Menstrual Hygiene Research Articles

A call to action: Standardisation of intravaginal hygiene product reporting in preoperative evaluation.

Preoperative checklists have demonstrated efficacy in improving patient care in the surgical setting. While the assessment of perioperative risks through patient inquiry is extensive, the menstrual status of the patient is one question that is not frequently discussed. If a patient is menstruating during their surgical procedure, unknown use of an intravaginal menstrual hygiene product, such as a tampon or menstrual cup, places the patient at risk of infection. This review seeks to bring attention to these risks by exploring Boyer v. Morimoto, a case where a patient developed toxic shock syndrome after a tampon was left in after surgery. We conclude with recommendations for standardised documentation of intravaginal menstrual hygiene products, with the aim to minimise perioperative risks.

Psychological and emotional aspects of menstrual health and hygiene management: Experiences of adolescent girls from rural Assam, India

The onset of menstruation is a landmark event in women’s life which is known to bring many psychological and emotional changes along with physical changes. In many countries, particularly in developing and emerging countries, such as India, it also brings various challenges for women to manage menstruation hygienically. Studies have often highlighted several well-known practical and physical barriers to Menstrual Health and Hygiene Management (MHHM); e.g., lack of WASH (Water, Sanitation and Hygiene) facilities, lack of affordable menstrual absorbents, and so on. However, there are also some psychological and emotional barriers; such as, trauma of menarche, feelings of embarrassment, stress, anxiety, and shame. These psychological and emotional barriers are known to create tremendous psychological burden for millions of girls while managing their menstruation. However, these challenges and their impact on women’s psychological well-being are relatively less acknowledged and ill-understood. The study was conducted in Assam, India, with a sample of 185 adolescent girls (10-19 years) who participated in 21 Focused Group Discussions (FGDs). Findings show that mostly girls were unaware about menstruation before menarche; their first encounter with menarche was traumatic. Lack of adequate guidance and counselling even after menarche result in significant mental pressure among girls. Several cultural and religious restrictions, feelings of shame and embarrassment, myths and misconceptions associated with menstruation were mentioned. The study concludes that the emotional and psychological barriers of MHHM are preventable by improving the channels of proper guidance and counselling about menstruation in a supportive environment. The study suggests some interventions for the same.

Menstrual cups to reduce bacterial vaginosis and STIs through reduced harmful sexual and menstrual practices among economically vulnerable women: protocol of a single arm trial in western Kenya

BackgroundIn western Kenya, menstrual hygiene management (MHM) is a pervasive problem. Challenges are compounded for economically constrained women who continue to engage in sex during menses and resort to practices such as vaginal insertion of tissue and cotton to maintain dryness during sex. These practices can be harmful to the vaginal microbiome (VMB) and can lead to high rates of sexually transmitted infections (STIs) and HIV. This study will evaluate whether menstrual cups that can be worn during intercourse may be beneficial to the VMB and help prevent Bacterial vaginosis (BV) and STI acquisition among these economically vulnerable women.MethodsIn this single-arm trial among economically vulnerable women in semi-urban western Kenya, we will evaluate the preliminary efficacy of menstrual cups on non-optimal VMB, BV, and STIs, and investigate safety, acceptability, and implementation needs. Through peer referral we aim to recruit 402 menstruating women aged 15–35 who exchange sex for money or basic needs. Women who are pregnant, have delivered in the past six months, or use an intrauterine device (IUD) will not be eligible. Participants will be seen every six months for 24 months and be asked about their sexual and MHM practices, with samples collected to assess BV and VMB. At baseline, 12-, and 24-month visits, additional samples will be collected to measure HIV and STIs (C. trachomatis, N. gonorrhoeae, and T. vaginalis). HSV-2 status will be assessed at baseline. Intervention provision will consist of one reusable disc-shaped menstrual cup per participant and a group-based training within four weeks of the 12-month visit, followed by monthly telephone surveys for the first three months to assess cup use, adverse events, and provide any assistance. Primary analyses of preliminary efficacy will compare probabilities of optimal VMB, BV, and STIs in the pre-intervention period to the post-intervention period. Primary safety analyses will compare occurrence of menstrual toxic shock syndrome and cervicovaginal laceration.DiscussionIf demonstrated safe and effective, this multipurpose reproductive health intervention will offer a dignified solution for the menstrual hygiene needs of women who engage in sex for livelihood and reduce their occurrence of non-optimal VMB, BV, and STIs.Trial registrationClinicaltrials.gov NCT05666778 (28th December, 2022); Pan African Clinical Trials Registry 202,305,912,778,108 (25th May, 2023).

