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.

Encarceramento feminino: um debate entre criminologia e perspectivas feministas / Female incarceration: a debate between criminology and feminist perspectives / Encarcelamiento femenino: un debate entre la criminología y las perspectivas feministas

Este ensaio teórico-reflexivo tem como objetivo discutir sobre as contribuições dos estudos da criminologia e sua crítica para as diversas formas de aprisionamento feminino, e mais atualmente para o encarceramento em massa no sistema prisional, além de abrir espaço para o debate sobre as diferentes perspectivas feministas e as relações com os estudos criminológicos, sobretudo com os posicionamentos da chamada criminologia crítica. Reconhecem-se importantes avanços e conquistas feministas no debate sobre a estruturação masculinizada do direito penal e do seu fazer jurídico, mas também a manutenção de diversas formas de violência de gênero que configuram um sistema penal antropocêntrico, seletivo, racista e discriminatório. Indica-se a urgência de estudos interseccionais que considerem as particularidades e reinvindicações das mulheres no cárcere e suas formas de militância, sobretudo diante de população carcerária feminina composta majoritariamente por mulheres negras, pobres e periféricas. Faz-se visível a necessidade de uma análise dos fatores que atravessam o encarceramento feminino por uma ótica feminista plural, adequada às realidades que se estudam e atenta às múltiplas perspectivas que podem existir dentro do feminismo.(AU)

This theoretical-reflexive essay aims to discuss the contributions of criminological studies and their critique of the various forms of imprisonment of women, and more recently of mass incarceration in the prison system, in addition to opening space for the debate on the different feminist perspectives and their relations with criminological studies, especially with the positions of the so-called critical criminology. Important feminist advances and conquests are recognized in the debate about the masculinized structure of penal law and its legal practice, but also the maintenance of diverse forms of gender violence that configure an anthropocentric, selective, racist, and discriminatory penal system. It indicates the urgency of intersectional studies that consider the particularities and claims of women in prison and their forms of militancy, especially in the face of the female prison population composed mostly of black, poor, and peripheral women. The need for an analysis of the factors that cross women's imprisonment from a plural feminist perspective, adequate to the realities under study and attentive to the multiple perspectives that may exist within feminism, becomes visible.(AU)

Este ensayo teórico-reflexivo pretende discutir las aportaciones de los estudios criminológicos y su crítica a las distintas formas de encarcelamiento femenino, y más recientemente de encarcelamiento masivo en el sistema penitenciario, además de generar debate sobre las distintas perspectivas feministas y sus relaciones con los estudios criminológicos, especialmente con las posiciones de la Criminología Crítica. Se reconocen importantes avances y logros feministas en el debate sobre la estructuración masculinizada del derecho penal y su práctica jurídica, además del mantenimiento de diversas formas de violencia de género que configuran un sistema penal antropocéntrico, selectivo, racista y discriminatorio. Se necesitan estudios interseccionales que consideren las particularidades y reivindicaciones de las mujeres en prisión y sus formas de militancia, principalmente ante la población penitenciaria femenina compuesta mayoritariamente por mujeres negras, pobres y periféricas. Se hace evidente la necesidad de analizar los factores que inciden en el encarcelamiento femenino desde una perspectiva feminista plural, adecuada a las realidades que se estudian y atenta a las múltiples perspectivas que pueden existir dentro del feminismo.(AU)

Repercussões da pobreza menstrual para as mulheres e pessoas que menstruam: revisão integrativa / Repercusiones de la pobreza menstrual para las mujeres y las personas que menstruan: revisión integrativa / Repercussions of period poverty for women and people who menstruate: an integrative review

Objetivos: investigar as repercussões da pobreza menstrual para as mulheres e pessoas que menstruam. Método: revisão integrativa da literatura, realizada nas bases de dados MEDLINE, Scopus, Web of Science e CINAHL. Foram incluídos artigos na íntegra, nos idiomas português, inglês e espanhol e com recorte temporal de sete anos (2017-2023) para responder a pergunta norteadora: Quais são as repercussões da pobreza menstrual na vida das mulheres e pessoas que menstruam? A inclusão dos artigos foi feita por dois revisores independentes e com consenso por um terceiro. Resultados: foram incluídos 15 artigos e observou-se três principais repercussões da pobreza menstrual: absenteísmo escolar, aumento do risco de infecções do trato genital e repercussões emocionais. Conclusão: a pobreza menstrual traz repercussões negativas para as mulheres e pessoas que menstruam, comprometendo a saúde física, mental e a esfera social, motivo pelo qual o tema precisa ser amplamente visibilizado e combatido.

