In the United States, the catch-all term ‘PMS’—short for ‘premenstrual syndrome’—describes any otherwise-unexplained physical or emotional affliction that women of menstruating age experience before their menstrual period. (Though technically inaccurate, in many popular contexts, PMS is even evoked during and after menstrual periods.) In some accounts, a version of this condition reportedly affects up to 90% of all women (U.S. Department of Health and Human Services 2018). By definition, any ‘syndrome’ is something of a medical mystery (Mukherjee 2009). Anecdotally, patients report a set of co-occurring medical symptoms. However, science has not identified a shared cause. If and when such a cause is identified, the moniker ‘syndrome’ drops off, and a new name for an actual disease is assigned. With ‘PMS,’ more than 150 symptoms have found shelter under this very wide umbrella (Studd et al., n.d.; cf. Stolberg 2000). Since no scientific research has isolated a common etiology of these symptoms, the scientific justification for ‘PMS’ remains dubious (DeLuca 2015).
Even so, PMS has been creatively adapted into a popular neologism by being turned into a verb—as in, “she’s PMS-ing.” Despite the long list of symptoms, this neologism typically indexes just one symptom: the supposed tendency for a menstruating woman to lose control of her emotions in general, and to express annoyance, critique, or anger in particular (Gottlieb 1988a). Both women and men who highlight this focus may evoke hormones to explain why they oppose women’s holding top political positions, which they claim would imperil citizens, due to unpredictable decisions (for example, Bradner 2015). To minimize the supposed risks of undisciplined behavior, modern menstruating women remain subject to new versions of ancient taboos, whose exploration will be at the center of this chapter.
For many modern readers, the word ‘taboo’ unconsciously evokes ‘primitive’ peoples from long ago or far away—people who unthinkingly obey(ed) arbitrary rules that restrict their lives and thoughts. Yet, images of menstruation as symbolically polluting retain strong staying power in a world ostensibly ruled by science (cf. Coronil 1997; Goffman 1963; Little 2012; Miner 1956; Moeran 2014). Even highly educated women perpetuate menstrual taboos in intimate and public ways alike. Robust research across several decades on the many euphemisms women use for their periods signals how sociologically taboo it remains for women in many settings to discuss this basic biological function (for example, Cauterucci 2016; Chrisler 2011; Ernster 1975; Thornton 2013). No matter their metaphoric content, these euphemisms share one goal: to avoid clear biological descriptors such as ‘menstruation,’ ‘menstrual period,’ or ‘period’ (Kissling 1996; Newton 2016; for examples beyond English, see Escaja 2018; Ren, Simon, and Wu 2018).
Words tell a story. So do efforts to avoid words. The discursive act of substituting euphemisms for certain words brings us straight to the territory of taboo. Words to be avoided carry what the philosopher John Austin (1962) dubbed an “anti-illocutionary force”—the opposite of the illocutionary force conveyed by words that are spoken (rather than avoided). Words silenced by euphemisms put us square in the realm of the “magical power of words,” as anthropologist S. J. Tambiah termed it (1968). Uttering phrases normally avoided violates the taboo—incurring emotional, sociological, spiritual, and/or political risks (cf. Allan and Burridge 2006; Pedraza 2018).
Why do words describing a biological process experienced by half our species have this symbolic power? I suggest that, in many parts of the world, the effort to circumvent speaking about menstruation in simple, neutral, or scientific terms and to rely, instead, on euphemisms that often involve shame and/or censure has deep roots in patriarchal ideology inherent in the Jewish and Christian traditions (and later adopted in Islam) (cf. Buckley and Gottlieb 1988a, 32). Of the many English-language euphemisms documented by scholars, one phrase recurs: “the curse.” In a study conducted in Oregon, 50% of English-speaking women (aged 18–80) referred to menstrual periods as “the curse” (Lee 1994).
