Key Social Norms Take-aways This study highlights how entrenched social norms — including menstrual stigma, silence, and restrictive gender expectations — profoundly shape girls’ experiences and limit their access to support and services. Effective interventions must address these social norms directly by engaging not just girls but also families, communities, schools, and boys and men, aiming to normalize menstruation and dismantle the taboos that reinforce gender inequality.

Objectives This study explored the menstrual health challenges faced by young women living in the urban slums of Lucknow, Uttar Pradesh, India, using the socio-ecological model to understand how individual, social, and institutional factors shape their experiences.

Methods Researchers conducted life course interviews with 70 young women aged 15–24, recruited through local NGOs. Thematic analysis was applied to the translated and transcribed interviews to identify key challenges across individual, social, and institutional levels.

Results At the individual level, most young women were uninformed about menstruation prior to menarche and received misinformation afterward, leading to knowledge gaps and anxiety. Socially, menstruation was widely stigmatized, limiting girls’ ability to discuss it openly and restricting their mobility and daily activities. Institutionally, school settings posed challenges, with girls facing embarrassment, teasing, and poor menstrual hygiene infrastructure, including dirty or inadequate toilets. Despite these barriers, most girls continued attending school during menstruation.

Conclusions The study concludes that addressing menstrual health challenges requires multi-level interventions that go beyond simply providing products or facilities. Interventions should also include early education, destigmatization efforts, and structural improvements to create a supportive environment for menstruating girls.