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“Just Put a Towel Down:” Approaching Conversations About Period Sex with an Intimate Partner

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Abstract

Despite its stigma, menstrual sexual activity is fairly common. The present study investigates the topics and attitudes surrounding conversations about menstrual sex that take place between intimate partners in which one or more may menstruate. Participants included 136 people who either identified with the experience of being a woman or had female sex assignment, of diverse gender and sexual identities. Findings suggest that across the gender spectrum, most people feel positively or neutrally toward menstrual sexual activity, and are generally satisfied with their interpersonal conversations about the subject. Many conversations about menstrual sex revolved around planning and negotiating the “messy” aspects of the sex act. Importantly, participants who were transgender or gender non-conforming identified that feelings of dysphoria may inhibit desire for menstrual sexual activity if they were the one menstruating, but they did not have negative feelings toward menstrual sex in general, and were generally happy to participate if a partner was the menstruating body. Findings and implications for perceptions of menstrual stigma’s filter on interpersonal communication and consequences for sexual communication are discussed.
Vol:.(1234567890)
Sexuality & Culture (2021) 25:1366–1382
https://doi.org/10.1007/s12119-021-09821-0
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ORIGINAL PAPER
Just Put aTowel Down:” Approaching Conversations About
Period Sex withanIntimate Partner
ValerieRubinsky1 · TaylorMcMahon2· AngelaCooke‑Jackson3·
JacquelineN.Gunning4
Accepted: 18 January 2021 / Published online: 3 February 2021
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature 2021
Abstract
Despite its stigma, menstrual sexual activity is fairly common. The present study
investigates the topics and attitudes surrounding conversations about menstrual sex
that take place between intimate partners in which one or more may menstruate. Par-
ticipants included 136 people who either identified with the experience of being a
woman or hadfemale sex assignment, of diverse gender and sexual identities. Find-
ings suggest that across the gender spectrum, most people feel positively or neutrally
toward menstrual sexual activity, and are generally satisfied with their interpersonal
conversations about the subject. Many conversations about menstrual sex revolved
around planning and negotiating the “messy” aspects of the sex act. Importantly,
participants who were transgender or gender non-conforming identified that feel-
ings of dysphoria may inhibit desire for menstrual sexual activity if they were the
one menstruating, but they did not have negative feelings toward menstrual sex in
general, and were generally happy to participate if a partner was the menstruating
body. Findings and implications for perceptions of menstrual stigma’s filter on inter-
personal communication and consequences for sexual communication are discussed.
Keywords Menstrual sex· Period sex· Menstruation· Sexual communication·
Transgender· LGBTQ sex
Menstrual sex is relatively common. According to research from the period-tracking
mobile application Clue and the Kinsey Institute, in a predominantly heterosexual
sample, about 15% of women engage in their normal sexual activity while menstru-
ating and just under half of women (49%) engage in some kind of sexual activity,
but may avoid genital touching (KI-CURT 2018). Menstrual sex is also important
to perceptions of health and the self. Menstrual sex influences sexual risk assess-
ment, with 30% of women reporting that they were less worried about the risk of
* Valerie Rubinsky
valerie.rubinsky@maine.edu
Extended author information available on the last page of the article
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“Just Put aTowel Down:” Approaching Conversations About Period…
pregnancy when not using a barrier method during menstrual sex, and one in three
women were unworried about STI transmission during unprotected menstrual sex
(KI-CURT 2018). Despite its frequency of occurrence, menstrual sexual activity is
fraught with stigma and misperceptions.
People who menstruate have mixed feelings about menstrual sex and their part-
ner’s perceptions of menstrual sex ranging from overt disgust, to general neutrality,
to enjoying and prioritizing physical intimacy while menstruating (Fahs 2011, 2013,
2014). Most scholarly work on the subject focuses on attitudes toward menstrual
sex or risk perception when engaging in menstrual sex (Allen and Goldberg 2009),
attending less to interpersonal conversations and discussions surrounding the topic.
Despite increased attention from popular press sources highlighting recommenda-
tions for how to talk to your partner about period sex (e.g., Healthline 2020; Mac-
Millan 2019), communication about menstruation in general and menstrual sex spe-
cifically has received little attention from communication scholarship despite some
evidence that partner communication influences perceptions of menstrual sex and
feelings toward one’s own menstruating body (Gunning etal. 2019).
Negotiating menstrual sex, like many other kinds of sexual communication, is
important and challenging, requiring people to manage heightened feelings of
stigma in an already face-threatening and sometimes uncomfortable conversation
(Anderson etal. 2011; Noland 2010) that individuals often feel ill-prepared for by
their sexual socializing systems (Holman and Koenig-Kellas 2018; Rubinsky and
Cooke-Jackson 2017). Despite being difficult, conversations about sex are impor-
tant, consistently predicting relational and sexual satisfaction (Byers 2011) and sex-
ual health behaviors (Noar etal. 2006). Thus, the content and quality of communi-
cation about a sex act laden with stigma, misinformation, and confusion warrants
specific attention.
