The walk of life is fraught with ups and downs, and to accommodate these changes, every individual goes through several transitions.

The walk of life is fraught with ups and downs, and to accommodate these changes, every individual goes through several transitions. Some of these are a result of natural biological changes within the human body, while others occur as a result of changing thought patterns, values, and beliefs, forcing the individual to imbibe diverse perspectives into their way of life. One such major transition occurs at the onset of puberty, especially in women and other individuals who undergo the process of menstruation and other bodily changes. Menstruation is a universal concept; however, how this phenomenon is interpreted varies greatly between different cultures. Each culture has its unique set of beliefs, norms, and values concerning the process of menstruation, which primarily stems from its historical and social contexts. As a result, each culture has its perceptions and experiences associated with pain, which is one of the symptoms of menstruation. The pain experienced during the menstrual cycle is referred to as dysmenorrhea in clinical terms. It is caused by the overproduction of uterine prostaglandins, which leads to inflammation causing discomfort (Helwa et al., 2018). Each culture has its own attitudes and behavioural patterns linked with health and related concepts, which distinguishes them in their approaches to confronting and effectively managing a distressed condition. Through the centuries, the concept of menstruation has traditionally been seen through a negative lens because of the stigmas associated with it. As a result, many prefer to cure their symptoms by utilising traditional remedies rather than seeking medical attention from healthcare professionals. Additionally, due to anecdotal evidence and ancestral linkages, traditional therapies and methods are widely believed and accepted, making them the primary source of relief during times of pain and anguish.

The expression of pain is quite multifaceted. Some cultures choose to showcase pain overtly as they believe that pain should be vocalised openly to seek communal support during suffering whereas some cultures believe in the practice of stoicism and maintaining self-control in painful situations. This subjective interpretation of pain is widely talked about in context to how dysmenorrhea hinders the successful completion of everyday tasks and affects the quality of life. Factors such as family, gender, religion, age, and emotions influence the way an individual addresses pain. Some cultures believe in employing pharmacological approaches to treat any distress, like using oral contraceptive pills to reduce the swelling in the uterus (Wong et al., 2009). On the other hand, some cultures resort to traditional practices to cope with it. Some commonly used traditional practices involve herbal therapy, warm compresses, exercises, etc. For example, countries like India, Pakistan, and Malaysia use ginger as an effective remedy to reduce primary dysmenorrhea (Negi et al., 2021). This disparity in the ways of addressing and behaving towards the same process comes from the psychological beliefs that have been passed on for generations and are deep-rooted in one’s cultural identity, making them more acceptable than modern ways of treating dysmenorrhea. These beliefs try to mould the perception of discomfort by evoking a sense of belonging among menstruators by associating the entire process with the communal roots of different cultures.

Dysmenorrhea and its associated symptoms have long been stigmatized as a very confidential and personal experience. In some cultures, like Arab countries, there is not much research on dysmenorrhea as it is treated like a prohibited subject due to social and cultural restrictions (Helwa et al., 2018). Additionally, the taboo of shame associated with the entire process compels people to keep their menstrual health private and use home remedies rather than seeking pharmaceutical assistance, which may require medical consultations and prescriptions. Many people have grown up seeing their family members tackle the pain using ‘gharelo nuke’ and they also feel the same comfort while following similar methods, implicitly conforming to the generational superiority of cultural norms and practices over modern pharmaceutical medications.

Even after urbanisation and the development of efficient medical treatments, people are hesitant to reach out to medical professionals and health caregivers to address their distress.

The reason behind that will be the trust and perception of traditional medication being safe and subjected to fewer side effects. In addition, self-management methods like yoga, acupressure, use of herbs, etc. foster the overall well-being of an individual rather than just merely alleviating dysmenorrhea symptoms. This point of view further encourages the consumption of conventional medications as it restores the internal equilibrium of the body without any potential harmful reactions. However, in many Western cultures, like the United States, people experiencing symptoms during menstruation sought anti-inflammatory medicines like ibuprofen, whereas, in southeastern countries like India, a study indicated that a small proportion of individuals pursued pharmaceutical methods for menstrual pain, while a majority population relied on alternative remedies to reduce discomfort (Helwa et al., 2018).

The belief in managing pain is a crucial component for coping with the discomfort. Clinical intervention in the field of diversified values and beliefs related to menstruation and dysmenorrhea is necessary to bring about a change in the persisting stereotypes in society so that individuals experiencing discomfort can openly express their distress. Health workers can contribute to reframing the negativity around dysmenorrhea, which can help lessen the intensity of the symptoms. Research has revealed that in chronic pain syndromes, negative attitudes and views are closely linked to the feeling and experience of pain by an individual (Rogers et al., 2021). Professionals can attain this by educating people about the benefits and limitations of various modern methods while respecting cultural variations, allowing individuals to make informed decisions about their menstrual health. Additionally, nurses and other healthcare givers should be culturally sensitive and must comprehend the diversified cultural backgrounds of their patients in a holistic manner to align their treatments with the patient’s beliefs to create an inclusive and non-imposing environment.

By recognising and respecting the cultural differences in the perception and expression of pain, healthcare givers can provide better treatment outcomes and work towards improving the quality of life of individuals enduring pain (Okolo et al., 2024). They can also guide the distressed towards evidence-based treatments, resulting in improved satisfaction and trust in obtaining professional help for something as private and intimate as menstruation.

 To conclude, the contrasting methods to tackle dysmenorrhea demonstrate how cultural beliefs and attitudes affect health behaviours and pain patterns. Thus, the healthcare industry must be more inclusive and culturally sensitive towards varied sentiments and practices to effectively pull menstruation and dysmenorrhea out from the mud of shame and prejudices.

Authors: Purvi Kapoor, Undergraduate Student, FLAME University, & Prof. Moitrayee Das, Faculty of Psychology, FLAME University.