Interrelationship between attitudes towards menstruation, support of women's movement, body appreciation and self-esteem

Размещено на http://www.allbest.ru/

FEDERAL STATE AUTONOMOUS EDUCATIONAL

INSTITUTION OF TERTIARY EDUCATION

«NATIONAL RESEARCH UNIVERSITY HIGHER SCHOOL OF ECONOMICS»

FACULTY OF SOCIAL SCIENCES

DEPARTMENT OF PSYCHOLOGY

Master's Program «Applied Social Psychology»

Master's Thesis

Interrelationship between attitudes towards menstruation, support of women's movement, body appreciation and self-esteem

Santoliva Echeverri, Claudia Patricia

Moscow, 2020

Abstract

The present investigation proposes an approach regarding menstruation and feminism to the experiences of Russian women. This study aims to examine the relationship of beliefs about and attitudes toward menstruation and attitudes toward feminism and women's movement to body appreciation and self-esteem by conducting an analysis in Russia. For that, four scales were implemented: BATM questionnaire, Body Appreciation Scale-2, Attitudes toward Feminism and Women's movement and Rosenberg Self-esteem. The research question that guided the study was: How do beliefs about and attitudes toward menstruation and attitudes toward feminism affect women's body appreciation and self-esteem in Russia? This study was conducted through the participation of 252 participants between the age ranges 17-53. Throughout history menstruation has been stigmatized among all cultures and even after centuries, there exist still some beliefs and attitudes toward menstruation and feminism that segregate menstruating women and prescribe them to do some daily activities, limiting their lives. When women have a positive experience with their periods, and when they support women's movement, they will have a positive body appreciation and they will tend to have a high self-esteem. When they are still confused about this feminine process, they will have negative attitudes towards menstruation and their bodies.

Key words: Menstruation, beliefs, attitudes, body appreciation, feminism, women's movement, self-esteem, Russia

Menarche is a fundamental part of female development because girls experience a huge transition and mark that differentiates women and men. Girls are becoming women with own responsibilities, different rights and status in their communities due to the possibility to give birth. After this experience, without a lot of preparation, lack of knowledge, many doubts and mostly negative feelings and thoughts about it, women start to bleed monthly. Menarche also comes with other secondary sexual changes in their bodies such as: widening of hips, growth of the breasts, and exit of pubic and axillary hair. Also, they are experiencing multiple changes; both: physical and psychological ones to be prepared for becoming women to have the opportunity to be mothers. (UNICEF Colombia, 2015)

The recurrent bleeding on women is named menstruation. Menstruation is a biological and natural process experienced by all healthy women during their reproductive stage and most of their lives. Although menstruation plays an important role and function in women's lives, it has a lot of taboos and stigmas surrounding this phenomenon and everything related to it. (Crawford, Menger, and Kaufman, 2014)

Throughout history, menstruation, the female natural process, has generated a series of mostly negative reactions in different cultures, limiting women to live and fully develop in multiple aspects of their lives. Taboos, prejudices, and indifference of society have generated a strong discrimination against women, covering such important areas as sexuality, limiting sexual life as a couple, discourse, not being able to prepare or manipulate food or being excluded from certain religious activities, between others (Crawford, Menger and Kaufman, 2014).

Attitude theory usually defines attitude as: “a tendency to locate some entity or “attitude object” along an evaluative dimension unfavorability/favorability, expressed in the three components of affect, cognitions and behavior” (Fassinger, 2005, p.389). Many feminist theories argue that gender is not innate, but it is something every human being does. As Toller, Suter and Trautman (2004) argue, there are some constraint and clear definitions about what being a woman means. In their study they showed, in general, the vast majority would agree with the following conception about femininity: “…a successful woman's performance of high femininity requires that the woman be nurturing, physically attractive, and passive” (p.85). They also mentioned that several previous researches revealed that feminists are often perceived as unfeminine (Toller, Suter, Trautman, 2004).

The negative attitudes towards menstruation, discourages authentic engagement with one's body, including a lot of doubts and disgust towards the capacity to breastfeed due to their own bodily fluids, embracing menstrual blood. (Bobel, 2010) Besides, understanding that menstruation and sexuality are related to the same bodily region - the genitals. It can be said that due to this association between menstruation and sexuality, women who develop negative attitudes and proscriptions to themselves, tend to develop negative reactions to menstruation and vice versa. For example, women who have experienced mostly negative moments while bleeding, probably will react the same way to everything related to being feminine and will be more inclined to consider sexuality and their bodies as something impure, dirty and something for keeping hidden (Rempel and Baumgartner, 2003).

For a better understanding, it is relevant to mention that after Foucault, bodies are:

“…always problematic and in need of correction through the vehicle of consumption. In the case of menstruation, the problem is its very existence; the solution is to render the process invisible by containing the menstruating body or, increasingly, eliminating it all together through cycle-stopping contraception, that is, menstrual suppression (Bobel, 2010).

