The Stigma Surrounding Menstruation: Attitudes and Practices Regarding Menstruation and Sexual Activity During Menstruation

Figures & data

Table 1. Scores and differences between men and women, and Dutch and Surinamese women, on 12 stigma statements composed by the authors (N = 439), inspired by Goffman’s stigma-theory (1963) (abomination of the body, 1–4; blemish, 5–8; social marker, 9–12).

Item	M	SD	t	p
1. Menstrual blood is more unpleasant than other bodily fluids (e.g., breast milk or saliva)	5.68	3.29	−.950	.343
Women	5.61	3.36
Dutch	5.47	3.22	−1.238	.217
Surinamese	6.04	3.39
Men	6.00	3.01
2. I feel comfortable when buying tampons and pads^a	7.90	3.33	2.459	.014
Women	8.08	3.33
Dutch	8.10	3.18	.732	.465
Surinamese	7.75	3.82
Men	7.08	3.25
3. I find menstrual blood dirty	5.22	3.28	.374	.708
Women	5.25	3.34
Dutch	5.03	3.25	−2.413	.017
Surinamese	6.15	3.22
Men	5.10	3.04
4. I believe others see menstruation as dirty	7.51	2.34	.923	.357
Women	7.56	2.42
Dutch	7.42	2.44	−1.710	.089
Surinamese	8.01	2.46
Men	7.29	1.93
5. I would feel embarrassed when I leak menstrual blood in my pants^b^,^c	8.47	2.28	3.419	.001
Women	8.71	2.04
Dutch	8.62	1.99	−2.407	.017
Surinamese	9.26	1.40
Men	7.49	2.99
6. I think others would feel embarrassed when they leak menstrual blood in their pants	8.62	2.06	1.964	.050
Women	8.71	1.97
Dutch	8.55	1.92	−1.152	.250
Surinamese	8.89	2.49
Men	8.21	2.42
7. I would sit next to a woman on the bus if I knew she was menstruating^a,b,^c	8.31	2.88	3.080	.003
Women	8.53	2.75
Dutch	8.75	2.54	1.764	.079
Surinamese	8.07	3.10
Men	7.32	3.27
8. I think others would sit next to a woman on the bus if they knew she was menstruating^a	6.78	3.10	1.088	.277
Women	6.86	3.13
Dutch	7.25	2.97	1.771	.078
Surinamese	6.48	3.31
Men	6.44	2.94
9. At their first menstruation, girls have become a woman^c,d	4.45	3.50	4.238	.000
Women	4.78	3.55
Dutch	3.72	3.30	−6.898	.000
Surinamese	6.88	2.97
Men	2.98	2.91
10. When girls start menstruating they should start acting like women^b,d	1.69	2.22	.674	.500
Women	1.72	2.25
Dutch	1.34	1.91	−3.595	.001
Surinamese	2.65	2.76
Men	1.54	2.10
11. Women are easily irritated when they are menstruating^d	6.22	2.67	.843	.400
Women	6.27	2.67
Dutch	5.63	2.62	−4.028	.000
Surinamese	7.11	2.44
Men	5.99	2.71
12. I think others see menstruating women as easily irritated^d	6.77	2.65	1.707	.088
Women	6.87	2.67
Dutch	6.56	2.63	−1.292	.198
Surinamese	7.07	2.99
Men	6.31	2.51

^aReversed question.

^bLevene’s test indicated unequal variances for comparison men/women: (Statement 5: F = 16.253, p < .001, df437→96; Statement 7: F = 9.019, p = .003, df437→105; or Dutch/Surinamese women (Statement 10: F = 25.391, p < .000, df249→91.64.

^cSignificant difference (p < .004) between men and women.

^dSignificant difference (p < .004) between Dutch and Surinamese women.

Table 2. Demographic characteristics of survey respondents.

