Work

From concealment to openness: navigating menstrual etiquette, stigma and shame

Year: 2026

Type: article

Abstract: ABSTRACT Menstruation is a natural biological process, yet it continues to be shaped by stigma, silence, and societal norms that contribute to feelings of shame and concealment. While research has highlighted the persistence of menstrual stigma, less is known about how individuals navigate the everyday pressures to hide or remain silent, and how these norms are resisted. This qualitative study draws on in-depth narrative interviews with Dutch people who menstruate to explore how societal expectations, menstrual etiquette, and the experiences of shame influence menstrual practices and perceptions. Participants described menstruation as something that should be hidden—physically, verbally, and emotionally. Social expectations were enforced through unspoken rules, interactions, and assumptions about what is appropriate. Participants spoke of managing menstruation discreetly, fearing visible signs such as leakage or being seen with menstrual products, and often feeling shame or embarrassment. At the same time, some described moments of openness and resistance, engaging in small but deliberate acts that challenged the concealment imperative when social contexts allowed. This tension between concealment and openness was central to how participants experienced and managed menstruation in daily life. By examining these lived experiences, the study extends theoretical work on the menstrual concealment imperative and highlights how stigma and shame are enacted and negotiated in practice. The findings suggest that while concealment remains dominant, everyday acts of openness and resistance reveal possibilities for shifting norms and fostering more open conversations about menstruation.

Source: SSM - Qualitative Research in Health

DOI: 10.1016/j.ssmqr.2026.100751

Authors: Lisa Zuidema, Jaklien C. Leemans, Marlies Y. Bongers, Peggy M.A.J. Geomini, Manna A. Alma

Institutions: Maastricht University Medical Centre, Maastricht University, Máxima Medisch Centrum, University Medical Center Groningen, University of Groningen

Language: English

Topic: Menstrual Health and Disorders

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDGs: Gender equality, Good health and well-being, Reduced inequalities

Open Access status: gold

Estimated APC paid: $1,720