Menstrual practice needs scale for the workplace: validation and associations with well-being among adult women in Kathmandu, Nepal and Nairobi, Kenya.

Mapping the Expertise and Understanding of Menarche, Menstrual Hygiene, and Menstrual Health among Adolescent Ladies in Low- and Center-Profit Nations

IntroductionSchools provide an important opportunity to sustainably reach and improve menstrual experiences and outcomes among adolescent girls. This study examined changes in psychosocial outcomes and menstrual practices after a pilot menstrual health intervention in schools in Northwest Tanzania.MethodsWe conducted a pre/post evaluation of a pilot menstrual health intervention in four schools in Mwanza region. The intervention included: (i) 10-hours comprehensive menstrual sexual and reproductive health (MSRH) education curriculum delivered over 5 days, (ii) distribution of menstrual management kits, (iii) improvement of school WASH facility guided by needs, and (iv) training on menstrual pain management strategies, supply of pain killers and training a specific teacher on dispensing. The primary outcome was measured using the Menstrual Practices Need Scale (MPNS). We assessed seven secondary outcomes: menstrual pain management practice; self-efficacy in managing menstruation; menstrual-related anxiety; self-reported urogenital infection symptoms; MSRH knowledge; participation in school during menstruation; and school climate score. We used linear (for MPNS, and school climate score), and logistic (for remaining secondary outcomes) random-effect regression models to examine changes in outcomes between baseline and endline.ResultsA total of 486 schoolgirls (mean age 15.6 years [SD 1.3]) were recruited for the baseline survey; of these 396 participated in the endline survey. At 12-months follow up, menstrual experience improved for MPNS-36 subscales of transport and menstrual material needs, (mean difference (MD), 0.52; 95% CI 0.38–0.66), and menstrual material reuse needs, (MD 0.32; 0.14–0.50), while menstrual materials reuse insecurity did not change, (MD -0.08; -0.27–0.11). For the secondary outcomes, there was an increased use of analgesics for menstrual pain management, (OR 2.21; 95% CI 1.33–3.67); improved self-efficacy for managing menstruation, (OR 2.02; 1.35–3.04); MSRH knowledge, (OR 5.23; 3.25–8.39), participation in school (OR 2.80; 1.89–4.16) and reduced menstrual-related anxiety, (OR 0.38; 0.25–0.59). There was no evidence of change in self-reported urogenital symptoms, (OR 0.71; 0.49–1.01) or school climate, (MD 0.05; -0.19–0.28).ConclusionThe pilot intervention showed improvements in menstrual practices, psychosocial outcomes and school participation among schoolgirls but had no effect on school climate or self-reported urogenital symptoms. Stronger evidence from rigorously designed trials is needed to confirm the effectiveness of the intervention and scalability of these findings.

BackgroundMenstrual health is essential for gender equity and the well-being of women and girls. Qualitative research has described the burden of poor menstrual health on health and education; however, these...

ObjectivesThe Menstrual Practice Needs Scale (MPNS) is a comprehensive measure of menstrual self-care experience including access to sufficient, comfortable materials to catch or absorb bleeding, supportive spaces for managing menstruation...

