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Blood Brothers: The Painful History of Male Menstruation

Menstruation is supposed to be a ‘female thing,’ so why do cultures all around the world (and throughout history) believe that men get their periods too?

If you were a boy growing up in rural Egypt at any point before the mid-20th century, there was a pretty good chance that at some point you’d start pissing blood. Maybe it would happen once. Maybe it would happen semi-regularly. But rather than freaking out and rushing you to a doctor, almost anyone you told would just shrug it off, or perhaps even congratulate you. Instances of hematuria were so common that, as the medical historians Helmut Kloos and Rosalie David have noted, locals interpreted them as “a normal and even necessary part of growing up, a form of male menstruation, linked with male fertility.” 

In other words, they believed men got periods, if irregularly.

This belief, and its open, enthusiastic acceptance, seems bizarre today, when most people view menstruation as a women’s health issue and a universal taboo. Granted, not every woman menstruates, and not everyone who menstruates is a woman. But since menstruation is key to cis female reproductive processes, we tend to label it as a definitive marker of biological sex. We also know that many menstruation taboos, which implicitly or explicitly tell people to feel ashamed of a basic biological function, are bound up in long histories of misogyny and patriarchal systems of social control.      

Yet strange as this belief seems now, and confounding as it was to Western researchers in the early 20th century, it wasn’t anomalous. Historically, many cultures across the globe believed that cis men could occasionally or regularly menstruate, in their own way. (Even today, while almost no one believes cis men menstruate, many people believe that men experience their own version of PMS: Irritable Man Syndrome, or IMS, caused by regular hormonal fluctuations.) Many more have used rituals, like penile cutting or piercing, to emulate or artificially induce a form of cis male menstruation as well.  

“It’s hard to assess how common these beliefs were,” notes Michael Stolberg, a medical historian who’s studied early modern ideas about menstruation. It’s also hard for us to fully understand the context and meaning of pre-modern penile cutting or piercing rituals. But based on the records we do have, some academics believe that these sorts of ideas and practices used to be fairly widespread, both across the world and throughout history. 

No matter how widespread they were, though, many historical ideas about cis male menstruation speak to the fact that modern norms about the hard lines between men and women — and modern menstruation taboos — are hardly as eternal or universal as some people today insist that they are

Scientifically speaking, Egyptian beliefs in male menstruation stemmed from misinterpretations of the symptoms of a parasitic infection known as bilharzia, or schistosomiasis. Long story short, the Nile is chock-a-block with a species of blood fluke, a type of parasite that moves from dirty water into human hosts by burrowing through our skin and into our circulatory systems before making their way into our bladders, causing inflammation and often leading to painful urinary bleeding. Medical texts from over 3,500 years ago suggest that ancient Egyptians actually understood the connection between dirty water and urinary bleeding, as they advised people to wear linen penile sheaths when going into the Nile to prevent a condition that sounds like bilharzia. (Fun fact: Their name for the condition transliterates to a-a-a.) But this medical knowledge either faded or never reached many areas where people saw blood issuing from men’s genitals and thought: Oh, menstruation. So, it was accepted, even celebrated, as a sign of maturity. 

This belief faded in the 20th century, thanks to a massive public health push led by the Egyptian government, which wanted to solve the nation’s astronomical rates of bladder cancer, caused in large part by chronic and widespread bilharzia infections. By the end of the century, it succeeded in educating people about the actual cause of cis male urinary bleeding, and brought rates of infection down so low that cis men no longer regularly experienced bloody discharges.  

Egypt’s experience with blood flukes was unique. But many cultures misinterpreted other sources of male bleeding as menstruation as well. Medieval European doctors, Stolberg notes, saw hemorrhoidal bleeding especially as “an obvious parallel to the monthly cleansing of the female body.” Even Albrecht von Haller, the 18th century Swiss anatomist many scholars describe as the father of modern Western physiology, talked about regular nosebleeds as a form of cis male menstruation.  

In Europe, these beliefs reflected the influential theories of Galen, the 2nd century C.E. Greek physician whose word was medical gospel for most Europeans well into the 16th century (much later in some circles). Long story short, Galen drew on earlier ancient Greek ideas about the need for balance in the four “humors — black and yellow bile, blood and phlegm — in a body to maintain health and wellness. Using a mixture of observations and inferences, he held that men on average ran hotter than women, and through that bodily heat burned off excesses of any given humor. Women menstruated, he held, because they ran colder and couldn’t burn off these excesses. 

