Menstrual Experiences Research Articles

Surfing the red tide: supporting the menstrual health needs and rights of students with disabilities in the classroom

ABSTRACT The states of Oregon and Connecticut and the District of Columbia in the USA mandate the teaching of menstrual education which means the teachers of students with disabilities are expected to be familiar with the topics of hygiene, self-care, and independent living skills in relation to menstrual health needs. Special education teachers may need to attend to pre-menstrual symptoms, collect data on challenging behaviour, and ensure their students have access to period products. Teachers can consult with parents about teaching these skills at home to ensure generalisation of skills across contexts, and to build strong communication between school and home. Teachers should also familiarise themselves with local resources for menstrual supplies and instructional materials for both students and parents. Teaching skills in relation to menstrual health is critical for increasing independence, maintaining individual dignity, and fostering a menstrual experience free of stigma and shame.

EXPLORING THE ASSOCIATION BETWEEN HOUSEHOLD SANITATION AND WOMEN’S MENSTRUAL HYGIENE MANAGEMENT IN RURAL ODISHA, INDIA

IntroductionAccess to water, sanitation, and hygiene (WASH) facilities has been globally recognized as a critical need, especially for women and girls to ensure their menstrual hygiene. This study aimed to investigate the association between household sanitation and women’s menstrual management experience in Odisha, India. MethodsA cross-sectional study was conducted in Balasore district of Odisha state in India among 694 rural women and girls aged 15-45 years selected using a multi-stage sampling method. The Performance Monitoring and Accountability (PMA) 2020 questionnaire was used for data collection. Multivariate logistic regression analysis was carried out using SPSS version 25. ResultsMore than two-third (68.4%) of rural families used improved sanitary facilities. Around 30% of households have been using an unimproved sanitary facility, which means the practice of open defecation is still prevalent in rural areas. About 40.6% of women and girls reported using clothes as their primary menstrual hygiene material. Further, women and girls with improved sanitation facilities (aOR = 1.56, 95% CI: 1.09 - 2.59) were more likely to change menstrual materials at the main household sanitation facility than those with an unimproved sanitation facility. In contrast, households using improved sanitation facility were less likely to use bedroom/sleeping areas to change the menstrual materials (aOR=0.65, 95% CI: 0.42-0.99) than those with an unimproved facility. ConclusionAvailability of improved household sanitation is critical to good menstruation management practices. State-specific policy for menstrual health and hygiene could provide the much-needed impetus to strengthen WASH infrastructure in rural and tribal regions of Odisha.

Menstrual management in transgender and gender diverse individuals: psychiatric and psychosocial considerations.

Transgender and gender-diverse (TGD) menstruators are individuals assigned female at birth (AFAB)*, who retain the capacity to menstruate and have a gender identity that differs from their natal sex. Reports indicate up to 1.6 million individuals in the US identify as TGD. Until recently, the mainstream menstrual discourse has failed to capture the experience of transmenstruators. However, a better understanding of the menstrual experiences of TGD-AFAB will allow for more individualized patient-centered care. In this review, we provide the relevant data necessary to inform the psychiatric management of menstruation in TGD-AFAB individuals, including experiences of menstruation, preferences for menstrual management, and the impact on mental health. Our review indicates that menstrual care in TGD patients must be tailored to the individual; clinicians should remain open-minded to the unique experience of transmenstruators; gender-affirming menstrual care is necessary to reduce psychological burden. It should not be assumed that TGD-AFAB menstruators are utilizing appropriate contraceptive methods and should receive contraceptive and fertility preservation counseling. We highlight the importance of having these conversations early in the reproductive arch, even before puberty onset. Keeping in mind the gender minority stress model, in the upcoming sections, we discuss the limited body of literature on mood disorders in TGD-AFAB individuals who menstruate, undergo menstrual suppression, or continue to ovulate. The psychological impact of hormonal therapies is also reviewed.

An intersectional approach on menstrual inequity as lived by women in circumstances of socioeconomic vulnerability in an urban and rural setting in Spain: a qualitative study

Since menstrual health and menstrual inequity are determined by social power structures, this study proposes to analyse, from an intersectional perspective, the experiences of menstrual inequity of women and people who menstruate (PWM) (≥18 years) under circumstances of socioeconomic vulnerability in an urban and rural setting in Catalonia (Spain), focusing on menstrual poverty, menstrual management and access to health care for menstrual health. An exploratory and interpretative qualitative study was conducted. Venue-based convenience sampling was carried out, recruiting women from a non-governmental organisation and a primary health care centre. Eighteen individual semi-structured interviews were conducted between October 2022 and February 2023. Data were analysed through reflexive thematic analysis. Analysis revealed that menstrual care was generally a distant preoccupation that revolved around circumstances of socioeconomic vulnerability, housing, and productive/reproductive work. Menstrual poverty, menstrual management and menstrual self-care challenges, barriers to accessing health care for menstrual health, and menstrual taboo, stigma and discrimination were commonplace and deepened by socioeconomic vulnerability. In this way, women’s menstrual experiences were rooted in intersecting axes of inequity, based on gender, race and class. Intersectional and critical participatory research, policy and practice are imperative to develop counter mechanisms that confront systems of privilege-oppression to modulate menstrual experience, health and equity.

