Desafios da gestão menstrual: uma revisão integrativa / Challenges of menstrual management: an integrative review / Desafíos de la gestión menstrual: una revisión integrativa

Objetivo: analisar as evidências disponíveis na literatura sobre os desafios da gestão menstrual. Método: revisão integrativa da literatura realizada nas bases de dados PubMed, BVS, SciELO e Mendeley, utilizando os descritores "Menstruação", "Produtos de Higiene Menstrual" e "Saúde", para responder à questão norteadora "Quais são as dificuldades e os impactos encontrados pelas pessoas na gestão de suas menstruações?". Resultados: foram incluídos dezessete estudos os quais permitiram a construção de infográfico, que destacou como principais desafios da gestão menstrual.: barreiras culturais e sociais, acesso a produtos de higiene menstrual, infraestrutura e ambientes adequados, educação e conscientização, e impacto na saúde e bem-estar. Considerações finais: barreiras culturais, falta de educação menstrual e acesso limitado a produtos e infraestrutura prejudicam a saúde e o bem-estar das mulheres, impactando suas atividades diárias, no âmbito escolar e/ou profissional. Reconhecer essas questões é crucial para a proposição de intervenções e políticas públicas.

Objective: To analyze the available evidence in the literature regarding the challenges of menstrual management. Method: Integrative literature review conducted in the PubMed, BVS, SciELO, and Mendeley databases, using the keywords "Menstruation," "Menstrual Hygiene Products," and "Health," to answer the guiding question "What are the difficulties and impacts encountered by individuals in managing their menstruation?" Results: Seventeen studies were included, allowing the construction of an infographic that highlighted the main challenges of menstrual management: cultural and social barriers, access to menstrual hygiene products, adequate infrastructure and environments, education and awareness, and health and well-being impact. Final considerations:cultural barriers, lack of menstrual education, and limited access to products and infrastructure negatively impact women's health and well-being, affecting their daily activities, both in educational and/or professional settings. Recognizing these issues is crucial for proposing interventions and public policies.

Objetivos:analizar las evidencias disponibles en la literatura sobre los desafíos de la gestión menstrual. Método: revisión integrativa de la literatura realizada en las bases de datos PubMed, BVS, SciELO y Mendeley, utilizando los descriptores "Menstruación", "Productos de Higiene Menstrual" y "Salud", para responder a la pregunta guía "¿Cuáles son las dificultades y los impactos encontrados por las personas en la gestión de sus menstruaciones?". Resultados: se incluyeron diecisiete estudios que permitieron la construcción de un infográfico, que destacó como principales desafíos de la gestión menstrual: barreras culturales y sociales, acceso a productos de higiene menstrual, infraestructura y entornos adecuados, educación y concienciación, e impacto en la salud y el bienestar. Consideraciones finales: barreras culturales, falta de educación y acceso limitado afectan la salud y bienestar femenino, impactando actividades diarias y profesionales. Reconocer estas cuestiones es crucial para proponer intervenciones y políticas públicas.

Acceso y prácticas de higiene menstrual en América Latina: revisión de alcance / Menstrual hygiene access and practices in Latin America: scoping review / Acesso e práticas de higiene menstrual na América Latina: revisão de escopo

Objetivo: sintetizar la evidencia disponible relacionada con el acceso y las prácticas de higiene menstrual en América Latina y el Caribe. Método: revisión de alcance de la literatura con protocolo de investigación registrado en el Open Science Framework, realizada en las bases de datos bibliográficas: PubMed, Scopus, Web of Science y Portal Regional da Biblioteca Virtual em Saúde. Los datos fueron analizados mediante estadística descriptiva simple y análisis temático. Resultados: se incluyeron 15 publicaciones, la mayoría de las cuales trataban sobre adolescentes en Brasil: 12 artículos, dos informes técnicos y una monografía de trabajo de conclusión de curso. Como temas recurrentes en las publicaciones se destacan: acceso a condiciones dignas para el manejo de la higiene menstrual; necesidad de acceso a información sobre el manejo de la higiene menstrual; y prácticas para el manejo de la higiene menstrual. Conclusión: adolescentes informan dificultades para acceder a baños, agua y materiales absorbentes, y falta de información sobre la salud menstrual, incluso en las escuelas, lo que lleva al ausentismo escolar. De esta manera, las lagunas en la literatura científica latinoamericana revelan desigualdades y diversidad en las experiencias menstruales interseccionadas por categorías como género, clase social y etnia.