IntroductionImproving menstrual health among schoolgirls is essential to meeting the Sustainable Development Goals (SDGs) of good health and wellbeing (SDG 03), quality education (SDG 04), and gender equality (SDG 05). School participation and wellbeing among girls in low and middle-income countries are impacted by inadequate access to quality menstrual materials and WASH facilities, taboos around menstruation, and poor knowledge. Comprehensive evidence is needed to address these challenges and guide policy and practice.MethodsAn assisted self-completed questionnaire was used to collect socio-demographic information, menstrual-related data, and school climate data from 486 girls in four mixed-gender government secondary schools in Mwanza, Tanzania. The mean (SD) of three Menstrual Practices and Needs Scale (MPNS-36) sub-scores were calculated. Specifically, the extent to which girls perceived needs for carrying and changing menstrual material in school (transport and school environment); washing and drying menstrual material (reuse needs); and privacy and drying menstrual material in school (reuse insecurity) were met. An ANOVA test compared MPNS scores for groups, and logistic regression examined the association between menstrual health and wellbeing outcomes (self-efficacy, menstrual anxiety, school attendance, and participation) and MPNS subscale scores.ResultsThe mean age of the 486 participants was 15.6 years (SD 1.3); 87% had started menstruating; the mean age at menarche was 14.2 years (SD 1.15). The majority (75%) of girls experienced pain during the last menstrual period, 39% had menstrual-related anxiety, and 16% missed at least one day of school due to menstruation. The mean MPNS subscale score (out of 3) for the reuse needs ranged from 1.0 to 2.1 across schools; 1.6 to 2.1 for reuse insecurity; and 0.9 to 1.8 for transport and school environment needs. The MPNS subscales had sufficient reliability (Cronbach alpha = 0.74 to 0.9). The subscales also had good construct validity with menstrual-related self-efficacy: higher scores for transport and school environment were associated with confidence to seek menstrual support, participate in class, and predict when periods were about to start.ConclusionsSchoolgirls have unmet needs related to transporting and using menstrual material in school, and these needs differed across schools in northern Tanzania. Menstrual-related pain remains a major reason for poor school attendance and participation. Interventions to address menstrual practice needs in schools are required and should include a strong pain management component.

Background: Menstruation is a normal biological process, and adolescent girls often are unaware when they experience menarche. Unhygienic menstruation can cause severe health risks, which may lead to respiratory tract infections (RTIs) and urinary tract infections (UTIs), and further may result in infertility and complications during birthing process. Menstruation is still a taboo in many parts of India and women are still behaved in a different way when on periods. Methods: A descriptive study was conducted in selected tea-estates of Golaghat district, Assam from 21 September 2024 to 17 January 2025 among 759 adolescents aged 10-19 year fulfilling the sample selection criteria using multi-stage random sampling technique. Self-structured socio-demographic questionnaires and standardized open access, Menstrual practice needs scale 36 tool was administered and an awareness program on menstrual health and hygiene was given to them thereafter. Results: The study findings reveal that menstrual hygiene practice need was found to be significantly associated with religion, monthly family income, type of material used during menstruation, disposal method of used menstrual material, education, residence, source of information about menstruation, type of family, age and frequency of changing of menstrual materials once get wet in a day. Conclusions: Improvement in menstrual health and hygiene practices among adolescents of tea-estates can be established by promoting overall well-being, dignity and empowerment of adolescents.

BackgroundThere is growing recognition of the importance of menstruation in achieving health, education, and gender equality for all. New policies in high income countries (HICs) have responded to anecdotal evidence that many struggle to meet their menstrual health needs. Qualitative research has explored lived experiences of menstruating in HICs and can contribute to designing intervention approaches. To inform the growing policy attention to support people who menstruate, here we review and synthesise the existing research.Methods and findingsPrimary, qualitative studies capturing experiences of menstruation in HICs were eligible for inclusion. Systematic database and hand searching identified 11485 records. Following screening and quality appraisal using the EPPI-Centre checklist, 104 studies (120 publications) detailing the menstrual experiences of over 3800 individuals across sixteen countries were included. We used the integrated model of menstrual experiences developed from studies in low- and middle-income countries (LMICs) as a starting framework and deductively and inductively identified antecedents contributing to menstrual experiences; menstrual experiences themselves and impacts of menstrual experiences. Included studies described consistent themes and relationships that fit well with the LMIC integrated model, with modifications to themes and model pathways identified through our analysis. The socio-cultural context heavily shaped menstrual experiences, manifesting in strict behavioural expectations to conceal menstruation and limiting the provision of menstrual materials. Resource limitations contributed to negative experiences, where dissatisfaction with menstrual practices and management environments were expressed along with feelings of disgust if participants felt they failed to manage their menstruation in a discrete, hygienic way. Physical menstrual factors such as pain were commonly associated with negative experiences, with mixed experiences of healthcare reported. Across studies participants described negative impacts of their menstrual experience including increased mental burden and detrimental impacts on participation and personal relationships. Positive experiences were more rarely reported, although relationships between cis-women were sometimes strengthened by shared experiences of menstrual bleeding. Included studies reflected a broad range of disciplines and epistemologies. Many aimed to understand the constructed meanings of menstruation, but few were explicitly designed to inform policy or practice. Few studies focused on socioeconomically disadvantaged groups relevant to new policy efforts.ConclusionsWe developed an integrated model of menstrual experience in HICs which can be used to inform research, policy and practice decisions by emphasising the pathways through which positive and negative menstrual experiences manifest.Review protocol registrationThe review protocol registration is PROSPERO: CRD42019157618.

