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Menstrual Shame: Exploring the Role of ‘Menstrual Moaning’


McHugh introduces the term ‘menstrual moaning,’ to refer to women’s negative communication about menstruation. Women’s talk about menstruation is often negative through its focus on pain, discomfort, and moodiness. McHugh ties menstrual moaning to the stigma associated with menstruation. Cultural attitudes that require girls and women to maintain secrecy and silence regarding menstruation contribute to the experience of menstrual shame. Breaking the taboos against menstrual talk may be a form of resistance. Brown argues that breaking the silence and secrecy taboo may help women to develop shame resilience. However, McHugh suggests that menstrual moaning, by reiterating negative cultural constructions of women’s bodies as flawed, deficient, and diseased, may have a deleterious impact on women’s menstrual attitudes, and perpetuate menstrual shame. Women could develop shame resistance and build community through more positive talk about menstruation, but positive menstrual conversations are rarely documented. McHugh recommends further research and activism on menstrual shame, resistance, and resilience.

classes confirmed that young women's conversations regarding menstruation addressed solely negative aspects of menstruation, and focused primarily on PMS symptoms (Sopko et al. 2018). Chrisler and her colleagues suggested that such complaining and negative talk around PMS can be a bonding experience for women (Chrisler et al. 2006, 371). As such, sisterhood may be experienced as a shared expression of bloating, cramping, and irritability (Arden, Dye, and Walker 1999, 264); women's accounts of shared misery may create a sense of connection (Fahs 2016, 27).
In this chapter, I examine women's negative communications regarding menstruation which I have termed "menstrual moaning." Menstrual moaning is employed here to refer to women sharing negative experiences of menstruation. I use the word moaning as a descriptive term for negative talk about menstruation; it is not meant to have a pejorative connotation. Examining the cultural taboos regarding menstruation that privilege negative, debilitating, and uncontrollable aspects of menstruation, I argue that menstrual moaning reflects shame about our menstruating bodies. Applying insights from shame theory, I consider the relation of secrecy/silence and menstrual moaning to the perpetuation of menstrual shame.

Menstrual stigMa and shaMe
Society, through negative messages about women's cycles and negative responses to any mention of the menses socially constructs menstruation as negative. Lack of knowledge about the body and the menstrual cycle may put girls and young women in a position where they experience negative feelings such as shame about their reproductive body functions and lower self-esteem (White 2013, 67). Johnston-Robledo and Chrisler (2013, 2-6) demonstrated that menstruation is a source of social stigma for women, and documented many ways that menstruation is viewed negatively in our culture. Roberts and her colleagues (Roberts et al. 2002) demonstrated empirically that even reminders of menstrual blood (for example, seeing a wrapped, unused tampon) can lead to avoidance and social distancing, which suggests that menstrual blood may serve as a blemish on women's character. Negativity about menstruation subjects women to ridicule, dismissal, and trivialization (Fahs 2016, 4) Most media messages in the United States represent menstruation as undesirable, and together they constitute a stereotype of menstruating women, especially premenstrual women, as violent, irrational, emotionally labile, outof-control, and physically or mentally ill (Chrisler and Gorman 2015, 87). McKeever (1984, 39) argued that girls arrive at puberty with negative attitudes toward menstruation, which are perpetrated through education, media, and folk wisdom.
Stigmatization and negativity toward menstruation is also reflected in communication via contemporary social media. Thornton (2011, 51) reported a content analysis of references to menstruation in over 2000 "tweets," (messages limited to 140 characters) posted in a two-week period through Twitter in 2010; the tweets posted reflected the social stigma attached to menstruation, viewing menstruation as debilitating. Similarly, recent research on public discourse about menstruation provided evidence for continued negativity and censorship of (online) communication about menstruation. Using critical discourse analysis, Lese (2016, 59) examined how menstruation is constructed (negatively) by public media discourse which reinforced norms of menstruation stigma. The use of language such as "leaks" isolated menstrual blood as outside of the acceptable norm, and reaffirmed that menstruation should not be seen. The stigma that women feel about hiding menstruation from others leads to overwhelming feelings of embarrassment (Cafolla 2015;Driscoll 2015;Sanchez 2015). Stigmatized language creates a culture of shame that teaches women that getting a period stain in public is one of the most embarrassing things that can happen to them (Sanchez 2015).