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.

Evaluation of a Menstrual Hygiene Education Program for Adolescent Girls in Rural India

ObjectiveTo assess the impact of a pharmacist-mediated education program on menstrual hygiene among adolescent girls in and around Balagangadaranatha (BG) Nagara, India. DesignPre- and postintervention study conducted over 6 months. Setting/Local ProblemAdolescent girls in India, especially in rural areas, may lack proper knowledge and a supportive atmosphere to deal with menstruation-related concerns. Many myths and taboos also make it difficult or impossible to find accurate information about menstruation and menstrual hygiene. ParticipantsThe sample included 585 female high school students who had begun menstruation and lived in and around BG Nagara, India. InterventionAn educational training session provided information about the menstrual cycle, sanitary products, proper disposal practices, and menstrual disorders. Information addressed the psychological and social dimensions of menstruation to mitigate stigma. Educational leaflets about personal menstruation hygiene practices were also provided. ResultsPre- and posttests were administered to assess participants’ knowledge of and practices regarding menstrual hygiene. Pretest scores indicated that 43.8% (n = 164) of participants had good knowledge of menstruation, 86% (n = 503) used sanitary pads, and 73.2% (n = 428) thought that increasing nutritious food was necessary during menstruation. Posttest scores indicated an increase in all areas (p < .001). ConclusionHealth education was associated with an improvement in female high school students’ knowledge of and practices related to menstrual hygiene. More menstrual health education strategies and awareness programs are needed to improve the knowledge and health of adolescent girls.

A Quasi Experimental Study to Assess Effectiveness of Planned Educational Programme on Knowledge &amp; Practice Regarding Menstrual Hygiene Among Adolescents’ Girls in Selected Urban &amp; Rural Community Area Of Almora, Uttarakhand.

A Quasi Experimental Study to Assess Effectiveness of Planned Educational Programme on Knowledge &amp; Practice Regarding Menstrual Hygiene Among Adolescents’ Girls in Selected Urban &amp; Rural Community Area Of Almora, Uttarakhand.

Assessment of the Readiness, Beliefs, and Practices Regarding Menstruation Among Women in Saudi Arabia.

Menstruation is a natural process that occurs monthly in women. Although menstruation is a fundamental aspect of women's lives, their readiness for and beliefs about menstruation vary. Moreover, their practices during menstruation can be influenced by various factors, including age, education level, mother's education, and field of specialty. This study aimed to explore menstruation-related readiness, beliefs, and practices among women who had experienced menstruation in Saudi Arabia. In addition, the study aimed to evaluate the factors affecting these women's readiness, beliefs, and practices regarding menstruation. This cross-sectional online questionnaire-based study included 3471 women of different ages who had experienced menstruation. The participants were selected using convenience sampling from all regions of Saudi Arabia. The questionnaire was distributed between late December 2022 and March 2023 and included questions on demographics and menstruation-related readiness, beliefs, and practices. Of the 3471 participants, 1627 (46.8%) were well prepared for menstruation. In addition, most of the study participants (80.2%) had positive beliefs about menstruation. However, the participants' menstrual practices varied. Over half of the participants (63%) used painkillers and approximately half (54.4%) used herbal medicine during menstruation. This study found that less than half of the participants were ready for menarche. In contrast, most participants displayed positive beliefs concerning menstruation. In terms of practices, the women exhibited certain dietary restrictions during their menstrual period and predominantly favored herbal remedies for pain relief over conventional painkillers. Implementing awareness campaigns and incorporating school education on menstrual readiness and hygiene is needed.

