The Research on the Causes and Countermeasures of Shame in Women's Menstrual Period

. Menstruation is supposed to be a normal physiological phenomenon for women, but even with the advancement of science and technology, the public has a partial understanding of the physiology of menstruation, while at the same time the stigma of menstruation still affects every woman. Menstrual shame is not only a physiological phenomenon, but also a social phenomenon with social connotations. This article summarises the menstrual shame that women experience in everyday life, and describes the direct and indirect negative effects of menstrual shame on women in terms of their physiology and psychology, work and study, as well as the negative effects of menstrual shame on society. The paper also examines the causes of menstrual shame, ranging from historical misconceptions to the lack of sex education and inappropriate media content due to the shame of “sex” in modern society. The lack of proper knowledge about menstruation can make it easier for people's attitudes towards menstruation to be influenced by societal attitudes. This paper also seeks to propose countermeasures: to popularise the physiological significance of menstruation through sex education and to guide positive attitudes towards menstruation through a proper understanding of menstruation. The paper also attempts to strengthen the regulation of menstruation-related content and to encourage talk about menstruation in public places.


Introduction
Menstruation is the cyclical shedding and bleeding of the endometrium that accompanies the cyclical changes of the ovaries [1].It occurs in the daily life of every growing and mature woman and affects her daily life and even her self-identity.However, in the twenty-first century, there are still taboos against menstruation in modern life, and in some cultures, menstruation means impurity, dirtiness and bad luck.In some areas, such as India, a woman who is menstruating will not be allowed to enter a temple.According to Goffman (1963), the term stigma refers to any stain or mark that distinguishes certain people from others.It conveys the message that such people have physical or character defects that undermine their appearance or identity.Menstruation as a stigma will affect psychological well-being on stigmatized individual [2].The stigma of menstruation such as menstrual shame has affected many families because of the incorrect understanding of female menstruation by various factors.Older women will teach young women in the family who have just had their first period that menstruation is a woman's problem and should be secretly hidden.This exposes the fact that many older women believe that menstruation is shameful.This shame about menstruation also affects many young girls, who can often be seen at school shyly taking sanitary towels out of their bags and hiding them up their sleeves, too ashamed to let others know they are having their period.Shame about menstruation is not only an expression of individual attitudes, but also has a social impact.Social media communications, such as advertising media, describe the representation of feminine hygiene products as small and undetectable.More than anything else, the social stigma attached to menstruation is reflected in the fact that people do not talk about it in public, that it is not something that should be discussed, and that even education about the physiology of menstruation is hidden [3].
Menstrual shame not only affects women's physical and psychological health, but also their working lives and even has a negative impact on women's health.For example, for society, menstrual shame also has the effect of reducing fertility rates.This is why it is important to analyse the causes of women's menstrual shame and to propose strategies to improve it, in order to understand the nature of the phenomenon from the perspective of women's roles and to explore strategies to improve the social media's role in avoiding menstrual shame.This paper is divided into two chapters, which examine the characteristics of women's physiological shame and the impact of menstrual shame respectively, and hope this research will provide further literature for future scholars.

The Characteristics and Influence of female physiological shame
Shame is defined as a self-critical emotion, according to which individuals display a negative consideration of themselves.It is this perception that results in an emotional response that might include feelings of awkwardness, rejection by others, personal failure, a sense of having done wrong, etc. Menstrual shame is a result of menstrual stigma, it can be divided into a social presence category, and a self-conduct category, depending on how it is expressed in different contexts.

For the Social Presence
1) What not to mention in public.
It is considered indecent to mention menstruation and related content in public.
2) Pain that you are afraid to talk about.Menstruation is the periodic shedding of the endometrial lining of the uterus, which can produce dysmenorrhoea and cause physical pain.Most women are not afraid to mention that they have pain about menstruation in their daily lives.Women may be afraid to mention menstruation and the parts associated with it because they think it is shameful.
3) Symbols in advertisements and books.
Advertisements for menstrual products contribute to the spread of taboos by emphasising secrecy, avoidance of embarrassment and novelty (Coutts and Berg 1993; Delaney et al. 1987; Hoppert 1999; Melskin 1999).Allegorical images, such as flowers and hearts, and blue rather than faintly red liquids, have been used euphemistically to promote secrecy and delicacy (Merskin 1999).Advertising exploits women's fear of being discovered as menstruating because discovery implies shame (Coutts and Berg 1993).At the same time, symptoms related to menstruation are presented in negative terms in books and magazines [4].

