising or resolving. As D'Ignazio and Klein explain in their seminal book Data Feminism, this makes data a convenient tool for oppressive institutions “to dominate, discipline, and exclude” marginalised groups.
Menstrual justice activists have long campaigned against such exclusionary gaps in public health knowledge and practice, perpetuated by chiefly white, Global North, middle class, male-dominated leadership and beneficiaries. A global 2020 study found that over 70% CEOs and board chairs of global health organisations are male, while just 5% are women from low and middle-income countries. Less than half of these organisations have public commitments to prioritising gender equality and only 38% fully disaggregate data by gender. Within this androcentric global system of healthcare, menstruators’ needs and voices remain underexamined and underfunded. Recent scholarship, for example, highlights the limitations of current gendered health research, including little understanding of the nuances of gender identity, few peer reviewers with expertise in gender-sensitive analysis, and limited strategies for mobilising results and recommendations to advocate for better gender-sensitive health practices. Although gender-sensitive analysis is becoming more common, there are also considerable obstacles to gaining funding for this research, including limited funding, no funding agencies dedicated to gendered medical sciences, and few journals willing to publish the results of gendered medical studies. The adverse experiences shared by many young menstruators in our survey, therefore, come about partly because we know so little about these experiences. Collecting and reporting on more robust menstrual justice data is a necessary first step in redressing these issues.
The need for youth-centred feminist research on menstrual health goes further. Our data collection and analysis process was designed by and for young menstruators aged 18-35, informed by our own experiences of barriers to menstrual healthcare and how these had become more pronounced during the pandemic. Our research was borne out of a series of participatory action research workshops, co-facilitated by INGO and research consultants Recrear International, who encouraged us first to reflect on our own challenges during the pandemic. In the context of open and fluid dialogue over a few weeks, our group of three researchers shared our impressions as young menstruators during the lockdown. It gradually became clear that we had all felt different levels of instability, as a result of limited professional menstrual healthcare and the increasing precarity of work, study and life as a young person in the UK. Worryingly, this collective experience seemed largely overlooked in current media, advocacy and research narratives. We were particularly influenced by shared experiences of having our own bodily experiences challenged, disbelieved and dismissed. As such, we felt passionately about countering these disempowering practices by developing our own relevant research and advocacy objectives, social media-led research methods and digital data collection, and short, accessible and engaging reports that centred the expertise, interests and communication preferences of young menstruators.
Before the pandemic, experiences of medical dismissal or disbelief had been concerningly common: a 2008 study of 4334 young women living with endometriosis showed that they had faced consistently high levels of dismissal or disbelief from medical professionals. In the Covid-19 context of scarce and socially distanced healthcare, the devaluation of young menstruators’ knowledge and experiences has even greater potential for harm. Many respondents said they struggle to be heard by healthcare professionals and feel that public health bodies and policies overlook young people’s menstrual and sexual health concerns. A few resorted to alternative and sometimes risky self-led approaches to healthcare as a result. One respondent, for example, took a friend’s caesarian-section prescription painkillers instead of visiting A&E. Alongside these adverse experiences, a common and often linked desire was for more opportunities to influence policy decisions based on young people’s needs. Youth-led feminist research offers a direct and often democratic avenue for this kind of advocacy - one which allows young people to determine the parameters of their project together, based on collective lived experiences.
Ultimately, what makes this kind of menstrual justice research truly powerful is that it gives us the tools to build a more equitable post-Covid reality for young menstruators around the UK. This is a future in which we have access to the resources we need; where our concerns are valued, heard and taken seriously by healthcare professionals and policymakers; and where there is broad equality of experience and access across the country. In short, period data is vital for both dignity and self-determination.