However, Galenian medicine held some space for sexual fluidity, arguing that some bodies had intermediate sexual characteristics, and that at times women ran hotter than average, and men colder. Thus, some women didn’t need to menstruate regularly, or at all. And, as Stolberg explains it, “male bodies sometimes needed to rid themselves of morbid, harmful, corrupted blood… or more-or-less healthy but superfluous blood,” through alternative forms of menstruation. 

Infamously, between the 13th and 17th centuries, European thinkers looking to justify anti-Semitic discrimination and violence advanced the idea that Jewish men menstruated regularly through their penises or anuses. The umph of this accusation wasn’t necessarily in the syllogism we might expect based on modern taboos: Menstruation is wicked. Jewish men menstruate. Therefore, Jewish men are wicked. As Stolberg stresses, many medieval European scholars actually viewed menstruation as a neutral or positive process. (Although many of them did hold other brutal biases against women.) The power of the claim was the idea that Jewish men were systematically different and fundamentally imbalanced. That level and scope of difference, not menstruation proper, seemingly justified bigotry to them. 

Centuries later and on the opposite side of the globe, European anthropologists studying life on Wogeo, an island off the coast of New Guinea (also known as Vokeo), recorded striking attempts to artificially induce cis male menstruation. Basically, the islanders reportedly had strict ideas about gender segregation, and believed contact between the genders could lead to contamination. However, they also acknowledged that inter-gender contact was inevitable — and, in the form of sex especially, quite enjoyable. They believed that menstruation offered most women a natural means of purging contamination; menstrual fluids were dangerous impurities, but the process itself was respected. So men, seeking the same purification, would periodically walk to a beach alone, fluff up an erection, take a piece of shellfish, tear a gash into their glans, bleed freely into the ocean, wrap their members in leaves and then observe a series of male menstrual rituals. 

Although they’re not as well-recorded or studied, scholars have proposed that a number of other penile piercing and cutting traditions practiced everywhere from the Americas to Africa to the Pacific were similarly meant to give men access to the perceived, presumably coveted, powers of menstruation. Notably, they point out, certain Central Australian aboriginal communities have long-standing traditions of penile cutting that permanently modify the glans to look like a vulva. 

Based on extant traditions and historical accounts of cis male menstruation, the anthropologist Chris Knight made headlines in the early 1990s with a bold hypothesis: All early hunter-gatherer cultures built their first rituals and proto-temples around monthly reverence for menstruation. These rituals held people who menstruated to be sacred for periods of time, and granted them social power. “When men began to assume sacred power for themselves,” he argues, as they slowly took control over socially vital technologies and practices, “they could only justify doing so by demonstrating that they, too, could periodically shed their blood.” As such, every culture and every religion, he argues, has its roots in cis male menstruation emulation rituals.  

“Once men began monopolizing ritual power at women’s expense,” he adds, “they propagated the doctrine that, while their own bleeding was potent and sacred, women’s was dangerous and polluting.” 

Knight’s narrative, and others like it, hinge on bold and selective readings of limited evidence, and on truly wild assumptions, like the idea that all women in hunter-gatherer societies regularly menstruated at the same time. They also reflect and reinforce the idea that modern taboos on menstruation are universal and eternal, when in truth they really aren’t. While taboos are common, cross-cultural and -temporal studies show that throughout history and today many cultures accept and respect menstruation, view it as a totally neutral process or have rituals that look repressive from the outside but that women actually view as a source of social power and safe spaces. That’s why it’s hard to lend too much credence to sweeping, universal narratives of menstrual envy like Knight’s. 

However, Knight’s narrative does tap into the core insight that historical beliefs in cis male menstruation — or cis male attempts to emulate menstruation — hold for us today: Dominant views of menstruation, and the ideas about sex and gender they so often reflect, are not eternal truths. 

Rather, we have a long, if sporadic, history of accepting fluidity in menstruation experiences, rather than a hard-and-fast sex-slash-gender divide. We also have a long history of accepting the idea that people can take autonomy over their bodies, determining their own relationships to menstruation rather than running with their biology at birth. Likewise, we have a long history of casual acceptance of, and even of jealous reverence for, menstruation, even in cultures that later adopted more fearful menstruation taboos. 

Put another way, humans have a long history of menstrual diversity. Maybe by looking back on it, we can open up space for more gender diversity and bodily autonomy, and erode the power of prevailing taboos in the modern day (though, hopefully, without all the penis cutting). 

The bladder parasites and regular bouts of bloody urination, however, we can leave in the past.