For the Social Presence
1)Mysterious items in black plastic bags.When shopping for feminine hygiene products, it often happens that young girls with their heads slightly bowed in front of the shelves, quickly putting the sanitary napkins on the shelves into the shopping cart and pushing them to the checkout, and the salesperson will fill up the sanitary napkin with a black opaque bag.
2)The secret code of silence.
When girls talk about menstruation, they rarely mention it, and if they do, they use other, more obscure words to refer to it, for example "aunt".

The Direct Harm to Women's Well-being
Menstrual stigma causes stress in adolescent women, the stigmatized group perceive stress, as their resilience varies, resulting in different physical and mental health outcomes.For adolescent women, their physical and mental development is not mature.Therefore, the resilience is relatively weak.This means that menstrual stigma may have a more profound effect on them.Negative attitudes towards menstruation can influence negative feelings about menarche in adolescent girls.This can lead to subsequent menstrual symptoms (Brooks-Gunn et al., 1977;Woods et al., 1982) and adjustment problems during adolescence, such as eating disorders (Arnow, Sanders, & Steiner, 1999; Fairburn, Cooper, Doll, & Welch, 1999), early sexual behaviour (Gagnon, 1983;Golub, 1992) and adolescent pregnancy (Wang & Chou, 1999) [5].
At the same time, the internalized stigma of menstruation will cause them not to talk about menstruation with others.This can lead to teenage girls being too ashamed to talk about the physical pain associated with menstruation, or even to go to the doctor, which can delay the treatment of the disease and affect their physical health.In the paper How do adolescent girls and boys perceive symptoms suggestive of endometriosis among their peers?Findings from focus group discussions in New York City, they mention about menstruation stigma will prevent help-seeking, as menstrual stigma often hinders conversations about menstruation and may extend to symptoms of endometriosis [5].This will cause a delayed treatment which is harmful to physical health.

The Indirect Harm to Women's Well-being
Due to the social silence about menstruation brought about by menstrual shame, men lack knowledge about menstruation-related issues.Men, on the other hand, may play multiple roles in society.In the family, when men are involved in decisions about the allocation of family resources.Where basic socio-economic structures such as kinship and marriage allocate power and authority primarily to men, women become dependent on men for food, medical services and other materials that contribute positively to health status (Singh, Bloom), including menstrual care products [6].This can mean that women and girls face problems in accessing these products [7].
The invisibility of the topic of menstruation due to menstrual shame may make many people unaware of the real problems associated with menstruation.For example, menstrual poverty.In more extreme cases, research has shown how girls can obtain menstrual products through transactional sex, which in some cases is the norm.This increases girls' risk of violence, sexually transmitted infections and other threats (House, Mahon and Cavill, 2012; Mason et al., 2013; Tellier and Hyttel, 2017).For girls who use disposable sanitary napkins, menstrual care products are often rationed, leading to less frequent changing of sanitary napkins, which can lead to discomfort, itching and even infection (Mason et al., 2013; Winkler and Roaf, 2015).

Other Damage
For Psychological damage to women, Menstrual shame may cause women to feel anxious when they menstruate.In the paper "Psychosocial and cultural factors influencing menarche expectationsa study of pre-menarche girls in China" the findings suggest that girls who are exposed to more negative cultural myths and stereotypes about menstruation will have negative emotional expectations about menarche.The social climate of menstrual shame can make women feel anxious about the onset of menstruation.
For the inconvenience to women's working lives, menstrual shame is a problem for society as a whole, and menstruation can bring about a stigmatization of the female community.Stigma and behaviour related to menstruation were found to have a significant negative effect on female employee performance.Menstruation specific non-work-related stress was found to partially mediate between menstruation-related stigma-employee performance and menstruation-related behavioremployee performance relationship.

The Social Problems Associated with Menstrual Shame
Women may have negative attitudes towards menstruation and related matters due to menstrual shame.Undergraduate women with a high tendency to self-objectify also indicated that they would prefer not to have a menstrual cycle (Johnston-Robledo et al. 2003) and reported positive attitudes towards the elimination of menstruation through the use of continuous oral contraceptives (i.e., suppression of menstruation; Johnston Robledo et al. 2007).Thus, self-objectification may lead women to maintain a sense of global shame about multiple reproductive events, including menstruation, childbirth and breastfeeding (Johnston-Robledo et al. 2007).Shame and lowered selfesteem can be psychologically damaging and may lead women to make reproductive decisions that may negatively affect their physical health (e.g., suppression of menstruation, elective caesarean Menstrual shame can bring about negative attitudes towards menstruation in women, and the social stigma attached to menstruation may be internalised in women themselves, causing them to feel identity shame about themselves, which may cause them to become anxious.At the same time, shame about menstruation may make women shy away from menstruation-related illnesses, or even cover them up, which may delay treatment for physical illnesses and have a negative impact on women's health.For society, menstrual shame can also have the effect of reducing fertility rates, for example.