In 2015 Rupi Kaur posted on social media a photo of herself lying in a bed with her back to the camera with a visible menstrual leak/stain on her pants and another on the sheet. The photo was removed from the social media platform twice (Kaur 2015) because it allegedly violated the social media app's norms. In taking down Kaur's photos, Instagram actively continued to "promote a long tradition of shaming people who menstruating . . . as though their bodies are naturally dirty" (Brodsky 2015), consistent with the view that women's bodies are seen as "gross" and "offensive" because they are outside of the normative, patriarchal frame that shapes dominant discourse (Cafolla 2015). Silence plays an important role in the stigmatization of menstruation; shame is engendered when being told not to speak. Kaur's photos themselves were silenced by dominant discourse, as controlled by Instagram, when they were deleted. Many of the public discourse authors analyzed by Lese (2016, 59-60) echoed the role silence played in their own experiences with menstruation. Menstruation is an experience that women are taught to hide and never speak of (Cafolla 2015;Driscoll 2015).
Period shaming is a consequence of the social construction of menstruation as an undesirable bodily event (Bobel 2008). Periods are perceived as a strictly negative process that is dirty, disgusting, and icky (Driscoll 2015). In a recent national poll of 1500 women conducted for Thinx (makers of period underwear), 42% of women reported having experienced period-shaming (Siebert 2018). Women polled reported feeling uncomfortable with references to the vagina, and 62% were irked by the term period. The poll responses are consistent with the position of Fahs (2016) who connects menstrual shame with body shame including shame of nakedness, smells, and body hair. Shame is extended to the vagina which is considered to be unpleasant. Use of euphemisms to refer to genitals (Braun and Kitzinger 2001) and to menstruation (Lee and Sasser-Coen 1996b, 78) reflects shameful attitudes. When women communicate about their periods, the conversations employ euphemisms to skirt around having to say "blood" or "menstruation" (Kissling 1996). Using euphemisms to discuss menstruation hides the shame of periods and the "offensive feelings associated with it" (Lee 2007, 12). The communication taboo is supported by the existence of dozens of euphemisms for menstruation (Johnston-Robledo and Chrisler 2011). In a crowd sourced study, Clue found 5000 euphemisms across many languages (https://helloclue. com/articles/culture/top-euphemisms-for-period-by-language). If there was no menstrual stigma, there would be no need for euphemisms, no "reason to call it anything other than its formal name: menstruation or the menses" (Johnston-Robledo and Chrisler 2013, 29).
Menstrual shame is a component of reproductive shame according to Johnston-Robledo and her colleagues (Johnston-Robledo et al. 2007). In their research, participants who expressed negative attitudes toward menstruation voiced similar negativity toward other aspects of women's reproductive bodies. For example, women who viewed menstruation as shameful also reported shameful attitudes toward breastfeeding. Women who reported higher levels of body shame and self-surveillance had significantly more shameful attitudes toward reproductive functions than women with lower levels of body shame and body surveillance. Schooler et al. (2005) examined menstrual shame as a factor in sexual decision making, concluding that menstrual shame may inhibit sexual agency, and the ability of women to acknowledge and advocate for pleasure; they found that menstrual shame was linked with sexual risk-taking and decreased sexual experience. Qualitative studies of women's attitudes toward menstrual sex indicated widespread negative attitudes (Fahs 2011); women reported disgust and shame associated with the menstrual messiness. Chrisler and Johnston-Robledo (2018, 76) conclude that even when women are not menstruating, sexual subjectivity is impacted by menstrual negativity, and they suggest that reducing menstrual shame may contribute positively to women's sexual agency.