There are multiple components which contribute to the understanding of what women's movement is. Firstly, it is relevant to mention that the movement is constantly transforming to improve. Taking this updating process into account, it can be said that women's movement tries to represent the experiences of all women and at the same time it seeks to redefine gender roles in order to eradicate particular feminist ideal - which force women to suit in created constructs by the societies. Secondly, some women nowadays, are working hard to reflect the detachment that individuals have towards menstruation and how it affects the relationship with their own bodies (Bobel, 2010). Menstruation is a female experience associated with sexuality, which is perceived as shameful and pollution that must be contained and fixed, which can be understood as imperfection of the female body. Thirdly, these perceptions may affect women's confidence and self-esteem because they start thinking that women are imperfect creatures and start focusing more on the damages and imperfection of having a feminine body, underlying the negative constructions of female body fluids (Bobel, 2010).

Furthermore, menstruation has a bad reputation in most of the societies and despite it is a life-event for women, it is perceived as: An illness or problem, “the curse”, “falling of the roof”, “being unwell”, “riding the rag” and “losing blood” (Golub,2017). These perceptions make societies label women as a disease, which makes people believe that women are disabled and suffering beings who experience an impairment of function (Golub,2017). Regarding this reality, some women, who support the women's movement, seek to: “understand the hidden justification for power differences contained in assumptions about what is normal or proper for women, for the cycle.” (Golub,2017, p.2).

According to the author, the feminist perspective contributes to approaching the menstrual cycle and healthcare in a more human and holistic way. Labeling women as disabled beings, make them have low self-esteem due to the labeling itself which has a negative connotation. Additionally, women are experiencing multiple hormonal processes; which alter their moods; making them feel insecure, anxious, pain, shy; while facing some difficulties to concentrate and fluctuations in their estrogens levels - which leads to lowering serotonin levels as well, affecting the emotional sensitivity (Golub,2017).

Problem statement

The problems of this study are: the lack of information of women about menstruation to make responsible decisions when they are sexually active, also women are restricted to do normal daily activities, absence from universities, women are adjudicated with supernatural powers and there are still so many taboos towards menstruation that urgently need to be taken into account by health professionals. Lack of formal education on this subject shows that the topic is not seen as important among the health professional's community, as well as society at large, causing generational myths towards everything related to menstruation. Although in Russia there have been many changes due to acculturation processes and dynamics, there are still present mostly negative experiences about menstruation and disinformation about this natural process. Women face segregation, confusion, pain, shame, disgust towards menstruation and women's movements, which leads to have a lower self-esteem and negative body appreciation.

In this order of ideas, there is a desire to get closer to some experiences of females in Russia towards this process and the feminist movement, to know their worldview about menstruation and observe what attitudes toward and beliefs about this feminine phenomenon they have and how it has a relationship with their bodies and their self-esteem.

Research question

That is why it is relevant to ask the following research question: How do beliefs about and attitudes toward menstruation and attitudes toward feminism affect women's body appreciation and self-esteem in Russia?

Novelty and scientific significance of the study

For Psychology it is important to carry out research on the significance of menstruation and since it is a phenomenon inherent to women that impacts on multiple aspects: biological, socio-cultural, psychological, among others. Additionally, it establishes a differentiating character between the feminine and the masculine, generating in some cultures segregation, discrimination, and rejection towards the menstruating woman. Psychology studies the human-being and multiple factors that go through his/her life, so it is important to approach understanding the complexity of the practices derived from the phenomenon of menstruation that several women live in the world. Menstruation is not only an organic aspect of women, on the contrary it is a multidimensional phenomenon that relates social, psychological, economic, biological and cultural factors, that is why, it involves ideas, beliefs, attitudes, practices that women internalize in their day to day and which impact them positively or negatively. Understanding menstruation, and having enough information about this phenomenon, could help women to socialize better and not live in an unequal world. Feminism and women's movement is booming at the moment and it is having a lot of reactions not only in women's lives, but in the entire population itself. Women are requesting for equal rights, more comprehension due to their physical condition for some specific jobs, respect and freedom to live their lives to the fullest, among others.

This study aims to examine the relationship of beliefs about and attitudes toward menstruation and feminism to body appreciation and self-esteem by conducting an analysis in Russia by inquiring the actions and behaviors of the society regarding these phenomena through a questionnaire that involves four different scales to measure attitudes and behavior.

Theoretical background

Menstruation in the context of modern psychology

Throughout history, the vast majority of people believed that menstrual blood had supernatural characteristics, such as, when menstruating women have any contact with men or even other girls, it would have serious and negative consequences. To clarify these limitations for menstruating women, it is relevant to mention that in early Western cultures, menstruation was believed and associated with danger. That is why several societies created specific rules and restrictions to limit as possible any contact of menstruating women with people of their communities, also some objects such as fruits and other living beings such as plants (Marvбn, Rбmirez, Cуrtes and Chrisler, 2006). More specifically, among Orthodox, menstruating women were not allowed to have a physical contact with their husbands and it was imposed to even sleep in separate beds. People used to believe that also at the end of the period, women should take a special bath (mikvah-ritual) in which they are cleaning and purifying their dirty bodies after bleeding (Marvбn, et. al., 2006).

