MENSTRUAL HYGIENE AND COMMON ADOLESCENT GYNECOLOGICAL PROBLEMS - A BIRD’S EYE VIEW

Menstrual disorders are a common problem in adolescents the world over. Though the onset of menstruation is part of the normal maturation process, Menstrual disorders form the commonest gynecological complaint (45-58 %) among adolescents. The series of natural changes occurring to the uterus and body starting from the first day(1) of periods until the day before next periods can be called as menstrual cycle. It consists of “menstruation” in which inner layers of uterus sheds along with blood, and “ovulation” in which the ovum is released from the ovary. Men- strual hygiene deals with special healthcare needs and requirements of women during monthly menstruation or menstrual cycle. Unhygienic menstruation is the prime cause of menstrual diseases. Abnormalities in menstrual cycle are increased or decreased menstrual flow and increased or decreased intervals between two menstrual cycles. Menstrual abnormalities are common pathological problems associated with women of puberty age, which is en- hanced by disturbed dietary and daily regimens. It requires early attention and interventions to protect them from having undesired health events in the future. In addition to this appropriate Ayurveda medicines are required to bring the body in a balanced state. Here an attempt is made to compile the ideas of Acharya about menstrual health problems for their proper understanding and treatment through Ayurveda- the science which survived the time. Keywords: Normal menstruation, Menstrual hygiene, Adolescent girls, Menstrual disorders, Treatment and pre- vention, Ayurveda, Ritu

Menstrual health and factors associated with school absence among secondary school girls in Luang Prabang Province, Lao People’s Democratic Republic: A cross-sectional study

In Lao People’s Democratic Republic (Lao PDR), information on school sanitation and menstrual health among secondary school girls is limited. This study aimed to explore knowledge and practices surrounding menstrual health and to identify factors associated with school absence due to menstruation among secondary school girls in Lao PDR. The study involved 1,366 girls from grade 9 to grade 12 in six secondary schools in Luang Prabang Province. Data on socio-demographics and menstrual health of the girls and data on school toilets was collected. Logistic regression analysis was performed to identify the factors associated with school absence due to menstruation. The mean age was 15.8 years old. The average age of menarche was 12.9 years old. Of 1,366 girls, 64.6% were shocked or ashamed when they reached menarche and 31.8% had been absent from school due to menstruation in the six months before this study was conducted. Factors associated with school absence due to menstruation were age ≥ 16 years old (AOR = 1.79, 95% CI 1.37–2.34), higher income (AOR = 2.38, 95% CI 1.16–4.87), menstrual anxiety (AOR = 1.55, 95% CI 1.09–2.20), using painkillers (AOR = 4.79, 95% CI 2.96–7.76) and other methods (AOR = 2.82, 95% CI 1.86–4.28) for dysmenorrhea, and disposing used pads in places other than the school’s waste bins (AOR = 1.34, 95% CI 1.03–1.75). Living with relatives (AOR = 0.64, 95% CI 0.43–0.95) and schools outside the city (AOR = 0.59, 95% CI 0.38–0.90) were significantly less associated with school absence. Although the association between school toilets and school absence was not examined, the results of this study suggest that school toilets should be gender-separated and equipped with waste bins in the toilet. Furthermore, menstrual education should start at elementary schools and teacher training on menstrual health should be promoted.

Understanding the impacts of humanitarian Menstrual Health Management for women’s confidence and agency: A case study on the Thai/Burma border

<p>Menstrual Health Management (MHM) is a growing focus within global humanitarian and development work. MHM aims to increase women and girls’ ability to care for their menstruating bodies through period products, hygiene facilities and education. It also seeks to challenge wider barriers that women face during menstruation – stigma, shame and ‘period poverty’ (the lack of access to menstrual products). NGOs promote ‘menstrual activism’ campaigns to ‘Reduce the stigma’ and ‘Help women and girls. Period.’ They tell stories of girls who, with their menstrual products, can now attend school during their period. Academic studies into the complexities of such programmes are sparse, however; particularly studies which privilege the experiences of the women involved and affected. Research on menstruation within the humanitarian field is also limited. This is despite the fact that women living in refugee camps and precarious spaces can have heightened difficulties due to scarcity of menstrual resources, disruption of support networks and facilities with inadequate privacy. Contextually and culturally embedded research that recognises the contributions and perspectives of these women can strengthen humanitarian MHM programmes and scholarship so that menstruating women can feel confidence and agency rather than stigma and shame. In light of these gaps, this study investigates Partners Relief & Development’s (Partners) ‘Days for Girls’ menstrual health programme in Thailand. The programme employs migrant women from Burma to make reusable menstrual hygiene kits and donates these kits to women in conflict-affected areas. The research worked within a feminist epistemology and mixed-methods methodology informed by principles of Appreciative Inquiry, to explore what is working well and what could be improved in Partners’ menstrual health programme. It involved refugees and migrants from Myanmar living over the border in Thailand, as well as the programme’s staff. Through thematic analysis, I found that the Days for Girls programme improves women’s agency (through increased community participation) and confidence (through menstrual literacy and menstrual provision). For the women who sew the Days for Girls kits, confidence and agency are also gained through income and skills-education. The strengths and challenges of Partners’ programme reveal the importance of menstrual literacy education, the use of women’s knowledge in NGO work with women, and a whole-of-community response to menstruation needs. The research also informs wider understandings of how MHM discourse and development practice affects menstrual stigma.</p>

