From concealment to openness: navigating menstrual etiquette, stigma and shame

Menstruation is a natural biological process, yet it continues to be shaped by stigma, silence, and societal norms that contribute to feelings of shame and concealment. While research has highlighted the persistence of menstrual stigma, less is known about how individuals navigate the everyday pressures to hide or remain silent, and how these norms are resisted. This qualitative study draws on in-depth narrative interviews with Dutch people who menstruate to explore how societal expectations, menstrual etiquette, and the experiences of shame influence menstrual practices and perceptions. Participants described menstruation as something that should be hidden—physically, verbally, and emotionally. Social expectations were enforced through unspoken rules, interactions, and assumptions about what is appropriate. Participants spoke of managing menstruation discreetly, fearing visible signs such as leakage or being seen with menstrual products, and often feeling shame or embarrassment. At the same time, some described moments of openness and resistance, engaging in small but deliberate acts that challenged the concealment imperative when social contexts allowed. This tension between concealment and openness was central to how participants experienced and managed menstruation in daily life. By examining these lived experiences, the study extends theoretical work on the menstrual concealment imperative and highlights how stigma and shame are enacted and negotiated in practice. The findings suggest that while concealment remains dominant, everyday acts of openness and resistance reveal possibilities for shifting norms and fostering more open conversations about menstruation. • Menstrual stigma persists through social expectations of silence and concealment • Participants managed menstruation discreetly, fearing visible signs or judgement • Shame and etiquette shaped how participants spoke about and experienced menstruation • Moments of openness revealed subtle acts of resistance to concealment norms • Study extends the “menstrual concealment imperative” through lived experiences