Objetivos: investigar las repercusiones de la pobreza menstrual para las mujeres y las personas que menstruan. Método: revisión integrativa de la literatura, realizada en las bases de datos MEDLINE, Scopus, Web of Science y CINAHL. Se incluyeron artículos en su totalidad, en los idiomas portugués, inglés y español y con recorte temporal de siete años (2017-2023) para responder a la pregunta orientadora: ¿Cuáles son las repercusiones de la pobreza menstrual en la vida de las mujeres y personas que menstruan? La inclusión de los artículos fue hecha por dos revisores independientes y con consenso por un tercero. Resultados: se incluyeron 15 artículos y se observaron tres principales repercusiones de la pobreza menstrual: absentismo escolar, aumento del riesgo de infecciones del tracto genital y repercusiones emocionales. Consideraciones finales: la pobreza menstrual trae repercusiones negativas para las mujeres y personas que menstruan, comprometiendo la salud física, mental y la esfera social, por lo que el tema necesita ser ampliamente visibilizado y combatido.

Objective: to investigate the repercussions of period poverty for women and people who menstruate. Method: an integrative review of the literature, performed in MEDLINE, Scopus, Web of Science and CINAHL databases. The sample included complete articles, in Portuguese, English and Spanish, and with a timeframe of seven years (2017-2023) to answer the guiding question: What are the repercussions of period poverty in the lives of women and people who menstruate? The inclusion of the articles was done by two independent reviewers and with consensus by a third party. Results: 15 articles were included and three main repercussions of period poverty were observed: school absenteeism, increased risk of genital tract infections and emotional repercussions. Final considerations: period poverty brings negative repercussions for women and people who menstruate, compromising physical, mental and social health, which is why the theme needs to be widely publicized and combated.

A confirmed case of menstrual cup-associated toxic shock syndrome: A Philippine perspective / Philippine Journal of Obstetrics and Gynecology

@#Menstrual toxic shock syndrome (TSS) is a severe, fatal, superantigen toxin‑mediated illness, which leads to multiorgan system failure early in its course. At the time of writing, there are no local data available on menstrual cup‑associated TSS. Reported is a 30‑year‑old healthy Filipino, diagnosed as a case of menstrual cup‑associated TSS. Diagnosis was confirmed by case definition criteria and supported by vaginal discharge culture of methicillin‑resistant Staphylococcus aureus. The patient was treated empirically with antibiotics that led to successful treatment outcomes with no recurrence. At present, when women empowerment is of utmost importance, we support women’s decisions pertaining to their health, including their choice of menstrual hygiene products. This case is reported to raise awareness, promote wellness and safety among menstrual cup users and to educate clinicians on the course and management of menstrual cup associated toxic shock syndrome to prevent its catastrophic sequelae.

The relationship between menstrual hygiene management, practices, and school absenteeism among adolescent girls in Johannesburg, South Africa

Background. Factors associated with menstrual hygiene management (MHM) and practices affect school absenteeism, with up to 7 million girls missing 25% of their given school year each month in South Africa (SA). Objective. To identify the most significant factors associated with MHM and practices affecting school absenteeism among adolescents in Johannesburg, SA. Methods. A secondary data analyses of a cross sectional study among 489 adolescent girls from 30 schools in Johannesburg, SA was conducted. Data was collected using a self-administered questionnaire. Logistical regression analysis was conducted for all variables affecting school absenteeism using STATA version 14. Results. Female adolescents who had pre-menarcheal training were more likely to attend school (odds ratio (OR) 1.96; 95% confidence interval (CI) 1.04 - 3.73; p= 0.038). Those who disposed of their absorbent materials by burning, throwing them by the roadside or on farmland were almost 2× more likely to be absent from school (OR 2.07; 95% CI 1.05 - 4.08; p= 0.038). Dysmenorrhea (painful menstruation) was associated with higher likelihood of being absent from school (OR 2.6; 95% CI 1.29 - 5.29; p=0.008). Conclusion. This present study reveals that MHM and practices related to school absenteeism extend beyond the availability of sanitary materials. These findings can be used to create dialogue between various stakeholders about best practices for reducing school absenteeism related to MHM

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)

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.

