Preparing Girls for Menstruation: Recommendations from Adolescent Girls
Koff, Elissa, Rierdan, Jill, Adolescence
As the menstrual cycle has come to occupy an increasingly important place in discussions of women's health (Dan & Lewis, 1992; Golub, 1993), attention is again focusing on the impact of the onset of menarche. Studies of girls' responses to menarche have determined that it is a highly salient, intensely experienced event, and a turning point in female development; they also have demonstrated that more adequate preparation is associated with a more positive initial response (Golub & Catalano, 1983; Koff, Rierdan, & Sheingold, 1982; Ruble & Brooks-Gunn, 1982). Despite a sense of being prepared for and even excited about the impending event, however, most girls still find menarche mildly stressful. When it occurs, they greet it with mixed feelings, including some degree of negativity (Koff, Rierdan, & Jacobson, 1981; Ruble & Brooks-Gunn, 1982; Whisnant & Zegans, 1975; Williams, 1983). Older adolescents and adult women looking back on menarche remember and relate feelings similar to those recounted by early adolescent girls (Golub & Catalano, 1983; Woods, Dery, & Most, 1982).
One interpretation of such findings is that menarche may be the type of experience for which it is virtually impossible to be sufficiently prepared (Brooks-Gunn & Ruble, 1982b); another is that the explanations we provide to girls as we prepare them for menstruation may be inadequate or misdirected, and may foster a subjective sense of being somewhat unprepared. For example, explanations may fail to include important aspects of the experience (e.g., what it feels like to menstruate); they may fail to address the personal concerns of maturing girls (e.g., reactions to bodily changes); they may be in a form that is difficult for girls to assimilate; or they may be presented off-time - too early or late to be informative or reassuring.
Girls today have access to a variety of sources of information about menstruation (Abraham et al., 1985; Brooks-Gunn & Ruble, 1982a; Havens & Swenson, 1988, 1989). They learn about it from mothers, siblings and peers, teachers and health providers, booklets and films, and advertisements of menstrual products in the teen media. Despite this plethora of resources and efforts to improve the content, mode of presentation, and cognitive accessibility of educational materials (Havens & Swenson, 1989), much of the information remains impersonal and abstract, and difficult for girls (Abraham et al., 1985) and their mothers (Lei, Knight, Llewellyn-Jones, & Abraham, 1987) to assimilate.
There is still a tendency to focus on the immediate and obvious biological and hygienic aspects of menstruation such that knowledge is disconnected from girls' own body experience (Sommer, 1981). It must be a challenge for girls who lack familiarity with the body parts involved in the menstrual cycle, and in particular with the internal reproductive organs, to relate the abstract information they receive about anatomy and physiology to themselves and their maturing bodies. They also must reconcile directions to minimize or ignore internal bodily signals while simultaneously being cautioned to monitor themselves for the possibility of accidents or odors that might be observable to others. It undoubtedly is difficult for fourth, fifth or sixth graders to find personal meaning in abstractions linking menstruation with femininity, womanhood, and reproductive potential. Also, it must seem paradoxical to be told that menstruation is normal and natural and something to be happy about while being instructed both to conceal its occurrence and to carry on as if nothing were happening.
Characteristic of this approach to menstrual preparation is the emphasis on menstruation as normal and natural and the relative neglect or minimization of its bothersome aspects (Golub, 1993). Letting girls discover these on their own inadvertently promotes feelings of inadequacy, shame, and disgust, as well as a sense of somehow having been misled. …