Objective: to synthesize available evidence related to menstrual hygiene access and practices in Latin America and the Caribbean. Method: literature scoping review with research protocol registered in the Open Science Framework, carried out in the bibliographic databases: PubMed, Scopus, Web of Science and Portal Regional da Biblioteca Virtual em Saúde. Data were analyzed using simple descriptive statistics and thematic analysis. Results: 15 publications were included, the majority of which addressed adolescents in Brazil: 12 articles, two technical reports and a course conclusion monograph. As recurring themes in the publications, the following stand out: Access to dignified conditions for managing menstrual hygiene; Need for access to information on menstrual hygiene management; and Practices for managing menstrual hygiene. Conclusion: adolescents report difficulties in accessing toilets, water and absorbent materials, and lack of information about menstrual health, including in schools, leading to school absenteeism. Thus, gaps in the Latin American scientific literature reveal inequalities and diversity in menstrual experiences intersected by categories such as gender, social class and ethnicity

Objetivo: sintetizar evidências disponíveis relacionadas ao acesso e práticas de higiene menstrual na América Latina e Caribe. Método: revisão de escopo da literatura com protocolo de pesquisa registrado no Open Science Framework, realizada nas bases de dados bibliográficas: PubMed, Scopus, Web of Science e Portal Regional da Biblioteca Virtual em Saúde. Os dados foram analisados por estatística descritiva simples e análise temática. Resultados: foram incluídas 15 publicações, cuja maioria abordava adolescentes no Brasil: 12 artigos, dois relatórios técnicos e uma monografia de trabalho de conclusão de curso. Como temas recorrentes nas publicações, destacam-se: acesso a condições dignas para o manejo da higiene menstrual; necessidade de acesso à informação sobre manejo da higiene menstrual; e práticas para manejo da higiene menstrual. Conclusão: adolescentes relatam dificuldades de acesso a sanitários, água e materiais absorventes, e falta de informação sobre saúde menstrual, inclusive nas escolas, levando ao absenteísmo escolar. Assim, lacunas na literatura científica latino-americana revelam desigualdades e diversidade nas experiências menstruais interseccionadas por categorias como gênero, classe social e etnia.

NEED FOR IMPROVING THE KNOWLEDGE AND PRACTICES OF ADOLESCENT GIRLS REGARDING MENSTRUAL HYGIENE AND REPRODUCTIVE HEALTH: A STUDY FROM URBANIZED VILLAGES OF NORTH INDIA

Context: In India nearly 71% of adolescent girls have no knowledge about menstruation until menarche. Menstrual practices still face several social, cultural, and religious restrictions and discouragement of open discussion on the topic acts like a major deterrent in the path of menstrual hygiene management. Moreover, lack of knowledge and incorrect practices during menstruation can sometimes have serious health outcomes. Hence, it becomes imperative to ascertain the knowledge of adolescent girls about menstruation and reproductive health and the practices adopted by them during menstruation so that health education programs can to tailored to address the gaps. The study Aims: aims to assess the knowledge of adolescent girls and their current practices with regard to menstrual hygiene and reproductive health and study the association of these with socio-demographic variables. This cross-sectional community based Methods: descriptive study was conducted among 181 adolescent girls selected from two urbanized villages of Meerut district of India using a semi-structured questionnaire. For assessment of level of knowledge a scoring system was developed. Both descriptive and inferential statistics were used for analysis. Based on the scoring, 77.3% of our study participants had overall poor Results: knowledge about menstruation and reproductive health, nearly 20% had satisfactory knowledge and only 2.2% had good knowledge. Most participants reported using sanitary napkins during menses (80.7%) and the remaining were using clean cloth (19.3%). 100% of the participants whose mothers were illiterate had poor knowledge about menstrual hygiene and reproductive health. Participants whose mothers were engaged in semi-skilled or skilled work were more likely to have satisfactory (39.4%) or good (4.3%) knowledge scores. Overall knowledge of our study participants regarding Conclusion: menstrual hygiene and reproductive health was poor; however the practices adopted by them during menstruation were good. The two main impediments in the path of menstrual hygiene management were lack of knowledge and non availability of services at affordable cost

Reproductive rights of women with intellectual disability in India.