Besides, in 1981 a study of patterns and perceptions of menstruation was conducted by The World Health Organization, in which more than 5,000 women from 10 different countries participated and it was concluded that menstruating women are considered as impure human beings and that is why some countries decided to proscribe some social and religious activities for women. Proscriptions such as: to avoid fields, flowers, and growing plants when menstruating due to the belief that women will pass the dirt of menstruation to these objects. In this study it was mentioned that some participants believed that it was not accurate to wash their hair while menstruating, due to of the bath will affect and interfere the natural and normal flow of the bleeding and also in some cases even increase physical discomfort and it would be negative and not advisable to general health. But at the same time, others believed it is more important to take baths more frequently during menses due to its smell and to relax a bit with clean water. In some countries there is still present the belief that certain cold food could cause menstrual cramps and hurt the women in general (Marvбn, et. al., 2006).

However, the mentioned study reveals that some of these beliefs and proscriptions have changed a little bit and, nowadays, modern western societies believe that women should avoid “sexual intercourse, swimming, cold water, strenuous activity, or exercise” (Marvбn, et. al., 2006, p. 454). Some beliefs still prevail such as not speaking about menstruation in public spaces and less and worse in front of men. Even from childhood, women are taught, to keep their menstrual status concealed. (Marvбn, et. al., 2006, p. 454). Additionally, some women report that they employ various coping strategies to keep their menstrual period as a secret because they feel ashamed when others notice that they are menstruating. That is how they curtail various daily activities and decide to wear certain clothing, avoiding the use of white pants. (Marvбn, et. al., 2006).

Menstruation is associated with womenґs weakness and disability to do several activities as men do. This belief attributing weakness to menstruating women, affects their performance because they can detach themselves from their responsibilities and also it can lead to different restrictions and inequalities for women in the society. Women can start feeling that they are weak and useless for societies which may lead to depression, anxiety, among others (Marvбn, et. al., 2006).

It is relevant to mention that most of the research that has been done about menstruation, was conducted by the Menstrual Attitudes Questionnaire (MAQ), which consists of 33 items and includes the measurement of five dimensions of menstrual attitudes: “menstruation as a debilitating event, menstruation as a bothersome event, menstruation as a natural event, anticipation and prediction of the onset of menstruation (because of premenstrual symptoms), and denial of any effects of menstruation (menstruation as having no physical or behavioral effects)”. (Marvбn, et. al., 2006, p. 456)

The BATM (Beliefs about and Attitudes toward menstruation) is a modification of the previous MAQ, which does not include personal items, meaning that men will be able to participate in the study as well. The modified scale is a pure measurement of beliefs and attitudes, without taking into account menstrual-cycle-related symptoms. At the same time, it measures certain stereotypical beliefs about this phenomenon (activities that women can or cannot do during bleeding). This scale also includes items that reflect positive attitudes towards menstruation and feeling of well-being during the menstrual period (Marvбn, et. al., 2006).

Furthermore, menstruation causes spatial boundaries in sub-Saharan African countries due to not easily access to buy sanitary products and the girls should stay at home because they are afraid of staining with menstrual mark, so the rates of low school attendances are relevant because the absence in recurrent and some girls from Kenya reported to feel ashamed during their periods (Jewitt & Ryley, 2014).

Conceptual references

It is relevant to consider certain key concepts for the theoretical revision: attitudes and beliefs, self-esteem and body appreciation, concepts which will allow guiding the study.

Attitudes and beliefs. From a perspective of Social Psychology, it can be understood that attitudes have two dimensions: one-dimensional and multidimensional. According Rosenberg and Hovlan (1960), from a multidimensional point of view, attitudes are predispositions that react and answer after a stimulus. These reactions or answers can be classified as affective, cognitive or cognitive-behavioral. The first reaction includes feelings of liking or disliking towards something, taking into consideration previous experiences. The cognitive one is information set which includes beliefs or opinions about a phenomenon or situation of human beings and the cognitive-behavioral element takes into account behavioral intentions, which means the tendency to act in a certain way (Pйrez, Ferreres, Gadea, Gonzбlez, Hernбndez and, Navarro, 1995). On the other hand, according to Petty and Cacioppo (1981), the one-dimensional model refers to attitudes as a general feeling that is permanently positive or negative towards a person, object or phenomenon (Pйrez, et. al, 1995). In general, both models argue that beliefs are related with attitudes towards something that is being experienced by an individual.

Eagly and Chaike (1993) argue that attitudes are “a psychological tendency that is expressed by evaluating an entity with some degree for or against.” (Eagly and Chaike cited by Pйrez, et. al, 1995). These evaluations contain different elements such as the cognitive, cognitive-behavioral and affective. Attitudes are also understood as a result of the beliefs and associations about an object, individual or situation (Pйrez, et. al, 1995).

