The medicalisation of menstruation: a double-edged sword

Background The intersection of menstrual and mental health is an under-researched area which is gaining attention from the public, researchers and clinicians. However, there may be unintended risks associated with this increased attention. Here we review some historical and cultural aspects of the well-intentioned medicalisation of menstruation and discuss their impact on gender (in)equality. Aims To critically integrate lessons from the past into current momentum around improving women’s healthcare. Method Narrative review with interdisciplinary authorship including psychiatry, medical anthropology, and history. Results We explore three exemplars. 19^th century psychiatry identified menstruation as a time of risk for mental disorder, which recognised relevant aspects of female experience but used this to argue against female education. The 20^th century discovery that hormone replacement therapy can ease menopausal symptoms has helped many, but aggressive marketing may increase gender-based stigma regarding female identity, the experience of menopause and aging. Lastly, the introduction of menstrual leave and menstrual product policies aims to ease the burden on those who menstruate, but may have the paradoxical effect of portraying those who menstruate as a burden themselves. Conclusions Menstruation research occurs in the context of historical and ongoing sexism and the process of menstruation is currently highly stigmatised in many cultures. This makes the process of change complex and rife with ‘double edged swords’ whereby well-intentioned initiatives can have unintended effects. Researchers and clinicians in this area should be aware of how attention to menstruation and gendered difference can be misconstrued and used to inadvertently further gender-based disparities.