Women and gender minorities who menstruate express polarized attitudes toward
menstrual sexual activity (Fahs 2013, 2014), with half identifying that they engage
in some kind of menstrual sex (KI-CURT 2018; Fahs 2011). Given this range of
attitudes toward menstrual sex, the present study qualitatively explores the conversa-
tions women and gender minorities report having with current and former intimate
partners surrounding sexual activity during menstruation. In doing so, we address an
important application of the research on attitudes toward menstrual sexual activity:
how those attitudes inform intimate communication.
Communication andMenstrual Sex
During a menstruating individual’s reproductive years, they may experience around
450 menstrual cycles, averaging 3500 menstruating days during a lifetime (Lehnardt
2019). The prevalence of menstruation in these individuals’ lives in turn affects the
ways they communicate with sexual partners, perceive their own needs and desires,
and do or do not participate in sexual behavior during their menstrual cycle. Accord-
ing to previous research, the majority of sexually active women may have engaged
in menstrual sex with no overt expression of disgust, especially for those women in
committed relationships (Allen and Goldberg 2009). In a larger study, interviews
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with 1,586 sexually activecisgender women found that more than one quarter of
them had engaged in menstrual sex during their last menstrual cycle (Tanfer and
Aral 1996). The evaluation of attitudes and behaviors toward menstrual sex from
younger women not in committed relationships provides another angle on the
topic. The analysis of a group of young women’s written diary entries after each
sexual experience during the span of seven months shows that during the reported
2684days of coitus, 2.4% of those entries include vaginal bleeding (Hensel etal.
2004).
Attitudes Toward Menstrual Sex
Research indicates that women may have very polarized opinions about menstrual
sex, with some describing the practice as “dirty” and “gross,” and others charac-
terizing it as affirming and positive (Fahs 2014). In an early interview study, Fahs
(2014) investigated women’s views about their genitals, sexual activities, and per-
ceptions of their body image. Women expressed strong emotional language, feelings
of anxiety, and desire to exercise control surrounding their sexual behavior and prac-
tices (Fahs 2014). In general, cisgenderwomen who show more comfort with their
sexuality tend to also display higher degrees of comfort with menstruation, and less
sensitivity to disgust (Rempel and Baumgartner 2003). Women who report engaging
in menstrual sex tend to possess greater comfort with sexuality and are more likely
to perceive menstruation as normal (Rempel and Baumgartner 2003). Thus, feelings
about menstrual sex are connected to general feelings about sexuality, the body, and
menstruation.
Intimate communication is an important aspect of menstrual sexual activity. Both
cisgender men and women who engage in menstrual sex attribute the ability to do so
to personal and relational maturation, positive communication, and relational nego-
tiation skills (Allen and Goldberg 2009). Older research indicates that both men and
women with higher education may be more likely to engage in sexual activity during
menstruation and spotting, compared to those with less education who were more
likely to view menstrual sexual activity as unhygienic and uncomfortable (Barn-
nart etal. 1995). Another study found a higher prevalence of negative attitudes cat-
egorized by uncleanliness, partner discomfort, and partner emotional maintenance
amongst white, heterosexual women and women of color compared to white lesbian
or bisexual women (Fahs 2011). Although comparatively fewer, positive accounts
of menstrual sex in regards to emotional pleasure and rebellion against anti-feminist
opinions were more prevalent in women who identify as bisexual or lesbian (Fahs
2011). Thus attitudes about menstrual sex may vary with race, sexuality, education,
and relationship status acting as possible filters. One factor that may influence atti-
tudes and behaviors surrounding menstrual sexual activity involves how, if at all,
one’s sexual partner feels about and communicates their attitudes toward menstrual
sex.
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“Just Put aTowel Down:” Approaching Conversations About Period…
Partner Communication About Menstrual Sex
Despite its overwhelming importance as a predictor of communication satisfac-
tion, relational satisfaction, sexual satisfaction, and sexual health behaviors like
condom use (Byers 2011; Montesi etal. 2011; Noar etal. 2016; Noland 2010,
among others), many couples hesitate to talk openly about their sexual activity
(Byers 2011; Cupach and Metts 1994; Noland 2010). Sexual communication is
vulnerable and face-threatening—or threatening to one’s expression of a positive
identity (Cupach and Metts 1994)—and comprises both a uniquely important and
uniquely challenging conversational domain that many couples avoid (Andersen
etal. 2011; Manning 2014; Rubinsky and Hosek 2020, among others). Research
on menstrual attitudes suggests that many people engage in menstrual sexual
activity and they are more likely to engage in menstrual sex in a committed rela-
tionship (Allen and Goldberg 2009).One study found that “period sex” messages
may be a frequent source of memorable messages about sexual and reproductive
health that young women and gender minorities receive, with many of these mes-
sages coming from intimate partners (Gunning etal. 2019). However, little work
has examined how, if at all, individuals discuss menstrual sexual activity with
their relational partners or what those conversations might look like.
