To understand the challenges and experiences related to menstruation in girls and adolescents from rural communities of the Colombian Pacific.Mixed research, mainly qualitative and quantitative to a lesser extent, which combined ecological, differential and intercultural approaches, as well as gender perspective. The participants were girls and adolescents, young people, teachers/principals of educational institutions, mothers and parents in general, as well as institutional officers from the Municipal Health and Education Secretariats, the Ministries of Health and Education, and the Vice-ministry of Water and Sanitation. Focus groups, in-depth interviews, surveys and the educational institutions were carried out in schools. The research was conducted in the municipalities of Bagadó (Chocó), Ipiales (Nariño) and Santander de Quilichao (Cauca).This study showed that insufficient information at the time of menarche, pain, poor access to restrooms, water and absorbent materials, as well as existing prejudices, cause menstruation to be experienced with pain and concealment. All these aspects are correlated with absenteeism in school and the strengthening of prejudices around "being a woman". Inequality in girls and adolescents, derived from constructs around menstruation, goes unnoticed by schools, families, entities and officers in charge of public policy management.Social and cultural constructs around menstruation in the municipalities studied lead to its configuration as a negative experience, which generates and reinforces taboos that materialize in inequity, stigma and discrimination against girls. In this context, community work and the design of public policies and actions are fundamental to promote gender equity.