the Menstrual Closet
The stigma associated with menstruation is reinforced through our cultural practices of secrecy; keeping menstruation a secret supports views of menstruation as dirty (Martin 1992). Girls report being embarrassed if they are seen with a menstrual product (Lee and Sasser-Coen 1996b, 60). Thus, menstruation is a condition that requires women to engage in surveillance and control practices to keep it hidden from others. Women and girls go to a great deal of effort to conceal their menstrual status (Oxley 1998). Young (2005, 106) referred to this cultural directive for secrecy as the "menstrual closet": "From our earliest awareness of menstruation until the day we stop, we are mindful of the imperative to conceal our menstrual pro-cesses…. Do not discuss your menstruation . . . leave no bloodstains on the floor, towels, sheets, or chairs. Make sure that your bloody flow does not visibly leak through your clothes, and do not let the outline of a sanitary product show" (106-7). Menstrual products (for example, tampons, pads) are designed to absorb fluid and odors, not to be visible through one's clothes, to be small enough to carry unobtrusively in one's purse, and to be discretely discarded in a lined bin in a public restroom (Kissling 2006). Because menstruation continues to be presented as a taboo topic, product manufacturers characterize menstruation as a "hygiene crisis" that requires the manufacturers' "expert" advice as to how to properly care for the menstruating body (Costos, Ackeman, and Pardis 2002). An analysis of media use of taboo-related words showed that advertisements of menstrual products reinforce the secrecy and taboo regarding menstruation (Thomas 2007). Moreover, they highlight the qualities of the product that mostly help consumers avoid shame and embarrassment (Raftos, Jackson, and Mannex 1998). Roberts and Waters (2004) described these cultural practices as relaying the message that women's bodies are unacceptable and need to be sanitized. In other words, menstruation must be kept under wraps. That is, it is a hidden rather than a visible stigma, but that is because women go to great lengths to conceal it (Oxley 1998). Lee and Sasser Cohen contend that "menstrual etiquette requires women to uphold taboos against themselves through their own behaviors of silence and concealment" (1996a, 78). Relatedly, Field and Woods (2017) discussed these practices in relation to what they term the "concealment imperative," a form of social control in which women constantly engage in their own medical surveillance so that women's experiences of menstruation become disembodied. Menstruators' subjugation to the menstrual closet is essentially an oppressive process of concealment and abjection of menstruation that constitutes a normalizing experience. In Young's (2005, 111) analysis, the menstrual closet is maintained by and contributes to women's experience of menstrual shame.
The social oppression of women as menstruators and as owners of a body regarded as unclean, deficient, and disembodied includes the mandate of silence and concealment (Perz and Ussher 2006) which contributes to menstrual shame, and feelings of shame maintain compliance. An analysis of the practices involved in the operation of concealment and secrecy helps to comprehend the functions of menstrual shame, and how menstrual shame might be resisted. To resist menstrual shaming, we must come out of the menstrual closet.

Menstrual shaMing in relation to shaMe theory
The stigma of menstruation has negative consequences for women's physical and mental health, sexuality, well-being, and social status. The menstruation taboo, like body shaming, is deeply ingrained. Sanchez (2015) argued that we will not eliminate hateful behavior toward women until we reject the notion that menstruation is shameful.
The elimination of menstrual shame may involve an understanding of the dynamics of shame. Here, the approach to women's shame articulated by Brene Brown based on her interviews with 200 women (2004) is employed as a framework for understanding and resisting menstrual shame. In her analysis, women experience shame when they fail to meet extensive, layered, complex and competing demands and expectations. Brown (2004) describes shame as an intensely painful experience of believing we are flawed and thus unworthy of acceptance and belonging. She observed that shame is experienced as a profound sense of inadequacy, and often results in women avoiding social contact, leaving women feeling trapped, isolated, and powerless. In other words, when feeling shame, women often hide from others to avoid further shame. When we avoid talking about shame, shame unravels our connection to others. Therefore, sharing our story is a strategy to establish connection. According to Brown (2007), the greatest challenge to developing shame resilience is the way shame actually makes us less open to giving or receiving empathy. Shame is maintained because it is very difficult for women to access its antidote, connection, and empathy. Empathy helps to heal shame, and empathy comes from community, a community of people who are facing the same struggle.
In Brown's later analysis (2006), women's shame is often tied to isolation and secrecy, and interrupts women's sense of community and connection. Brown's perspective on shame resilience is that women should share their stories, including their pain, with other women (Brown 2006). Woman-towoman connections can resolve shame. But menstrual shame undermines women's capacity to speak about menstruation and build those necessary connections. And yet, finding the courage to speak about our experiences, and anticipating and receiving an empathetic response are key to women's resilience to shame (Brown 2006). Feminist activists encourage women to resist the expectation of silence through, first, examining shame and shame-making experiences in a social context. Recognizing our shared experiences of shame can help us to recognize our collective vulnerability and women can come to realize that they are not alone. Once the shame is exposed as a sexist social construction, feminist activists urge women to break the taboo regarding talking about menstruation. Recognizing our shared experiences of shame can help us to recognize our collective vulnerability and women can come to realize that they are not alone. Thus, sharing our menstrual stories with empathetic listeners might help to reduce menstrual shame. This perspective also has been suggested by Schooler (2001), who found that communication about menstruation among a community of women may lessen girls' shame (Schooler 2001). In fact, talking openly about menstruation is one point of menstrual activism (Fahs 2016).