'It's a Horrible Place to Have a Period': A Survivor-Led Investigation of Experiences of Menstrual Health in Psychiatric Inpatient Settings in England.

This study examined patients' experiences of menstrual health in psychiatric inpatient settings in England as reported by staff and patients. Questionnaires were conducted with 67 staff members and 101 people with lived experience of menstruation and treatment on a psychiatric ward. 10 semi-structured interviews were conducted with people with lived experience. Data were analysed using reflexive thematic analysis. Grouped into overarching themes of institutional and interpersonal environments, four themes were identified: access to menstrual materials; the lack of privacy when menstruating in psychiatric inpatient settings; attitudes and approaches to menstruation; and menstrual support needs and care provision. There was variation among the experiences reported, with some patients receiving dignified care, whilst others described facing 'degrading' and 'dehumanising' treatments and enhanced feelings of shame and embarrassment around menstruation, in comparison with what they usually experience. This appeared to arise due to the interplay between mental health services overlooking menstruation and the overreliance on restrictive practices. These experiences may be understood as menstrual injustices, period poverty,potentially amounting to neglect and posing iatrogenic harms. Participants also discussed how their mental illness and distress, particularly within the context of trauma and/or eating disorders, shaped their menstrual experiences. However, many patients did not receive adequate support in relation to this. Patients' pain and disorder related to menstruation, or gynaecological conditions, was often described as being dismissed by staff or being viewed as beyond the responsibility of mental health services. This study highlighted the urgency for actions to be taken to provide greater support for patients who menstruate in psychiatric inpatient settings.

Period poverty behind the numbers: gender, race, and class in the menstrual experiences of girls from an urban periphery in Brazil

ABSTRACT This article analyzes period poverty based on interviews with six girls living in a region on the outskirts of the city of Porto Alegre (Brazil). The results of the qualitative study reveal some realities that are behind the numbers. The lack of information about menstrual health, menstrual cycles, and the limited self-awareness about the body became evident. All the interviewed adolescents who sought health services due to any menstrual or body-related issues during puberty received a racist, sexist, or ageist treatment or a combination of these prejudices. Their accounts regarding access to menstrual hygiene products and sanitation infrastructure do not fully correspond to the data on period poverty: the girls have access to disposable sanitary pads during menstruation, clean water, and bathrooms in usable conditions. The stories told by the teenagers expand the discussion about period poverty as they highlight cultural factors related to their menstrual experiences. Their accounts also show that initiatives and public policies to combat menstrual precariousness cannot be limited to the material field and point to the need for systemic cultural changes to combat racism, sexism, and ageism.

‘At what point will they know’: A thematic analysis of how UK university men experience menstrual education

Previous studies report men’s vulnerability to menstrual misinformation and ideologies that negatively impact menstruators. Yet, research of men’s menstrual education is sparse. Therefore, the present study conducted a Reflexive Thematic Analysis to explore: From whom and how do UK cis-gender males experience menstrual education? Eight male university students in England aged 18 to 24 participated in online interviews. Four identified themes: Sitting on the Sidelines, A Comedy Amongst Men, It’s a Girl Thing, and Beyond Biology revealed limited education which cultivated stigma, ignorance, confusion, and curiosity. Humorous methods were utilised to seek and express knowledge. Despite barriers of knowledge and relatability, holistic menstrual information was requested. The findings suggest that men do not have knowledgeable others to scaffold positive learning and pro-social behaviours. Thus, enhancing education programs and advocating for inclusive changes at micro and macro levels of society are essential to improving men’s menstrual educational experiences and combatting women’s subjugated position.