The reproductive rights of women with intellectual disability (WID) are a matter of concern for all stakeholders, including the woman herself, caregivers, guardians and her treating physicians. The judicial system often calls upon psychiatrists to opine regarding the “capacity to consent” of a WID to procedures such as medical termination of pregnancy and permanent sterilisation. Apart from physical and obstetric examinations, assessment of mental status and intelligence quotient (IQ) are also carried out to facilitate an understanding of the above issue. The Rights of Persons with Disabilities Act, 2016, (RPwD) and the Mental Healthcare Act, 2017, elucidate what constitutes free and informed consent as well as how to assess capacity. The assessment process of “capacity to consent” to reproductive system procedures among WID is important and can guide clinicians. Before assessing capacity, the treating physicians should educate a WID with appropriate information on the proposed procedure, its risks and benefits through various means of communication and then evaluate the “capacity to consent” to the procedure. This article summarises the provisions of the existing legislations on the reproductive rights of WID and puts forward guidance for clinicians on how to approach the issue.

Practice of menstrual hygiene among school going adolescent girls in the rural areas of district Muzaffarnagar

Background: Every year, May 28 is considered as the Global Menstrual Hygiene Day. Many studies have revealed that most of the adolescent girls had incomplete and inaccurate information about the menstrual physiology and hygiene. Hygiene related practices during menstruation are of considerable importance, as it has a health impact in terms of increased vulnerability to reproductive tract infections (RTI) and other health problems. Aim & Objectives: To find out the menstrual hygiene practices and their association with socio-demographic characteristics of study participants. Material and Methods: A cross sectional study was conducted among 286 school going adolescents girls in the age group of 11-19 years in 5 schools (three government and two private) in the rural area of district Muzaffarnagar. Study was conducted in December, 2021 using a pre- designed, pre-tested questionnaire. Data was analysed statistically and chi square test was applied. Results: Most of the girls achieved menarche at the age of 10-13 years (79.7%). Mothers of around 83.5% girls were illiterate and these girls were less aware about menstrual hygiene practices. Only 63% girls knew about menstruation before menarche. According to 75.5% girls, source of menstrual bleeding was vagina and only 65.7% girls knew about the physiology of menstruation. Conclusion: The study shows that there is significant lack of knowledge among girls regarding menstruation. Only 62% girls use sanitary pads as absorbent material due to various reasons like shyness, high cost, etc. Majority of girls had restrictions of not touching kitchen items and not to take bath during menses. There is a need to make the girls aware regarding menstrual hygiene by various health awareness programs in schools and the community.

Effect of structured lecture on the knowledge and practices of menstrual health in adolescent girls of urban slum

Background: Menstruation is natural physiological processes. Psychosocial and religious taboos around it make it complicated as health issue. Poor menstrual health is not only associated with health and well?being of women, but also reflects on morbidity and mortality patterns of female population. Aim and Objectives: The study aims to assess the effect of a structured lecture on the knowledge and awareness about practices of menstrual health in adolescent girls of urban slum. Materials and Methods: A cross-sectional study was conducted among adolescent girls of slum area in Aurangabad city of Maharashtra. Pre-structured Questionnaire to assess the knowledge and practices about menstruation and menstrual hygiene was given. Structured lecture was organized and postlecture questionnaire was taken. Results: 72% were in age group of 10–14 years and mean age of menarche was 12.7 years. Before lecture 64% had poor awareness about hygienic menstrual practices, 24% had fair, 12% had good awareness. But after the lecture, the majority of girls, that is, 56% showed good awareness, 30% had fair while 14% girls still showed the poor awareness. This difference was found statistically significant. The reasons behind the unhygienic practices most commonly quoted were poverty, high cost of sanitary pads, ignorance and lack of privacy. Conclusion: If perception and attitude of adolescent girls toward menstrual hygiene is improved then it will definitely enhance their reproductive health. Moreover, awareness created among them will indirectly affect their mother’s reproductive health and their next female generation as well.

Effectiveness of Health Education in Improving Menstrual Hygiene Knowledge and Practices among Adolescent Girls of Rural India

Introduction : Menstruation is still surrounded by many myths, misconceptions and taboos. Adolescent girls in India, seems to have inadequate and inaccurate knowledge on menstruation and its hygiene. Improper menstrual hygiene can lead to reproductive tract infections which can adversely affect a woman's reproductive health. This study was aimed at assessing the effectiveness of health education in improving the knowledge on menstruation and menstrual hygiene practice among rural adolescent girls of India. Method: An interventional study was done among 82 college girls selected by convenient sampling in a rural area of Tamilnadu, India. Intervention done was health education on menstrual physiology and hygiene practice using animated video and interactive session in local language. Questionnaire on knowledge about menstruation and menstrual hygiene practice was administered to the participants before health education session. Improvement in knowledge and practice was assessed after one month of the session. Results: Baseline knowledge about menstruation was adequate only for 57.5 percent of participants. Baseline menstrual hygiene practice was good only among 8.8 percent of participants. Following health education, knowledge about menstruation significantly improved to 90%. Menstrual hygiene practice also showed a significant improvement from 8.8% to 30 percent%. Conclusion: This study showed that providing a comprehensive health education on menstrual physiology and hygiene would greatly improve the menstrual hygiene practice of adolescent girls.