Understanding the impacts of humanitarian Menstrual Health Management for women’s confidence and agency: A case study on the Thai/Burma border

<p>Menstrual Health Management (MHM) is a growing focus within global humanitarian and development work. MHM aims to increase women and girls’ ability to care for their menstruating bodies through period products, hygiene facilities and education. It also seeks to challenge wider barriers that women face during menstruation – stigma, shame and ‘period poverty’ (the lack of access to menstrual products). NGOs promote ‘menstrual activism’ campaigns to ‘Reduce the stigma’ and ‘Help women and girls. Period.’ They tell stories of girls who, with their menstrual products, can now attend school during their period. Academic studies into the complexities of such programmes are sparse, however; particularly studies which privilege the experiences of the women involved and affected. Research on menstruation within the humanitarian field is also limited. This is despite the fact that women living in refugee camps and precarious spaces can have heightened difficulties due to scarcity of menstrual resources, disruption of support networks and facilities with inadequate privacy. Contextually and culturally embedded research that recognises the contributions and perspectives of these women can strengthen humanitarian MHM programmes and scholarship so that menstruating women can feel confidence and agency rather than stigma and shame. In light of these gaps, this study investigates Partners Relief & Development’s (Partners) ‘Days for Girls’ menstrual health programme in Thailand. The programme employs migrant women from Burma to make reusable menstrual hygiene kits and donates these kits to women in conflict-affected areas. The research worked within a feminist epistemology and mixed-methods methodology informed by principles of Appreciative Inquiry, to explore what is working well and what could be improved in Partners’ menstrual health programme. It involved refugees and migrants from Myanmar living over the border in Thailand, as well as the programme’s staff. Through thematic analysis, I found that the Days for Girls programme improves women’s agency (through increased community participation) and confidence (through menstrual literacy and menstrual provision). For the women who sew the Days for Girls kits, confidence and agency are also gained through income and skills-education. The strengths and challenges of Partners’ programme reveal the importance of menstrual literacy education, the use of women’s knowledge in NGO work with women, and a whole-of-community response to menstruation needs. The research also informs wider understandings of how MHM discourse and development practice affects menstrual stigma.</p>

Connecting the Dots Between Mental and Menstrual Health: An Exploratory Review

Context: Mental and menstrual health, two emerging aspects of health critical to the female population, are bidirectionally linked. But there is limited empirical evidence that establishes the association between these entities. This essay aims to draw the attention of researchers to this healthcare niche. Evidence Acquisition: An exploratory review was carried out on literatures sourced from medical databases (e.g. PubMed, Google Scholar, Scopus, Science Direct, and Web of Science), and gray sources-popular and reputable institutional and journalistic websites that publishes mental or menstrual health research. The key words used for the search are “menstruation, menstrual hygiene, menstrual disorders, premenstrual syndrome, period poverty, menarche, menopause, mental health, mental disorder, mental illness, depression, anxiety, phobia, mania, mood, and affect”. The initial search generated 368 results. But after the duplicates were removed, the exclusion criteria (publication before 2000, and in languages other than English) was applied, and manual review of abstract (for relevance) was done, 21 publications from the databases and 5 from gray sources were included in this review. Results: Associations were found between menstrual cycle irregularities and disorders; and mental disorders such as premenstrual syndrome, premenstrual dysphoric disorder, major depressive disorder, major anxiety disorder, psychotic disorder, bipolar disorder, borderline personality disorder, sleep disorder, substance use/abuse, and suicidal ideation and attempts. Few positive associations between mental and menstrual health were recorded, and several research and treatment gaps were identified. Conclusions: Research into the links between mental and menstrual health should not remain a fringe area of scientific curiosity, as it shows tremendous promise in improving healthcare offered to women/girls globally.

Drivers of menstrual material disposal and washing practices: A systematic review

Background Disposal and washing facilities and services for menstrual materials are often designed based upon technical specifications rather than an in-depth understanding of what drives peoples’ choices of practices. Objectives and data sources This systematic review identified and summarised the main behavioural drivers pertaining to the choice of disposal and washing practices of menstrual materials through the thematic content analysis and study appraisal of 82 publications (80 studies) on menstrual health and hygiene published since 1999, reporting the outcomes of primary research across 26 countries. Results Disposal and washing behaviours are primarily driven by the physical state of sanitation facilities; however, this is intrinsically linked to taboos surrounding and knowledge of menstruation. Implications Using reasons given for disposal and washing practices by menstruators or those who know them well, or inferred by authors of the reviewed studies, we identify the key considerations needed to design facilities and services which best suit the desired behaviours of both planners and those who menstruate. Inclusivity The term menstruators is used throughout to encompass all those mentioned in the studies reviewed (girls and women); although no studies explicitly stated including non-binary or transgender participants, this review uses inclusive language that represents the spectrum of genders that may experience menstruation. Registration The review protocol is registered on PROSPERO: 42019140029.