Menstruation has long been relegated to taboo status in most conversational
domains, with societal discourse surrounding menstruation influencing many
aspects of life for women and gender minorities who menstruate (Chrisler 2014;
Jackson and Falmagne 2013; Kissling 1996, Mathew 2018). Many people who
menstruate feel pressure to conceal their menstruating bodies and discomfort sur-
rounding conversations about menstruation (Rubinsky etal. 2018). Others have
argued that menstruation is a source of social stigma for many women and other
people who menstruate transmitted through multiple sources of socializing agents
(Johnston-Robledo and Chrisler 2013). This menstrual stigma may have impor-
tant consequences for menstruating individuals’ health and sexuality (Johnston-
Robledo and Chrisler 2013).
Self-silencing, policing, and stigma surrounding menstrual and pre-menstrual
experiences for women and gender minorities who menstruate remains well docu-
mented (Chrisler 2011; Chrisler etal. 2014; Johnson-Robledo and Chrisler 2007;
Rubinsky etal. 2018). More positive body appreciation may relate to more posi-
tive attitudes or less internalized stigma surrounding menstruation (Chrisler etal.
2014). Menstrual shame may also relate to less sexual activity and higher levels
of sexual risk-taking (Rempel and Baumgartner 2003). One study investigating
what contributes to that menstrual shame that may affect sexual decision-making
found that body shame likely acts as a mediator between menstrual shame and
sexual decision-making (Schooler etal. 2005). Thus, menstrual stigma and its
relationship to communication about menstrual sex is connected to larger dis-
courses about women’s bodies.
In previous research, menstrual stigma also affected interpersonal interac-
tions between cisgender men and women. In one study, menstruating women
believed they were stigmatized relative to non-menstruating women and that a
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male interviewer liked them less if he knew they were menstruating (Kowalski
and Chapple 2000). Similarly, non-menstruating women perceived men liked
them more and formed more favorable impressions of them than menstruating
women (Kowalski and Chapple 2000). In another study, partner overt attitudes of
discomfort contributed to women’s negative feelings about menstrual sex (Fahs
2011). Given the polarized attitudes about menstrual sex, and the importance of
sexual communication, the present study investigates how women communicate
with their intimate partner(s) about menstrual sexual activity in an effort to iden-
tify both what conversations are taking place, and gaps that exist for scholars and
practitioners to pursue through further study. Thus, we pose the following inter-
related research questions:
(1) How do women and gender minorities feel about menstrual sex? (2)How
do women and gender minorities communicate with their intimate partner(s)
about menstrual sexual activity? (3) Do women and gender minorities find
those conversations satisfying?
Methods
Recruitment
As part of a larger study on communication and intimacy for women and gender
minorities, the sub-set of data reported in this article includes three open-ended
questions. The survey was hosted on Qualtrics.com and distributed across a variety
of social media platforms including Facebook, Reddit, and Twitter, during the course
of several months. In order to increase the diversity of the sample, the recruitment
call was posted on the /lgbt and /bisexual sub-reddits, as well as the /women and /
samplesize subreddits, and the researchers’ personal social media pages. The study
called for participants who were at least 18years old and identified as a woman and/
or other gender minority (e.g., transgender, gender non-conforming, non-binary).
Participants who clicked on the survey link were directed to an informed consent
page. The first round of participation included the possibility of entry into a raffle
to win one of fifty $10 Amazon.com giftcards. After giftcards were distributed to
winners, following IRB re-review, another round of data collection with no offer for
potential compensation was completed. Participation in the questionnaire was anon-
ymous, with contact for gift card distribution collected via a separate survey link, so
there was no connection between a particular response set and an identifiable indi-
vidual. The survey remained open for several months, and recruitment stopped when
no more additional volunteers emerged from re-posting the survey.
Instrumentation
In order to address the research questions, participants were asked the following
open-ended questions: (1) Have you ever talked about period sex with a partner?
Please describe that conversation. (2) Do you feel satisfied with that conversation?
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“Just Put aTowel Down:” Approaching Conversations About Period…
(3) Generally speaking, how do you feel about period sex? Open-ended responses
ranged between a few words in length (e.g., “Very comfortable,” “Yes,” “No big
deal”) to several paragraphs. We considered “N/A” a valid response. Because
question 2 could be answered as a yes/no question, although we provided an open
text box for response and many participajnts did elaborate, 91 participants (67%)
responded to that question in fewer than 3 words (e.g., “yes,” “no,” “Yes I am,”
“N/A”).
Demographics
Participants included 136 people between the ages of 18–57 (M = 26.98, SD = 9.94).
Participants were mostly white (n = 100, 74.1%), followed by Asian or Pacific
Islander (n = 10, 7.4%), two or more races (n = 9, 6.6%), Latinx or Hispanic (n = 6,
4.4%), and Black or African American (n = 4, 3%). Participants’ gender identities
varied, with just over half identifying as cisgender women (n = 78, 57.8%), and
others identifying as transgender men (n = 14, 10.4%), transgender women (n = 7,
5.2%), cisgender men (n = 6, 4.4%), gender fluid (n = 3, 2.2%), nonbinary (n = 11,
8.1%), or otherwise under the transgender or gender non-conforming umbrellas
(n = 13, 9.6%). Participants also reported their sexual orientations, which included
gay or lesbian (n = 15, 11.1%), heterosexual (n = 44, 32.6%), bisexual (n = 40,
29.6%), pansexual (n = 9, 6.7%), asexual spectrum (n = 10, 7.4%), or otherwise
under the LGQ umbrella (n = 15, 11.1%).
