For many women, becoming a mother does not necessarily mean becoming more knowledgeable about their own health and well-being. During a recent community visit, I sat with a group of women, most of them young mothers, alongside older women and girls from the community. The purpose was to discuss sexual and reproductive health and rights and create a space where participants could ask questions, share experiences, and seek information about their bodies. But the conversation soon became much more specific on menstruation. The women began talking about the changes they experience during their menstrual cycles, pains and discomfort they face, and the questions they have about their bodies. Several women described symptoms that, from a medical perspective, should not simply be accepted as part of being a woman. Yet many had never sought medical attention. They had assumed that the pain, heavy bleeding, or changes they experienced were normal. Some had been told that these were simply things women had to live with. This encounter reflects a wider, largely invisible gap in reproductive health literacy that spans generations and cuts across rural and urban communities alike. It deserves naming, because the consequences are not abstract: delayed diagnoses, preventable complications, and daughters navigating puberty with inaccurate information passed down from mothers who themselves were never taught. Understanding what is medically normal matters. A typical menstrual cycle runs about 21 to 35 days, with bleeding usually lasting 2-7 days. Some variation, especially around puberty, after childbirth, and as menopause approaches, is expected. But certain signs warrant medical attention rather than quiet endurance: heavy bleeding, bleeding between periods or after menopause, pain severe enough to interfere with daily life, or cycles that stop entirely without pregnancy or menopause as an explanation. These can point to treatable conditions such as fibroids, hormonal imbalances, anemia, infections, among others. Left unaddressed, they can affect fertility, worsen anemia, and diminish quality of life for years. Normalizing these symptoms comes because older women grew up with little formal reproductive health education in households and schools where menstruation was rarely discussed openly. Silence was often mistaken for modesty, and pain was framed as something to endure rather than examine. That inherited silence is now being passed to the next generation, not out of neglect, but because mothers genuinely lack the knowledge to pass it on. This gap widens in rural areas, where health facilities are farther away, cultural beliefs and myths are profound, and the cost or time needed to seek care adds another barrier. When limited knowledge combines with limited access, women become less likely to seek help even when they sense something is wrong. Closing this gap is a public health responsibility, not simply a family or cultural matter. Reproductive health education should extend beyond adolescent girls in schools to mothers, grandmothers, and other adult women who may have missed these conversations themselves. In Rwanda, community health workers are well positioned to support this effort if equipped with accurate, practical, plain-language information. Radio programmes and community dialogues can further bring these conversations into homes and communities, particularly where access to health services is limited. Men should also be included, because reproductive health is not a women’s issue alone. This requires sustained investment in health literacy across the life course from adolescence and motherhood to the years approaching menopause. A woman should be able to recognize important changes in her body, understand when to seek care, and have the confidence to ask questions without shame. And when she does, she is better prepared to become the informed first source of guidance for her children. Breaking this cycle means ensuring that women are not only cared for, but equipped with the knowledge to care for themselves and guide the generation that follows. The writer is a global health specialist and healthcare mission curator at African Leadership University (ALU).
