Menstrual stigma and the role of culture and religion in the south Asian diaspora: a cross-sectional study of a nationwide cohort

Menstruation is a physiologic aspect of reproductive health; however, menstrual equity—defined as access to products, supportive environments, and comfort during menstruation—is not universally achieved. Menstrual stigma, often shaped by cultural and religious norms, is a key driver of inequity. While this has been described in global South Asian populations, its influence among South Asians in the United States remains underexplored. To assess the association between cultural and religious influences, menstrual stigma, and menstrual equity among South Asian menstruators in the U.S. This cross-sectional study (March–November 2024) recruited South Asian-identifying menstruators via social media. Participants completed a validated 33-item Menstrual Attitudes Questionnaire assessing beliefs, experiences, and menstrual equity indicators. Descriptive statistics and univariate linear regression were used for analysis. Of 101 respondents, 86% identified as Indian, 53.5% reported menarche at age 11–12, and 59.4% reported regular cycles. Heavy menstrual bleeding was reported by 11.9%. Non-standard menstrual products were used by some participants, including toilet paper (20.6%), paper towels (7.5%), and rags (3.1%). Greater reported cultural or religious influence on menstrual beliefs was associated with denial of any menstrual effect (p = 0.001). Cultural and religious influences were associated with denial of menstrual effects but were not directly associated with overall menstrual stigma. These findings suggest that cultural frameworks may shape menstrual perception in nuanced ways, potentially reinforcing barriers to menstrual health discussion and education. Further research is needed to clarify how cultural and religious norms influence menstrual equity and health-seeking behaviors in South Asian American communities.