Joanne's ignorance of menarche, the onset of menstruation, is not unusual for 12-year-old girls. According to a study to be published later this month, more than 12 per cent of girls know nothing about menstruation when they first start; 35 per cent learn not from their parents, but from friends and magazines and at school.
Shirley Prendergast, a senior research fellow at Cambridge University, has spent three years studying how girls cope with menstruation. Her findings, based on interviews with 500 girls in single-sex and mixed schools around the country, and many of their teachers, show that, while sex may be openly discussed at school, menstruation is often covered in one brief lesson that emphasises the biological aspect, rather than emotional or practical consequences. Girls' experience, how they cope, and what the school can do are rarely considered.
Parents often feel that it is the school's duty to cover the topic, but information provided during personal, social and sex education (PSE) lessons is often too little and too late. At least 9 per cent of girls begin to menstruate at primary school, some as young as nine. Yet few junior schools mention it and many lack even the most basic facilities for menstruating pupils. Girls hear disturbing things from each other, generally about bleeding and pain, and their anxiety may not be dispelled by PSE classes at secondary level.
Surprisingly, most teachers appeared not to have thought about the significance of their own attitudes and behaviour, or the effect of school facilities and policies on girls' ability to cope - often school secretaries were more aware and understanding. Although more than 80 per cent of the girls in the study reported tiredness, irritability and heavy bleeding, male teachers in particular were found to ignore the problems, and some women took the attitude that 'We coped, so you must, too.'
Evelyn Tully, a trained nurse who recently moved to the all-girls Parliament Hill School in north London, was surprised at how much girls suffer. 'Those who experience very severe pain are very distressed and very anxious. They need support. Once we've eased the pain, we talk about their anxiety. They don't want others to know, but sometimes they think they're the only ones to have such pain, and that there's something wrong.'
The school allows the use of pain- killers, and details of girls using them are circulated to year heads. But Ms Tully is concerned at the overuse of these drugs, and recommends instead hot-water bottles, lying down and aromatherapy. The girls at Parliament Hill are lucky; few schools nowadays provide a medical room, let alone a nurse. Sixty per cent of the girls in the study took pain-killers regularly each month; 5 per cent of girls coped by using the Pill.
Half the girls in the survey were found to skip school completely. Jane, a pupil at Parliament Hill, said: 'I often take two days off each month. I get migraines and stomach aches. I'm aggressive. I just go to bed for two days and sleep.' One in ten girls claimed to have missed an important exam or test, and many more said they were as concerned about coping with a period as with doing well on a test day. Yet none of the schools took this possibility into account, or advised pupils how best to cope.
Ms Prendergast says that the girls' desire to keep their menstruation secret wastes energy that could be going into work: 'It takes energy to plan everything. Keeping supplies hidden, but to hand. Not revealing that you're unwell or tired, and making sure that you don't show. Forty-five per cent of girls claimed they suffered lack of concentration, so it seems likely that many are under-achieving.'
The condition of many schools' basic facilities added to the girls' misery: half of all lavatories were reported to be closed during lessons. When they were open, half the cubicles had no locks. Half had no toilet paper, 70 per cent had no soap and 60 per cent had inadequate disposal facilities. One pupil, Zoe, could be speaking for almost any girl in the survey when she said: 'The lavatory locks are broken, so you have to get a friend to hold the door. There's only one bin, it's always overflowing and there are bloody towels on the floor. You have to flush your pad down the loo, and it blocks. Then you can't wipe yourself or wash your hands properly.'
Teasing about menstruation is an every-day event. In their second and third years at secondary school, boys not only break out of their sexual shyness, but also become extremely competitive with girls; often, this is expressed in the kind of group teasing that easily turns into bullying. In many schools there are no lockers, so girls are obliged to carry their sanitary supplies in their bags. One of the most common forms of harassment is to turn a girl's bag out in public, so that towels, tampons or knickers can be flung around the classroom.
Young girls with unpredictable periods may be caught unawares and need to leave the classroom. One girl who was repeatedly refused permission by a male teacher to leave the classroom during a lesson was seen, at the end of the lesson, to have blood on her chair; for the next two years she was known by boys throughout the school as 'bloody Mary'.
Games are a particular problem. In mixed schools girls find it very difficult to tell male teachers, often in front of boys - and the teachers can be every bit as embarrassed as their pupils. Debbie Ramms, physical education co-ordinator at Parliament Hill, has a more open approach than most PE teachers. 'The girls all think that everyone knows that they're on their periods. They think everybody is looking at them, hanging upside down on a rope in their gym knickers,' she says. 'When girls say they don't want to do gym, I ask them what they think happens to me: I don't stop because of my period. Usually they have a go, but if it's bad, they can sit it out.'
Ms Prendergast says schools should examine how they handle an issue that affects half their pupils once a month. She suggests that they need to 'look not only at the formal curriculum and how it is delivered, but also at the hidden curriculum, expressed in the physical environment and the attitudes and behaviour of the staff and pupils'.
A free leaflet, 'Helping girls to cope with menstruation in school', is available from The Health Promotion Research Trust, 49-53 Regent Street, Cambridge CB2 1AB (0223 69636).
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