Data Analysis
To address general satisfaction with conversations about menstrual sexual activ-
ity, we engaged in pattern coding. Pattern coding is a means of managing open-
ended data to assess general patterns in the data, usually assigned a numerical
marker (Saldana 2015). To do this, the first and second author identified four gen-
eral patterns, and all four coders met to discuss and agree on these patterns. Table1
describes the frequencies with which each pattern emerged. To address the con-
tent of conversations and menstrual attitudes, which had much longer responses
than the satisfaction answers, we engaged in Owen’s Thematic Analysis. Accord-
ing to Owen’s Thematic Analysis, a theme should meet the conditions of repetition,
Table 1 Satisfaction with conversations about menstrual sex
One response was coded as “other” (n = 1, .7%)
Response coded nPercentage Example
Yes/mostly satisfied 97 71.9 “Yes. He is very menstruation and sex positive” (Participant
104)
No/mostly unsatisfied 12 8.9 “Not really. I can’t help that I bleed. I don’t like that it’s viewed
as gross” (Participant 17)
Somewhat satisfied 8 5.9 “Somewhat” (Participant 5)
N/A (did not discuss) 17 12.6 “N/A” (Participant 68)
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recurrence, or forcefulness (Owen 1984). We used Owen’s as a second order analyz-
ing technique. For the first round, each coder read through the data set twice inde-
pendently and generated their own in-vivo codes, mostly preserving participant lan-
guage. We then met to discuss and merge codebooks. The first and second authors,
utilizing the combined codebook, read through the data again to synthesize codes
into higher order themes and subthemes using the conditions of Owen’s Thematic
Analysis as a guide. After this process, final themes were assigned a number and
each author independently coded 10% of the data to determine reliability, discussing
discrepancies until all authors determined the codebook sufficiently represented the
data. Cohen’s kappa was k = 0.80, indicating good reliability between coders in order
to add validity to the frequencies of our findings. Because responses came from an
online survey, all capitalization, punctuation, and emphasis is directly quoted from
the participants.
Findings
Attitudes andConversations About Menstrual Sex
Attitudes About Menstrual Sex
First, we asked participants in general how they felt about “period sex.” We organ-
ized participant responses into five overarching themes: (1) I used to feel negatively,
but now it’s okay; (2) It’s too messy or “gross”; (3) I like it; (4) I like it but I am
concerned about my partner, and (5) It’s too dysphoria-inducing. We elaborate on
each finding here.
I Used To Feel Negatively, but Now It’s Okay Many participants noted that
either because of general stigma about menstrual sex or the way a previous rela-
tional partner caused them to feel through their communication or reactions, they
may have some lingering negative or stigmatized feelings surrounding menstrual
sex. However, at present, these participants identified either enjoying it or feeling
mostly neutral toward menstrual sexual activity, regarding negative feelings as a pre-
vious state of being, or “in the past.” For example, this participant said, “I used to
be a little apprehensive. I don’t like making a mess. But I have had multiple partners
now who were fine with a bit of blood and it’s made me feel more comfortable over
time” (Participant 77). Another participant said, “We are in other times society has
changed a bit so I feel NEUTRAL” (Participant 78). These participants note that
their feelings about menstrual sex have changed over time, either attributing these
changes to perceptions of shifting societal acceptance toward menstruating bodies or
to specific or ongoing interpersonal encounters.
Too Messy, Gross, or Uncomfortable Many participants, including those who
liked and engaged in menstrual sex, and those who did not, referenced the possibil-
ity for the particular sex act being messy and requiring clean up. Most participants
who identified not liking period sex attributed their dislike to descriptions of men-
strual sexual activity as too “messy,” often in that the mess created a hassle that
made them feel the act was not worthwhile, or caused them or their partner to feel
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“Just Put aTowel Down:” Approaching Conversations About Period…
uncomfortable. For example, “It’s not my favorite because it kind of grosses me out,
but sometimes I want to have sex right before or right after my period really starts/
stops” (Participant 57), as well as, “Too much clean up” (Participant 33). Reference
to the mess or associated preparation and cleaning afterward inhibiting sexual activ-
ity, or specific references to the word “gross” were more common.
Others, in general, indicated that period sex was unsanitary or “gross” without
as much elaboration. For instance, this participant noted, “I think it’s unsanitary.
Nasty” (Participant 99).
Many of these responses were only a few words indicating general dislike for the
act. For example, “Awkward. Like it would be unclean and messy” (Participant 27).
Some noted that the mess made them feel self-conscious. For example, “I feel
self-conscious, since I am the one bleeding. I prefer to avoid it because I am too in
my head about staining the sheets or something that I can’t enjoy it” (Participant
56). Thus, some participants’ focus on the possibility for staining or mess was exter-
nal, highlighting that it was sometimes just impractical or that they didn’t care for it,
but others focused internally, noting that the mess made them feel personally bad in
some way.
