Death by suicide after 1st period: Why menstruation education is important

In the wake of the recent incident of a 14-year-old girl dying by suicide due to stress from her first period, Mid-day.com got gynaecologists to shed light on how parents must have crucial conversations around menstruation with teenagers

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This writer got her first period at the age of 15. However, she first learned about menstruation at the age of 14. She recalls her mother sitting her down and explaining what a menstrual cycle is, how to use sanitary products, and the relevance of menstrual hygiene. Additionally, the writer was told that the process was normal and there was nothing to fear.  
  
Although most mothers might educate their menstruating children, considering that periods are still a taboo topic in our society, some might not. This is one of the key reasons why most individuals, irrespective of their gender, even those residing in an urban and progressive city such as Mumbai, are unaware of menstruation.  
  
Recently, a 14-year-old girl from Mumbai’s Malad died by suicide on March 26. The reason for her death, as reported by the media, was due to the stress of menstruating and the period pain that followed. Although the mother informed her that periods and the pain were normal, the girl, unable to handle the stress, died by suicide.   
  
This incident once again highlighted the lack of awareness and education among the masses about menstruation and the dire need for it to avoid any deaths that happen out of something as natural as menstruation.  
  
Mid-day Online contacted gynaecologists to seek their take on the incident and suggestions on how parents can take active steps to educate their daughters about menstruation and the health impacts surrounding it.   
  
Dr Nandita Palshetkar, obstetrician, gynaecologist, director of Bloom IVF India and president of IVF Society of India (ISAR) says, “It's truly sad to learn about the teenage girl's suicide linked to a painful first period. This underscores the critical need for menstrual education and support systems. Parents and schools must ensure girls receive proper education to feel informed, prepared, and supported during this important transition.”  
  
Similarly, Dr Anuja Thomas, consultant, obstetrician and gynaecologist, Motherhood Hospital, Kharghar, Mumbai states, “The death of the teenage girl by suicide is due to lack of education regarding periods. It is difficult to understand what would be going on in her mind. She might have felt ashamed, unable to bear period pain may have felt that she is grappling with any life-threatening disease that is causing bleeding down there due to an infection. If girls receive proper education and information from parents and teachers in school it is possible to prevent deaths by suicide arising out of these concerns.”  
  
These experts chose to brush up on the basics to help understand more about periods.  
  
What is a menstrual cycle?  
The period is a monthly natural cycle in which a woman prepares her body for pregnancy. Every month one of the two ovaries drops an egg during ovulation. If it doesn’t get fertilised by a sperm, the womb lining that thickens up to receive a possible pregnancy is shed off. We call this the shedding period. Regular periods show that there is normal ovulation taking place, something crucial in fertility. In addition, regular periods suggest balanced hormones such as estrogen and progesterone which are important in overall reproductive health. 
  
Dr Divya Vora, obstetrician and gynaecologist tells Mid-day.com, “Regular periods indicate that the body’s hormones are balanced which, in turn, informs us about our orthopaedic, thyroid, and metabolic health. While the length of a menstrual cycle may vary from 21 to 35 days, depending on individual physiology, a regular menstrual cycle — getting your period at the same interval with a similar flow — is a telltale sign that the body is functioning as it should.” 
  
Traditional calendars or current menstruation-tracking apps can help parents and daughters track this cycle. This will ensure prompt attention to any irregularity in timing or length of menstruation. 
  
During menstruation, menstruators may experience physical symptoms such as cramps, bloating, fatigue and mood swings. Parents can support them by offering comfort, understanding and being attentive to their needs. 
  
What are the signs that a girl is approaching her first period?  
When menstruators approach their first period, they start showing certain signs. Some common signs include breast growth, growth of pubic hair, vaginal discharge and mood swings. Parents need to pay close attention to their children to be aware of these biological changes.  
  
According to Palshetkar, parents should start having conversations with their teenagers around this time. The conversations should include giving them detailed information about what is a menstrual cycle, why the bleeding happens, sanitary products to be used and an assurance that they will soon get there naturally and normally. 
  
Thomas opines, “Parents should conduct discussions about menstrual hygiene with a sense of openness and comfort, creating a safe space for their daughters to share any doubts, concerns, or difficulties faced by them. Proper hygiene practices during periods can help one to enjoy a fuss-free period. Encouraging the use of high-quality menstrual products, like organic pads or menstrual cups helps to maintain better hygiene and comfort during menstruation.”  
  
Further, Palshetkar tells us, “Girls usually begin menstruating between the ages of 10 to 14, but this timing can be influenced by factors like genetics, nutrition, and overall health. Due to lifestyle changes, early menstruation is becoming more common. Therefore, it's crucial to start discussing menstruation well before a girl reaches the age of 10.”  
  
Vora states, “As parents, it’s important to watch for telltale pubertal symptoms that your child is expecting her first period. These include breast and public hair development, which predate the child’s first period by one to three years. Many girls may experience acne and mood swings, and some also go through a growth spurt just before beginning menstruating.”  
  