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.

Systematic Review on Sanitary Pads and Female Health / 이화의대지

The majority of South Korean females use sanitary pads, which contain various organic solvents which could be excreted before and during their menstruation. However, they are not provided with findings from studies about the health effects of sanitary pads. Therefore, this study aims to establish a list of potential health hazards of sanitary pads and address the need for further extensive research by pointing out the limitations of the previous literature. A systematic review was adopted to conduct quantitative and qualitative reviews based on the PRISMA (preferred reporting items for systematic reviews and meta-analyses). Studies from electronic databases such as PubMed, RISS, and Google Scholar were retrieved for the final analyses. In accordance with our findings, we proposed a set of limitations of the previous studies. A systematic review revealed that there were effects of sanitary pads on vaginal or vulvar skin, endometriosis, and vaginal microflora. The review also revealed that organic solvents, which sanitary pads are composed of, bring potential harmful effects on pregnancy, autoimmune disease, cardiovascular disease, and neurological development. Social environments such as hygiene use or puberty education also turned out to affect female health. It was inferred that a lack of non-occupational and domestic studies reflecting the distinguishing features of sanitary pads with a reliable sample size remains as an important limitation. This study suggests that organic solvents in sanitary pads may increase some health risks bringing reproductive, autoimmune, cardiovascular, and neurological effects. Due to a lack of studies, a more extensive study can contribute to the public health of South Korean females.

Status of Use of Menstrual Hygiene Products and Genital Organ Hygiene Management in Unmarried Women

PURPOSE: The purpose of this study was to investigate the status of use of menstrual hygiene products and genital organ hygiene management in unmarried women. METHODS: Data from 161 unmarried women were used for analysis. The instruments consisted of self-reported questionnaires that included 40 items: 20 on General Characteristics & Sexual Health Related Characteristics, 8 on Using Status of Menstrual Hygiene Products, 12 on Genital Organ Hygiene Management. RESULTS: The subjects used disposable sanitary napkin as the most frequently but the satisfaction was low, while the use of reusable sanitary napkin and tampons were few, but satisfaction was high. Sixty-seven percent of the unmarried women had sex experience, and more than 60% experienced abnormal symptoms in the genital organ. There was a significant difference in genital organ hygiene management according to sex experience. Among subjects of this study, 44.1% wanted to use menstrual cup, and 98.8% wanted to have education for their menstrual hygiene products. CONCLUSION: Based on results of this study, a nationwide survey of the demand for menstrual hygiene products used by Korean women is needed, it is necessary to educate about the proper use of menstrual hygiene products and genital organ hygiene management.

El ciclo menstrual en el siglo XXI. Entre el mercado, la ecología y el poder femenino / O ciclo menstrual no século XXI. Entre o mercado, a ecologia e o poder feminino / Menstrual Cycle in the XXI Century. Between the marketplace, ecology and women's power

Resumen: Este artículo analiza las concepciones relativas al género, la sexualidad, la salud, la espiritualidad/religiosidad, la política, el medio ambiente y el empoderamiento femenino, presentes en el mercado de productos "alternativos" que atienden y celebran el ciclo menstrual en la Argentina contemporánea. Se trata de un estudio cualitativo basado en el análisis de páginas web, blogs y perfiles de Facebook de mujeres que fabrican, comercializan y/o difunden toallas de tela y copas de silicona; la observación participante en talleres sobre el ciclo y entrevistas personales con sus organizadoras. El estudio visibiliza la emergencia y difusión de visiones que celebran el ciclo menstrual, considerándolo una fuente de identidad y empoderamiento femenino, y las tensiones que se dan con otros enfoques que cuestionan estas premisas.

Resumo: Este artigo analisa as concepções relativas ao gênero, à sexualidade, à saúde, à espiritualidade/religiosidade, à política, ao meio ambiente e ao empoderamento feminino, presentes no mercado de produtos "alternativos" que atendem e celebram o ciclo menstrual na Argentina contemporânea. Trata-se de um estudo qualitativo baseado na análise de páginas, blogs e perfis do Facebook pertencentes a mulheres que fabricam, comercializam e/ou difundem toalhas de pano e copos de silicone, observação participante em oficinas sobre o ciclo e entrevistas pessoais com suas organizadoras. O estudo visibiliza a emergência e difusão de visões que celebram o ciclo menstrual, considerando-o uma fonte de identidade e empoderamento feminino, e as tensões que se dão com outro enfoques que questionam estas premissas.