Furthermore, attitudes reflect the internalization of human values, beliefs and norms that govern them. (Ortega, 2017). Attitudes are global and relatively stable assessments that human beings make about what happens around them. They are also defined by Allport (1935) as hypothetical constructions or mental states that appear through the experience of individuals (Ortega, 2017). These constructions are the answers to the phenomena experienced by human beings. It can be summarized that attitudes are constructions that occur throughout life and that determine or modify to some extent the behavior of the subjects towards certain people, objects or phenomena. (Ortega, 2017). Popular beliefs and certain attitudes are based on experiences, precepts, cultures, time and they have been historically transmitted generation after generation.

Negative attitudes towards menstruation. In all cultures that menstruation has been an object of study, it was concluded that women show and have mostly negative attitudes towards this phenomenon. This is a common circumstance and condition in diverse societies. Adukia (2013), meanwhile, introduces the "Hypothesis of menstruation" (p.1) to analyze current practices of some cultures. This hypothesis states that this phenomenon creates an obstacle to female schooling, which contributes to the high absence rates among girls of puberty age in Ethiopia. It was observed and concluded that girls did not attend classes during their menstrual periods due to their school latrines lacked a door. The participants started relating this period with negative emotions such as the need to hide something that is “wrong”, pain and even shame to go to public places because they are going to be labeled if other students or even teachers can see them with menstrual blood. They mentioned that they do not have privacy and that this experience is really disgusting for them and that they start seeing their bodies as something imperfect and associating at the same time characteristics about females with “dark” things that need to be hidden due to its dangerous and dirty nature.

Together, Kapoor and Khari assure that there are several restrictions which are imposed on the girls who are menstruating and the secret around them, affect them psychologically, diminishing their self-esteem and providing them with feelings of shame and disgust. Most girls impose self-restrictions such as going to school or playing based on the mistaken belief that they are physically weak in those days. (p 43)

From an ethnographic perspective, it is identified that menstruation has different conceptions:

Menstruation is also conceived as that transition between childhood and adolescence, giving the possibility to motherhood. In the following study, the main idea is that menstruation represents a really essential experience due to the transition of being a girl to become a “lady”, it involves a change in ladiesґ status because it shows that the woman has the opportunity to be a mother. Now she is fertile and this new condition generates anxiety and fear within the families (UNICEF Colombia, 2015)

Besides, taking into account the negative experiences that can be involved within this process, it is relevant to mention that there still exists the belief that menstruation is a "thing" that happens to all women, making them change their mood, and generating weakness in their bodies. In a negative sense, is a punishment and a situation that women must endure, a disease. As menstruation involves a cycle, there are some beliefs that related this period with the lunar cycle, therefore prescribing activities according to the phases of the moon "(UNICEF Colombia, 2015).

Although Russia continues to be a traditional country that maintains its customs and doctrines in a prominently rigid manner and that talking about menstruation in public places is still a taboo, there are few studies that show some menґs perceptions and attitudes towards their menstruating partners. Several restrictions towards menstruating women still remain in Russia, such as Russian Orthodox Christians, who believe in menstrual taboos and prejudices. That is why it is allowed to seclude women while they are menstruating, so basically, they are not allowed to attend church services or have contact with men.

This phenomenon is such a hidden topic that even in women's bathrooms, they do not have dispensers with different sanitary products such as tampons, sanitary pads or wet cloths to maintain adequate menstrual hygiene. It shows how some people try to deny this natural and feminine process, not giving the necessary tools to the women if they need to use sanitary products. Menstruation is something that needs to keep secret. The idea of not having sanitary products for women in bathrooms is still a practice that prevails nowadays. Therefore, it can be said that this dispenserґs exclusion from public spaces, exposes clearly how menstruation is perceived and the way women are forced to treat menstruation as a not natural body function, which belongs to womenґs nature. Women treat other body functions as natural ones, but not menstruation. (Smiley, Cannon, Carlson & Bobel, 2018)

According to Smiley, et. al, 2018, menstruation has long been considered a sign of imbalance and weakness. Historically, the medical profession has contributed to the understanding of people about how the male bodies are the biological ones, the ideal ones; but assigning a pathologized characteristic and also a deviant condition of health for female bodies, because of menstruation. This understanding has inspired misogynistic distrust of women's emotions, physical autonomy, and mental competence. The belief of early medicine, which saw this process as a way for women's' bodies to restore the balance of the four bodily humors, implying that women were always in a state of flux or imbalance, is still present. Even after multiple advances in society. The history of beliefs and practices towards menstruation, period products, prejudices, lack of information, taboos, have been an attempt to give women the ability to pass as non-menstruating.