Traditional Misconceptions
In primitive conceptions, the division of social roles between men and women and the distribution of activities by means of production have led to a certain specific perspective on the treatment of the characteristics and status of the female body.When looking at menstruation through the lens of religious anthropology, it is clear that menstrual taboos exist in the majority of human societies [8].The study of menstrual taboos in the context of religious anthropology focuses on the relationship between women and defilement.Menstruation was seen as unknowable and unclean.Among primitive ancestral peoples, the phenomenon of women bleeding vaginally during menstruation was incomprehensible, as bleeding usually meant death, and so menstruation was considered frightening and inauspicious to primitive ancestral peoples.At a lower stage of civilisation, menstruating women were the subject of superstition and fear, and so many restrictions on women arose.Women were forbidden to participate in religious rituals, and even many men considered it dangerous to touch a menstruating woman.In some societies, women were required to segregate themselves from other people when they had their periods.Many societies also derived from this that female-related objects were also unclean.The taboo against menstruation has also become part of the patriarchal society's control over women.In some societies, menstruating women were not allowed to participate in socioeconomic activities.They considered menstruating women to be a dangerous influence and thus restricted their activities.Some societies require women to stop all work during menstruation, believing that crops touched by menstruating women will wither and cooking will turn sour.This restriction on women's working life due to menstruation causes a further reduction in women's status.

Lack of Gender Education
Menstruation is an important physiological feature that distinguishes women's existence from that of men, and in a society where men dominate, women's menstruation is not valued.As the status of women continues to diminish, menstruation is seen as an even more unknown presence.The process of perception of menstruation is linked to men's attitudes towards women.Men consider women to be of a more inferior status, and menstruation, a physiological phenomenon that exists differently for women than for men, cannot be inferior and cannot appear in the public spaces that men enjoy, but only occur in silence.
With the development of civilised society and the process of scientific understanding of menstruation, people are able to generally realise that menstruation is the shedding of the lining of the female uterus and is a normal physiological phenomenon for women.
However, in most modern societies, such as China, there is still a state of shame about sexuality [9], and menstruation is among those associated with it.This social silence about sex has led to a lack of knowledge about the physiology of menstruation and a misconception of the phenomenon.
In the early 2020s, when Wuhan was closed in the immediate aftermath of the new crown epidemic, there was a shortage of sanitary towels.Female health workers, including those on the frontline, were also faced with the dilemma of not having sanitary napkins and other physiological supplies during menstruation, and after the story appeared on social media, comments emerged that made people aware of the lack of knowledge about the physiology of menstruation.Some have suggested that it is indecent to mention menstruation as a topic on public social media, while some male users have suggested that menstruation is something that women can control and overcome on their own, like tears, and that women are weak and intolerant.These comments show that menstruation is still a subject that cannot be mentioned in the public perception, that it is shameful and needs to be hidden.Men's lack of knowledge about women's physiology is compounded by the fact that the phenomenon of menstruation leads to an underestimation of women's work and that women are weak.Their misconceptions and discriminatory views about menstruation lead to discrimination against menstruation, which is also reflected in the fact that women who do not menstruate do so.This is due to the lack of sex education.The population as a whole lacks knowledge of the biological differences between men's and women's bodies, gender awareness and cultural connotations.
As men are the other half of society that live with women, information about women also be relevant to men.Men may take on many roles in a woman's life, such as father, teacher, classmate and colleague.As men get older, their roles will change.The closer they are to a woman, the more likely they are to exert influence on her.
In modern society, men's knowledge of the physiology of menstruation is still inadequate.According to the paper Study on the Menstrual Culture of Youth Men-A Case Study of College Students, young Chinese men learn about menstruation mostly through their families, peer groups and the mass media, and less in schools due to differences in educational attitudes, such as physiological knowledge [10].The mass media is not only a way for young men to actively seek knowledge about menstruation, but also a way for menstruation-related advertisements to silently influence them.This shows a lack of awareness of men's knowledge of menstruation.Young men adopt three strategies of action: avoidance, joking and support when dealing with menstrual matters.Young men's choice of action strategies is not only influenced by the meaning of their discourse, but also by the role of the group in which they live.