Summary: This article explores meanings related to gender, body care and women's health, spirituality/religiosity, politics, environment, and women's empowerment, present in the marketing of "alternative" menstrual products (cloth towels, menstrual cup, books which celebrate menstrual cycle) and workshops and virtual networks about the menstrual cycle in contemporary Argentina. This is a qualitative study based on the analysis of publicity, blogs and Facebook groups of female entrepreneurs who manufacture, sell and/or promote these products, as well as participant observation in workshops and interviews with their organizers. It focuses in the tension between visions which privilege hygiene and perceive menstruation as a bad time for women and those which celebrate the menstrual cycle and consider it a source for women empowerment.

Knowledge, Problems and Practices of Adolescent Girls During Menstruation.

Background: Menstruation is a normal phenomenon and is almost universal in all females of reproductive age. Adolescence has been recognized as a special period which signifies the transition from girlhood to womanhood with the start of menstruation but there are substantial lacunae in knowledge about menstruation, problems they face and practices they adopt in this period. Objectives: 1.To know the knowledge about menstruation in adolescents, 2.To assess problems of menstruation, 3.To address the special needs regarding maintenance of hygiene during menstruation, 4.To notice impact of socioeconomic status upon them. Material and Method: A descriptive observational (cross sectional) study was carried to assess the knowledge, problems and practices by adolescent girls attending schools in a rural area of Kishanganj district (Bihar). A proforma consisted of predesigned , pretested, structured questionnaire to be filled up by the students and a check-list of height, wt, BP, HC, WC, to be filled up by the researchers , were used. Results: Among 200 adolescents, 70% knew that menstruation is a normal phenomenon; 79% were suffering from menstrual problems and regarding type of absorbats; 70% were using only sanitary napkins, while 30% were using both sanitary napkins and cloth as absorbants. Conclusion: This study shows a lack of understandings of the importance of maintenance of hygiene during menstruation and a lot of gap is present between problems during menstruation in adolescents due to lack of knowledge and proper guidance.

Clinical and psychological repercussions of videolaparoscopic tubal ligation: observational, single cohort, retrospective study / Repercussões clínicas e psíquicas da ligadura tubária videolaparoscópica: estudo observacional de coorte única, retrospectivo

CONTEXT AND OBJECTIVE: Tubal ligation is one of the most commonly used contraceptive methods worldwide. Since the controversy over the potential effects of tubal sterilization still continues, this study aimed to evaluate the clinical and psychological repercussions of videolaparoscopic tubal ligation. DESIGN AND SETTING: Observational, single cohort, retrospective study, conducted in a tertiary public hospital. METHODS: A questionnaire was applied to 130 women aged 21-46 years who underwent videolaparoscopic tubal ligation by means of tubal ring insertion or bipolar electrocoagulation and sectioning, between January 1999 and December 2007. Menstrual cycle interval, intensity and duration of bleeding, premenstrual symptoms, dysmenorrhea, dyspareunia, noncyclic pelvic pain and degree of sexual satisfaction were assessed in this questionnaire. Each woman served as her own control, and comparisons were made between before and after the surgical procedure and between the two techniques used. RESULTS: The clinical and psychological repercussions were significant, with increases in bleeding (P = 0.001), premenstrual symptoms (P < 0.001), dysmenorrhea (P = 0.019) and noncyclic pelvic pain (P = 0.001); and reductions in the number of sexual intercourse occurrences per week (P = 0.001) and in libido (P = 0.001). Women aged ≤ 35 years at the time of sterilization were more likely to develop menstrual abnormalities. The bipolar electrocoagulation method showed greater clinical and psychological repercussions. CONCLUSION: Regardless of the technique used, videolaparoscopic tubal ligation had repercussions consisting of increased menstrual flow and premenstrual symptoms, especially in women aged ≤ 35 years, and also had a negative influence on sexual activity. .