Besides, it is important to mention that this topic, menstruation, represents itself as a socially non-favorable. It is something that people do not want, like or do not know how to discuss it in public. In Russia, women over 25 mostly learned about this phenomenon and everything related to it. Women under 25 receive the information from online sources such as tutorials, discussion forums, blogs, magazines - non-scientific sources because they are not guided or led by professionals but by other girls who already experienced this process or that can even have more doubts that the ones that are searching for new information. (Burina & Burina, 2016)

Self-esteem. Self-esteem is a construction made by humans that takes place, especially throughout childhood and it is modified by several elements such as the early interplay within the family, the immediate environment, the experience of puberty that is linked to body-esteem due to the multiple psychological and physical changes that humans experience through this transition of changing their status of being kids to enter the adolescence - becoming a lady. (Rembeck, Gunnarsson, and Mцller, 2006) The body is one of the most important elements for construction of the self-esteem because the body is “an ongoing personal project with a lesser or greater possibility for selfinfluence” (Rembeck, et. al, 2006, p.707).

Body appreciation. Evaluation and appreciation of both, positive and negative emotions, for one's own body. It also includes the image that humans create due to the different parts of the bodies and their characteristics or functions of each part or organ. Due to the physical appearance of axillary hair, widening of hips, breast growth, and appearance of acne that is characteristic of the transition from being kids to adolescence, individuals start to reflect about their bodies and to create an own body appreciation/image about themselves. Body appreciation/image can be defined as “the individual, subjective sense of satisfaction or dissatisfaction with one's body or physical appearance” (Meland, Haugland and Breidablik, 2007, p.342)

Body appreciation/image can be defined as a multi-faceted concept that makes reference to individualsґ opinions, experiences, perceptions, attitudes or beliefs about their own bodies; particularly but not exclusively its appearance. (Tylka, 2015)

Body appreciation/ and self-esteem. Taking into consideration that menstruation is an embodied experience; it plays an important role in womenґs body appreciation self-esteem. Like any other natural phenomenon that surrounds humans, menstruation is not an exception and individuals have beliefs and attitudes towards it. Menstruation has been stigmatized and due to this, some women all over the world tend to hide their menstrual status from others - especially from men. Women prefer to change their choice of clothing and to restrict some activities. There is present the communication taboo which argues that people should not speak about menstruation in public places and this contributes to body shame because it is easy to identify that this taboo reinforces the idea that women's bodies and their “reproductive functions are disgusting or embarrassing” (Chrisler, Marvбn, Gorman and Rossini, 2015, p. 78).

Women's bodies have been objectified and some women start distancing their “self” from their bodies and analyzing, evaluating, and labeling themselves from otherґs eyes (Chrisler, et., al., 2015). It can be said that positive body image/appreciation tends to make women have positive attitudes towards menstruation and vice versa, negative body image/appreciation leads to negative attitudes towards menstruation. In a study conducted by Chrisler, et. al, 2015, the authors concluded that, in order to have a positive body appreciation, it is fundamental to attend its needs and understand that body includes phenomena such as: sexuality, pregnancy, birthing, breast-feeding. (Chrisler, Marvбn, Gorman and Rossini, 2015, p. 78).

It should be mentioned that different perspectives such as religion, research from the social sciences, biology, psychology and ethnography, have been determinants when it comes to meaning the menstrual period and everything that this entails. Taboos, prejudices and indifference of society have generated strong discrimination towards women to cover fundamental areas such as sexuality, limiting sexual life in couple, not being able to prepare or manipulate food or being excluded from certain religious activities, among others.

Religion. Religion in Russia is diverse; it is most diverse with Christianity, especially Orthodoxy, being this one the most widely professed faith with some minorities professing other religions. It is relevant to mention that religions may influence people's experiences and attitudes towards menstruation. For example, Christianity has been influenced by Judaism in doctrinal questions regarding the cleanliness and purity of women, therefore, considers the phenomenon of menstruation as imperfection; this is what Iglesias (2009) argues. When some Jewish concepts of impurity and danger of menstrual blood came into contact with Christian philosophy, they were immediately related to the imperfection of women. As an example, at the first ecumenical council held in Nicea, city of Asia Minor, today Turkey, in the year 325 a.C., it was prohibited for women who were menstruating to enter in the churches. (p.283)

Social sciences.

Within the social sciences, several investigations have been developed that have addressed the phenomenon of menstruation. This is the case of Aliaga (2007) who states in his text Phallic Order: Androcentrism and gender violence in the artistic practices of the twentieth century, that menstruation, denoted and conceived as a contaminant in certain cultures, has even led to the removal and segregation of women from the community during their periods, which is hidden and labeled as dirty. Menstruation has been used and understood as the main obstacle, the pretext to justify the non-intervention of women in some circumstances and activities in their communities, for example the exclusion of hunting in prehistory. (p.240) menstruation feminism body

Biological perspective.

Not only does menstruation acquire a connotation because it is a socially perceived and interpreted phenomenon, but the biological point of view plays a fundamental role in the female body since the biological perspective marks physical differences between women and men, including menstruation as a characteristic female phenomenon.

