Menstruation is a biological, normal natural process experienced by all adolescent girls and women, yet it is not spoken about openly causing unnecessary embarrassment and shame. Lack of a separate and usable girl’s toilet in schools and public places and a toilet at home leaves adolescent girls and women to face the indignity of open defecation. However, safe and effective menstrual hygiene management is a trigger for better and stronger development for adolescent girls and women.
Let’s have a look at some terms related to our topic:
- Menarche: The first occurrence of menstruation
- Menopause: The time in a woman’s life when her menstrual periods stop and she is no longer
able to have children
- Menstruation or monthly periods: A biological process in a woman where each month blood and other material is discharged from the lining of the uterus. It occurs from the onset of puberty until menopause, except during pregnancy.
- Menstrual Hygiene: The articulation, awareness, information, and confidence to manage menstruation with safety and dignity using safe hygienic materials together with adequate water and agents and spaces for washing and bathing with soap and disposal of used menstrual absorbents with privacy and dignity.
- Menstrual absorbents: These are the products used to catch menstrual flow, such as pads, cloths, tampons or cups. The material absorbs the flow of blood from her vagina
- Menstrual waste: This includes a used sanitary cloth, napkin, towel or pad that contains blood
So, Menstrual Hygiene is an essential aspect of hygiene for women and adolescent girls between menarche and menopause. We need to understand that access to safe and dignified menstruation is a fundamental need for women and girls. We wish that there’s a world where every girl can learn, play, and safeguard her own health without experiencing stress, shame, or unnecessary barriers to information or supplies during menstruation. A growing evidence base from low- and middle-income countries shows that many girls are not able to manage their periods and associated hygiene with ease and dignity. This deprivation is even more acute for girls and women in emergencies. These girls and women cannot practice good menstrual health and hygiene at home, at school, at work or in other public settings, due to a combination of discriminatory social environments, inaccurate information, poor facilities, and limited choice of absorbent materials.
We need to work to improve girls’ and women’s menstrual health and hygiene in four areas: social support, knowledge and skills, facilities and services, and access to absorbent materials and supportive supplies. It is estimated that over 75% of women and girls in high- and upper-middle-income countries use commercially produced products, while over half of women and girls in low-and-middle-income countries use homemade products. Let’s see some of the products used during menstruation as blood absorbers:
Menstrual Cloth: Cloths are reusable pieces of fabric worn externally to the body. It is cheap and widely used in low-income countries. Proper washing and drying is crucial for a safe use, though often difficult due to lack of privacy and stigma. It is often not recommended for menstrual hygiene management as their use has been associated with abnormal vaginal discharge, skin irritations, and urogenital infections.
Reusable Pads: They are worn externally to the body. They are made from a variety of natural or synthetic materials. After use, they are washed, dried, and reused for approximately one year. When compared to disposable pads they are sometimes found inconvenient. Proper washing and drying is crucial for safe use. There might be an association with urinary tract infections and bacterial vaginosis, and the use of damp materials can lead to skin irritations. These pads can be used for approximately one year and thus produce significantly less solid waste than single-use, disposable materials. Reusable pads are generally cost-effective when annualized.
Disposable Sanitary Pads: They are worn externally to the body. They are disposed of after a maximum of 8 hours. They are often preferred and considered aspirational by girls and women as they are cited to be reliable, hygienic, comfortable, easy to use (especially in contexts with limited privacy), and require no access to water for cleaning. No significant adverse health effects are reported, though there is inconclusive evidence on the impact of disposable pad use and bacterial vaginosis, and reproductive tract infections especially in relation to prolonged wear time. As pads are disposed off after one use they create large quantities of litter, accumulate in landfills, block sanitation systems when thrown in toilets, and release toxins when burned incorrectly.
Tampons: They are absorbent materials made from cotton and/or rayon that are inserted into the vagina to absorb menstrual flow. They expand with moisture and thereby avoid leakage. They can be worn for up to 8 hours, after which they are removed using the removal string, and disposed of. Tampons are often not available and are rarely used in low-income countries. Girls and women often express fear of pain and the tampon getting stuck as reasons for non-use. Residual chemical and fragrance can lead to allergic reactions. As tampons are disposed after one-time wear, they create large amounts of waste. The flushing of tampons in toilets can lead to clogging of pipes, service disruption, and increased maintenance costs. When burned incorrectly, they can release furans and toxins. Only tampons made from natural fibers are biodegrade, while those containing plastics remain in the environment.
Menstrual Cup: It is a non-absorbent bell-shaped device that is inserted into the vagina to collect menstrual flow. It creates a seal and is held in place by the walls of the vagina. It is typically made of medical-grade silicone. It collects three times more blood than pads or tampons and needs to be emptied every 6-12 hours, after which it is rinsed and re-inserted. It can be used for 5-10 years and thus produces significantly less waste. While cups require water for boiling, they need far less than reusable pads or cloths. It allows its user to safely handle menstruation without reoccurring costs for many years.
A lack of information about menstruation leads to damaging misconceptions and discrimination, and can cause girls to miss out on normal childhood experiences and activities, and also absenteeism from school. Stigma, taboos and myths prevent adolescent girls and boys from the opportunity to learn about menstruation and develop healthy habits. There is a need to destigmatize the menstruation process because only then, the world will be able to improve in menstrual hygiene.
Here are some key facts about menstruation:
- On average a woman menstruates for about 7 years during their lifetime.
- The first period can be met with either celebration, fear, or concern. For every girl, this signifies an important transition to womanhood, a time when they would benefit from the support of family and friends.
- Many girls do not have a complete and accurate understanding of menstruation as a normal biological process. Educating girls before their first period and, importantly, boys on menstruation, builds their confidence, contributes to social solidarity and encourages healthy habits. Such information should be provided at home and at school.
- Poor menstrual hygiene can pose physical health risks and has been linked to reproductive and urinary tract infections. Many girls and women have limited options for affordable menstrual materials. Providing access to private facilities with water and safer low-cost menstrual materials could reduce urogenital diseases.
- Girls and women with disabilities and special needs face additional challenges with menstrual hygiene and are affected disproportionately with a lack of access to toilets with water and materials to manage their period.
- Many women and girls do not have access to materials to manage their menstruation, especially in times of emergency- natural disasters and conflicts.
- Menstruation, being a biological process, is connected with numerous disorders like Amenorrhea, abnormal uterine bleeding, Oligomenorrhea, Premenstrual syndrome, Premenstrual dysphoric disorder, etc. Some females may also face painful or irregular periods.
- Globally, 2.3 billion people lack basic sanitation services and in Least Developed Countries only 27 percent of the population has a handwashing facility with water and soap at home. Managing periods at home is a major challenge for women and adolescent girls who lack these basic facilities at home.
- About half of the schools in low-income countries lack adequate drinking water, sanitation and hygiene crucial for girls and female teachers to manage their period. Inadequate facilities can affect girls’ experience at school, causing them to miss school during their period. All schools should provide running water, safe and clean toilets for adolescent girls.
- Many non-profits around the world are working with local communities, schools and governments to research and provide information about menstruation, promote positive hygiene habits and break down taboos.
Sit and think why there is a stigma around the word ‘periods’?