Overcoming menstrual hygiene challenges through innovation and empowerment

Overcoming menstrual hygiene challenges through innovation and empowerment

UNDERSTANDING THE PERCEPTION OF MENSTRUAL POVERTY IN HOMELESS WOMEN

Brazil faces profound social inequalities that impact millions of individuals, especially homeless women, who are subjected to conditions of heightened vulnerability. This study aimed to understand the perceptions and biopsychosocial repercussions of menstrual poverty in women living on the streets. A descriptive and exploratory cross-sectional study was conducted using a qualitative approach with semi-structured interviews. Four homeless women, selected through an active search in Goiânia/GO, were interviewed between April and June 2024. The interviews were analyzed according to Grounded Theory. The analysis of the interviews revealed four explanatory categories: (1) History before and after arriving on the streets; (2) Challenges related to living on the streets and health care; (3) Challenges for menstrual hygiene and coping with menstrual symptoms; and (4) Perception of the consequences of living and menstruating on the streets for health: a vision of the future. Period poverty is identified as a serious public health problem that affects the well-being of homeless women, with direct implications for their physical and mental health. There is an urgent need for public policies that guarantee access to hygiene products and health care, in addition to promoting the visibility and dignity of this group. The implementation of comprehensive support and assistance programs is crucial to mitigate the repercussions of period poverty and other vulnerabilities faced by these women, ensuring their dignity and quality of life.

WASH recommendations for improving disaster preparedness and recovery in schools in Indonesia

Access to functional and clean toilets which maintain privacy and dignity and support girls’ Menstrual hygiene management (MHM) plays a crucial role to getting girls back to school post-disaster. This could also help in managing feelings of shame and disgust experienced when using toilets in schools in post disaster settings. In this paper, we report on our assessment of water, sanitation and hygiene (WASH) facilities in schools three-years post the 2018 multi-hazard event in Indonesia. We used a mixed-methods approach using visual observations, interviews with school principals, surveys with schoolgirls and focus group discussions with schoolgirls and teachers to understand the lived experiences of students using toilets at school. Our results highlight that across schools descriptive and injunctive social norms were supportive of littering, inadequate toilet facilities for girls to manage their menstruation and bullying and antisocial behaviour by opening toilet doors while the facilities were occupied. Based on these results, we developed two types of interventions, physical and behavioural, piloted in three schools to increase WASH and MHM awareness and the safety of sanitation facilities. Our interventions showed that approaches for WASH interventions in schools can only be designed if we understand the local barriers to carrying out interventions that integrate maintenance plans. We provide recommendations to support practitioners in mitigating risk and improving circumstances for girls in schools in Indonesia, which have the potential to address SDG 4 on inclusive and equitable education and SDG 5 on gender equality and girls’ empowerment.

Association between attitude and menstrual hygiene management practices among adolescent girls with disabilities in selected schools in Wajir County, Kenya

Background: Menstruation is the recurrent peeling of the uterine lining that occurs monthly on girls and women of the reproductive age. Many adolescent girls in African countries have poor knowledge regarding menstruation and this is even worse among menstruating girls with disabilities who are faced with a greater challenge as they require private and specific sanitation facilities. The study focused on establishing the association between attitude and menstrual hygiene management practices among adolescent girls with disabilities in selected schools in Wajir County. Methods: A descriptive cross-sectional design was adopted. Census method was used to select respondents where 101 were interviewed. Pretested questionnaires were used to collect data. All necessary research approvals from relevant institutions were obtained as well as consent and assent sought from respondents and guardians where applicable. Data was managed using SPSS version 22.0 software. Results: Most 88.1% of the respondents did not practice menstrual hygiene management. Further results revealed that 98.9% of those who had negative attitude had not practiced menstrual hygiene management. There was a significant statistical association between nature of attitude and practice of MHM (χ2=11.009, p*=0.029). Conclusions: About 9 out of 10 adolescents with disabilities in Wajir County did not practice menstrual hygiene management. The nature of attitude towards menstrual hygiene management was significantly associated with practice. The study recommended provision of free sanitary pads by relevant stakeholders to all girls who are living with disabilities and provision of enough washrooms to address privacy issues.

Menstrual Hygiene and Sanitation Practices Among Female College Students in Surkhet

Menstrual Hygiene and Sanitation Practices Among Female College Students in Surkhet

"We pray for the night to be shorter, so we can change our menstrual pads": A qualitative exploration of menstrual hygiene challenges among internally displaced adolescent girls in Northern Ethiopia, 2023.