Does India’s Menstrual Hygiene Management Scheme exclude the disabled?

The Menstrual Hygiene Scheme of the Government of India wishes to generate awareness among adolescent girls, and provide them with hygienic and affordable sanitary napkins. The scheme has been criticised for many reasons by various reviewers. However, we draw attention to a hitherto unaddressed gap that the scheme has effectively overlooked, the menstrual hygiene needs of disabled adolescent girls, and has thereby denied them their right to health and healthcare. This exacerbates health disparities, and raises questions of public health ethics. We conclude with recommendations on how to redress the situation and make the scheme more inclusive.

Avaliação da segurança e conforto no uso do coletor menstrual durante a prática esportiva: um estudo de coorte prospectivo / Evaluation of the safety and comfort of menstrual cup during physical exercise: a prospective cohort study

Objetivos: Avaliar o conforto no uso do coletor menstrual durante o exercício físico. Métodos: Foi realizado um estudo prospectivo com uma coorte de 49 jogadoras de handebol universitário. As participantes foram convidadas a usar o coletor menstrual descartável Softcup® durante três ciclos menstruais. O desfecho primário foi a satisfação geral no uso do coletor. Os desfechos secundários incluíram: facilidade de inserção e remoção do dispositivo, dor, desconforto nas relações sexuais, vazamento de sangue e/ou perda durante o exercício físico. Resultados: A idade média das participantes foi de 22 ± 2 anos. O grau de satisfação geral durante o esporte foi alto (82%). A inserção e a remoção do dispositivo menstrual foram consideradas fáceis pela maioria das usuárias e o grau de satisfação aumentou nos ciclos subsequentes. A queixa de vazamento do fluxo menstrual durante o esporte ocorreu em 63,3% das atletas no primeiro ciclo e caiu para 42,9% no último ciclo (p > 0,05). Houve perda do dispositivo durante o exercício em 36,7% das atletas no primeiro ciclo, 30,6% no segundo e 26,5% no terceiro ciclo (p > 0,05). Das atletas que tiveram relações sexuais com o uso do coletor menstrual, 90,9% não apresentaram desconforto. Conclusão: O conforto no uso do coletor menstrual durante o exercício físico foi elevado. Vazamento menstrual e perda do dispositivo tendem a diminuir com ciclos subsequentes.(AU)

Objective: To evaluate the safety and comfort of menstrual cup during physical exercise. Methods: A prospective cohort study was setting analysing a total of 49 female handball players with a mean age of 22 ± 2 years. The participants were invited to use Softcup® disposable menstrual during three menstrual cycles. The main outcome measures was overall satisfaction. Secondary outcomes included ease of insertion and removal of the device, pain, discomfort in sexual intercourse, blood leakage and/ or loss of the menstrual cup during sport. Results: The degree of overall satisfaction during sport was high (82%). The insertion and removal of the menstrual cup was considered easy by most users, and the degree of satisfaction increased in subsequent cycles. The complaint of menstrual flow leakage during sport occurred in 63.3% of the athletes in the first cycle and fell to 42.9% in the last cycle (p > 0.05).(AU)

Knowledge and practice of menstrual hygiene management among women living in a low-income neighbourhood, Karachi, Pakistan

Background: The aim of the study was to determine the degree of awareness and practice of proper menstrual hygiene management among women living in low-income neighbourhood in Karachi, Pakistan.Methods: A cross-sectional study was conducted at the Bizerta Lines, Karachi between January and June 2019. All women of reproductive age were included in the study. Amenorrheic, menopausal, or women on birth control were excluded from the study. Degree of awareness and current practices pertaining to menstrual hygiene management were assessed through pro-forma. The study tool collected the participant’s knowledge, awareness, and misconceptions about menstruation. The factors affecting the quality of life during menstruation of women living in poor socio-economic conditions were also observed. Statistical Package for Social Sciences (SPSS v.23) was used to analyze the collected data.Results: Of the 338 participants, 82.5% had no knowledge of menstruation prior to their first menstrual period. Only a minority of the women knew that the source of menstrual blood was the uterus while 41.4% of the women incorrectly claimed that the menstrual blood and urine were expelled from the same orifice. More than half of the participants used disposable sanitary napkins (55.5%). 65% of the participants changed the absorbent at least 1 to 3 times a day.Conclusions: Most of the participants used disposable sanitary napkins. However, the basic knowledge of female anatomy and physiology behind menstruation was poor among women.