From the biological perspective, in the middle of the sixteenth century, the medical tradition maintained by Late Medieval Scholasticism adjudicated to the menstrual blood the poisonous property, malignant, noxious and toxic nature (Cabrй & Salmon, 2013). Likewise, the authors incorporate the poisonous and infectious conception of menstruation when they affirm in their book Sex and gender in medicine: An introduction to the studies of women and gender in health sciences (2013) that exactly when women are bleeding, certain corrupted vapors from the boiling of menstrual blood, start ascending to the head and are eliminated by the pores of the eyes. They also mention that if a woman looks at herself in the mirror then it will become fogged with a cloud of fog. (p.101)

From the medical perspective, menstruation is necessary for women since it fulfills the function of cleaning its toxic and poisonous nature. It is a derogatory conception that gives noxious properties to this phenomenon.

A universal conception about menstruation is that it is a normal biological event experienced during a large part of a woman's life from puberty to menopause, which consists of a monthly discharge of blood and cellular waste from the uterus by non-pregnant women" ( Crawford et al., 2014). Also, there are "secondary sexual changes in their bodies (widening of the hips, tail, growth of the breasts, exit of pubic and axillary hair)" (UNICEF, 2015, p.15)

According to Iglesias (2009), this natural process is a function of the female genital organs that appears at puberty and that is repeated periodically approximately every month. It is manifested by a series of phenomena, of which the most visible is a flow of blood, which from the uterus, reaches the vagina and vulva. (p.1)

Psychological perspective.

From the psychological point of view, the woman is labeled as "imperfect", "cold", "humid" (Iglesias, 2009). (Galeno, 2nd-century a.C. cited in Iglesias, 2009) thought that "(...) menstruation appeared due to the imperfection of the woman, due to her lack of warmth (...)" (p.283).

In the text The Menstruation: A Matter on the Moon, Poisons and Flowers (2009), Iglesias quotes Plinio, El Viejo:

Terrible things have been said about the monstrous power of menstruations, whose magic I have already discussed, of which I can repeat the following without shame: If the strength of the woman begins to flow in a solar or lunar eclipse the damage will be irremediable, and even if there is no Moon, sexual intercourse is pestiferous or fatal for men; the purple is contaminated by menstruating women. That's how big your strength is. But at other times during the menstrual period, if women walk naked through the field, worms, beetles and other pests are eliminated. (Plinio, 1966, cited in Iglesias, 2009, p.283)

There is also the conception that menstruation is related to topics of the demon and that it represents multiple risks for women: "... the period of puberty is often full of demons; she is exposed to irregularities of her menstruation, and severely threatened by its consequences” (Iglesias, 2009).

Iglesias (2009) alludes to the term coined by Bela Schick "menotoxins" - the characteristic of bacterial toxicity (p.284) of the blood of menstruating women since they dried plants, changed the wine, caused the barley to fall, all due to the chemical components in their menstrual blood (p.284).

Hypotheses.

The present research tested the following hypotheses.

1. Positive beliefs about and attitudes toward menstruation will lead to a positive body appreciation and high self-esteem.

2. Negative beliefs about and attitudes toward menstruation will lead to a negative body appreciation and low self-esteem.

3. Beliefs and attitudes toward menstruation are mediators of a link between feminism attitudes and body appreciation and self-esteem.

Research design

Sample description

Table 1 Sample Description

The selected sample consisted of 252 female participants from Russia with an age range between 17-53 years. There are few investigations but taking into account participants with a low income. The choice of that specific age range is because like this it is more likely to find structured, maintained and rooted beliefs about and attitudes toward menstruation and feminism over time. The participants were recruited from different Universities and from their workplaces along with the country.

Besides, people that are 35 years or older, usually make prevail some of their traditions and customs, which is interesting to analyze in countries like Russia that has experienced multiple acculturation processes. Additionally, there are few studies conducted in Russia related to menstruation, but more directed and oriented on the usage of tampons or the influence of social media toward the menstrual period, not a lot of studies about the beliefs about and attitudes toward this process and feminism.

It is relevant to include adults in this study because they are the members that have a long course within the population and that, in general, are more rooted in past customs, so it is important to have an approach to them. Younger people (17-35) could represent the leaders of the countries and they can also generate the greatest impact in their closest environment, which is why they are a very relevant source of information as they are references for other individuals, they are updated. Women who have already experienced menstruation for several years may have a structured concept of what it represents for them, which is why they are key to research. It is also relevant to investigate if the beliefs and attitudes are mostly similar and also if the younger people (17-35) and the older ones (35-53) may present any differences according to their ages or if the speech about menstruation remains the same within the time for different generations.