MENSTRÜEL SEMPTOM YAŞAMA DURUMU İLE AİLEDE MENSTRÜEL SEMPTOM ÖYKÜSÜ VE ALGILADIKLARI SOSYAL DESTEK İLŞKİLİ Mİ: KESİTSEL ÇALIŞMA

This study aims to determine the relationship between menstrual symptom experience, the presence of menstrual symptoms in the family, and perceived social support in women of reproductive age. This descriptive and cross-sectional study was conducted with women aged 18–49 living in XXX on online platforms between April 1 and June 30, 2022. Participants were invited to the study through social media platforms. The women 942 constituted the sample of the research. The mean age of the women who participated in the study was 28.45±6.75 years. Of the participating women, 80.1% reported that they had regular menstruation and 71.1% had a family history of menstrual symptoms. The mean total scores of the Menstruation Symptom Questionnaire (MSQ) and Multidimensional Perceived Social Support Scale (MSPSS) were 63.02±16.07 and 66.97±14.95, respectively. The results of the study showed a strong relationship between experiencing menstrual symptoms and a history of menstrual symptoms in the family. There was a low-level significant relationship between experiencing menstrual symptoms and social support. Accordingly, it is recommended to conduct more studies on the relationship between social support and menstrual symptoms using an increased sample size and prospective methods.

Nursing Students' Menstrual Experiences and Period Poverty

The aim of this study was to determine the menstrual experiences and period poverty status of nursing students. The study was conducted with 234 students who were menstruating, using Personal Information Form and Menstrual Practice Needs Scale(MPNS) in May-June 2023. An average of 18.63±9.26 pads was used during one menstrual period. Of the students, 14.1% had problems accessing menstruation products in the last year, 9.4% were hesitant to obtain menstruation products, 48.3% had financial difficulties while procuring the products, with 23.5% not using sanitary pads. The MPNS mean scores of the students were 2.31±0.40 for the material and home environment needs subscale, 1.88±0.55 for the transportation and school environment needs subscale, 1.70±0.64 for the material reliability concerns subscale, and 2.42±0.49 for the replacement and destruction insecurity subscale. As a result of the study, some students had financial difficulties in obtaining menstrual products, therefore they used menstrual products for longer than they should be used.

“You have to stay in your house…because trouble can come”: The impact of education, policy, and COVID-19 on menstruation experiences in Florence, Italy

Starting from menarche to menopause, menstruators have an overall negative view of menstruation, and there is a prevalent need for community awareness to increase regarding this topic. Menstruators in Italy and Europe arrive at menarche earlier than they have in previous decades, allowing less time for them to receive preparatory knowledge. Some European countries have started employing menstrual policies, yet current menstruation education minimally supports menstruators in terms of recognizing irregular symptoms and learning how to manage them. Additionally, the COVID-19 pandemic caused menstrual lifestyle patterns and experiences to be altered. The purpose of this study is to gain an understanding of menstruation-related education and policies accessible to menstruators and the impact COVID-19 had on menstruators. Researchers conducted 28 in-depth interviews in English with menstruators aged 18+ years who lived in or around Florence, Italy. All interviews were transcribed verbatim. Researchers used thematic analysis during coding to explore and understand participants’ menstruation education at menarche, menstrual leave policy opinions, and how COVID-19 impacted their menstruation experiences and the availability of menstrual resources. Participants discussed varying timelines regarding when they were taught about menstruation. Their education sources varied between family, peers, personal experiences, and school. Most participants expressed enthusiastic feelings toward menstrual leave policies. Many participants reported having faced challenges accessing menstrual products during COVID-19. Most participants expressed having positive impacts, while few expressed negative impacts during COVID-19. Results found most menstruators learned about menstruation through their family before menarche but did not consider themselves prepared for their first cycle. The COVID-19 pandemic influenced many menstruators to adopt some lifestyle habits, shedding light on the varying opinions on the need for a menstrual leave policy. Revamped policies related to timing, education type, and personal leave should be considered.

Generative Design Research for a Culturally Sensitive Subject: Exploring Menstrual Practices and Product Experiences to Inspire Design

The intimate nature of menstruation and the taboos surrounding it cause numerous challenges for conducting research in this field. To explore menstrual practices and product experiences, in this study, a generative workshop study was designed with participatory research tools and co-design exercises, following a semi-structured interview schedule. The generative research was seen as having the potential to overcome the intimate nature of the research subject and to gather design insights for menstruation. The workshop sessions include physical and visual research tools and generative exercises that are deliberately thought to remind the participants of the context of use, evoke dialog, and inspire new ideas. Understanding the underlying complexities and motives behind menstruation is crucial for the development of better solutions, products, and/or services. The data obtained from the workshops were analyzed to reveal design criteria for menstruation products and experiences by following the procedures of grounded theory. “Failures,” “limitations,” “social codes,” “tactics,” and “improvements” have been identified and discussed as design criteria that could inspire designers.