Menstruation as Curse
Why a curse? At one level, one might cite certain biological facts that could produce this dramatically negative view. Menstrual blood differs in many ways from venous blood. It cannot clot (Yang et al. 2012). It flows only from a single place in the body. It stops flowing of its own accord and should not be staunched; an obstructed flow (or amenorrhea) generally signals a problem such as polyps, fibroids, an eating disorder, a birth defect, or a genetic disorder (Pinkerton 2017). Although it may cause suffering, it rarely causes unstoppable hemorrhaging, hence it is rarely lethal. Menstrual blood is typically associated with only one gender—although, as discussed below, not universally. Perhaps a combination of these characteristics has endowed menstrual blood with mystical properties; hence, menstrual blood might readily become subject to taboos—mystically based rules that govern who may (and may not) touch, see, or speak about it (Steiner 1956).
However, none of these characteristics should inevitably produce a notion of a spiritual curse causing women’s menstrual suffering. Rather, in Western/ized nations, the widespread concept of menstruation-as-curse likely derives from one specific religious tradition: the Jewish and Christian traditions’ sacred text, the Bible. In the Hebrew Bible (a.k.a. the Pentateuch or Old Testament in Christianity), the first book, Genesis, explains that the mythical first woman, Eve, disobeyed her god by eating a forbidden apple. While Genesis names the pain of childbirth, not menstruation, as the curse for Eve’s transgression, the Bible’s third book, Leviticus, mentions the pain of menstruation and lists required and forbidden activities for menstruating women. Perhaps building on early Mesopotamian ideas about purity (Morrow 2017), generations of Bible readers—both Jewish and, later, Christian—have associated the two stories, such that menstruation is widely considered, and named, a curse like childbirth. As O’Grady has written (2003, 5):
many biblical commentators throughout history have viewed the Levitical menstrual prohibitions as divine punishment for the sinful nature of woman, which, through the actions of Eve, effected the fall of humankind. Menstruation becomes the divine “curse” of women.
As early as the sixth century, Pope Gregory made this association, and across the ensuing 15 centuries, the popular interpretation has had authoritative theological foundations (Wood 1981, 713–14). One scholar argued that Hebrew Bible-based menstrual taboos account for the continuing exclusion of women from high office in many Jewish and Christian congregations, organizations, and communities (Phipps 1980; see also Cohen [Chapter 11] in this volume). As the third Abrahamic religion, Islam’s sacred book, the Qu’ran, retained a version of these views, with menstruation deemed a “painful condition.” In most modern Muslim communities, fasting during Ramadan, entering a mosque, praying, having sex, and making the full pilgrimage to Mecca are all forbidden for menstruating women (Ahmed 2015; Haleem 2011), although the textual basis of these injunctions is sometimes debated (Lizzio 2013; cf. Mazuz 2012; see also Maharaj and Winkler [Chapter 15] in this volume).
In short, the menstrual lessons of Genesis and Leviticus have cast a wide shadow across both time and space. Although Jews have always constituted a tiny proportion of humans (in 2015, a mere 0.2%—see Hackett and McClendon 2017), their religious heirs—first Christians, then Muslims—have expanded to constitute, collectively, some 54% of the world’s contemporary population (Pew Research Center 2015). From many centuries of missionary and military activity, the impact of these two proselytizing religions has meant that virtually no community anywhere remains untouched by one or another of their teachings (for example, Comaroff and Comaroff  1997; Pawliková-Vilhanová 2007), and menstrual lessons stemming from the three religions are widely known and accepted (although Hinduism and other religions may have their own origins for menstrual taboos). My discussion of the Jewish-Christian-Muslim tradition of ‘the curse’ is intentionally broad here, precisely because it is a dominant (though not hegemonic) perspective across much of the world, despite local variations, interpretations, and contestations.
