Adolescent girls’ experiences of menarche and menstruation: a qualitative study of silence, stigma, and menstrual health knowledge

Menstrual health is increasingly recognized as a critical public health and gender equity issue; however, adolescent girls’ experiences of menstruation continue to be shaped by stigma, gender norms, and limited access to reliable information, particularly in contexts where menstrual communication is constrained by sociocultural expectations. While previous research has primarily focused on menstrual knowledge and hygiene practices, less attention has been paid to how adolescents construct and negotiate menstruation as an embodied, socially regulated, and morally mediated experience. This qualitative study employed a phenomenological approach to explore the menstrual experiences of adolescent girls in an underserved sociocultural context in southeastern Iran. Fifteen girls aged 15–18 years were recruited through purposive sampling from secondary schools. Data were collected through in-depth semi-structured interviews and analyzed using Colaizzi’s method. Trustworthiness was enhanced through peer debriefing, reflexive practices, and continuous review of coding and interpretations. Analysis revealed four interrelated themes: (1) menarche as embodied shock and moral repositioning, (2) gendered silence and the discipline of disclosure, (3) maternal mediation and the partial reconstruction of meaning, and (4) ambiguous hygiene knowledge and risky health practices. Participants described menarche as an embodied disruption marked by fear, confusion, and uncertainty in the absence of prior knowledge. Menstruation was further regulated through gendered norms of silence, modesty, and restricted disclosure, limiting open communication and access to reliable information. Although mothers played an important role in normalizing menstruation and reducing emotional distress, their guidance often remained partial and did not fully address practical health concerns. Participants also described fragmented and contradictory information regarding hygiene practices, diet, and symptom management, contributing to uncertainty and inconsistent health behaviors. Menstruation emerged as an embodied and socially regulated experience shaped by menstrual stigma, gendered silence, moral meanings, and fragmented health knowledge. The findings underscore the importance of addressing menstruation not only as a biomedical issue but also as a sociocultural and communicative experience. Culturally sensitive menstrual health interventions that strengthen school-based education, family communication, and menstrual health literacy may help reduce stigma, uncertainty, and harmful misconceptions among adolescent girls.