The Experiences of Menstruation in Schools in High Income Countries: A Systematic Review and Line-of-Argument Synthesis

Menstruation is a global public health issue with negative discourses of shame, embarrassment, and disgust. There is growing anecdotal evidence linking negative menstruation experiences at school to absenteeism. This systematic review and line-of-argument synthesis aims to develop a conceptual understanding of menstruation experiences in schools in high-income countries. MEDLINE (Ovid), PsycINFO (Ovid), EMBASE (Ovid), HMIC (Ovid), and ERIC databases were searched. NVivo was used for thematic synthesis and reciprocal translation to generate third-order constructs: overarching themes that interpretatively describe social processes around menstruation in schools. One thousand three hundred and thirty-three studies were screened, with 19 meeting inclusion criteria. Six third-order constructs were identified and integrated into a synthesized line-of-argument illustrating menstrual injustice at school. To ensure menstruating students do not face academic disadvantage because of schools' failure to accommodate menstrual needs, schools should challenge stigma, provide facilities to improve students' capability and confidence to manage menstruation, and provide academic support to menstruating students who miss classes. Future research should explore experiences of period poverty in HIC schools, examining the influence of gender identity, disability, race, and class on menstruation experiences.