The field of critical menstruation studies is burgeoning. And so this Handbook arrives just in time to capture a robust and carefully curated view of where we are now and where we might go next.

But it is 2020, and menstruation is as old as humanity itself. Why is this the first handbook to bring together this body of knowledge?

To state the obvious, menstruation and more broadly, the menstrual cycle are often dismissed and derided. The same goes for menopause, at the further end of the reproductive life span. It is transgressive to resist the norm of menstrual (and menopausal) concealment. With notable exceptions, across cultures and historical eras, we socialize this biological process—including serious inquiry into its form, function, and meaning—into hiding. This is shortsighted and at the same time deeply revealing, as it shines a bright spotlight on the need for change. After all, a dearth of attention to a fundamental reality and indeed a vital sign is not only a profound knowledge gap, it is an exposure of the power of misogyny and stigma to suppress knowledge production. And when we lack knowledge, we cannot effectively act to effect change.

Menstruation as lens

Of course, there has been relevant scholarship, but until recently menstruation as a subject of research and advocacy has been relegated to the fringes. There have been moments when menstruation broke through, such as when feminist artist Judy Chicago created her iconic lithograph “Red Flag” in 1971, a depiction of a hand removing a tampon, shocking viewers into engaging the everyday reality of menstruation. In 1977 The Society for Menstrual Cycle Research (SMCR) was founded by a multidisciplinary group of scholars who were feminist pathbreakers in understanding the centrality of menstrual cycle research to women’s health. In 1978 Gloria Steinem penned her classic satirical essay “If Men Could Menstruate”—a piece, included in this Handbook because it continues to slyly expose the sexism that shapes our menstrual culture. And in the early 1980s, an outbreak of Toxic Shock Syndrome, a rare but severe illness, was linked to the use of super-absorbent tampons. These breakthroughs—artistic, scholarly, popular, and tragic—laid important ground now being built upon in the early twenty-first century, a time in which the menstrual cycle moves from margin to center as a subject of urgent concern and enthusiastic exploration.

Menstruation as opportunity

It has been said so often it is now cliché—“menstruation is having its moment!”

November’s issue of Cosmopolitan dubbed 2015 “the year the period went public,” and indeed, the half decade since has brought us a tremendous diversity of menstrual -positive expressions—from the artistic to the practical, the serious and the playful, the local and the global. Instagram made the news when Rupi Kaur’s photo of her period-stained pajama pants was (twice) removed and outcry across social media was loud and persistent. The unique menstrual challenges of women and girls living on the streets and schoolgirls in low- and middle-income countries inspired a raft of grassroots campaigns. Efforts to de-tax menstrual products succeeded in multiple countries—first in Kenya in 2004. Canada dropped the tax in 2015, and Malaysia, India, and Australia followed in 2018. In 2019, a short documentary about the birth of a menstrual-pad-making microbusiness won the Academy Award for best short documentary just a year after a biopic about the inventor of the machine making those pads, Arunachalam Muruganantham, enjoyed Bollywood success—and beyond. We finally have a period emoji—no small thing, given the centrality of phones and social media in everyday life—and menstrual apps abound. National, state, and municipal programs in countries from Kenya to Scotland provide free menstrual supplies to menstruators in schools, prisons, shelters, and other public facilities. Considered together, these events constitute a shift. Since these watershed moments, attention to menstruation has intensified and diversified. To those of us working in this area, we find ourselves breathless, trying to keep up.

But we are not complaining!

Menstruation is having its moment—no doubt. And we aim to seize it in the shape of the Palgrave Handbook of Critical Menstruation Studies. We built this book—numbering 72 chapters, written by a total 134 contributors from 23 countries—to provide an unmatched resource for scholars, activists, policy makers, and practitioners, both those new to and already familiar with the field.

At its core, the Handbook is animated by two intertwined central questions: What new lines of inquiry, including research questions and social justice engagements, are possible when we center our attention on menstrual health and politics across the lifespan? And what knowledge is gained when menstruation emerges as a dynamic category of analysis? The answers to these questions take shape in this collection of empirical research and theoretical essays that are supplemented with first-person narratives; practice notes from those working in the field; poetry, and visual art. We conclude each of our six sections with what we call “transnational engagements”—rich conversations across diverse spaces, experiences, and identities which appear as actual dialogues in some sections and as distinct voices responding to a shared set of questions in others. What unites these different forms of knowledge is a shared commitment to advancing menstruation as a way to make sense of political, social, medical, and/or biological processes, and the recursive work embedded in the menstrual cycle’s myriad social constructions.