The age of respondents ranged from 17 to 53 years (M = 28.2, Age SD =4.63, Minimum= 17 and Maximum= 53, Marital status SD= .65, Religion SD= 1.56 and Level of Education SD= .417). Due to the fact that Russia has multiple religions, the questionnaire included a question about asking to what religion participants belong to. In the answer it can be seen that they belonged to the following religions: (Orthodoxy, Agnosticism, Atheism, Christianity, Irreligious, Islam, Buddhism and Buddhism).

Procedure of the study

It was fundamental to work with an informed consent that is was included in the online form/questionnaire (BATM) that was sent to the participants, which explained the benefits or possible damages of taking part in this research. It was specified to the participants that the information collected was only going to have academic purposes. A cognitive interview was conducted in order to check that the population understood correctly the statements without any misunderstandings due to the original version that is in English. The BATM (Beliefs about and Attitudes toward menstruation) was translated into Spanish and again into English to verify. After verifying that the translation was accurate, after validating the cognitive interview, the translated BATM was applied in Russia. The data was collected by using the snowball technique. As menstruation is an intimate topic, this private atmosphere for the participants, gave them the opportunity to feel confident to answer in an honest way because they were alone in front of their computers, answering the instrument in privacy. The participation was totally voluntary, knowing that the information that they provided was going to be strictly confidential and anonymous. It was mentioned the fact that there were no right or wrong answers to the statements. The participants have been told that they could withdraw if at any point they decided not to complete the study.

The original version of the instrument is in English, so it was necessary to translate it into Russian. I translated it into Russian and other native speakers translated from Russian into English and it was correct. After all these processes, my advisor gave me the approval to continue by creating a GForm and share with the respective population. The required sample size was determined by choosing between 15-20 participants for each scale (5 scales in total). So, the final minimal sample size should have been 100 participants for Russia.

For the other questionnaires, it was necessary just to include them in the online questionnaire with their corresponding items. The original versions were in English, so, the procedure was the same as the mentioned above. The questionnaires are validated and applied in several studies all over the world, so that means, they are reliable.

Design of the study

The present research was quantitative, understanding that the BATM consisted of 25 items that are divided into 5 factors that have to be evaluated with a Likert-Scale. According to Hernбndez, Fernбndez and Baptista (2014) the quantitative method collects data in order to test and verify the researcherґs hypotheses. The author of the research can make conclusions basing his/her arguments on numerical measurement and statistical analysis and like that, the author will be able to establish behavioral patterns and test theories. The steps of a quantitative method are rigid and organized in order to deduct if the proposed hypotheses apply or not. The remaining questionnaires also evaluated with 4 or 5-point-Likert-Scale.

Materials/measures and variables

The BATM guided the study measuring the responses with a 5-point Likert-scale. It consists of 45 items, divided into 5 elements: secrecy, annoyance, proscriptions and prescriptions, disability, pleasant which intend to measure some aspects related to menstruation (Chrisler, Marvбn, Gorman & Rossini, 2015). The 5-point Likert scales establishes 1- strongly disagree, 2 - disagree, 3 - donґt know, 4 - agree and 5 - strongly agree. RMSEA (Root mean square error of approximation) suggests a good fit of the model to the data, with a value of .054, which is acceptable. As for CIF (Comparative Fit Index) suggests a satisfactory fit, with .926. Below, the corresponding tables from AMOS. Few indices were deleted in order to check how to improve the RMSEA. In the secrecy factor, secrecy2 and secrecy6 were deleted for the analysis.

The variables to measure are body appreciation, self-esteem, beliefs and attitudes related to menstruation and attitudes toward feminism and women's movement. The choice of these instruments is due to their openness to involve positive and negative attitudes in the research, and not only including personal items. The BATM is a modified version of the MAQ (Menstrual Attitudes Questionnaire) that mixes attitudes related to the menstrual cycle, not only the bleeding days. The BATM also includes some items in order to measure some prescriptions and proscriptions for women during their menses. Last, but not least, the BATM includes items to measure positive beliefs about and attitudes toward menstruation, that is relevant because other instruments only focus on the negative side.

The questionnaire to measure the attitudes towards feminism and the women's movement was created to measure subjective feelings toward the attitude object. The previous version consisted of 86 items, but the modified one, only includes 10 items, which are evaluated with a 5-point Likert-Scale, ranging from 1- strongly disagree, 2 - disagree, 3 - donґt know, 4 - agree and 5 - strongly agree (Fassinger, 2005).

The Body Appreciation Scale-2 consists of 10 items, ranging from 1 - never, 2 - seldom, 3 - sometimes, 4 - often, 5 - always. This modified version includes 5 items from the original version but also new ones, which are based on positive body image research (Marvбn, et. al., 2006).

For measuring the psychological construct self-esteem, the Rosenberg Self-esteem measure was applied, which goes from 1 - strongly disagree to 5- strongly agree. It consists of 10 items, which show a list of statements that are related to people's general feelings (Rosenberg, 1960).