If the dominant legacy of the Jewish-Christian-Muslim heritage propagates an image of menstruation-as-curse, what, exactly, is meant by the term? The Oxford English Dictionary (OED) defines a curse as: “1a. An utterance consigning, or supposed or intended to consign, (a person or thing) to spiritual and temporal evil, the vengeance of the deity, the blasting of malignant fate, etc. It may be uttered by the deity, or by persons supposed to speak in his [sic] name, or to be listened to by him [sic].” This definition signals that certain unfortunate events presumably emanate from spiritual entities. A later definition further highlights the notion of divine punishment: “4a. The evil inflicted by divine (or supernatural) power in response to an imprecation, or in the way of retributive punishment.” Implied in both definitions is an assumption of inevitability. The very notion of a god relies on the assertion of a power greater than that of humans. If a god curses a human, the suffering is, by definition, inexorable. A further OED definition specifically links women’s menstrual experience with such inevitable suffering—“4d. the curse: menstruation. colloquial.”
With the notion of a curse come specific behaviors and practices that, typically, communities require and women internalize. In communities influenced by the three Abrahamic religions and not (yet) experiencing challenges to their orthodoxies, notions of symbolic ‘pollution’ and ‘stigma’ typically join that of ‘the curse’ to ostracize menstruating girls and women on discursive, conceptual, and physical registers. ‘Pollution’ normatively becomes the community idiom through which ‘stigma’ assigns menstruators blame for the symbolic danger they represent. Even when religious discourses are absent, a powerful ‘yuck factor’ frequently teaches menstruators to maintain their distance from non-menstruators (and vice versa), both verbally and spatially. In these ways, conventional expectations concerning taboo behavior spread well beyond communities oriented around the Bible or the Qur’an. But are all taboos created equal?
Taboo as Morally Neutral
In its original context, the Polynesian word, tapu—from which we derive the English ‘taboo’—refers to a state of being too powerful to discuss or act on (Steiner 1956). In Polynesian societies, neither positive nor negative associations inevitably apply; the word simply evokes the notion of morally neutral power. When applied to earlier menstrual practices in Polynesian societies, tapu often lacked negative associations of stigma.
For example, in some Austronesian language-speaking societies in Polynesia, such as the Micronesian atoll of Ulithi, menstruators were traditionally categorized as tapu and, as such, were required to distance themselves from the community, in offsite buildings (Lessa 1966). But such ‘menstrual huts’ normally drew several menstruating women at once. Taking advantage of what the philosopher Alfred Schutz (1967) might have classified as “consociality,” co-menstruating women in the same structure often pursued crafts and other relaxing activities together. In this way, what an outsider might have perceived as a stigmatizing exile could feel like a welcome space of female sociability and rest. On the nearby island of Yap, women maintained a similar tradition. In the 1990s, they renamed the building for menstruating women the Faliyon Women Association’s Cultural Center (Beardsley 1999). Among the Kwaio, yet another Austronesian-speaking community on the Solomon Islands, stringent menstrual taboos used to work to women’s advantage by giving them access to spiritual power of ancestors (Keesing 1982); however, more recently these taboos have worked against women, for complicated reasons relating to anti-colonial protests and other components of modernity (Akin 2003). Their situation demonstrates the dynamic nature of taboos, which may change meanings across eras.
The notion of power as morally neutral, including as it relates to menstruation, exists far beyond Polynesia. In West Africa, the Beng people of Côte d’Ivoire traditionally partake of this view, using power in both supportive and destructive ways (Gottlieb 1989, 1992). This nuanced orientation contrasts markedly with a dominant Western ethos, which, rooted in the binary thinking of Plato and other ancient scholars, typically insists on moral decisiveness and excludes moral ambiguity: Things are either good or bad—not both or neither. By contrast, with a conceptual orientation rooted in non-binary thought, the Beng view taboos as morally neutral.
