Colman Noctor: Silence around menstruation leaves girls quietly isolated

The hormonal changes and pain associated with menstruation can cause low mood and irritability. The understanding of parents and teachers is vital in helping girls navigate their experience. Picture: iStock

After 25 years of working with teenage girls, especially girls with eating disorders, I’ve had more conversations about periods than most men would in several lifetimes.

What those discussions have taught me is that the menstrual cycle is not a biological footnote in adolescence, but a key factor in young girls’ mental health and how they come to understand themselves.

My conversations with young girls are rarely just about periods: They are about identity, control, confusion, and silence.

For a long time, periods were seen as something to be quietly endured; a private inconvenience. Given the more open discussions recently around menopause and perimenopause, I had hoped this openness would extend to menstrual cycles.

While it is understandable for teens not to talk about their bodies, a stigma around periods can lead to silence, shame, or misinformation.

Adolescence is already a time of major change. The brain develops rapidly, emotions intensify, and the social environment grows more complex. In addition, nature introduces a powerful hormonal rhythm that interacts with the brain, causing fluctuations in oestrogen and progesterone. 

This influences neurotransmitters, such as serotonin and dopamine, which are both essential for mood and emotional regulation. So, the menstrual cycle is not just a physical process — it is also psychological.

This physical-and-psychological storm might explain why puberty marks a divergence in mental-health outcomes for boys and girls. Rates of anxiety and depression increase for girls and while the social expectations play a role, hormonal biology cannot be ignored.

About 70% of teen girls experience period pain and girls with more severe symptoms are considerably more likely to struggle with their mental health.

These are not small fluctuations. They are meaningful shifts that deserve attention. And yet, many young girls are often left to make sense of this on their own.

Without open dialogue, patterns between mental distress and the menstrual cycle are likely to go unnoticed.

A girl experiencing cyclical anxiety might believe she is losing control. Another dealing with significant pain might be made to feel like she is overreacting.

Withdrawal, irritability, and low mood can all be misinterpreted.

A shared experience

When we fail to name what is happening, we personalise what is, in fact, a shared biological experience. This is where education becomes a form of protection.

Colette Duffy, founder of the Blossom Menstrual Education programme, which has been run in a number of schools, believes the difference between receiving guidance and being left to figure it out alone is profound.

Girls in Ireland are starting their periods at younger ages, sometimes as early as eight. However, the support they receive varies greatly, with some being guided with clarity and reassurance, and others left to navigate confusion, fear, and embarrassment.

Duffy believes when education is age-appropriate and compassionate, a sea change happens. Fear is replaced with understanding, shame begins to dissolve, and young people start to trust their bodies rather than question them.

Good menstrual education, she says, is not just about explaining biology, it is about creating an environment where conversations can happen without discomfort or judgement and where questions are welcomed, not avoided.

Duffy, who was previously a home economics teacher, notes menstrual education is often only briefly covered in school within broader subjects, with limited time and depth.

The quality of delivery largely depends on the teacher’s confidence and training. Some do it exceptionally well, while others, understandably, may feel underprepared or uncomfortable.

The result of the uneven education is that some students have a clear understanding of their bodies, while others rely on peers, family, or social media for information, and the quality, accuracy, and tone of those latter sources can vary greatly. This leads not just to gaps in knowledge, but also to inequality.

Duffy suggests school-based menstrual education can normalise conversation, reduce stigma, and even identify health issues early. It should ensure all students, regardless of background, receive the same foundational understanding, which conveys the powerful message that it matters.

A father’s reassurance

Schools should not carry the full burden of responsibility — these discussions also need to take place at home. And this is where many parents, especially fathers, may feel uncertain.

For most fathers, menstruation is unfamiliar territory. It may feel like something that is better left unsaid. But silence, even when well-intentioned, is not neutral.

When fathers avoid this topic, daughters can internalise the idea that periods are to be hidden, something that men should not engage with. But this belief doesn’t protect them; it distances them.

I am not suggesting fathers need to have in-depth conversations with their daughters about their menstrual cycle, but small signals of openness can have a significant impact. These acts demonstrate a willingness to listen, a lack of embarrassment, and an important message that nothing about their health is off-limits.

Teenage girls do not require their fathers to be experts, but they may appreciate their presence and efforts to understand. When that emotional availability is present, it acts as a buffer.

Research has shown girls who feel supported by their fathers experience lower levels of anxiety, higher self-esteem, and better emotional regulation. This support becomes particularly important when emotions appear unpredictable, a common aspect of the menstrual cycle.

One of the most common challenges in parenting teenagers is understanding their inconsistency.

A daughter who seems fine one week may appear overwhelmed the next. Her motivation fluctuates, emotions intensify, and conflict can escalate quickly.

The parental instinct is often to attribute these reactions to their daughter’s attitude or behaviour. But a more helpful question might be: I wonder if this is related to her cycle?

Considering the role of menstruation in adolescent behaviour is not about making excuses — it is about providing context to inform our response.

Without understanding, irritability may be met with frustration, withdrawal may be seen as disengagement, and emotional reactions may be interpreted as defiance.

With understanding, the same behaviours are more likely to be met with curiosity, patience, and empathy. And that shift, from reaction to insight, can be the difference between reducing conflict and escalating it.

When young girls are supported in learning about the menstrual cycle, they gain more than just knowledge and a sense of predictability. They start to recognise patterns in mood, energy, and focus, and learn what is normal for them and what might indicate that something is amiss. As a result, they become better prepared to seek help when necessary.

Somewhere, right now, a teenage girl is trying to understand her feelings in a body that feels unpredictable. She might be questioning why she feels overwhelmed, why her energy dips, her mood swings, and why something that seemed manageable yesterday feels like too much today.

If no one helps her link those experiences to a hormonal pattern, she might internalise that confusion and believe she is getting it wrong.

But if we can offer her a different narrative that explains the rhythm, normalises the experience, and invites conversation rather than silence, we give her something powerful: Not just information, but reassurance.

And when that reassurance is reinforced at home, in school, and in the wider culture, something will shift, and the menstrual cycle will go from being hidden to being understood.

• Dr Colman Noctor is a child psychotherapist