Data Analysis

It was not necessary to analyze any missing data due to the nature of the questionnaires that were designed in a particular way for the participants so they would not have the option to submit the form with answering questions. Some stages were followed in order to analyze the data. Firstly, a descriptive analysis was done and frequencies were chosen to know the number of people who took part in this questionnaire including their level education. After collecting this demographic information, an exploratory factor was run to check factor structure and for verifying the reliability of each scale and factors of the questionnaires. Also a structural equation modeling (SEM) was run in order to examine the covariation among the variables.

Limitations of the study

Due to the length of the questionnaires, the original version of the BATM could not be applied. It will be relevant for future investigations, to include all the items to verify if something changes. It was very difficult to include men in the study because they show a higher rejection of this topic, but it would be interesting to compare both; masculine and feminine attitudes and beliefs. For further investigations, it can be relevant to compare the results between different cultures.

Results

Reliability and validity of BATM

KMO was .780 which is good considering the rule that anything <.5 is good and acceptable. Reliability analysis was run and the items that composed each of the fifth factors were evaluated and for the first factor: Secrecy, it is possible to verify that (Cronbach's alpha = .591) for the Russian sample is reliable. For the second scale: Annoyance, it is possible to verify that (Cronbach's alpha = .781) which means, it is reliable. For the third one:

Proscriptions and Prescriptions (Cronbach's alpha = .631). For the fourth one:

Disability (Cronbach's alpha = .631) and for the last one, the fifth one:

Pleasant (.647). In general, it can be concluded that the total BATM reliability is estimated between .6 and .8, which is good. For Body Appreciation (Cronbach's alpha = .954). The scale Attitudes toward Feminism and the women's movement showed (Cronbach's alpha = .915), which is really good. For self-esteem it can be seen that (Cronbach's alpha = .875), is reliable.

Table 2 The model fit for Secrecy, Annoyance, Disability and Pleasant

Picture 1 Confirmatory factor analysis between the factors (Secrecy, Annoyance, Disability, Pleasant)

Confirmatory factor analysis (CFA) was performed on the data using the statistical package analysis of moment structures (AMOS). The multiple goodness-of-fit tests used in the analysis were: the Chi-squared test (CMIN/DF), the Comparative Fit Index (CFI), the Root Mean Square Error Approximation (RMSEA) and the Standardized Root Mean Square Residual (SRMR). The Chi-Square value (CMIN/DF) is a measure that evaluates an overall model fit and, “assesses the magnitude of discrepancy between the sample and fitted covariances matrices” (Hu and Bentler, 1999: p.2). According to Carmines and McIver (1981) a ratio of 3 to 1 is acceptable. In terms of the P value, according to Barrett (2007, a good model fit is insignificant below 0.05. CFI is a revised form of the NFI which analyses the change in fit between the hypothesized model and the independence model and takes into account sample size (Tabachnick and Fidell, 2007). When the CFI is greater than 0.9 then there is a good fit to the data (Hu &amp; Bentler, 1999). RMSEA is based on the analysis of residuals and tells us how well the model with unknown but ideally chosen parameters fits the population's covariance matrix (Byrne, 1998). When the RMSEA index value is below 0.08 then there it is assumed there is a good fit for the model data (McQuitty, 2004). The SRMR is an absolute measure of fit and it can be seen as the standardized difference between the observed correlation and the predicted correlation: a value of less than 0.08 is considered a good fit (Hu &amp; Bentler, 1999).

Correlation analysis

Picture

Additionally, there are three types of correlation. Low (-), medium (**) and high (***) significant. Pleasant has a negative relation with Annoyance (-.438**) and a negative relation with Disability (-.282**), both correlations are medium significant. It means that when participants enjoy, have a pleasant experience with menstruation and feminism, they will not be annoyed about the period of belonging to women's movement. They are not going to experience a disability for their daily activities during their periods. Pleasant and body appreciation show a positive relation (.257**), which means when women have pleasant experiences with menstruation, they will have a positive body appreciation about themselves. This factor also shows a positive relationship with the self-esteem factor (.146*), women have high self-esteem if they have pleasant experiences with menstruation and the feminist movement. The relation with the attitudes toward feminism and women's movement with pleasant is positive (.148*). Pleasant and secrecy have a positive (.207**) relation, which means that women who have pleasure, prefer to keep this phenomenon as secret. It is important to mention the other obtained results:

Structural equation modeling

A mediation model was built to investigate the relationships between feminism (women movement), attitudes toward menstruation, self-esteem and body appreciation. The model is represented below. It could be also seen in the model fit. It can be assumed that the model has a good fit CFI > 0.950, RMSEA < 0.07.

Table 3 The model fit

Picture 3 SEM model of the relationships between feminism, attitudes toward menstruation, self-esteem and body appreciation

First, direct relationships between independent and dependent variables were considered. The regression coefficients are represented in the table.

Picture 4 Regression coefficients for the SEM model

It is relevant to mention that the factor Secrecy that had some reversed items that is why the correlation will appear with negative significance or positive one, but the interpretation should be vice versa. The items should not be reversed because it would mean openness instead of secrecy.