The Content of Media Campaigns
The stigma of menstruation is communicated through various socio-cultural outlets such as advertising, social media, and even magazine articles and educational books.
Advertising is a cultural product that plays an important role in the social construction of meaning (Merskin 1999).In some advertisements for feminine products such as sanitary napkins, there are dramatic scenes of women experiencing emotional ups and downs and hysteria during menstruation.This creates negative attitudes and stereotypes about menstruating women and creates a new stigma about menstruation, which affects public attitudes towards menstruation and women.The public's attitude towards menstruation may in turn affect the willingness of the stigmatised group to disclose it, with more negative attitudes leading women to choose to keep their menstruation-related conditions hidden.This avoidance can lead to a greater perception of menstruation as shameful.Many feminine hygiene products related to menstruation are advertised as "small, hidden and undetectable", which contributes to the spread of menstrual taboos, conveying and affirming the idea that menstruation is shameful and needs to be hidden from the public.
Especially in the absence of systematic sexuality education, men's perceptions of menstruation are more easily influenced by the mass media and peer groups.If there are advertisements with negative attitudes towards menstruation, this may contribute to men's negative attitudes towards menstruation.In turn, men's attitudes towards menstruation may have a direct impact on women's attitudes towards menstruation.
In cultures where women's bodies are often sexually objectified, women themselves can internalise the sexual objectification of their bodies and see themselves through the lens of the critical male gaze.This self-objectification may lead women to constantly monitor themselves and change their selfpresentation accordingly.Negative male attitudes towards menstruation can cause women to feel shame about it.

Female Self-Expression
When personal expression is hindered, it somehow creates an inconvenience for the affected group to express themselves.By strengthening women's self-expression, women's voices in society can be increased and more women can feel the influence of their peers to face their situation and express themselves authentically and courageously.Traditionally, whether a woman hides or discloses her menstruation depends on the attitude of the society she belongs to towards menstruation.In societies that have negative attitudes towards menstruation, most women choose to hide it and not talk about it with others.The more concealed a woman's menstruation is, the more girls become less knowledgeable about it and perceive it as a shameful, unknowable existence in an atmosphere of silence and secrecy.
As society develops, due to the negative attitude towards menstruation, older women also teach younger women that menstruation is not to be known and try not to mention it in their own lives.This hidden attitude towards menstruation also conveys the idea that menstruation is something to be ashamed of.This is why it is important for women to start with themselves, to influence their peers by being truthful about their feelings and to increase their voice in order to gain the social status they deserve.

The Measures to Improve Shame
Menstruation is a normal female phenomenon, but it still has many negative social connotations that have a negative impact on women's self-esteem, self-expression and sexual health.To address this issue, changes should be made to improve the current situation in terms of departmental initiatives, media awareness and the social environment and conditions of women's menstruation.

Strengthening Gender Education
Scientific and healthy gender education can have a real impact on social groups' perceptions of the gender representation of men and women.Since negative attitudes towards menstruation are largely due to a lack of knowledge about the physiology of menstruation, the education sector should strengthen gender education based on this phenomenon, through a series of initiatives to make society aware of the different structures and basic physiological knowledge of men and women, and to acquire a correct view of the female physiological period.For example, about education, schools and the relevant education authorities should establish sex education courses for male and female students, including sex education on physiological structures, so that they are aware of the fact that menstruation is a normal physiological phenomenon, do not have a shameful attitude towards it, so that all genders can understand each other's physiological structures and have a positive attitude towards menstruation.
In addition, schools can also set up "girls' health corners" in schools, where menstruation leaflets can be set up at regular locations to educate girls who are menstruating for the first time and who need to seek information about their periods, to dispel their doubts and relieve their stress, and to educate boys who are too shy to talk about it, because they do not know about female physiology.It is also a good idea to educate boys who do not know about women's physiology and are shy about talking about it.
Thirdly, the education sector could also provide regular training for female teachers in schools, so that they can monitor the physiological and psychological situation of female students after school, by asking simple and friendly jargon, decrease the distance between themselves and female students, and find out whether they are disturbed by menstrual problems, so that they can provide some awareness and practical help, and the phenomenon of female solidarity can start to spread from school.The aim is to make more women aware, through solidarity, of the objectivity and naturalness of expressing their own physiology and to be proud to be a mature woman in the future.