Poor management of menstrual hygiene: a leading cause of school absenteeism among adolescent girls in the urban slum of Madhya Pradesh

Background: Despite the strides made in the field of adolescent and women health, menstrual problems remain a stigma. Unsatisfactory menstrual hygiene practices have a profound influence on the adolescent girl’s health and academic performance. Therefore, the present study aimed to assess the relationship between school absenteeism and poor MHM and its impacts on school girl’s day to day lives.Methods: This is a cross-sectional study conducted among 384 adolescent girls enrolled in anganwadi centres of the urban slum of Madhya Pradesh from January to June 2018. A pre-designed and pretested questionnaire used to collect the data regarding menstrual hygiene practices and school absenteeism. Data were analyzed using the SPSS software (version 16.0. Chicago, SPSS Inc.).Results: The study found that around two-thirds (64.3%) and nearly one third (30%) of the participants were using a simple cloth and sanitary pads. About half (50.6%) of the respondents miss their school during the menstruation. Majority of them perceived that menstruation interferes with their school performance. The main reason for missing the schools was fear/ shame of leakage. In multivariable regression lack of sanitary facilities and painful menstruation remained significant predictors of school absenteeism.Conclusions: There is a dire need to fortify efforts directed towards increasing awareness on menstrual hygiene, to revamp the existing measures for improving menstrual health of the adolescent girls. Focused attention is warranted by policymakers to improve the quality of life of this vulnerable group.

A Study of Nutritional Health Problems of Adolescent Girls in Rural Area of Nagpur District: A School Based Cross Sectional Study

Introduction: "Adolescence" literally means "to emerge"or "to attain identity" and is essentially the period of rapidphysical and psychological development. The World HealthOrganization (WHO) defines “adolescent” as an individualbetween 10 to 19 years of age. About 19.7% of Indianpopulation is adolescents. Nutritional health problems areone of the important health problem faced by adolescents.Prevalence of anemia in adolescents (15-19 years) girls is54%. Underweight is seen among 46.4% adolescent girls.Hence this study was conducted to find out nutritional healthproblems of adolescent girls in a rural area of Nagpur district.Menstrual hygiene was also studied.Material and methods: A cross sectional study was carriedout in one of the randomly selected school in a rural area ofNagpur. Calculated sample size was 145, though the studywas carried out on 150 adolescent girls in August 2019 usinga pre-designed and pre- tested questionnaire.Results: Mean age of study participants was 14.87± 2.77years. Prevalence of anemia was found to be 80%. Prevalenceof undernutrition was 36%. None of the student receivedweekly iron and folic acid tablets in last three months. Only28% study subjects received information of menstrual hygieneprior to menarche.Conclusion: Prevalence of anemia and undernutrition wasfound to be high in a school of rural area of Nagpur district.WIFS program should be strengthened through inter-sectoralcollaboration among health and education sectors

Menstrual cup: awareness among reproductive women

Background: Menstrual cup is an alternative to sanitary pads, which has received attention in relatively small-scale studies in high income, and low- and middle-income countries, including among schoolgirls. Made of high-grade medical grade silicone (biodegradable) have the advantage of reuse, and can potentially last up to 10 years. Objective of this study was to assess and analyse the awareness regarding menstrual cup among the women of reproductive age group.Methods: Data collected from the selected eligible participants by an interviewer administered study proforma. It is a descriptive cross-sectional study over 1 month in women in reproductive age in A. J. Institute Mangalore, Karnataka, India.Results: A total 82% were aware about menstrual cup but only 2.6% have used it.Conclusions: One challenge of menstruation that is taken for granted in affluent countries is the simple question of how to manage or contain the menstrual flow and what happens to a girl or woman who is not able to do this successfully. Menstrual hygiene management is therefore an increasingly important (yet often unrecognized) issue that is heavily intertwined with girls’ education, empowerment, and social development.