Alternatively, other participants who mentioned the mess indicated that it’s
not necessarily prohibitory and that it can be enjoyable despite possibly causing a
“mess.” For example, “It can get a bit messy but I don’t mind it. I didn’t like it as
much when I was the one menstruating, but if it’s someone else and we put a towel
down, it’s all good” (Participant 29), as well as, “It’s messy but I always enjoyed it
on my period. Made my cramps better, and I was always really horny” (Participant
25).
Several participants who described the mess as a difficulty that made sexual activ-
ity too difficult to engage in described that this may vary by sex act, with penetrative
sex being possible, but oral sex being unpleasant or difficult. For example, “It never
seemed to affect PIV intercourse for me much, but I’d never done oral, which might
be a bigger issue?” (Participant 3). For another example, this participant said:
Penetration is fine, towels may be needed but cleanup isn’t too hard. Oral sex
is a no go, I am self-conscious of the hormonal smell and taste changes that
would go along with it. As long as there aren’t any comments made about it
being gross (which chunky discharge can be), I’m completely comfortable
having regular sex (Participant 24).
Some participants identified that in addition to the emotional discomfort of
stigma or the potential for a mess, physical discomfort associated with menstrual
symptoms (e.g., swelling, tenderness, pain, bloating) reduced their desire to have
any kind of sexual activity. Although some participants also noted this didn’t neces-
sarily rule out menstrual sex, but did direct the sex acts they engaged in while men-
struating. For example:
I have minimal desire to have intercourse while I am menstruating. Not
because my sexual drive is lower but because I experience a lot of tender-
ness/swelling/pain and the like which makes the idea of penetration unap-
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pealing. My partner and I do engage in oral sex (exclusively clitoral stimu-
lation) and/or mutual masturbation while I have my period (Participant 61).
Thus, the potential for messiness associated with menstrual sex prompted a
range of emotional and behavioral reactions for participants. Some participants
write off menstrual sex as gross and uncomfortable with minimal explanation.
Others note that the mess was prohibitory, and not worth the hassle, with some
highlighting the feelings of shame and self-consciousness that arise from stig-
matizing the “mess.” Alternatively, many participants note that the mess is
easily managed with a little planning, or altering the choice of sex act while
menstruating.
I Like It Other participants indicated that in general they liked it or felt the same
toward menstrual sexual activity as they would non-menstruating or “normal” sex-
ual activity. For example, “It’s fine” (Participant 31), “I’m okay with it” (Participant
52), “It is normal” (Participant 74), “I like it” (Participant 75), and “Positively (but
I’d rather not have periods)” (Participant 42) were common responses. Some were
even more enthusiastic, for example, this participant noted, “Enthusiastic, positive,
and like period sex is great” (Participant 53). Thus, many participants felt generally
positive or at least regarded menstrual sexual activity with a similar level of interest
and enthusiasm to non-menstruating sexual activity.
I Like It But… Other participants noted that while they themselves enjoy men-
strual sexual activity or were neutral toward it, they were concerned either that a
partner did not like it or a potential future partner would not enjoy it. For example:
I enjoy it, and would be disappointed if a partner had a problem with it. It
wouldn’t necessarily be a deal breaker though, depending on the reason why. If
they just think it’s gross, we may have to re-evaluate. But if they are genuinely
afraid of blood or if I’m in a relationship with someone who is asexual, I’d be
okay with it (Participant 60).
In addition, this participant noted, “I am very comfortable with it, personally,
though I understand that not everyone is and would not assume a pasrtner was ok
with that before asking” (Participant 47). Another participant noted, “I would love
to have more period sex if my periods are heavy, but partner wasn’t comfortable”
(Participant 97). In general, participants who elaborated on their personal positive or
neutral feelings toward menstrual sex also expressed concern about a real or poten-
tial partner’s feelings.
Dysphoria Lastly, a number of participants, particularly those who menstruated
but did not identify as cisgender women, noted that menstrual sex could trigger feel-
ings of gender dysphoria and for that reason they liked to avoid it. For example, “To
each their own; I personally get too dysphoric to have sex” (Participant 18). In addi-
tion, “It honestly makes me dysphoric, but I don’t think it’s gross. Wet wipes and
putting down a towel work out pretty well” (Participant 20).
Several of these participants added the caveat that they had no problem with men-
strual sex in general or if their partner was the one menstruating, but would prefer
to avoid it if they were the menstruating party. For example, “I can’t have sex on my
period because dysphoria, but if other people want to have sex while having their
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periods that is fine. i’m not opposed to having sex with someone on their period”
(Participant 84).
The inclusion of transgender and gender non-conforming participants in the pre-
sent study highlights the distinction between general attitudes toward menstrual sex-
ual activity and feelings about one’s own menstruating body. Most participants who
referenced dysphoria indicated that their concern was having sex while they were
menstruating, but did not mind sexual activity with a menstruating partner.
Conversations About Menstrual Sex
Participants also described what conversations, if any, they have had with current or
previous partners about menstrual sex. These conversations largely reflect the atti-
tudes about menstrual sex discussed earlier, elaborating on concerns and negotiation
surrounding the potential for pain or messiness to interfere with sexual activity and
how, if at all, to manage them. Specifically, we identified four major themes with
several subthemes that describe the content of these conversations: (1) Menstrual
symptoms: Pain v. pleasure; (2) Too messy; (3) Sex act matters; and (4) It’s a discus-
sion. We describe each below.