	Total		Women		Men
	100%	(N = 439)	81.8%	(N = 359)	18.2%	(N = 80)
Age in years
Mean	24.8 (SD = 7.3)		24.5 (SD = 7.0)		26.1 (SD = 7.8)
Median	23		23		24
Range	17 − 63		17 − 63		17 − 62
Sexuality	%	N	%	N	%	N
Heterosexual	93.4	410	91.9	330	100	80
Bisexual	4.6	20	5.6	20	0.0	0
Homosexual	1.4	6	1.7	6	0.0	0
Other	0.5	2	0.6	2	0.0	0
Ethnicity	%	N	%	N	%	N
Dutch	57.9	254	51.0	183	88.8	71
Non-Dutch	42.1	185	49.0	176	11.3	9
Surinam	15.9	70	18.9	68	2.5	2
Antillean	8.0	35	9.8	35	0.0	0
Ghanaian	1.6	7	2.0	7	0.0	0
Turkish	1.6	7	1.7	6	1.3	1
Moroccan	1.6	7	1.7	6	1.3	1
Mixed ethnicity	3.6	16	4.5	16	0.0	0
Other	9.8	43	10.6	38	6.3	5
Attained education*	%	N	%	N	%	N
Higher	64.5	283	61.3	220	78.8	63
Middle	32.6	143	35.1	126	21.3	17
Lower	3.0	13	3.6	13	0.0	0

* = Higher education = Hoger beroepsonderwijs (HBO), wetenschappelijk onderwij (WO); Middle education = hoger algemeen voortgezet onderwijs (HAVO), voorbereidend wetenschappelijk onderwijs (VWO), middelbaar beroepsonderwijs (MBO) 2–4; Lower education = Voorbereidend middelbaar beroepsonderwij (VMBO), MBO 1.

Table 3. Distribution of reasons to avoid or engage in sexual activity during menstruation.

I do engage in sexual activity during menstruation because (n = 139):	Women (n = 99) %	Dutch women (n = 71) %	Surinamese women (n = 8) %	Men (n = 40) %
It does not bother my partner	65.6	62.0	62.5	50.0
It does not bother me	57.6	56.3	50.0	62.5
I do not find it dirty	32.3	35.2	12.5	45.0
It is pleasurable	32.3	29.6	40.0	20.0
No particular reason	25.3	21.1	37.5	35.0
My partner likes it	15.2	16.9	12.5	22.5
I do not engage in sexual activity during menstruation because (n = 300):	Women (n = 260) %	Dutch women (n = 112) %	Surinamese women (n = 60) %	Men (n = 40) %
It is not hygienic	67.7	55.4	85.0	50.0
It is uncomfortable	62.3	58.9	73.3	27.5
It is dirty	57.3	46.4	80.0	45.0
It is embarrassing	46.5	50.0	51.7	35.0
It is not erotic	30.0	24.1	33.3	32.5
My partner does not like it	20.8	21.4	23.3	22.5
I learned I should not	21.5	10.7	45.0	10.0
It is not pleasurable	19.2	17.0	21.7	20.0
It produces pain	12.3	8.0	6.7	0.0

Note: Numbers represent the percentage of the study sample that answered with this response. Respondents were able to give multiple answers. Sorted by total % of choices (high-low).

Table 4. Main beliefs regarding sexual activity during menstruation (N = 439).

I believe that sexual activity during the menstruation is:	Women (n = 359) %	Dutch women (n = 183) %	Surinamese women (n = 68) %	Men (n = 80) %
Not hygienic	71.0	62.8	85.3	48.8
Not comfortable	62.7	56.8	67.6	41.3
Not pleasurable	53.5	49.7	61.8	40.0
Not erotic	43.2	45.9	36.8	40.0
Not a sin	27.3	35.5	14.7	45.0
Natural	26.5	33.9	11.8	33.8
Not something that can give me a disease	32.3	31.7	8.8	37.5
Not painful	27.0	26.2	8.8	33.8
Not natural	20.9	10.9	33.8	11.3
Healthy	18.7	19.1	5.9	21.3
Painful	16.4	10.9	5.9	2.5
Unhealthy	15.3	6.0	22.1	8.8
Pleasurable	9.2	9.8	2.9	11.3
Something that can give me a disease	7.5	2.2	14.7	5.0
Erotic	5.3	3.3	1.5	7.5
A sin	3.9	0.5	2.9	3.8
Hygienic	2.5	2.2	0.0	5.0