“Unfortunately,” Vora continues, “in several cultures and households, periods are still considered taboo. Many young girls are made to experience shame and guilt for a natural physical process and are also subjected to ostracism from social events and gatherings. As parents, it is your role to prepare your child mentally and physically for stepping into this life stage.” 
  
She says, “Learn about the underlying science so that you can explain facts to your child simply and straightforwardly. Answer any questions that your child may have honestly, and without judgment. Initiate conversations about puberty when your child is roughly nine years of age. It’s not necessary to get too technical; the idea is to make your child comfortable with her body and to help her understand how it works. Set aside a specific time and pick a calm place that is free of distractions. It helps to practice what you will say in advance. You can use age-appropriate language and even metaphors to ease your child into the conversation. It’s normal for children to talk in their circles — ask your child what she has heard and clear any misconceptions.”  
  
“Educate your child about the physical aspects of getting her period, including menstrual pain/cramps, mood changes, and period stains. Offer support in the form of coping methods — hot water bottles, pain medication, naps, sanitary products, and hygiene tips.” 
  
It is crucial to note that menstruation education is not just the responsibility of parents alone. Schools must also conduct sessions or make the subject of menstruation a part of the curriculum for classes starting from third and fifth children. Further, it is also necessary to educate all students about menstruation regardless of their gender for a widespread understanding and awareness about this critical topic.   
  
What are the different menstrual products available?   
There are various menstrual products available, some of these include pads, tampons, menstrual cups and period underwear. Parents should take into account comfort factors, ease of use, compatibility with lifestyles and personal preferences while helping their menstruating teenagers choose a suitable menstruation product. To be able to select one that suits their teenager the most, parents have to engage them in an open talk concerning their needs and concerns. 
  
Vora elucidates, “Sanitary pads or napkins are the most commonly used menstrual hygiene products. These come in various levels of absorbency and should be changed every 3-4 hours. Tampons are also widely used but can take some patience and practice to get used to. These are best suited if your child has to undertake swimming or other athletic activities. Today, more people are switching to menstrual cups and period underwear, considering the environmental impact of single-use menstrual hygiene products.” 
  
Additionally, it is also essential to inculcate hygienic menstrual habits in menstruators early on. Parents can have conversations about menstrual hygiene by stressing the importance of washing hands before handling menstrual products, changing them regularly every four to six hours, ensuring proper cleaning of intimate areas and disposing of menstrual products correctly to prevent infections. These discussions help in promoting good hygiene habits and reducing the risk of infections during menstruation. 
  
Are there any common menstrual disorders or issues to be aware of?  
Common menstrual disorders include painful periods, irregular cycles, heavy bleeding as well as premenstrual syndrome (PMS). Parents need to be aware of such conditions so that they seek medical attention for their menstruating teenagers when symptoms worsen or abnormalities persist for long durations. Early medical treatment helps in managing these discomforts as well as minimising pain associated with periods. 
  
When there is severe menstrual pain or irregularities experienced by a menstruator, parents must consult an obstetrician and gynaecologist as soon as possible to get evaluated thoroughly and manage periods effectively.  
  
Thomas urges parents to listen to their daughter's concerns without judgment and offer empathy, willingness to help, and understanding. She says, “Consider seeking medical advice from a gynaecologist to determine the underlying cause of the pain or irregularities and then seek proper treatment.”  
  
Additionally, Palshetkar cautions, “Never ignore or overlook your child’s worries. Addressing their issues will help provide a platform for identification and early detection of any underlying issues.”  
  
What dietary and lifestyle habits must be practised to ensure a healthy menstrual cycle?  
Menstrual health is largely influenced by diet, exercise, approach towards stress management and sleep patterns. To ensure menstruators have a holistic approach towards health, parents should encourage embracing a balanced diet, regular physical training exercises, anxiety management and quality sleep. These lifestyle habits influence overall well-being and are beneficial for menstrual health. 
  
How can parents promote a positive attitude towards menstruation and body acceptance?  
Parents must establish healthy attitudes about having periods and body acceptance by conversing openly about menstruation, normalising it as a natural process, disregarding cultural taboos on the same and cultivating practices of self-care and self-love.  
  
Palshetkar shares, “It is important to educate both parents within the household and challenge societal norms that spread stigma surrounding menstruation. Parents especially the woman of the house, should pave the way for a more inclusive and supportive environment for girls. Even now, I'm aware that in some households, when a girl has her period, she's forbidden from certain activities like touching things or going into the kitchen. I believe we must shift our mindset and household practices because young girls observe these norms. It's essential to educate everyone about menstruation and discontinue such restrictions and rituals. Parents should be more understanding and refrain from imposing these limitations on girls.” 
  
Similarly, Thomas tells parents and teachers to try debunking myths surrounding periods and bodies by highlighting the beauty of diversity in body shapes, sizes, and functions. She says, “Creating a supportive environment where menstruators feel accepted and understood can impact one’s self-esteem and overall health.”  

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