Menstrual Symptoms Many participants mentioned menstrual symptoms as
characterizing the content of or rationale behind their conversations about menstrual
sex. Specifically, these fit two general sub-themes: (1) Sex can help manage men-
strual symptoms; and (2) Menstrual symptoms are too distracting.
Some participants noted that sexual activity can help reduce menstrual pain or
distract them from unpleasant menstrual symptoms like cramping, or that menstrual
symptoms could be managed easily to still engage in sexual activity when desired.
For example, “Yes. He said ‘I don’t mind if you don’t mind.’ And I said ‘The blood
doesn’t bother me, lay down a towel. But the cramps will be a distraction.’ Short
and sweet and now I take an ibuprofen before hand if I know sex is imminent” (Par-
ticipant 92). In addition, another participant said, “My first partner told me that he
doesn’t mind it, especially if it’s toward the end, as it helps with cramps” (Partici-
pant 68).
Other participants identified that menstrual symptoms, like being in pain, bloat-
ing, or other discomfort, reduced their desire to engage in sexual activity so they
either avoided the conversation or told their partner they did not want to engage in
menstrual sex for this reason. For example, “Only very briefly, as in me saying, ‘It’s
my period and I don’t want to have sex right now.’ It doesn’t help with my cramps,
but actually makes them worse” (Participant 93). Conversations about menstrual
sexual activity often referenced, to some degree, the presence of menstrual symp-
toms and pain, either as a motivator for having sex to manage those symptoms, or as
a deterrent to sexual desire.
Too Messy Similar to general attitudes about menstrual sex, a number of par-
ticipants identified not wanting to engage in menstrual sex or bring up the con-
versation because it was too gross or messy. Others noted that they talked about
it with their partner, but one or both of them felt because it was too messy it was
not worthwhile. For example, “We’ve discussed it. He was more open to it than
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I was. I just don’t care for messes” (Participant 56), and, “Yes. We try to avoid it
because we like to avoid getting the sheets dirty” (Participant 73).
While most participants were more general in their discussion of menstrual
sex’s “messiness” being a deterrent and discussing that with their partner, some
participants were more specific in attributing their partner’s perceptions. Specifi-
cally, some noted that while they assumed most guys would find menstrual sex
to be “gross,” or that in past relationships their previous male partners found it
unsettling, their current male partner was okay with it or accepting of it or that
previous instances where men found it unsettling were characterized by imma-
turity. For example, “Yes, with multiple partners. I don’t particularly like it, so
would prefer not to have period sex, but most of my male partners actually did not
have negative feelings towards it and were quite game to have it” (Participant 51).
For another example, “Yes. Conversation centers around how it’s no big deal.
Dudes squeamish about period blood are immature. Everybody does it if you’ve
been together long enough” (Participant 94). In addition, this participant said:
Yes. I used to be really against it because my first partner freaked out the
first time we had sex on my period (he knew what was happening) and ran
away to take a shower and left me all alone for 20min while he scrubbed his
dick. I told my current partner a short/edited version of that right before we
met up for the first time b/c I was going to be in my period. They laughed at
my ex for being an idiot and promised not to do that (Participant 45).
Further, this participant noted:
Yes! I regret to admit that I am almost 30 and still find this conversation
embarrassing, but ladies have been taught to avoid mentioning their Aunt
Flow, and I can’t overcome years of gender shaming by myself. Regardless,
I am open to period sex and bring up the option if I have a partner when
I’m on my period. I only bring up this option if it’s someone I’m already
comfortable with, and in all cases, the partner has taken me up on the offer
and been a responsible, open-minded and mature person about it. I’ve never
been shamed for talking about my period by anyone else as much as I shame
myself (Participant 62).
In general, a number of participants noted that while mess might be a deter-
rent, or they personally found it messy and did not want to bother, in general they
entered conversations with the assumption that (usually male) partners would be
bothered by it, but after discussing it they learned their partner was not bothered
by it. Often, they attribute these successful negotiations to personal and relational
maturity.
Sex Act Matters Participant discussions with partners about menstrual sex
sometimes revolved around negotiating which sex acts would be acceptable, with
most concluding that penetrative sex in various forms was acceptable, but oral
sex would not be acceptable while menstruating. For example, “Yes. Asked if we
would have sex on period. We were both okay with fingering, but no oral” (Par-
ticipant 40).
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“Just Put aTowel Down:” Approaching Conversations About Period…
However, some noted that this differed depending on partner gender or if there were
two menstruating bodies in a relationship compared to one. For example, “We were
both cool with it. I think it helps that we were both women” (Participant 60).
It’s a Discussion Regardless of the content of the discussion, participants pretty uni-
formly suggested that the topic needed to be discussed. A few participants indicated
that menstrual sexual activity occurred in their relationship “by accident” and that was
what prompted a talk, but many more identified that they understood it was something
they should not spring on their partner and should be discussed first. For example:
Yes. Generally conversations were establishing that neither of us are bothered by
period sex, or menstrual blood. ‘Do you mind period sex’ ‘No’ ‘Me neither’—
I have not personally encountered a lesbian or bi woman that was bothered by
period sex (Participant 88).