CONTEXTO E OBJETIVO: A ligadura tubária é um dos métodos contraceptivos mais utilizados em todo o mundo. Como a controvérsia sobre seus possíveis efeitos ainda continua, o objetivo deste estudo foi avaliar as repercussões clínicas e psíquicas da laqueadura videolaparoscópica. TIPO DE ESTUDO E LOCAL: Estudo observacional de coorte único, retrospectivo, conduzido em hospital público terciário. MÉTODOS: Foi aplicado um questionário a 130 mulheres, entre 21-46 anos, submetidas à ligadura tubária videolaparoscópica, pelas técnicas de eletrocoagulação bipolar/secção ou inserção do anel tubário, entre janeiro de 1999 e dezembro de 2007. Nesse questionário avaliou-se: intervalo do ciclo menstrual, intensidade e duração do sangramento, sintomas pré-menstruais, dismenorreia, dispareunia, dor pélvica não cíclica e grau de satisfação sexual. Cada mulher serviu como seu próprio controle, foi realizada análise comparativa entre os períodos pré- e pós-cirúrgico e entre as duas técnicas utilizadas. RESULTADOS: As repercussões clínicas e psicológicas mostraram-se significativas, com aumento de sangramento (P = 0,001), de sintomas pré-menstruais (P < 0,001), dismenorreia (P = 0,019), dor pélvica não cíclica (P = 0,001), e redução no número de relações sexuais por semana (P = 0,001) e na libido (P = 0,001). Mulheres com idade ≤ 35 anos, no momento da laqueadura, mostraram-se mais propensas a desenvolverem alterações menstruais. A técnica de eletrocoagulação bipolar mostrou maiores repercussões clínicas e psíquicas. CONCLUSÃO: A ligadura tubária videolaparoscópica, independentemente da técnica, repercutiu com ...

A community-based study of menstrual hygiene practices and willingness to pay for sanitary napkins among women of a rural community in northern India.

Background. Hygiene-related practices of women during menstruation are of paramount importance. There is a lack of sizeable literature on menstrual practices from northern India. We documented the menstrual hygiene practices of rural women and assessed their willingness to pay for sanitary napkins. Methods. A cross-sectional study was done in villages under the Comprehensive Rural Health Services Project (CRHSP), situated in Ballabgarh, Haryana. The study participants were women in the age group of 15–45 years. Nine villages were selected randomly while the number of respondents in each selected village was decided through the probability proportionate to size sampling method. The households were selected using systematic sampling. One woman was interviewed in each household using a pre-tested questionnaire. Results. A total of 995 women were interviewed. A majority of them (62%) were unaware of the reason(s) for menstruation. The role of the health sector in providing information regarding menstruation was low as only a few women (1.5%) had got information from the auxiliary nurse midwife (ANM)/health worker (HW). For the majority of women, besides religious activities, other routine activities did not suffer during menstruation. Only 28.8% of women were using sanitary napkins and of those who did not use napkins, only one-fourth (25.3%) were willing to buy them. The mean (SD) price per napkin that these women were ready to pay was `0.54 (0.43), equivalent to US$ 0.01. Conclusion. Women in the reproductive age group should be provided with appropriate information about menstruation, and they should be told about the advantages of using sanitary napkins. Health sector functionaries should play a proactive role in the delivery of such information.

Impact of Pro-environmental Behavior on Dysmenorrhea

PURPOSE: In this study the impact of pro-environmental behavior, well-being oriented behavior, and use of cloth menstrual pads on dysmenorrhea in Korean female adults was examined according to the theory of reasoned action. METHODS: A cross-sectional study was conducted with 195 Korean female adults. Data were collected from June to August, 2010 using self-report questionnaires. Data were analyzed using t-test, one-way ANOVA, Pearson correlation coefficients, multiple regression, and logit regression with STATA 10.0. RESULTS: Pro-environmental behavior explained 48% of well-being oriented behavior. Well-being oriented behavior explained 10% of cloth pad use. Use of cloth pad explained 4% of dysmenorrhea and 5% of menstrual pain. The path through well-being oriented behavior had a significant effect from pro-environmental behavior to cloth pad use. CONCLUSION: Use of cloth pad was significantly related with well-being oriented behavior, pro-environmental behavior, social influence, dysmenorrhea, and menstrual pain. The results of this study suggest that pro-environmental strategies can help health care providers diminish clients' menstrual symptoms. Nursing intervention can support pro-environmental behavioral strategies.