There is growing recognition of the importance of menstruation in achieving health, education, and gender equality for all. New policies in high income countries (HICs) have responded to anecdotal evidence that many struggle to meet their menstrual health needs. Qualitative research has explored lived experiences of menstruating in HICs and can contribute to designing intervention approaches. To inform the growing policy attention to support people who menstruate, here we review and synthesise the existing research. Primary, qualitative studies capturing experiences of menstruation in HICs were eligible for inclusion. Systematic database and hand searching identified 11485 records. Following screening and quality appraisal using the EPPI-Centre checklist, 104 studies (120 publications) detailing the menstrual experiences of over 3800 individuals across sixteen countries were included. We used the integrated model of menstrual experiences developed from studies in low- and middle-income countries (LMICs) as a starting framework and deductively and inductively identified antecedents contributing to menstrual experiences; menstrual experiences themselves and impacts of menstrual experiences. Included studies described consistent themes and relationships that fit well with the LMIC integrated model, with modifications to themes and model pathways identified through our analysis. The socio-cultural context heavily shaped menstrual experiences, manifesting in strict behavioural expectations to conceal menstruation and limiting the provision of menstrual materials. Resource limitations contributed to negative experiences, where dissatisfaction with menstrual practices and management environments were expressed along with feelings of disgust if participants felt they failed to manage their menstruation in a discrete, hygienic way. Physical menstrual factors such as pain were commonly associated with negative experiences, with mixed experiences of healthcare reported. Across studies participants described negative impacts of their menstrual experience including increased mental burden and detrimental impacts on participation and personal relationships. Positive experiences were more rarely reported, although relationships between cis-women were sometimes strengthened by shared experiences of menstrual bleeding. Included studies reflected a broad range of disciplines and epistemologies. Many aimed to understand the constructed meanings of menstruation, but few were explicitly designed to inform policy or practice. Few studies focused on socioeconomically disadvantaged groups relevant to new policy efforts. We developed an integrated model of menstrual experience in HICs which can be used to inform research, policy and practice decisions by emphasising the pathways through which positive and negative menstrual experiences manifest. The review protocol registration is PROSPERO: CRD42019157618.

Background and Purpose: Menstrual health literacy (MHL) refers to an individual’s ability to access, understand and apply accurate information about menstruation, including biological processes, hygiene practices, and cultural perceptions. Despite its importance, menstruation has remained stigmatized, leading to misinformation and inadequate MHL among young female adults. This study describes young female adults’ MHL, beliefs and hygiene practices in Northern Mindanao. It also examined differences in MHL between urban and rural areas, considering factors such as education, healthcare access and cultural norms. By identifying gaps in knowledge and practices, the study provided insights into the factors influencing MHL in this population. Materials and Methods: This descriptive study utilized a cross-sectional design to assess the associations between cultural influences, educational backgrounds, socioeconomic status, and menstrual beliefs among young female adults. Based on the Cochran formula for sample size determination, the study sample consisted of 477 participants, 212 selected from urban areas and 265 from rural areas in Northern Mindanao. Participants were selected using simple random sampling. Data were collected using a self-administered, structured questionnaire, which included 28 close-ended items adapted from the menstrual practices questionnaire and tailored to local cultural contexts. The questionnaire assessed participants’ MHL, beliefs, hygiene practices and the types of menstrual materials used. Inferential statistical methods, including analysis of variance (ANOVA), t-test and the Pearson correlation, were used to analyze relationships between MHL and demographic characteristics. Results: The study found that educational attainment significantly influenced menstrual hygiene awareness (P<0.01). College graduates had the highest awareness (mean=3.57) of menstrual hygiene routines and practices, while those with no formal education showed the lowest awareness (mean=2.67). Geographic location impacted menstrual practices (P=0.026), with rural respondents exhibiting slightly higher awareness (mean=3.45) compared to urban respondents (mean 3.37). However, no significant difference was observed for menstrual hygiene routines (P=0.561). The type of menstrual material used also affected awareness (P<0.01). Tampon users had the highest awareness of menstrual hygiene routines (mean=3.71), while reusable sanitary pad users had the highest awareness of menstrual practices (mean=3.51). In contrast, cloth/towel users had the lowest awareness in both areas (mean=3.06 and 3.15, respectively). Pearson correlation analysis revealed no significant relationship between awareness of menstrual hygiene and menstrual beliefs, with P=0.410 for menstrual hygiene routines and 0.752 for menstrual practices, indicating that awareness did not strongly correlate with changes in beliefs. Conclusion: The study highlights the need for educational interventions and improved access to modern menstrual materials to enhance menstrual hygiene awareness and practices. By focusing on education and promoting modern menstrual products, it is possible to improve menstrual health outcomes among young female adults.