In addition, this participant noted, “Yes, we have discussed the consequences of hav-
ing period sex” (Participant 99). Further, this participant said:
I have had this discussion with more than one partner. One conversation sticks
out, though. We had planned for an evening of food and sex, but my period
started unexpectedly while we were making dinner. I apologized and he asked
why. I said because now sex was off the table. He said that it only had to be if I
wasn’t comfortable because he was happy with all aspects of sex even if I was
bleeding. We negotiated while we cooked and came up with ways to make me
comfortable (Participant 77).
Thus, regardless of conversational topic, most participants recognized that it was
indeed a conversation and not the type of sexual activity that should be characterized
by spontaneity.
Discussion Satisfaction
To address the second research question, we also asked participants in an open-
ended manner if they felt satisfied with the result of that discussion. Coded responses
included: (1) Yes, or mostly satisfied; (2) No, or mostly dissatisfied; (3)We didn’t dis-
cuss it; and (4) Somewhat satisfying. Because these responses were generally brief
(e.g., “Yes, satisfied” or “Not really”), we present the frequencies with which they
occurred in Table1. From these findings, it appears that participants are generally satis-
fied with the conversations they and their partners have had about menstrual sex. Par-
ticipants who were unsatisfied typically reported that they felt their partner thought it
was “gross” when they did not feel that way, thus resulting in dissatisfaction.
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V.Rubinsky et al.
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Discussion
In this study, we sought to investigate the topics of ongoing attitudes and conversa-
tions about menstrual sexual activity between intimate partners. Overall, findings
suggest that many people across the gender spectrum feel neutrally or positively
about menstrual sexual activity, although some participants still identified that either
they or their partner found it awkward, uncomfortable, “gross,” or the perceived
mess associated with the sex acts was a deterrent. Many participants who identi-
fied as transgender or gender non-conforming (approximately 35% of the sample)
indicated that menstrual sex could prompt feelings of dysphoria for them if it was
their menstruating body. However, most also noted that the sex act itself wasn’t
bothersome, and if their partner menstruated, that was not a particular deterrent.
In describing conversations about menstrual sex, participants highlighted discus-
sions about menstrual pain either motivating menstrual sex to reduce discomfort,
or the discomfort inhibiting desire for sexual activity. Other participants noted that
it depended on the type of sex act, with penetrative sexual activity preferable to oral
sex during a menstrual cycle. Some indicated that it was too messy, but most high-
lighted that regardless of topic, period sex is a “talk” that needs to occur before the
sex act occurs. The majority of participants (71.9%) indicated that they were gen-
erally satisfied with their partnered conversations about menstrual sexual activity,
often attributing the successful negotiations to personal and relational maturity. In
this section, we discuss the findings in light of menstrual stigma and management of
challenging conversations.
Stigmatized Conversations About Menstruation
Previous research effectively establishes that menstruation and its symptoms are
heavily stigmatized, with women at many life stages managing the consequences
of the stigmatized designation (Fahs 2011, 2014). Further, research about menstrual
communication generally suggests that any talk about menstruation, if it occurs at
all, is challenging and typically furthers feelings of stigma and shame that younger
women may experience as they begin to navigate menstruating bodies (Fahs 2013;
Gunning etal. 2019; Rubinsky et al. 2018). However, the present study found that
while participants certainly reflect an awareness that menstruation is stigmatized—
several noting feelings of discomfort that they needed to overcome, or reflecting
on the fact that they still feel embarrassed by it—many participants indicated that
the conversations about menstrual sex with their partners were normal, coalescing
around an attitude that everyone does it eventually.
The present study’s findings support and extend Fahs’ (2014) study about
menstrual attitudes. Many negative attitudes about menstrual sex were similar to
Fahs’ (2014) findings about menstrual attitudes, that often positioned general nar-
ratives about bodies with vaginas as “dirty or gross” or requiring maintenance.
Thus, our findings suggest that menstrual stigma certainly still infiltrates intimate
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“Just Put aTowel Down:” Approaching Conversations About Period…
spaces like the bedroom. However, many people do not view it as a deterrent for
engaging in sexual activity if they want to engage in it.
Further, many participants indicated that while they expected a male partner to
react negatively to a discussion of menstrual sexual activity, most of their actual
experiences did not reflect shame or negativity from their sexual partners. Alter-
natively, many described their partners as mature, sex positive, or simply sug-
gested that it would be weird if they were actually bothered by it. Often, discus-
sions reflected planning for and managing a potential “mess” or preference for a
particular sex act or accommodation (e.g., needing to take ibuprofen first) rather
than negotiating whether or not each person possessed any negative attitudes
toward menstrual sex.
This detour from common perceptions about menstrual sex as deviant (Gun-
ning etal. 2019), and previous research positioning it as stigmatized (Fahs 2014),
might be due to the present study’s sample. More than half of the participants in
the present study fell under the LGBTQ umbrella, with only about 30% identify-
ing as both cisgender and heterosexual. In more diverse samples, many women
report that they perceive menstrual sex as normal and natural (Morrison et al.