Our choices here deviate from those made in most conventional academic handbooks. In this rapidly growing field of inquiry and advocacy, a diversity of voices and approaches shape what we know—and this Handbook aims to capture those many articulations. We take very seriously feminist critiques of epistemological rigidity that reflect a very narrow (and privileged) idea of what counts as knowledge. Indeed, expertise comes in many forms. The broad range of the content is its strength, but it also stretches the limits of what some readers might consider a more uniform set of readings. Through our editorial processes, we chose to preserve the unique writing styles of our contributors, pushing against the usual impulses in edited collections to standardize content so that each chapter aligns nicely with the next. In our section titled “Menstruation as Structural,” for example, several practice notes written by policy makers are peppered among more scholarly chapters penned by academics who review the extant literature and/or offer new insights based on their original research. The Handbook also includes personal narratives that explore cultural and religious practices related to menstruation, menstruating while in detention, and the relationship between child marriage and menstruation. These chapters bring together different ways of peering inside what’s at stake when menstruation is regarded as a structural issue, one ripe for policy interventions, with real-life implications for human beings. Throughout the book, our editorial choices should make clear that we value the implied dialogue and symbiosis between those living the issues, those conducting research, and those putting it to work.

With this in mind, the chapters in this collection reflect different forms of knowledge that are shaping critical menstruation studies—a field that, from its beginning, has been a site where activists, artists, journalists, clinicians, and researchers have each contributed to its articulation and application. A field that, until recently, went largely unnamed. Similar to critical race studies or critical gender studies, critical menstruation studies is premised upon menstruation as a category of analysis: asking how systems of power and knowledge are built upon its understanding and, furthermore, who benefits from these social constructions. Critical menstruation studies—which some argue might be more aptly named critical menstrual studies, to capture the menstrual cycle across the life course, including, but not limited to, menstruation itself—is a coherent and multidimensional transdisciplinary subject of inquiry and advocacy, one that enables an exciting epistemological clarity that holds significant potential for knowledge production and social transformation. This Handbook is the first to coin the term—with thanks to Sharra Vostral who suggested it and conceptualized the Handbook structure with me at the advent of this project. The Handbook’s purpose, then, is to represent a particular landscape of knowledge that highlights its current diversity and promise as the field rapidly develops and expands. We seek to explore this landscape in all its diversity with lively intent.

But this is not an intellectual playground where ideas are vetted out of reach of the lived experiences of real people in real time. The stakes in this emerging field are high. Between 1970 and 1980, 941 American women were diagnosed with Toxic Shock Syndrome, 73 of which died (Vostral 2018). The story of tampon-related TSS is an object lesson at the intersection of capitalism, gendered consumption, and faulty techno-science, a tragic illustration of both the literal and figurative costs of stigma. Stigma’s impact can be quite insidious and expansive in ways that capture far less media attention than the TSS crisis. To wit, we include a chapter about endometriosis by patient advocate and health educator Heather Guidone who describes the damage done—physically, psychologically, emotionally, and socially—through a combination of lengthy diagnostic delays and disease illiteracy, causing both patients and practitioners to dismiss the disease’s wide-ranging symptoms as routine. In short, and quite literally, menstrual stigma harms.

And that is why we are unequivocal. Attention to menstrual issues across the life span surfaces broader societal issues and tensions, including gender inequality, practices and discourses of embodiment, processes of racialization and commodification, and emergent technologies as read through various disciplines and interdisciplines (for example, history, psychology, communication studies, sociology, anthropology, art, nursing, gender studies, public health, law policy analysis—the list goes on). Put differently, menstruation-as-unit-of-analysis serves as a gateway—both conceptually and symbolically—to reveal, unpack, and complicate inequalities across biological, social, cultural, religious, political, and historical dimensions. Yes. Menstruation matters.

Menstruation as lens: menstruation as opportunity

The members of the editorial team share a commitment to produce a collection that is purposely interdisciplinary and transnational. It draws on fields in the humanities and social sciences, intentionally stopping at the boundary of basic biomedical research about menstruation. Here, we used “menstruation as lens, menstruation as opportunity” to think beyond anatomy and biology. We chose to dig into the meanings of menstruation. As such, we opted to organize the Handbook outside the more normative life course approach from menarche to menopause. While we acknowledge this linear process, we also recognize its limitations. Here, we are doing something different. We have organized the book thematically into six overlapping sections, each edited by an associate editor: Menstruation as Fundamental, Menstruation as Embodied, Menstruation as Rationale, Menstruation as Structural, Menstruation as Material and Menstruation as Narrative. Each of these sections is introduced by a short framing essay, authored by its editor. We acknowledge that the Handbook is hardly comprehensive. For one, we failed—in spite of our best efforts—to produce a collection that adequately decentered Western voices by engaging more scholars from the Global South. We hope that subsequent editions of the Handbook will more successfully meet this crucial goal. And of course, there are many topics left unaddressed. We need more work that explores the measured impacts of menstrual stigma, for example, especially for marginalized menstruators. There is a need for research that bridges menstrual and menopausal realities in the Global South and Global North, to substantively and responsibly explore not only the differences, but also the similarities in these spaces. No doubt, readers will see, and we fervently hope, respond to innumerable opportunities for further study. Because, done right, critical menstruation studies not only sheds light on diverse experiences across the menstrual life course, it also brings fresh fodder to persistent questions: What is the relationship between embodiment and identity? What constitutes a health crisis? How do we navigate the tensions between tradition and modernity? How do we create a world where all bodies thrive? Through these sections and the Handbook as a whole, we aim to demonstrate the richness that is the field of critical menstruation studies, a polyvocal constellation of scholarship and advocacy that is finally coming into its own.