Why we link sex and menstruation

Yesterday someone commented on an earlier post called Making menstruation personal again.  Here is what she (or he) said:

I find the “medicalization” of menstruation abhorrent, but I disagree that “menstruation is one of the first parts of teaching young women about sex and sexuality.” Of course sex ed is really important, but I think explanations about periods should be separate from it. I understand that menarche is part of puberty, but menstruation is not a sexual event and is not part of one’s sexuality. Getting your period is a normal bodily function and I think it does people a disservice to link it to sex.

Before I say anything else, I want to be clear that getting your period is absolutely a normal bodily function.  As is sex.

Now, I realized as I was responding to the comment that I feel very strongly that menstruation must be an explicit part of sexuality education.  I didn’t want to start raving in my own comments section, so instead decided to write a whole post on it.  So here are my reasons why menstruation must be included in a good sexuality education program for individuals of all ages:

  1. Many people have times in their lives when they are trying to have – or not have – children.  At these times in their lives, people’s fertility is closely tied to their sex lives.  They need to understand their own fertility and their partner’s fertility – including menstruation – in order to make choices about their sexual actions that supports their pregnancy (or non-pregnancy) goals.
  2. As is alluded to in 1, family planning choices affect sex.  However, menstruation also often affects when and how women want to engage in sexual activities (for example: distaining sexual activity during their period or really enjoying it).  Moreover, the hormonal changes around women’s fertility cycles often affect their interest in sex.  Therefore, menstruation can be a sexual event, and is part of many women’s sexuality – even if they have not explicitly acknowledged it as such.

Now, this is not to suggest in any way that when a young girl is approaching puberty, it’s the right time to give her a full rundown of the connections between menstruation and sexual intercourse or even an in-depth talk about reproduction and what role sexual intercourse plays in that.  The age when a girl starts to menstruate has a huge impact on how much information needs to be included in those pre-menstrual and menarche conversations.

Over time, however, those connections do need to be made in age-appropriate ways.  My college students still have questions for me about the connections between fertility cycles and sexuality – and they are good, important questions that are often born out of their own experiences, and I can’t think of another place where they might have the opportunity to ask them.

About Karen Rayne

Dr. Karen Rayne has been supporting parents and families since 2007 when she received her PhD in Educational Psychology. A specialist in child wellbeing, Dr. Rayne has spent much of her career supporting parents, teachers, and other adults who care for children and teenagers.


  1. “They need to understand their own fertility and their partner’s fertility – including menstruation – in order to make choices about their sexual actions that supports their pregnancy (or non-pregnancy) goals.”

    I would be very careful when planting the idea in a teenager’s head that the girl’s menstrual cycle is in any way related to birth control.

    I understand that, scientifically, a woman’s cycle affects her fertility, but as a practical matter this needs to be taught with one enormous asterisk: that the “timing method” is not, as a practical matter, a from of birth control. Even among women who take the time and effort to monitor their bodily functions, the real world failure rate is 20%.

    Obviously you already know this, but I just wanted to give you a friendly reminder that people, and especially teens, tend to hear what they want to hear. And if they want to hear that they don’t have to go buy condoms and face the cashier, and/or they don’t have to get a pelvic, etc., that they can just use the “timing method”… that’s what they are going to hear. Any mention of this needs to be accompanied by the words “20% chance of pregnancy each year” and “zero STD protection”.

    I’m probably preaching to the choir here, but just in case…

  2. I can’t imagine an age at which a girl could be menstruating when it would not be appropriate to talk about the full implications of that, fertility-wise. I mean, I realize that some girls start as young as 8 or so these days but that is still old enough to know these things. If a girl ha a functioning reproductive system, she needs to know how it works.

  3. Thank you for bringing up this point, Bob, because I completely agree.

    I don’t generally go into enough detail about menstrual cycles with younger groups for them to believe they can use natural family planning, nor do I explain the process of natural family planning. I also point out that it is possible for them to ovulate at any point in their cycle.

    With older students (late high school, college), after I describe the female fertility cycle in detail, we do generally talk about natural family planning. I show them examples of the temperature chart that women who use natural family planning create over a month and talk about the necessary parts of using this birth control method: taking your temperature immediately upon waking up, feeling your vaginal secretions, using condoms about two weeks out of the month, and being open to the idea of having a baby. After we go into the process in great detail, they are generally very respectful of it and completely uninterested in doing it themselves.

  4. I’m with Lone Star Ma: menstruation is so totally tied to fertility, biologically, that I see it as a part of the whole discussion.

  5. I plan to give my daughter a copy of Taking Charge of Your Fertility by Toni Weschler as soon as she starts menstruating. I think the information about our bodies is a very important thing to have. Of course it doesn’t mean that sexually active teenagers (or adults) should stop using condoms. It just means they know that much more about how their own bodies work.

    And FWIW, fertility awareness, like all other forms of contraception, is effective WHEN USED CORRECTLY, albeit a bit more complicated than some methods to learn to use correctly. My husband and I used it for three years to prevent, then we used it to conceive, and now we’re using it to prevent again. It’s not something I would recommend be used alone unless you are in a good position to raise a child if you slip up. But used just for information, with condoms every time, I think it’s appropriate for most people.

    I don’t think more information is a bad thing in any case.

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