2010). Several participants referenced having two women or two menstruating
bodies as changing the nature of the conversation around menstruation and men-
strual sex in their relationships.
Further, the inclusion of a larger transgender and gender non-conforming sam-
ple also highlights that perceptions of menstrual sexual activity generally may
differ from one’s own feelings about their menstruating body or having sex while
they are menstruating. Many transgender participants said that they did not per-
sonally have any problems with menstrual sex or having sex with a menstruating
partner, but menstruation was for them a dysphoria-inducing event, so they might
not want to be touched while they were menstruating.
Menstruation and its associated stigma is connected to larger discourses and
feelings about female bodies and femininity (Fahs 2013). Transgender and gen-
der non-conforming participants largely confirmed this connection in emphasiz-
ing that menstruation, typically constructed as a feminine process, still prompted
feelings of dysphoria or disconnection for them. This disconnect inhibited a
desire for sexual activity if the transgender or gender non-conforming person was
personally menstruating. Even still, participants who were transgender or gender
non-conforming emphasized that they did not have any problem with menstrual
sex as an activity if it was a partner who was menstruating. This distinction is an
important one, emphasizing that feelings of dysphoria are not a reflection of one’s
feelings in general about bodies assigned as female or bodily processes associated
with femininity. As menstrual suppression and discussion about the connection
of menstruation to womanhood is highly contested, political space (Fahs 2013;
Jarvis 2013), evidence that one’s personal feelings about their own menstruating
body might not be reflective of feelings about other people’s menstruating bodies,
serves as a counter to suggestions that individual choices about menstrual sup-
pression or menstruation reflect negative attitudes about menstruation in general.
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V.Rubinsky et al.
1 3
Limitations andFuture Research
The present study contributes to the literature on stigmatized conversations, men-
strual attitudes, and women’s sexual health behaviors, offering a sample with a
high degree of sexual and gender diversity. However, there are several limitations
through which the present study’s conclusions should be interpreted. Most impor-
tantly, despite efforts to recruit diverse samples from online spaces, as is common
with survey research, our sample was still predominantly white. Future research
may attend to this limitation by seeking participants intentionally from Black and
Latinx spaces, where different or similar conversations may be taking place about
menstrual sex while navigating other intimate communication and intimate health
barriers. Research on Latinx and Black women and gender minorities’ conversa-
tions with intimate partners would be especially worthwhile for future research to
consider. The sample size is also too small to draw broad, generalizable conclu-
sions from.
In addition, the method of open-ended surveys allowed us to maintain partici-
pant anonymity and generate a high breadth of uninhibited responses, but does
not facilitate asking follow-up or clarification questions where relevant. This was
a particular problem because many participants in same-sex relationships refer-
enced the two menstruating bodies, or indicated “it’s different with two women”
but did not elaborate on why. Focus groups and in-depth interviews may be ben-
eficial for future research where facilitators can inquire about what makes those
relationships different. Sexual communication between people with shared bodily
experiences or shared bodily experiences but differing identities (e.g., a cisgender
woman with a transgender man who may still menstruate), may invoke meaning-
ful differences in communication compared to opposite sex, cisgender pairs.
Conclusion
In conclusion, while previous research and popular wisdom suggests many peo-
ple, particularly people who have sex with male partners, might encounter shame,
stigma, and barriers in negotiating “period sex” within their intimate relation-
ships, findings from our study suggest that the practice is fairly normal, and the
conversations are not as difficult as participants expected them to be. This may
reflect shifting societal attitudes toward menstruation or a sample of diverse sex-
ual and gender identities reflecting attitudes in LGBTQ community that may be
more body-positive compared to societal messages at large. Regardless, findings
normalize the practice of menstrual sexual activity while still acknowledging that
it is not a sex act to spontaneously engage in without a prior conversation.
Funding This project was funded internally by the second author’s institution.
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“Just Put aTowel Down:” Approaching Conversations About Period…
Compliance with Ethical Standards
Conflict of interest The authors declare they have no conflicts of interest.
Human and Animal Participants All procedures performed in studies involving human participants were
in accordance with the ethical standards of the institutional research committee (Northeastern University
IRB Approval # CPS19-04–335) and with the 1964 Helsinki Declaration and its later amendments or
comparable ethical standards. This article does not contain any studies with animals performed by any of
its authors.
Informed Consent Informed consent was obtained from all individuals included in this study. This data
set is not available.
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maps and institutional affiliations.
Authors and Aliations
ValerieRubinsky1 · TaylorMcMahon2· AngelaCooke‑Jackson3·
JacquelineN.Gunning4
Angela Cooke-Jackson
acookej@calstatela.edu
Jacqueline N. Gunning
jgunning2@huskers.unl.edu
1 Social Science Program, University ofMaine atAugusta, 46 University Drive, Augusta,
ME04330, USA
2 Intimate Communication Lab, Intimatecommlab.Org, Boston, USA
3 Department ofCommunication Studies, California State University, 5151 State University
Drive, LosAngelesLosAngeles, CA90032, USA
4 University ofNE – Lincoln, 352 Louise Pound Hall, Lincoln, NE68588, USA
ResearchGate has not been able to resolve any citations for this publication.
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