Higiene íntima femenina y vaginosis bacteriana: Encuesta Epidemiológica Latinoamericana 2008 / Intimate hygiene and bacterial vaginosis: Epidemiological Latinoamerican Survey 2008

Objetivos: hacer una aproximación a la prevalencia de vaginosis bacteriana (VB) en mujeres en Latinoamérica y explorar la asociación entre el tipo de hábitos higiénicos y prácticas sexuales con la presencia de este diagnóstico. Metodología: estudio de corte transversal en mujeres de 10 países de Latinoamérica entre los 16 y 49 años, vida sexual activa y ciclos menstruales. Se excluyeron las mujeres que presentaban otro tipo de infección vaginal, en gestación o en puerperio, con incapacidad para responder la encuesta o con cambio de pareja sexual en el último trimestre. Igualmente, se realizó muestreo por conveniencia de 1.000 mujeres. Se presenta la prevalencia de punto de VB. Se aplicó una encuesta que contenía información sociodemográfica, información sobre actividad sexual e higiene íntima y se hizo el diagnóstico presuntivo de vaginosis bacteriana basado en criterios clínicos y de laboratorio. Se evalúa la asociación entre VB, los hábitos higiénicos y prácticas sexuales por medio del OR y su intervalos de confianza del 95%. Resultados: la prevalencia de VB fue del 40% en las pacientes encuestadas. Se encontró asociación con el uso de alcohol y tabaco. Como actores protectores se identificaron el lavarse las manos después de orinar o defecar (OR=0,32; IC95%, 0,16-0,63); utilizar una técnica “adecuada” de aseo genital (OR=0,55; IC95%, 0,41-0,74) el uso de jabón en forma líquida (OR=0,62; IC95%, 0,46-0,84) y el uso de un jabón exclusivo para el área genital (OR=0,56; IC95%, 0,42-0,75). Como factores de riesgo se encontraron el uso de tampón (OR=3,00; IC95%,1,88-4,80), tener relaciones sexuales durante el período menstrual (OR=1,46; IC95%, 1,03-2,07) y usar lubricantes durante el coito (OR=1,68; IC 95%, 1,07-2,64). Conclusión: la prevalencia de VB es similar a la previamente informada en Latinoamérica. Su frecuencia esta asociada a los hábitos higiénicos y prácticas sexuales.

Objectives: presenting an approximation to bacterial vaginosis (BV) prevalence in Latin America and exploring the association between types of hygienic habits and sexual practices presented along with such diagnosis. Methodology: this was an epidemiological survey of women aged 16 to 49 from ten Latin-American countries who had active sexual lives and menstrual cycles. Females having another type of vaginal infection, pregnant females or those in puerperium, those unable to fill in the survey or who had changed their sexual partner during the last three-month period were excluded. 1,000 females were included by convenience sampling. The survey revealed BV prevalence; it had and provided data about presumptive diagnosis of BV, sociodemographic data, information about sexual activity, physical grooming, genital hygiene, underwear, intimate and menstrual hygiene and protection related to sexual activity. A presumptive diagnosis of BV was based on clinical and laboratory criteria. The association between BV and the females’ hygienic habits and sexual practices was evaluated by means of OR and 95% confidence intervals. Results: 40% of the surveyed patients had BV. An association was found between BV and alcohol and tobacco use. Washing hands before and after urinating or defecating (OR=0.32; 0.16-0.63 95%CI), using a “suitable” genital washing technique (vulva to anus) (OR=0.55; 0.41-0.74 95%CI), using liquid soap (OR=0.62; 0.46-0.84 95%CI) and soap just for the genital area (OR=0.56; 0.42-0.75 95%CI) were found to be protection-inducing factors. Hygienic habits explored as being risk factors for BV included tampon use (OR=3.00; 1.88-4.80 95%CI), having sexual relations during the menstrual period (OR=1.46; 1.03-2.07 95%CI) and using lubricants during coitus (OR=1.68; 1.07-2.64 95%CI). Conclusion: BV prevalence was found to be similar to that previously reported for Latin-America. Such frequency was found to be associated with hygienic habits and sexual practices.