Acceptability and safety of the menstrual cup: A systematic review of the literature / Aceptabilidad y seguridad de la copa menstrual: revisión sistemática de la literatura

RESUMEN Objetivo: realizar una búsqueda sistemática de la literatura para evaluar la aceptabilidad y seguridad de la copa menstrual como producto de higiene genital femenina. Materiales y métodos: se realizó búsqueda en las bases de datos PubMed, Cochrane Library, Scopus, PopLine y Google Scholar, desde 1966 hasta julio de 2019. Se utilizaron los términos: "Menstrual" AND "Cup" OR "Copa" AND "Menstrual". Se incluyeron estudios cuantitativos, cualitativos y mixtos, series y reportes de caso publicados en inglés y español que hubieran evaluado la copa menstrual en mujeres en edad reproductiva. Los estudios fueron selecciona- dos y los datos fueron extraídos por dos evaluadores de manera independiente. Como resultado primario se evaluó la aceptabilidad y seguridad. La síntesis de información se presenta de manera narrativa. Resultados: se encontraron 737 títulos para revisión inicial. Finalmente, se incluyeron 38 estudios. La copa menstrual tiene una aceptabilidad que varía entre el 35 y el 90 %. Del 10 al 45 % la encontraron difícil de usar. Fue descrita como más cómoda comparada con el tampón y la toalla higiénica de fabricación industrial. La continuidad de su uso está entre el 48 y el 94 %. En cuanto a la seguridad se presentó un caso de síndrome de choque tóxico, uno de atrapamiento mecánico, uno de alergia al producto y mayor riesgo de expulsión en usuarias del dispositivo intrauterino. Conclusión: la copa menstrual es una alternativa cómoda, segura y eficiente para la higiene mens- trual. Se requieren más estudios controlados alea- torizados y cohortes prospectivas a largo plazo para determinar el riesgo de complicaciones por una exagerada colonización bacteriana o menstruación retrógrada.

ABSTRACT Objective: To conduct a systematic review of the literature and assess the acceptability and safety of the menstrual cup as a feminine hygiene product. Materials and methods: A search was conducted in the PubMed, Cochrane Library, Scopus, PopLine and Google Scholar databases for publications be- tween 1966 and July 2019. The terms ("Menstrual" AND "Cup") OR ("Copa" AND "Menstrual") were used. Quantitative, qualitative and mixed studies were included, as well as case series and case reports published in English and Spanish assessing the menstrual cup in women in childbearing age. The studies were selected and the data extracted by two reviewers working independently. Acceptability and safety were assessed as the primary result. The summary of the information is presented in narrative form. Results: Overall, 737 titles were found for initial review and, in the end, 38 studies were included in this work. The acceptability of the menstrual cup ranges between 35 % and 90 %. Between 10 to 45 % of women found it difficult to use. It was described as more comfortable when compared to tampons and pads. Continued use of the cup ranges between 48 and 94 %. In terms of safety, there was one case of toxic shock syndrome, one case of mechanical entrapment, and another case of allergy; and a higher risk of expulsion was found among intrauterine device users. Conclusion: The menstrual cup appears to be a comfortable, safe and efficient option for menstrual hygiene. Further randomized controlled studies and long-term prospective cohort studies are needed in order to determine the risk of complications due to excess bacterial colonization or retrograde menstruation.

Prevalence and Risk Factors Associated with Bacterial Vaginosis and Candidiasis in Non-Pregnant Women of Western Odisha, India

The prevalence of Bacterial Vaginosis (BV) and candidiasis is high in Indian women in the reproductive age groups. Poor menstrual hygiene management (MHM) practices and low socio-demographic features are the major risk factors associated with BV and candidiasis. The aim of the study was to access the MHM practices in association with BV and Candida infection in the population of western Odisha.METHODSThis cross-sectional study was carried out in the outpatient department of O & G, VIMSAR, Burla, Odisha, from December 2016 to November 2018. Vaginal swabs were collected from the posterior vaginal fornix for analysis. BV was diagnosed by using Nugent’s laboratory diagnostic criteria and identification of Candida was done by Albi QuickTM rapid test. A pre-coded questionnaire was used to collect demographic, clinical, and behavioural (MHM practices) features from the study participants. All data were double-entered into Epi Info 7 software and analysed using Stata 11.0.RESULTSIn 352 women, the prevalence of BV and candidiasis was found in 38.92% (137/352) and 32.67% (115/352) of women respectively. Women were divided into three groups on the basis of age i.e. 18-25 years: 87 (24.72%); 26-35 years: 194 (55.11%); and 36-45 years: 71 (20.17%). Both BV and candidiasis were significantly high in women of 36-45 years age group compared to 18-25 years age group (p<0.05). Women of 36-45 years age group had more number of cases with low education (19.72%), housewife (67.61%), and living in rural villages (61.97%) compared to younger women (p<0.05). Regarding MHM practices, women in the higher age groups used more reusable cloths as absorbent materials (p<0.002), changed absorbent material less frequently (p=0.042) and changed their absorbents somewhere other than in a toilet facility (p<0.018) compared to younger women.CONCLUSIONSThe higher prevalence of BV and candidiasis in higher age groups of women may be due to the poor MHM practices, lack of higher education and other low socio-demographic conditions compared to younger age women. An increased awareness for MHM practices is important to combat the associated morbidities related to BV and candidiasis.

