PhD Defence: Maria Carmen Punzi

Abstract

Menstrual health affects billions of people, yet it has long been surrounded by silence, shame and neglect. For decades, cultural taboos have shaped how institutions, markets, and even healthcare systems respond to menstruation, often by not responding at all. Products remain hard to access, research is underfunded, and public discussion is limited. At the same time, traditional menstrual product companies have historically reinforced secrecy rather than empowerment, slowing progress and innovation. This doctoral dissertation explores how a new wave of social entrepreneurs is working to change this landscape. These ventures blend business tools with social missions, using education, advocacy, and product innovation to challenge stigma and push for systemic change. Across three qualitative studies, the dissertation examines how these mission-driven organizations operate in a field shaped by taboo. The first study shows how social enterprises strategically engage with stigmatized topics, turning menstrual stigma into an opportunity for disruption and public conversation, with humor and empathy, drawing on multimodal approaches (language, visual, digital). The second study uncovers why some social enterprises thrive while others struggle, uncovering effective - and ineffective -  combinations of strategies. The third study asks what happens when these ventures begin to achieve their goals, showing how they evolve, expand, or shift focus as menstrual stigma slowly weakens. Together, these studies highlight how social entrepreneurship can help transform deeply rooted cultural norms. They show that improving menstrual health is not only about better products: it is about reshaping narratives, challenging outdated systems, and creating lasting social change.