ArticleBMJ open2025
Exploring the lived experiences of first blood among adolescent girls in Pakistan: a phenomenological qualitative study.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Menarche as a silent transition: islamic modesty norms, mother-daughter communication, and menstrual readiness among rural Indonesian adolescents.Frontiers in reproductive health · 2026Article
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7 authors.
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Abstract
objectiveThe study aims to explore the experiences of adolescent girls with the onset of their first menstruation in the context of Pakistan and to highlight the sociocultural aspects that shape those experiences.
designThe study employs an exploratory phenomenological approach.
settingThis study has been conducted at a public sector higher education institute, University of the Punjab, Pakistan. Female students enrolled in the first semester of the undergraduate degree programme were included in the study using a predefined inclusion and exclusion criteria.
participantsData was collected from six 18 years old girls who had their menarche in the last 6 years through face-to-face in-depth interviews using a semi-structured interview guide from June 2024 to August 2024. The interviews were audio-recorded given the written consent of the participants. Transcripts were analysed thematically following Braun and Clarke's framework.
resultsThematic analysis of six interviews revealed three major themes: (1) Experience of first blood: emotional, social and practical difficulties; (2) The problem of mismanagement of first menstruation and the strategies used; and (3) Restrictions during menstruations. The study found that adolescent girls are provided with little to no prior knowledge regarding menarche and menstruation that causes various complexities and vulnerabilities. The social and cultural expectations and the gendered norms construct the experiences of the adolescent girls regarding their first menstruation, while the idea of womanhood is preserved in the society by restricting, isolating and alienating the adolescent girls and modifying their conduct and behaviour accordingly.
conclusionMenarche is often experienced as distressing, secretive and isolating for adolescent girls in Pakistan. Educational interventions in families and schools are needed to provide accurate, timely information and to support girls in navigating this transition with confidence and dignity.
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