Attainment of menstrual hygiene by girls in boarding secondary schools in a state in Sub-Saharan Africa

Background: Menarche is the most dramatic manifestation of puberty in girls; unlike the biometric developmental changes that occur at puberty, menarche requires the personal adjustment and response of an affected girl in order to attain good menstrual hygiene. This study was designed to evaluate how boarding secondary school girls manage their menstruation in school, away from the guidance of their parents.Methods: A cross sectional survey was performed in four public boarding secondary schools in the study area with the aid of structured questionnaires to evaluate how such girls manage their menstruation while in school.Results: The study population was 975 girls whose survey revealed the mean age at menarche of 12.5±1.4 years.  Seven hundred and two (72.0%) respondents had received sexuality education before onset of menarche. Respondents who attained good menstrual hygiene were 775(79.5%). Such respondents were those who had received sexuality education (p<0.001) and those who had access to synthetic sanitary pad (p=0.005). Duration of the menstrual period and the volume of menstrual blood loss did not affect (p=0.219) the ability of respondents to attain good menstrual hygiene. Respondents who received sexuality education had about 605 chances of attaining good menstrual hygiene than those who did not receive such education.Conclusions: A vast majority of the respondents had received sexuality education before onset of menarche and a larger proportion attained good menstrual hygiene. Major factors that positively influenced the girls’ capacity to attained good menstrual hygiene were prior sexuality education and access to synthetic sanitary pad.

Menstrual awareness, hygiene, practices and perceptions among the adolescent girls of Nahan, Himachal Pradesh, India

Background: Onset of first menstrual cycle also termed as “menarche” signifies the initiation of sexual maturation of girls. The present study aims to represent an amalgam of menstrual awareness, perceptions and hygiene in light of the associated menstrual practices prevalent in the adolescence girls of Nahan.Methods: A cross-sectional data of 189 girls aged between 10 to 16 years were collected from Nahan, district Sirmaur in Himachal Pradesh. Data regarding perceptions, awareness and hygienic conditions during menstruation were also gathered through an interview based schedule.Results: Menarche was known to be a normal physiological process by only 53.43% girls, while the rest of the participants didn’t know the reason for its occurrence. For 81.2% girls the informant was their mother and a very little role was played by sisters (5.36%), books (0.67%), friends (6.04%) and relatives (5.36%). Most of the girls (95.28%) used sanitary napkin as absorbent for menstrual flow, but the use of single sanitary napkin for 7 to 8 hours by 48% participants was of alarming concern. Stomachache was the most common problem associated with menarche, whereas breast heaviness (16.98%), body ache (16.03%) and backache (26.41%) were witnessed in considerable proportion of girls. A significant number of girls (78.3%) were prohibited from entering in the holy places/temples during this period.Conclusions: Although menarcheal health is acquiring greater significance across the globe, but the age old social restrictive practices associated with menstruation are still common and prevalent in this societies.

A study of knowledge and practice of menstrual hygiene among adolescent school girls in rural and urban field practice area of RajaRajeswari Medical College and Hospital, Bangalore, India

Background: The word adolescent is derived from Latin word adolescence which means to grow into maturity. Adolescence is a period of transition from childhood to adulthood. WHO has defined adolescence as the age group 10-19 years. These are formative years when maximum amount of physical, psychological, developmental and behavioral changes take place. In India adolescent girls accounts for a little more than one- fifth of the population. The onset on menstruation is one of the most important changes occurring among the girls during the adolescent years. The event of menarche may be associated with taboos and myths existing in our traditional society which has a negative implication for women’s health, particularly their menstrual hygiene. Women having better knowledge regarding menstrual hygiene and safe practices are less vulnerable to reproductive tract infections.Methods: This was a cross-sectional descriptive study. The sample size of 184 is obtained in each group and rounded off to 190 (urban and rural schools). The duration of the study was for 5 months among adolescent high school girls in randomly selected schools.Results: The mean age of urban girls was 12.87±0.94 years whereas rural girls it was 12.85±0.86 years. Among 380 study subjects 43.4% were aware about menstruation before attaining menarche, 62.4% were aware that menstruation is a natural process. Majority of study subjects (58.9%) were using sanitary pads during menstruation and 46.8% of study subject’s changes absorbents twice a day.Conclusion: Knowledge and practice regarding menstrual hygiene among adolescent high school girls is better in rural area as compared to urban adolescent high school girls.