Menstrual Moaning
Cultural attitudes that require girls and women to maintain secrecy and silence regarding menstruation contribute to the production and maintenance of menstrual shame. Breaking the taboos against talking about menstruation may be viewed as a form of resistance. Talking about the symptoms, discomfort, and moodiness associated with the menstrual cycle may represent (young) women's attempts to use connection and community created through communication to resist the culturally imposed directives for secrecy and silence regarding menstruation. But negative talk may not be an effective way to resist menstrual shame.
As previously reviewed, young women's talk about menstruation is typically negative. Burrows and Johnson (2005, 236) reported their respondents in a focus group study revealed a negative perspective. When pressured to present a positive perspective, the respondents relayed negative symptoms associated with the menstrual cycle (Burrows and Johnson 2005, 243). Stubbs and Costos (2004, 42) describe the negativity of their students toward menstruation observed over twenty years of teaching. Students are only able to list negative symptoms associated with the menstrual cycle. Shame toward menstruation is so deeply rooted that women could not even name one positive aspect of menstruation, with some noting they thought, "the answer could not exist" (Stubbs and Costos 2004, 41). My students, over three decades, also easily report an array of negative symptoms associated with menstruation, such as cramps, acne, or lack of energy and/or concentration. However, the students do not recognize any time in the menstrual cycle when they have a good appetite or digestion, when skin is clear or when they have high energy and focus. They do not perceive menstruation as a cycle, but a series of symptoms experienced premenstrually or menstrually. This point was made effectively in Chrisler's et al. (1994) development of the Menstrual Joy Questionnaire. Participants who completed the MJQ often reported surprise, as most had not considered any positive aspects of the menstrual cycle before (Chrisler et al. 1994).
When students in my class were asked to report the kinds of statements about menstruation that they might make, all of the statements were negative (Sopko et al. 2018) referring to embarrassment, disgust, leakages, cramps, pain, and inconvenience. Like fat talk, menstrual moaning may actually reinscribe shame rather than resist it. The term fat talk was coined by Nichter and Vuckovic (1994) to refer to the tendency of girls and young women to disparage their own bodies as fat, a tendency observed in their ethnographic study of high school girls. Young women engage in fat talk frequently and openly. Research has tied fat talk to social norms, and young women's acceptance of social values about thinness and weight management (Clarke, Murnen, and Smolak 2010, 2). Fat talk may make participants feel better when they share concerns about their bodies with others, and communicate to others that they perceive being thin as ideal; fat talk may open the door for an empathic response and connection to another woman. Fat talk and menstrual moaning may be viewed as parallel phenomena as both involve young women (in conversations with other young women) making negative comments about their bodies, as reported through ethnographic research. Bonding with other women is one possible motivation for both fat talk and menstrual moaning.
But there are differences between the two discourses. Menstrual moaning separates from fat talk because, due to menstrual stigma, many young women do not talk openly and frequently about their menstrual experiences or cycles. But when they do, the talk is inevitably negative much like fat talk. In moaning or complaining about menstruation, women communicate a shared experience, and more specifically they express shared cultural perspectives on the negativity of menstruation, bleeding, premenstrual experiences, and the female body. Sharing accounts of discomfort, pain, and embarrassment may create connections with other women, as discussed earlier.
Fat talk is typically a clearly self-shaming discourse (for example, my butt is too big to wear yoga pants) whereas menstrual moaning typically involves negativity toward "it" (the period) not the self (Lee and Sasser-Coen 1996b, 43); menstruation is viewed as an external entity rather than as aspect of oneself. Kissling (1996, 300) similarly observed that girls avoided descriptive language such as "menstruate" "blood," "menarche," or even "period"; by using terms such as "it" when discussing menstruation, girls may maintain a level of distance. Therefore, it may be less clear to the women who engage in menstrual moaning that such talk is self-shaming.
Importantly, research on fat talk has demonstrated that participating in fat talk, in spite of Brown's research on the power of connection to reduce shame, does not make women feel better about their body concerns shared with others. In fact, fat talk has been shown to have deleterious effects. For example, Salk and Engeln-Maddox (2011, 27) found that students overhearing fat talk were likely to engage in fat talk themselves, and the level of fat talk engaged in by the women then related to their reported levels of negative self-esteem and body dissatisfaction. The analysis of fat talk as a social practice contributing to women's negative body attitudes, and as a form of self-shaming is easily appreciated. Possibly the analysis of young women's motivation to voice negative menstrual attitudes and experiences, and the impact of those negative statements is less apparent.