Evaluation of habitual behavior related to genital hygiene in women living in a health care center area

To evaluate that habitual behaviors related to genital hygiene in women living in a Health Care Center Area. In this cross-sectional study, 400 women were sampled to represent women in reproductive ages [15-49 ages] living in the Park Health Care Center Area, Ankara, Turkey between June and September 2008. Three hundred and eighty-six [96.55] women were interviewed for evaluation of habitual behaviors related to genital hygiene. The chi-square test was used for statistical analysis. The man age of the study group was 32.19 +/- 9.54 [15-49] years. Of the study group, 21.5% had daily baths, 77.2% used cotton underwear, and 71.8% wiped front to back after using the toilet. Of those who menstruated, 83.4% used hygienic pads during menstrual periods, and 42.1% of the 321 married women confirmed practicing vaginal douching. The education level [p=0.001, p=0.000], income level [p=0.034, p=0.005], employment [p=0.022, p=0.000], and house type [p=0.005, p=0.006] were found as factors affecting general frequency of bathing and type of pad used during the menstrual period. Frequency of vaginal douching was higher in housewives than employed women [p=0.000]. The rate of women who had appropriate behaviors related to genital hygiene among the study group was found to be low, particularly within groups with a low socioeconomic level. Thus, it will be useful for health care employers to emphasize this issue at every opportunity

Menstruation and menstrual hygiene amongst adolescent school girls in Kano, Northwestern Nigeria

This study examined the knowledge and practices of adolescent school girls in Kano, Nigeria around menstruation and menstrual hygiene. Data was collected quantitatively and analyzed using Epi info version 3.2.05. The mean age of the students was 14.4 ± 1.2 years; majority was in their mid adolescence. The students attained menarche at 12.9 ± 0.8 years. Majority had fair knowledge of menstruation, although deficient in specific knowledge areas. Most of them used sanitary pads as absorbent during their last menses; changed menstrual dressings about 1-5 times per day; and three-quarter increased the frequency of bathing. Institutionalizing sexuality education in Nigerian schools; developing and disseminating sensitive adolescent reproductive health massages targeted at both parents and their adolescent children; and improving access of the adolescents to youth friendly services are veritable means of meeting the adolescent reproductive health needs in Nigeria (Afr. J. Reprod. Health 2010; 14[3]: 201-207)

A Study of the Perception about Menstruation and Discomforts of Using Disposable Menstrual Pads / 여성건강간호학회지

PURPOSE: This study was to explore the perception about menstruation and discomforts of using disposable menstrual pads in menstruating women. METHOD: A survey was conducted of 132 menstrual women recruited by convenience sampling. Data were collected by a face-to-face interview and a study questionnaire, and analyzed by frequency and chi-square-test. RESULT: More than half of the subjects expressed a negative perception about menstruation, while 25% expressed a mixed perception and 24.2% expressed a positive perception. Women who perceived their menstruation negatively had more menstrual pain than the others (p<.001). The most frequently experienced discomforts of using disposable pads were an unpleasant smell (18.9%), leakage (18.9%), and discomfort (16.6%). Adverse effects of using disposable pads were reported as an itching sense (23.1%), skin rash (20.2%), and skin irritation (10.6%). Alternate materials were reported with tampons, alternate washable pads, and maternity pads. CONCLUSION: The results indicate that disposable menstrual pads cause several discomforts and common adverse effects such as skin problems. To decrease these discomforts and relieve adverse effects, planned nursing education including women's personal hygiene methods and information about an alternate pad may be helpful.

Knowledge and practice regarding menstrual hygiene in rural adolescent girls of Nepal.

OBJECTIVE: This study was done in the adolescent girls to evaluate the knowledge and practice on different aspects of menstrual hygiene. METHODS: One hundred and fifty adolescent girls of age 13-15 years from 3 schools of Shivanagar and Patihani village development committees of Chitwan district were involved in this study. Altogether 27 questions were asked to each of them. RESULTS: During our study, we found that they were not properly maintaining the menstrual hygiene. Only 6.0% of girls knew that menstruation is a physiologic process, 36.7% knew that it is caused by hormones. Ninety-four percentages of them use the pads during the period but only 11.3% dispose it. Overall knowledge and practice were 40.6% and 12.9% respectively. CONCLUSION: Although knowledge was better than practice, both were not satisfactory. So, the girls should be educated about the process and significance of menstruation, use of proper pads or absorbents and its proper disposal. This can be achieved by giving them proper training and health education (by teachers, family members, health educators, and media) so that there won't be any misconception to the adolescent girls regarding menstrual hygiene.