La copa menstrual, una alternativa de higiene femenina: revisión de la literatura / The menstrual cup, a female hygiene alternative: literature review

INTRODUCCIÓN: La copa menstrual (CM) es un dispositivo diseñado para apoyar a la mujer durante el manejo de su higiene menstrual. OBJETIVO: Caracterizar la literatura existente en torno al uso de la CM, como una alternativa de higiene femenina. METODOLOGÍA: Revisión de la literatura de estudios publicados en los metabuscadores Proquest, Google Scholar, Pubmed y a través del rastreo manual de los artículos divulgados en revistas no indexadas a las bases de datos mencionadas. Los términos MESH fueron combinados con operadores booleanos permitiendo la elaboración de ecuaciones de búsqueda. Posterior a la selección de los estudios catalogados como elegibles, los investigadores procedieron a implementar las listas de verificación propuestas por la Critical Appraisal Skills Programme español (CASPe) y la Iniciativa MINCIR. RESULTADOS: Fueron incluidos 21 estudios que superaron el 75% de los criterios evaluados en las listas de verificación. El proceso de sistematización de los datos expresados en los estudios permitió la constitución de tres ejes temáticos sobre los cuales gira la literatura en esta área, que corresponden a: I. La CM en el desarrollo de la higiene femenina, II. Beneficios y desventajas del uso de la CM, III. Factores socioculturales asociados a la higiene menstrual. CONCLUSIONES: La CM es un dispositivo que puede aportar grandes beneficios a la higiene menstrual como un elemento moderno, discreto, económico y amigable con el medio ambiente.

INTRODUCTION: The menstrual cup is a device designed to support the woman during the management of her menstrual hygiene. OBJECTIVE: To characterize the existing literature about the menstrual cup use, as an alternative of feminine hygiene. METHODOLOGY: Literature review of studies published in the search engines Proquest, Google Scholar, Pubmed and by means of manual tracking of the articles spread in not indexed journals to the databases mentioned above. The MESH terms were mixed with booleanos operators allowing the elaboration of searching equations. Subsequent to the section of studies denominated as eligible, the researchers proceeded to implement the check list proposed by the Critical Appraisal Skills Programme español (CASPe) and MINCIR list. RESULTS: It was included 21 studies that overcame the 75% of the criteria evaluated in the check lists. The systematic data process in the studies allowed the conformation of three thematic axes, which revolve around the literature in this area, that correspond to: I. The CM in the development of feminine hygiene, II. Benefits and disadvantages of the use of CM, III. Sociocultural factors associated with menstrual hygiene. CONCLUSIONS: CM is a device that can bring great benefits to menstrual hygiene as a modern, discreet, economical and environmentally friendly element.

Knowledge, attitude and practice regarding menstrual hygiene among adolescent girls in a rural private school

Background: Being a developing country, India is faced with many health problems which can be averted by education and implementation of basic guidelines. Menstrual hygiene is one such topics which is rarely brought to attention but forms an integral part of a women’s life. This topic has been neglected not only in rural areas but in the poor socioeconomic corners of metropolitan cities. This ignorance has taken a great toll on the quality of life of women. Poor hygiene predisposes them to reproductive tract infections which may lead to increased incidence of infertility and mortality. Misconceptions regarding this have also prevented women to seek out professional help. Keeping this in mind the study was undertaken to spread awareness and eliminate the taboo this topic is regarded with.Methods: A cross sectional study was conducted amongst adolescent girls in a private school located in Angaon village, Bhiwandi Taluka, Mumbai. A self-administered questionnaire was given to the adolescent girls to assess their knowledge, attitude and practices regarding menstrual cycle. Percentages were used for statistical analysis.Results: 83 girls (96.51%) were aware of menstrual cycle. 49 (56.98%) girls perceived that menstrual blood is dirty. 72 (83.72%) knew that it is a physiological process. 85 (98.84%) were also aware about menstrual hygiene. 85 (98.4%) felt that girls should be addressed regarding menstrual cycle, hygiene before achieving menarche. 50 (58.14%) girls followed restrictions during menstruation.Conclusions: The findings of the present study emphasize the need to address physiology about menstrual cycle as well as the myths and misconceptions associated with it.