Let’s talk periods – that is the tagline being used by a popular cricket club to encourage dialogue and break taboos surrounding menstruation, as they compete in the Indian Premier League. When the Rajasthan Royals put on their jerseys that displayed a sanitary pad advertisement, it prompted an outpour of social media messages encouraging people to speak freely about menstruation without embarrassment or shame. With a record 269 million viewers tuning in to watch the <a href="https://www.thenationalnews.com/sport/cricket/anushka-sharma-watches-as-virat-kohli-s-bangalore-lose-in-dubai-in-pictures-1.1099353">IPL tournament, being played in the UAE</a>, advocates hope the campaign, which includes advertisements on social media and television, will bring awareness to the troubles faced by millions of girls and women without access to menstrual products or appropriate health services. The advertisements, by Niine, a menstrual hygiene products company, urge women “not be ashamed, the silence has gone on for too long”. Rajasthan Royals have pledged to distribute free hygiene products for women based on the number of runs the cricketers hit. But Ranjit Barthakur, the team’s chairman, said the initiative goes beyond that. "This is probably the first time a woman's product is being promoted like this by a male team and, if we can reach millions, it is such a wonderful thing," he told <em>The National</em>. “The following for cricket is just short of religion in India and the viewership is phenomenal. We wanted to take this opportunity to promote women’s health. “The sanitary pad is just one item. We want to convey that women are our driving force and always must have our support. This is the critical thing behind this movement.” IPL matches are being held in the UAE this year because of soaring coronavirus cases in India. <a href="https://www.thenationalnews.com/uae/health/ipl-2020-how-rigorous-testing-and-bio-bubbles-will-keep-cricket-stars-safe-in-the-uae-1.1077988">Players keep to a bio-secure bubble</a> as part of strict safety guidelines. Other athletes have thrown their weight behind the initiative. An open attitude in the sporting industry, they say, is long overdue. “It’s about time we address the menstrual taboo because culturally around the world this has brought shame and embarrassment to many women,” said Suzanne Al Houby, the first Arab woman to climb Mount Everest and the Seven Summits, and a resident of Dubai. Ms Al Houby <a href="https://www.thenationalnews.com/uae/first-arab-woman-to-climb-mount-everest-hopes-to-be-an-inspiration-1.25614">challenged physical and mental boundaries</a> when she joined an otherwise all-male team that took on the world's highest peaks in 2011. Like many women athletes in high intensity sports, she initially took medication to control her menstrual cycle before deciding against it because it was negatively affecting her health. Ms Al Houby kept her period pain to herself and added it to a list of extreme climbing conditions she endured, including dehydration and frost bite. “Hushing it is what usually happens. It’s pretty significant if we can start to normalise talking about it. There could be many changes that arise.” Another issue is a lack of communication between parents and daughters. Dr Rasha Rady, a paediatric haematologist in Egypt, who was <a href="https://www.thenationalnews.com/lifestyle/how-three-middle-eastern-women-are-changing-the-world-through-healthcare-1.1006097">recognised for pioneering work in health care</a>, said some mothers have a female doctor speak to their daughter or not address it at all, creating more confusion. “Reaching puberty is very important for a girl so if you are not equipped about how to talk to her, you will transfer this same problem to her. This cycle has to be broken,” said Dr Rady, an assistant lecturer of paediatrics at Cairo University Children's Hospital. An absence of information can affect women’s physical and mental health. Dr Rady told of a concerned family, who approached doctors after spotting a pronounced abdominal bump on their daughter before she was set to get married. The woman had, until then, never told her mother that she had never had a period. Doctors diagnosed a medical condition that restricted the menstrual flow from being properly discharged and corrective surgery was performed. Dr Rady said girls and women were often made to feel like they should isolate themselves while on their periods. “A girl feels at this time of month she has to stay out of sight. Men believe she is emotionally unstable and should be avoided," Dr Rady said. “I tell them menses is normal, this is physiology. But a girl does not understand it because her mother never talked about it. “You want to raise your kids to live their lives and not to repeat your mistakes, this is important for parents to understand." Cultural constraints are not limited to Asia and the Middle East but extend to the West and put the health of millions of women at risk. About 130 million girls worldwide are out of school, with periods and lack of sanitation among the major reasons, according to Unesco. The World Bank estimates that at least 500 million girls and women lack proper access to menstrual hygiene facilities. Studies have linked neglected gastrointestinal issues and problems managing menstruation to basic difficulties accessing clean toilets. Ms Al Houby said the campaign could help young athletes openly talk about the challenges they face while on their periods to their coaches, who are usually men. “It is a fact that women suffer from premenstrual stress and sometimes painful periods. It’s not that we are going to use it as an excuse not to train as hard," the climber said. “But we shouldn’t just sit down and wait for coaches to understand how peculiar or unique our needs are at certain days of the month." She said female athletes should speak to their coaches about the challenges they face. “It may be uncomfortable now but it will make it easier in the future when all these taboos are no more taboos.” In the UK, researchers are educating coaches to break down these barriers. Sarah Zipp, a lecturer at the University of Stirling, advocates more menstrual health education in sport with a programme called Power to Play, Period. “The period taboo is a global problem. Studies in the UK show similar results to studies in India, across Asia and the global south. People are embarrassed to talk about their periods and this can prevent them from asking for help,” she said. “We know that girls are more likely to drop out of sport around the age of 12. We also know that age 12 is the most common age that kids get their periods. Having to navigate PE locker rooms and wearing white shorts as part of their kit can be embarrassing. “We don’t want to lose those kids, if they drop out at age 12, it’s really hard getting them back to physical activity. We need to listen and understand what they need.” Scotland was the first country in the world to provide free menstrual products in schools and colleges two years ago. This year, the Scottish parliament approved legislation to make tampons and sanitary pads available free at all community centres and pharmacies too. Ms Zipp said the Rajasthan Royals sent out a strong message by taking a stand with women. “This campaign is powerful because it’s coming from a masculine standpoint,” she said. “You have these sporting heroes and they are saying – I’m not afraid to talk about this, you shouldn’t be afraid too. “It’s a powerful message to girls. They are making it okay to openly discuss period woes and that opens the door for people to ask for help and get support.”