Background: Menstrual health and hygiene are critical to the well-being of adolescent girls. Understanding perceptions and practices surrounding menarche and menses within educational settings, such as the contrasting environments of public and private schools, is essential for developing targeted support systems. Objectives: This study aimed to compare the perception, emotional experience, and hygiene awareness of adolescent girls regarding menarche and menstruation between public and private secondary schools in Kathmandu Valley. Specific aspects investigated included emotional experiences at menarche, communication patterns, menstrual regularity, pain severity, prior familiarity with menarche, and hygiene practices. Methods: A quantitative, descriptive, and explanatory research methodology was employed. Data were collected from 504 students selected via simple random sampling from public and private secondary institutions in Kathmandu Valley. Findings: Key differences emerged between school types. Public school students were more likely to perceive menarche as a normal physiological event, whereas private school students reported being "terribly frightened" at first menstruation. Menstrual patterns were significantly more regular among public school students. Although a higher proportion of private school students reported severe menstrual pain, this difference was not statistically significant. Hygiene practices were generally good but significantly better among public school students. While private school students had higher familiarity with menarche prior to its onset, gaps remained in their emotional preparation and the translation of knowledge into consistent hygiene practices. The initial confidante (often the mother) did not differ between school types. Conclusion: The study concludes that significant disparities exist in menstrual experiences and practices between public and private school students in this setting. It underscores the need for intensified, standardized school-based menstrual health education that addresses not only knowledge but also emotional preparedness and the consistent application of healthy hygiene practices. Novelty: This research provides a direct comparative analysis of menstrual health perceptions and practices between public and private educational systems in Nepal. It highlights that higher socioeconomic status (associated with private schooling) does not inherently translate to better emotional or practical menstrual health outcomes, revealing a critical gap between knowledge acquisition and its emotional integration and practical application.

Assessment of Menstrual Health and Bleeding Symptoms in Adolescent Girls and Young Women with Sickle Cell Disease

BackgroundAdolescent and young adult (AYA) females in low- and middle-income countries often face disparities in menstrual health (MH). Poor MH and lack of sexual and reproductive health education leads to school absenteeism, increasing risk for adverse psychosocial and educational outcomes. Further, disasters (e.g., earthquakes) are linked with unsafe living environments and sanitation facilities for women. We sought to describe MH perspectives and practices among AYAs in rural Haiti.MethodsWe conducted a cross-sectional survey in two rural communities in Haiti. AYA females aged 14–24 years completed questions on demographics, the Menstrual Practice Needs Scale (36 items; MPNS-36) and the Menstrual Practices Questionnaire (4 items). We performed descriptive statistics and Chi square or Fisher’s Exact tests to compare responses among sub-groups.ResultsAmong 200 respondents, the median age was 20 years (IQR 17–22). 51% (95% CI 44%, 58%; 102/200) were currently attending school at least 3 days/week and 97% (94%, 99%; 193/200) were not married. According to the MPNS-36, 68% (62%, 74%; 136/200) of participants had unmet MH needs. Seventy-one (77%) reused some of their menstrual materials during their last menstruation. During their last menstruation, 44% (37%, 50%; 87/200) reported they often or always skipped school because they had their menses, and 31% (25%, 37%; 62/200) sometimes skipped. Many felt always or often worried that someone or something would harm them while they were changing their menstrual materials at home and at school.ConclusionsAmong AYAs in rural Haiti, three-quarters reported menses-related school absenteeism and two-thirds had unmet MH needs. AYA females often lacked a safe environment to change their menstrual materials. Given recent disasters in Haiti, (August 2021 earthquake), safe environments for MH are critically needed to offset risk for poor psychosocial and health outcomes. Future efforts to improve MH among AYAs in Haiti are needed to ensure access to MH resources and school attendance.