Menstruating Beng women are subject to several taboos, including prohibitions on entering the forest, where their fields are located (otherwise they may experience difficulty in their next childbirth), and on touching a corpse (otherwise they may suffer a state of perpetual menstruation). However, these two prohibitions do not derive from a view of menstrual blood as inherently evil or polluting. Rather, menstrual blood is considered a symbol of human fertility, hence it should be separated from both vegetal fertility (agricultural fields) and death (corpses) (Gottlieb 1992). An indigenous male priest (or “Master of the Earth”) of the Beng religion, Kouassi Kokla, explained:
Menstrual blood is special because it carries in it a living being. It works like a tree. Before bearing fruit, a tree must first bear flowers. Menstrual blood is like the flower: it must emerge before the fruit—the baby—is born. Childbirth is like a tree finally bearing fruit, which the woman then gathers. (personal communication with author)
In evoking this metaphor, Kokla implied that menstrual taboos do not derive from pollution ideologies. Rather, they separate two kinds of fertility (human vs. vegetable), and they separate life (human fertility symbolized by menstrual blood) from death (corpses). This view of menstrual taboos speaks to broader ontological axioms, rather than patriarchal notions of female pollution. The fact that red palm nut sauce cooked for many hours by a menstruating woman is considered by most Beng people to be the most delicious of the many sauces locally available further signals a positive view of menstruation held by men and women alike (Gottlieb 1988b).
Taboo as Morally Ambivalent
Taboos may link to visions that are fully positive, fully negative, or neutral. They may also, in some communities, signal ambiguity, even ambivalence. As documented by a British colonial officer’s report, in the early twentieth century the Asante people of Ghana held a morally ambivalent valuation of menstruation. According to Rattray’s 1927 study, menstruating Asante girls and women traditionally maintained numerous taboos, including avoiding cooking for any adult men (including a husband), swearing an oath, crossing certain rivers deemed sacred, and touching certain drums and amulets. In earlier days, if a menstruating woman entered the shrine where ancestral stools were kept, she would have been immediately killed (74–75). These practices imply a view of menstrual blood and menstruating women as polluting and evil in the extreme.
However, these taboos, along with the draconian punishment for their violators, only told part of the story. Traditional Asante priests incorporated menstrual blood into mystically powerful brooms (kunkuma) that purportedly protected them from mystical harm (Rattray 1927, 14). This practice suggests a view of menstrual blood as both powerful and able to be harnessed for good. Indeed, the above-mentioned taboos were kept from fear that a menstruating woman’s spiritual powers were so strong that they could annul men’s powers (Rattray 1927, 75). More recently, an indigenous scholar reported that Asante women may still use menstrual blood to make “love charms and potions” (Agyekum 2002, 377).
Adding further complexity to menstruation’s moral biography, Asante communities traditionally celebrated menarche with an empowering ritual. Publicly seated beneath an enormous, beautiful, hand-made umbrella of the sort normally reserved for kings, queen mothers, and chiefs, girls menstruating for the first time traditionally received gifts and congratulations, while community members sang and danced in their honor (Rattray 1927, 69–74). Some reports suggest that the ritual, called bragorɔ, remains vibrant today (Agyekum 2002, 380; Akwasi 2018). In the 1990s, this ritual proved important enough for some migrating families to bring to New York (Daniels 1991).
The ambivalence outlined above finds expression in language. Euphemisms for menstruation in the Akan languages spoken by the Asante and other linguistically related groups include phrases that emphasize “indisposition” and “seclusion” (Agyekum 2002, 372) and view menstruation as “toxic,” “polluting,” “revolting,” and “dreadful” (ibid., 374). However, these negative terms are counterbalanced by phrases that emphasize “transition” (ibid., 379–81), “menstruation as a protective visitor” (ibid., 382), and “the importance (power, purification, and fertility) of menstruation” (ibid., 374; original emphasis), and that suggest pride in “the fertility and societal recognition of the female” (ibid., 367). The official euphemism to tell an Asante queen mother that an Asante girl under her jurisdiction has her first period is the phrase, ɔ-a-yɛbra—literally, “she has been made perfect” (ibid., 380). In short, the complex set of Asante practices surrounding menstrual blood includes both extremely negative and extremely positive associations. A multilayered view of menstrual symbolism among the Asante leads us far beyond a simple model of menstruation-as-pollution.
