Medicalising menstruation: a feminist critique of the political economy of menstrual hygiene management in South Asia

Women's use of water differs from men in essentially one aspect: in cleansing the body of menstrual blood. The pledge of the water, sanitation and hygiene (WASH) sector to place 'women at the centre' of development has in recent years, therefore, come to focus on menstruation. International development agencies have begun to push the agenda of menstrual hygiene management (MHM), but their use of a medical approach requires critical rethinking. This article argues that through MHM lessons, menstruation is medicalised to construct new and repressive expectations of normality for the female body. A medical construction also poorly accommodates the natural biological process of menstruation within the gamut of existing sociocultural practices. Consequently, menstruation becomes associated with the perceived need for not only sanitisation of the female body of the rural poor, but also to turn it into a working body that is able to ceaselessly and 'normally' perform its productive and reproductive chores. I note that the success of medicalisation relies upon the separation of the body from its purported waste, the menstrual blood. Once menstruation is confined to a pathological condition, treatable only by public agents such as doctors and commercially produced goods such as sanitary napkins, a defining essence of womanhood is thereby dissociated from the female body.