Menstrual hygiene management is a critical aspect of adolescent health. However, access to adequate menstrual hygiene products and sanitation facilities is severely restricted during times of war. There is a dearth of information about the menstrual hygiene needs of adolescent girls during humanitarian crises. This study investigated the menstrual hygiene management needs of the internally displaced adolescent girls in the war-torn region of Tigray, Ethiopia. A qualitative study was conducted in three centers for internally displaced people in Mekelle, Tigray Region. Four focus-group discussions and six in-depth interviews were conducted using the local language among 39 adolescent girls aged 13-19 years. The collected data were recorded, transcribed, translated, and analyzed using the ATLAS.ti-7.5.18 software through a qualitative thematic analysis approach. Six primary themes were identified: 1) shortage of menstrual pads; 2) poor accommodation of latrine facilities; 3) silence around menstruation; 4) exchange of menstrual pads for life-saving commodities, 5) lack of privacy; 6) menstruation is a "curse" for adolescent girls living in displaced people's camps. The study highlights the significant challenges faced by internally displaced adolescent girls in managing their menstrual hygiene while living in camps for internally displaced people. Lack of access to adequate menstrual hygiene management supplies often leads them to use rags or worn-out clothing instead of menstrual pads. Access to adequate menstrual hygiene products and sanitation facilities is severely limited among displaced adolescent girls in Tigray. The findings emphasize the urgent need to address menstrual hygiene issues during emergencies. Supplying essential items such as sanitary pads, soap, water, sanitation infrastructure, and improved information on menstrual hygiene management should be prioritized.

Utilizing Citizen Generated Data to enhance Women's Access to Sexual and Reproductive Health Services in Somalia: Insights, Barriers, and Pathways Forward

Purpose: This study was undertaken to capture citizen’s insights on practical steps that individuals, families, communities, and institutions could take to support the improvement of Sexual and Reproductive Health (SRH) services in Somalia. This includes raising awareness of issues affecting women's access to SRH, such as Gender-Based Violence (GBV) and Female Genital Mutilation (FGM). Methodology: This research employed a qualitative research design, utilizing semi-structured radio questions distributed through various channels such as radio promos, mini-dramas, interactive radio shows, and Short Messaging Service (SMS) on mobile phones. To enhance and validate the findings from the radio series, thirty Focus Group Discussions (FGD) involving 270 'hard-to-reach' participants were conducted across all Federal Member States (FMS) of Somalia, excluding Somaliland. Collaborating with 20 radio stations, a total of 4,268 participants from across Somalia were involved in this study. The qualitative data obtained was categorized into themes, and the subsequent information was analyzed using content analysis methodology for qualitative data, as well as descriptive statistics and inferential analysis through statistical package for social science (SPSS) version 25 and excel for quantitative data. The presentation of the data included the use of tables and figures. Findings: This study outlined key challenges in accessing quality SRH services for women in Somalia. Priorities included enhancing healthcare infrastructure and availability of SRH professionals, along with emphasizing health education on reproductive health and family planning. Food insecurity's impact, especially among displaced populations, was noted. GBV and FGM were highlighted, calling for comprehensive survivor care and male involvement in prevention. Collaboration between schools and the private sector was proposed for menstrual hygiene. Men's support for SRH access was deemed crucial. Addressing stigma around SRH access, GBV, and FGM was stressed, urging comprehensive awareness campaigns and improved healthcare provision for survivors. Unique Contribution to Theory, Practice and Policy: Addressing women's SRH in Somalia involves investing in healthcare infrastructure, expanding health education programs, ensuring access to nutritious food, and engaging men as allies in promoting women's SRH rights. Moreover, efforts to combat stigma, GBV, and FGM must be culturally sensitive and inclusive, involving religious and community leaders, and addressing underlying socio-economic factors contributing to these issues.

An observational study on menstrual hygiene practices among adolescents girls attending zilla parishad high school at Kommadi village in Visakhapatnam

Under RMNCH+A strategy, adolescent health program is relatively a new concept, particularly for female gender, and has been considered to be a continuum of health services up to adolescent age. The priority interventions among adolescent girls are, nutrition, Adolescent Friendly Health clinics (AFHCs), Counselling, Menstrual hygiene and preventive health checkups. Menstrual hygiene component has been taken for the present study among the adolescent girls in a Zilla Parishad High School aged 10 to 19 years. Rastriya Kishora Swastya Karyakram (RKSK) is broader one including both gender for distinct health services in India. : To study the association of various socio- economic and cultural practices influencing the usage of sanitary napkins by menstruating adolescent school girls. : Cross sectional study among menstruating adolescent girls in a Zilla Parishad High School at Kommadi village. 198 adolescent girls were randomly selected for study using semi structured questionnaire. Each menstruating girl is questioned categorically (yes/no) as per the structured questionnaire covering socio economic status, literacy of mother, awareness about ASHA etc. Appropriate statistical tests like frequencies, percentages and chi-square tests are applied to analyse and interpret the collected data.Socio-demographic factors of the target population in the community from where the adolescent girls attending zilla Parishad High school were subjected to study and found that 19(22%) adolescent girls having white ration card are using sanitary napkin. 46% of sanitary napkin users in our study are aware of using cloth available in the house during menstruation. 39 (52%) adolescent girls using sanitary napkin are aware of ASHA worker visiting their colony. One of the family members, either mother or elder sister being a member in Self Help Group in the colony is influencing the usage of sanitary napkin 46 (50.5%). Habit of Over-the-Counter drugs usage in the family has significantly (55%) influenced the adolescent school girls in using sanitary napkin. School drop-outs 51(62.9%) are also observed among sanitary napkin users during menstruation.: The usage of sanitary napkin replacing the traditional home-made cloth is highly essential for proper menstrual hygiene management among adolescent girls attending the school regularly without drop out. The role of ASHA workers and other paramedical staff in the community cannot be undermined.