"It shouldn't be just hush-hush": A qualitative community-based study of menstrual health communication among women in Philadelphia.

Although menstruation is a natural biological process, many people feel embarrassed of their menses and struggle to discuss it. To mitigate menstrual communication stigma, it is necessary to first elucidate communication experiences and perceptions. Thus, we qualitatively explore menstrual communication among cisgender women who menstruate and their family, friends, healthcare providers, and community. In partnership with No More Secrets (NMS), a Philadelphia menstrual health non-profit, we conducted a community-based participatory research (CBPR) project in Fall 2020. Cisgender, menstruating individuals ages 18-45 recruited from NMS' catchment in Philadelphia participated in semi-structured interviews about their menstrual experiences and communication (N = 20). A deductive, theory-driven approached based on the social-ecological model was used to analyze the data. Varying emotional responses arose across social-ecological levels: communication was awkward and simplistic with family; positive and supportive with friends and community members; and uncomfortable and frustrating with healthcare providers. Participants echoed the importance of menstrual communication as a means of sharing information, feeling less alone, and decreasing menstrual stigma. Findings can inform future CBPR workshops that address stigma in familial, healthcare, and community-based discussions to improve menstrual health and experiences for cisgender girls and women, transgender men, and gender non-binary individuals who menstruate.

School teachers’ menstrual experiences and practices: reflections from rural Rajasthan, India

Menstruation is considered an off-limits subject in India where menstruating woman continue to face silence, discrimination and isolation. A mesh of patriarchal cultural practices surrounding the subject of menstruation places restrictions on girls and women who are menstruating. This paper explores the menstrual experiences and challenges experienced by teachers from a village located in a Kishangarh block in rural Rajasthan. Informed by qualitative research, the study reveals the irony in thrust to distribute disposable menstrual pads to adolescent girls in school while ignoring the needs of teachers. The study calls for the inclusion of teachers as key stakeholders in the design of school based menstrual hygiene management and awareness initiatives and programmes.

Menstrual Practice Needs Scale short form (MPNS-SF) and rapid (MPNS-R): development in Khulna, Bangladesh, and validation in cross-sectional surveys from Bangladesh and Uganda

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...

THE SILENT FLOW: MENSTRUAL EXPERIENCES AND THEIR SUPPRESSION IN POPULAR DISCOURSE

Menstruation, a biological phenomenon experienced by half the global population, has historically been shrouded in stigma and silence across cultures. This paper examines the suppression of menstrual experiences in popular discourse, focusing on cultural taboos, media representation, and societal norms. It highlights how this silence perpetuates gender inequalities and restricts open discussions about health and well-being. The paper also explores emerging literature, film, and social media counter-narratives that challenge these taboos, advocating for menstrual equity and normalisation. Through a critical analysis of cultural practices and media portrayals, this study calls for reimagining menstruation as an integral, natural aspect of life.

Degendering Menstruation: A Scoping Review Exploring the Experiences of Transgender and Non-Binary People

ABSTRACT Menstruation is a biological process experienced by up to 800 million people on any given day. Historically, menstruation has been studied from the female perspective. However, it should be considered that not all who menstruate are women. Therefore, the purpose of this research was to determine the status of evidence on transgender and non-binary individuals’ experiences with menstruation. Arksey and O’Malley’s (2005) framework for conducting a scoping study was used to guide this review. The authors used five steps of the six-step process to identify the research problem and search strategy, select studies based on defined inclusion and exclusion criteria, extract key information from five selected studies, and chart, summarize, and report the results as themes. The analysis resulted in the identification of four themes: (1) gender dysphoria and the influence on identity; (2) menstrual management and transformation as a turning point; (3) managing menstruation in precarious spaces; and (4) moving toward an open dialogue. Findings suggest a need for awareness of diverse and inclusive menstrual experiences. Inclusive advertising and menstrual products are needed to support transgender and non-binary people and reduce gender dysphoria. Policy initiatives should support the reconceptualization of infrastructure so that bathrooms are safe and comfortable places. Future opportunities for research exploring menstrual management within transgender and non-binary populations with emphasis on global research with diverse cultures and social structures is necessary to address gaps in the existing literature.

Understanding Adolescents' Experiences With Menstrual Pain to Inform the User-Centered Design of a Mindfulness-Based App: Mixed Methods Investigation Study.