Such multilayered perspectives on menstruation exist in many other communities. For example, among the native Yurok of northern California, aristocratic women celebrated their periods with ten days of rituals that accrued prestige to them by heightening spiritual powers, while commoners lacked this privilege (Buckley 1988). In southern India, social class (inflected by the traditional Hindu caste system) shapes menstrual experiences differently. There, menarche rituals still practiced today teach young women ambiguous lessons about their sexuality and social position: Girls learn that their periods are sources of power that may either enhance or disrupt their families’ sense of honor and caste standing and, for that reason, they must be monitored carefully (Cardiff 2016; see also Sukumar [Chapter 13] in this volume). On the Balinese island of Indonesia (historically influenced strongly by India), menstruating women refrain from entering a Hindu temple, cooking, having sex, and touching certain objects of men. In some circumstances, they must even sit atop a trash heap. At the same time, all menstruating women enjoy the symbolic status of a raja, or prince (Pedersen 2002). Even so, class further distinguishes menstruating women’s experiences. High-caste Balinese women may enjoy prestige from their periods, yet they must also adhere to additional menstrual (and other) restrictions that significantly limit their autonomy. Low-caste women may not receive prestige from their periods nor face extensive menstrual restrictions, but their overall lower status may leave them feeling oppressed for different reasons (Pedersen 2002, 309–11). The complicated Yurok and Balinese cases argue for a nuanced approach that prioritizes local experiences and acknowledges multilayered value systems. Rather than starting from an assumption of menstrual experience as a biological given that identically shapes all menstruators in a community, the diverse anthropological record urges us to start inductively. How do individual menstruators experience their periods? How do others perceive them? And how do local value systems, power structures, and menstrual technologies shape these perceptions? These questions provide the most productive starting points for any menstrual inquiry.
Taboo and Shame
In contrast to the cases just discussed, Western interpretations of tapu have emphasized an exclusively negative moral valuation of taboo, for reasons, as noted earlier, related to the dominant philosophical orientation of dualism (Buckley and Gottlieb 1988a). With this emphasis on menstruation as taboo, a girl or woman in such communities who speaks openly of her period, especially if boys or men are present, is considered scandalous (Brumberg 1993; Houppert 1999).
In communities pervaded by such expectations, speaking of menstrual experiences even with medical staff may produce shame. In one study in Sweden, only 38% of women who suffered from excessive menstrual bleeding reported their condition to their doctors (Kadir, Edlund, and von Mackensen 2010). One medical researcher suggested, “Social taboos related to menstruation . . . may explain why women have a reluctance to discuss issues relating to menstruation with clinicians, especially male clinicians” (McLintock 2018, 24). Researchers point out that when the taboo on discussing menstruation applies to medical staff, health risks may result. Moreover, reluctance to seek help and information can lead to misunderstanding that can incline some women to seek unnecessary hysterectomies (O’Flynn 2006) or neglect detection of endometriosis (Seear 2009). A recent editorial in The Lancet (2018), notes: “In the UK, nearly 80% of adolescent girls have experienced concerning menstrual symptoms (such as unusually heavy or irregular bleeding) but hadn’t consulted a health professional; 27% of those said they were too embarrassed to discuss the topic. The rooted silence surrounding periods is putting lives at risk.”
It is not just words that are problematic. Equally powerful social expectations restrain behavior surrounding menstruating and menstruators. As I have suggested, the biblical story of menstruation-as-curse is widespread, especially in Western(ized) nations—but not universal. I have mentioned several communities in AfricaSeeSeespecific country and Asia in which the biblical/qur’anic interpretation of menstruation as a curse has no hold; many other such communities exist elsewhere (for example Baldy 2018; Hoskins 2002a; Maggi 2002). Even so, not all women accept dominant norms, even when influenced by the Bible or the Qur’an. These norms may appear universal because of their broad discursive power, but they are not hegemonic. Moreover, the ways that menstruators challenge taboos vary from community to community and from person to person. In the next section, I survey some contemporary challenges to normative, taboo-based menstrual regimes; many of these find fuller discussion in other chapters in this collection.