A Geographical Analysis of Access to Adequate Menstrual Health and Hygiene Resources Among Young Women in India

A Geographical Analysis of Access to Adequate Menstrual Health and Hygiene Resources Among Young Women in India

Awareness and Practices Related to Menstrual Hygiene and Associated Problems in Adolescent Girls Residing in Tea Garden Areas of Jorhat, Assam, India

Awareness and Practices Related to Menstrual Hygiene and Associated Problems in Adolescent Girls Residing in Tea Garden Areas of Jorhat, Assam, India

Unveiling disparities: a non-linear decomposition analysis of the gap in menstrual hygiene material use between adolescent women in Aspirational and the remaining districts of India.

This study aimed to investigate the factors contributing to the gap in the use of hygienic materials during menstruation to collect blood among adolescent women between Aspirational and the remaining districts of India. The study sample consisted of 114805 adolescent women (20835 women from 112 Aspirational districts and 93970 women from 595 remaining districts) from the National Family Health Survey-5. Fairlie decomposition was used to identify and measure the factors contributing to the gap in the use of hygienic materials between Aspirational and the remaining districts of India. This study determined that the use of hygienic materials during menstruation varied significantly between Aspirational and the remaining districts. While only 37% of adolescent women used hygienic materials in Aspirational districts, almost 52% did so in the remaining districts. Seventy-five per cent of Aspirational districts (84 of 112 districts) reported less than 50% use of hygienic materials, which is lower than the national average and the average of the remaining districts. It was revealed that nearly 90% of the total explained gap between the two groups was accounted for by household wealth, place of residence, exposure to mass media, and education level. Wealth was the main contributor to the gap, explaining about 46% of the difference in hygienic materials use between Aspirational and the remaining districts, followed by the place of residence (18%), exposure to mass media (15%), and education level (11%). Findings suggest that targeted interventions to improve access to hygienic materials among adolescent women in Aspirational districts, particularly those in the northern states of Uttar Pradesh, Bihar, and Chhattisgarh, are necessary. Policy efforts should focus on women from poor households, improving access to education, and expanding mass media exposure in Aspirational districts to reduce the gap in menstrual hygiene practices among adolescent women in India.

A Study on Dysmenorrhea and Its Self-Care Behaviors Among Women of Reproductive Age in Tiruvallur District, Tamil Nadu.

Menstrual cramps, which can be categorized as primary or secondary depending on the etiology, are a painful feature of dysmenorrhea.Researchers from throughout the country found that self-care practices for dysmenorrhea included reducing physical activity, adjusting diet, medications, or treatments, adopting alternative therapies, recording symptom clusters of discomforts, and expressing feelings. Methodology:There were 246 women in the reproductive age range who took part in this study. Thiruvallur district's Thirumazhisai town panchayat served as the location of a community-based cross-sectional study.Parameters such as menstrual history, food history, self-care techniques during dysmenorrhea, and sociodemographic information were evaluated using a pre-tested semi-structured questionnaire. The prevalence of dysmenorrhea was found to be 71.54%. Among 47.15% of the participants, 75.8% who were married were found to have dysmenorrhea, whereas 67.7% of the 52.54% participants who were unmarried had dysmenorrhea. The association between age, smoking habits, exercise, and the presence of dysmenorrhea was found to be statistically significant. Women, especially in India, have certain taboos and misconceptions associated with menstruation which can hurt their hygiene and self-care practices. This study highlights the need for menstrual hygiene awareness among women and proper self-care methods to be followed.

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.