Digital interventions are increasingly popular for the provision of nonpharmacological pain interventions, but few exist for adolescents with menstrual pain. User-centered design involves incorporating users across phases of digital health intervention design, development, and implementation and leads to improved user engagement and outcomes. A needs assessment is the first step of this approach. The goal of this study was to conduct a needs assessment to understand menstrual pain management needs and preferences and mindfulness experiences, preferences, and knowledge of adolescents with menstrual pain to inform the future development of an app for managing menstrual pain. We used an explanatory sequential mixed method design that included a survey followed by focus groups. Adolescents aged 13-17 years completed a survey (n=111) and participated in focus groups (n=16). Data were analyzed using descriptive statistics and thematic content analysis and synthesized to provide specific recommendations based on adolescent responses. Adolescents (n=111) who completed the survey reported a moderate understanding of mindfulness and menstrual pain. Over three-quarters (n=87, 78%) of participants practiced some form of mindfulness and 87% (n=97) of survey participants used nonpharmacological pain management strategies. Teens had a moderate perception that mindfulness could help their menstrual pain (mean 4.51/10, SD 2.45, with higher scores suggesting more interest). Themes were generated related to mindfulness experiences, menstrual pain knowledge and experiences, and app functionality. These themes underscored adolescents' need for continued support and flexible access to mindfulness activities; their awareness of multiple influences to pain, with potential for further education in this area; and the need for menstrual pain-specific content, along with content relevant to typical day-to-day experiences of adolescents. Adolescents with menstrual pain have an interest in using a mindfulness app for pain but have unique needs that need to be addressed to ensure app engagement and relevance for this population. Concrete recommendations for future app development are provided.

Protocol for the Adolescent Menstrual Experiences and Health Cohort (AMEHC) Study in Khulna, Bangladesh: A Prospective cohort to quantify the influence of menstrual health on adolescent girls’ health and education outcomes.

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...

A Qualitative Analysis of Urbanization and Menstrual Health Among Young Women.

This qualitative study, grounded in theory, employed inductive coding for analysis, focusing on menstrual health among urban women aged 10-25. The research aims to explore the menstrual health status, practices, and beliefs of participants. The research delves into the impact of recent government initiatives on menstrual health and assesses the role of urbanization in shaping evolving menstrual health practices among young girls. Employing in-depth qualitative methods such as interviews and focus group discussions, the study seeks a comprehensive understanding of participants' experiences and perceptions related to menstrual health. The dynamics of women's menstrual experiences are significantly influenced by urbanization, heightened exposure to social media, evolving lifestyles, and government initiatives like the distribution of menstrual products in schools and the enhancement of water, sanitation, and hygiene (WASH) facilities in government institutions. Positive shifts have been observed, including reduced restrictions on menstruating individuals, enhanced access to affordable hygiene products, and improved disposal facilitated by municipal garbage collection services. However, notable gaps persist in basic knowledge about menstruation, hygienic practices, effective interpersonal communication with schoolteachers or community health care workers, and compliance with government programs promoting weekly iron-folic acid supplementation and biannual Albendazole intake, calling for substantial improvement.

Associations between psychological distress in adolescence and menstrual symptoms across life: Longitudinal evidence from the 1970 British Cohort Study

PurposeThis study aimed to investigate the association between psychological distress (PD) at age 16 and menstrual symptoms experienced across women's life. MethodsUp to 2584 females from the 1970 British Cohort Study, a study of individuals born within one week in 1970, were included. PD at age 16 was measured with the 12-item General Health Questionnaire. Three categories were derived: low PD (<11), moderate PD (11–15), and severe PD (>15). Five menstrual health symptoms were self-reported at each age (16, 30 and 42 years). Binomial logistic regressions examined associations between PD at age 16 and each individual symptom, adjusted for age of menarche, sleep and appetite problems, physical activity levels and socioeconomic position. ResultsThe most prevalent symptoms were “pain” (61 %), “painful period” (10 %) and “heavy period” (33 %) at ages 16, 30 and 42, respectively. At age 16, those with severe PD were more likely to experience depression (OR: 2.92; 95% CI: 2.31, 3.70)), irritability (1.67; 1.33, 2.11), menstrual pain (1.34; 1.01, 1.80), and headaches (1.29; 1.02, 1.63). A weak association was found between severe PD at age 16 and pre-menstrual tension at age 30 (1.72; 1.01, 2.83). At age 42, those with severe PD at age 16 were more likely to experience pre-menstrual tension (1.89; 1.46, 2.44), painful periods (1.64; 1.27, 2.11), and heavy periods (1.28; 1.00, 1.62). DiscussionMenstruating females with higher levels of PD in adolescence have an increased risk of menstrual symptoms across adolescence, early and mid-adulthood. Our findings suggest the need to consider early-life psychological interventions to improve women's menstrual experiences across their reproductive years.