Standardize Promotional Content
Advertising, as a form of public discourse that is highly visible and influential, should play a positive role in improving attitudes towards menstruation and respecting women's biological functions.Social media platforms have a certain influence on the public's perceptions, and what people hear, see, think and are led to believe in on different occasions can gradually lead to the formation of stereotypes and prejudices, that are not conducive to the development of self-concept and an objective understanding of what is right.Therefore, in the promotion of women's physiology, whether it is a daily physiological product or a similar physiological knowledge film, it is influential to show the real situation in a realistic and intuitive way, and to give women psychological support when buying physiological products alone.By making the public aware of the realities of women's physiology, they will be able to understand, appreciate and respect the unique physiology of women, and women will be able to go to the supermarket and choose physiological products for themselves with ease and naturalness, given the influence of social attitudes.Therefore, the social media should not only regulate the content of communication, but also promote and popularise the phenomenon of women's menstruation to a certain extent, so that the public can be guided by the influence of the media, and menstruation can be transformed from a figurative media image to a concept that is widely disseminated in society and even regarded as a common phenomenon.

Encouraging Phenomena to be talked about
When a phenomenon can be talked about naturally by the general public, it becomes in a sense a routine.In terms of society, encouraging a climate of occasions to talk more openly about menstruation will allow more people to recognise menstruation as a biological phenomenon that happens to women on a daily basis.There are also several ways in which the social environment can be improved to encourage menstrual talk in order to effectively influence the perceptions of audiences.For example, by setting up women's themed exhibitions in the respective pavilions, using pictures and audio-visual content of women talking about menstruation, the audience can be made to feel emotionally involved and think about it in a visual way.In today's society, there are many artists who are committed to gender equality and the female perspective, such as directors, photographers and painters.Through the opinions of influential people and the influence of the exhibition on the audience, it is possible to engage people in a certain amount of discussion when viewing the works, and even to analyse and write about the artworks, further increasing the public's understanding of the phenomenon of girls' physiology and the problems they face.In addition, other forms can also be set up such as interactive topics and super talk communities on online platforms like Weibo and Xiaohongshu, so that women can feel comfortable communicating their feelings in the comment section, or spreading and expressing their true feelings about their physiological periods by forwarding the corresponding topic settings, or through today's offline entertainment activities such as stand-up comedy, where female stand-up comedians narrate segments on the phenomenon of physiological periods in a funny and roundabout way, to clarify social misconceptions and discrimination against women's physiology and to properly express the unique physiology of girls themselves.

Improving Menstrual Conditions
As well as providing the public with a proper understanding of women's periods through the social and media forces, practical solutions to the problems that women faced during their periods, will also reduce the psychological and physical stresses women had.In some poorer areas, women are not provided with adequate physiological supplies due to economic conditions, which not only affects their daily travels but also leads to a certain risk of infection due to improper care.In addition, in some public places and even in everyday offices and schools, women are often faced with embarrassment when their periods suddenly start due to the unstable nature of their periods or the lack of hygiene products at the moment.Therefore, it's important that charitable organisations and the relevant regional governments provide "women's boxes" in special locations to store physiological products for women in case of emergency.During this period, manufacturers of physiological products should also effectively benefit women in terms of technology and cost, by improving technology and reducing costs to make the price of menstrual hygiene products lower, so that more women can afford to buy and use physiological products that need to be replaced frequently.This will enable women to trust the quality of the products they use and to feel physically and psychologically relaxed and convenient through hygienic replacement.

Conclusion
Menstruation is not only a physiological phenomenon that women experience every month, it is also a social phenomenon with social connotations.This article has reviewed the menstrual shame that modern women experience as a result of the stigmatization of menstruation, from its social manifestation to the individual woman's experience, and has summarized the possible negative effects of menstrual shame.Menstrual shame has a negative impact on a woman's physical health, and also on a woman's perception of herself and her self-esteem.At the same time, not only do the painful after-effects of menstruation have an impact on women's working lives, but the stigmatisation of menstruation creates a negative social stereotype of menstruation and the "emotional ups and downs" of women during menstruation.This paper reviews the causes of menstrual shame in the literature and offers responses to improve menstrual shame, calls for widespread sex education for all, encourages talk about menstruation, and hopes that government authorities will take responsibility for regulating the dissemination of information about menstruation and its physiological products.The stigma of menstruation reinforces the stigmatisation of women, and improving menstrual shame will enhance women's status, reduce friction in women's social lives, and allow women to participate more confidently in society.It is hoped that future scholars can pay more attention to the dilemma of women's menstrual period and explore optimal solutions around themselves and policies.