“I’d rather suffer in silence than speak up and risk being embarrassed,” says Fatimah Umar, a 400-level student of Usmanu Danfodiyo University, Sokoto (UDUS).
On the morning of a computer-based examination, Fatimah felt the now-familiar warmth of menstrual flow before she had even left her hostel. The cramps followed quickly sharp, persistent, and draining. It was examination week, when sleep is scarce and anxiety high. Resting was not an option. Neither, she believed, was asking for understanding.
She joined the queue at the crowded CBT centre, battling dizziness and abdominal pain. At one point, she watched a male student skip the line after telling supervisors he was ill.
“I didn’t speak up,” she recalls. “I don’t think menstrual pain would count as an excuse. I didn’t want to be embarrassed in public.”
Across campuses in Nigeria, stories like Fatimah’s are common but rarely spoken about. For many female students, menstruation is treated as a private inconvenience rather than a legitimate health concern even when the pain is severe enough to disrupt academic performance.
A Widespread but Underreported Health Challenge
Menstrual pain, medically known as dysmenorrhea when severe, affects millions of women globally. Studies show that between 60 and 93% of females experience painful menstruation. In Nigeria, gynaecologists estimate that over 70% of adolescent girls and young women suffer from it to varying degrees.
Dr Olawale Shittu, a reproductive health specialist, describes dysmenorrhea as one of the most common gynaecological complaints among young women.
“It can significantly affect concentration, mood and physical functioning,” he explains. “Without proper management, it interferes with daily activities — including education.”
To assess its impact in tertiary institutions, this reporter conducted a survey among female students across six Nigerian campuses. The findings reveal that menstrual pain is not an isolated inconvenience but a routine academic barrier.
Nearly nine in 10 respondents said their academics suffer during menstruation. About 42% reported being unable to study effectively, while more than a third admitted missing classes entirely. Some performed poorly in examinations because they struggled to concentrate; others arrived late or left early due to discomfort.
Yet 73% said they had never reported their condition to a lecturer.
The reason, many said, was fear of being dismissed, mocked or not taken seriously.
“I Don’t Want to Be Accused of Pretending”
At Kwara State University (KWASU), Aishat Gazali, a final-year student, describes her menstrual cycle as a monthly ordeal.
“I sometimes faint from the pain,” she says. “It’s like my body shuts down.”
During one test, she left the examination hall abruptly as cramps and nausea intensified. It was her only opportunity to improve her continuous assessment score.
“I didn’t complain,” she explains. “I once saw a lecturer accuse a girl of pretending. I don’t want to put myself in that situation.”
Aishat said relies heavily on over-the-counter painkillers to cope sometimes against medical advice.
“I know it’s not good for my health, but I can’t afford to fail,” she says.
Medical experts warn that frequent unsupervised use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and diclofenac can cause serious complications, including gastritis, ulcers and gastrointestinal bleeding.
“The proper approach is medical evaluation,” Dr Shittu says. “Persistent severe pain should not be self-managed indefinitely.”
The Hidden Cost of Endurance
For Oseni Aminah, a linguistics student at the University of Ilorin, menstrual pain does not always mean absence from class — but it means diminished learning.
“I reread the same paragraph without understanding it,” she says. “I feel mentally slower and emotionally anxious.”
Despite worries about staining or leakage, she avoids requesting bathroom breaks during exams.
“It draws attention,” she says. “I’d rather endure it.”
Maryam Hassan, another UDUS student, says prolonged use of painkillers has altered her cycle. Her menstrual flow has become heavier, increasing her use of sanitary pads from 10 to 15 per cycle which is a financial burden she struggles to bear.
The World Health Organisation defines “menstrual poverty” as the inability to afford and access menstrual products. Globally, about 800 million women and girls menstruate daily, with many in developing countries lacking adequate support.
Maryam says poor sanitation worsens her situation. During one exam, she had to change her pad behind a building because the available restroom was unusable.
A visit by this reporter to restrooms on campus found several locked and others without water or adequate hygiene.
Institutional Gaps and Cultural Silence
Dr Hameed Adediran, Senior Programme Manager for Menstrual Health Initiatives at PSI Nigeria, says stigma plays a central role.
“Students suffer in silence because they are told it is normal and not worth complaining about,” he says. “But if a girl misses five days a month, that’s about 60 days a year — enough to significantly affect her academic progression.”
Karo Omu, founder of Sanitary Aid Nigeria, argues that university policies are built around a “neutral” student model that ignores gendered health realities.
“Menstrual health is viewed as a private inconvenience rather than a public health and educational concern,” she says.
While some lecturers may show individual compassion, there are few structured accommodations that recognise menstrual pain as grounds for excused absence or alternative assessment.
The Dean of Student Affairs at UDUS, Professor Umar Aliyu, says students experiencing unbearable pain should report to the student affairs office.
“We can provide medical care and reschedule examinations where necessary,” he says, though he acknowledges that responses may vary across departments.
Toward Structural Solutions
Advocates suggest workable frameworks that would not disrupt academic systems. These include integrating menstrual health into existing medical excuse policies, allowing limited self-declared absence days supported by campus clinics, flexible test dates within defined limits, and improved sanitation facilities.
They also emphasise the need for gender-sensitivity training for staff and confidential reporting channels for students.
“Addressing menstrual health is not about special treatment,” Omu says. “It is about equity.”
For students like Fatimah, however, change still feels distant.
When asked whether she would speak up if faced with the same situation again, she pauses.
“I don’t know,” she says softly. “Sometimes, it’s easier to keep quiet.”
But as more students share their stories, the silence that once defined menstrual struggles on Nigerian campuses may slowly begin to break.