Menstrual moaning may be viewed as women's resistance to the secrecy, taboos, and concealment imperatives. In this sense, talking about one's menstrual experiences may be viewed as a form of activism, a breaking of the menstrual taboo, and/or a form of resistance to the patriarchal norm. But, like fat talk, engaging in menstrual moaning may have a deleterious impact on women's menstrual attitudes. Engaging in menstrual moaning reiterates negative cultural construction of women's bodies as flawed, deficient, and diseased. Research has indicated that communication about menstruation must be negative. Typically, women's negative talk about menstruation views women's experiences as both biological and personal, (Lee and Sasser-Coen 1996b, 47) and fails to recognize the socio-cultural factors that contribute to menstrual stigma, especially the social construction of menstruation. Thus, even as women share and connect with other women about the menstrual experience, menstrual moaning may not be constructive and may actually reinforce shame rather than encourage shame resilience and women's empowerment.
Further, talking about menstruation as PMS, in particular, reinforces medicalization and medical experts' control of women's bodies and experiences (Chrisler 2018, 23). The medicalization of menstruation frames periods as a problem needing management rather than a natural process of the female body (Chrisler and Gorman 2015, 91). The biological and medicalized approach to discussing menstruation frames the body as a problem, promotes women's silence, and reinforces period shaming.
Menstrual moaning may reify the patriarchal and medicalized construction of menstruation as problematic, pathological, and painful, and contribute to women's negative experience of menstruation. Women's participation in menstrual moaning, that is negative menstrual conversations, reflects and reinforces negative attitudes toward menstruation and women's levels of body shame and body surveillance. Frequently engaging in negative menstrual conversations may be associated with higher levels of body shame and more negative attitudes toward menstruation. In research on partner communications regarding menstrual experiences and distress, Ussher and Perz (2008, 147) reported that empathy, support, and understanding offered by partners, common in lesbian relationships, reduced guilt and self-pathologizing of women in relation to menstruation. The shame framework suggests discussions of menstruation, including sharing our own menstrual experiences can build shame resilience when the discussions are positive or at least balanced. Stubbs and Costos (2004, 41) describe their students as both ignorant of and resistant to any positive connotations and experiences connected to menstruation. Before proposing positive attitudes and talk about menstruation as a form of activism and shame resilience, it may be important, even necessary to understand why girls' and young women's reactions and expressions regarding menstruation are negative.

Menstrual aCtivisM
Menstruation is an everyday experience for women 1 and should be acknowledged and understood as a natural bodily function for which our (negative) attitudes toward menstruation are neither natural, nor inherent. In fact, the negativity and stigma surrounding menstruation are cultural products created in a social context in which women and women's bodies are viewed as inferior to men's bodies (Young 2005, 110), and reproduction as a system is viewed as a deficient, dysfunctional, and disgusting (McHugh and Chrisler 2015, 3). Ignorance and invisibility of menstruation create fertile grounds for the development of disparagement and abhorrence of menstrual blood and the menstruating woman. Menstrual scholars and activists argue that we need to challenge, upset, and reverse the silence and shame surrounding women's menstruation (for example, Fahs 2016, 94-96). Recognizing, respecting, and even celebrating menstruation "disrupts the boundaries of patriarchy, and underscores the realities of misogyny" (Fahs 2016, 115). On the other hand, by keeping our menstrual cycles closeted, we are participating in the patriarchal system (Sangre Menstrual 2009, cited by Fahs 2016. In this essay, I have examined talking about menstruation as an attempt by women to resist the silence and taboo surrounding menstruation. However, when our talk regarding menstruation remains negative, that is menstrual moaning, we may not resist negativity regarding menstruation. Rather, we may affirm it. This hypothesis, of course, requires empirical verification. If menstrual moaning is confirmed as contributing to, or even increasing, menstrual negativity and shame, we might encourage women to recognize and talk more positively about menstruation, recognizing that they may be resistant to such suggestions. In research cited here, young women have been surprised at the idea of positive aspects of the menstrual cycle, and resistant to adopting a positive stance toward menstruation. Young women may not be likely to adopt a positive attitude toward menstruation as long as our culture views women's menstruating bodies as deficient, disgusting, and/or diseased. And yet, the most productive path toward a culture free of menstrual stigma may depend on a shift in the way we talk about periods. note Open Access This chapter is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/ by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.
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