Background: A two-generation study on menstrual health and hygiene practices among daughters and their mothers is limited. In this study, the primary objective was to compare menstrual health practices, period poverty and menstrual hygiene practices between female college students and their mothers. Methods: A community-based cross-sectional study was conducted among 500 female college students (mean age 19 years) and their mothers (n=500, mean age 41 years) in the Thoothukudi district. Five colleges were selected from the twenty colleges in the district using simple random sampling. From the list of students from the selected colleges, female students were selected using computer-generated random numbers and the mothers of all the selected students were included in the study. Information on menstrual health, period poverty and menstrual hygiene was collected using a pre-tested structured interview schedule. Results: Among daughters, 80.4% speak about menstrual pain more than mothers 44% (p<0.001). Of the daughters, 46.2% and 19.8% of the mothers had information about menstruation before menarche (p<0.001). Among daughters 63% and among mothers 30.2% are embarrassed about buying period products (p<0.001). Sanitary pad use among daughters was 93.2% compared to 69.9% among mothers (p=0.001). Using cloth as their menstrual product was reported by 21.8% of daughters and 50.4% of mothers (p=0.001). Conclusions: During menstruation, daughters reported better hygiene practices than their mothers. However, some of the daughters still use clothes as menstrual material, which needs improvement.

BackgroundMenstrual health is a recognised important public health issue and is essential for the realisation of gender equality and the achievement of Sustainable Development Goals. This study aimed to explore the menstrual health experiences of young people in Sweden and how the menstrual cycle affects their health and lives. The study also aimed to identify the facilitators and barriers to achieving menstrual health.MethodsWe conducted a qualitative study in Sweden. Sixteen young people aged 18–28 who have experienced the menstrual cycle participated in individual interviews. Purposeful sampling combined with snowball sampling was applied to recruit the participants. The data were analysed using reflexive thematic analysis.ResultsParticipants viewed menstruation as a sign of having a healthy and functioning body. Menstruation was linked to becoming a woman and fostered a sense of community and sisterhood, which was viewed as positive among cis women. Further, the results showed that physical and emotional symptoms related to the menstrual cycle limited the participants’ everyday lives and social relationships and had a negative effect on their sexual and mental health. While managing their emotional discomfort and other menstrual complaints, they also had to deal with the public stigma and norms about menstruation contributing to shame and worries. Barriers to menstrual health included stigma and norms related to menstruation, which led to the adoption of expected behaviours, such as avoiding participation in social activities. The normalisation of menstrual complaints also contributed to delays in seeking healthcare, despite having symptoms that had a negative effect on their health. An important factor promoting menstrual health and quality of life is access to prompt treatment to mitigate and decrease symptoms that limit everyday life.ConclusionsThe results indicate that menstrual stigma and related norms create challenging situations limiting menstruating people’s everyday lives and reluctance to seek healthcare despite needing to. To promote the menstrual health of menstruating young people in Sweden, organised and systematic screening of menstrual cycle-related symptoms should be provided within student health services at schools and universities, and primary healthcare. Policymakers should consider integrating stigma-reducing efforts into public health interventions to improve general awareness and promote gender equality.

ObjectivesDevelop and validate short and rapid forms of the 36-item Menstrual Practice Needs Scale (MPNS-36).DesignItem reduction prioritised content validity and was informed by cognitive interviews with schoolgirls in Bangladesh, performance...