What is Menstrual Hygiene?

The onset of periods signifies an important change in girls’ lives. It initiates the transition to adulthood.1 She would benefit from her family and friends' support at this point.2 Periods, however, are thought to be unclean or embarrassing.1 Many cultural beliefs and myths restrict women from daily activities and hygienic health practices, which may lead to adverse outcomes such as infection.3

In India, 200 million women are estimated to have poor knowledge of menstrual hygiene practices.4 Practising hygiene during periods is essential5 for promoting good health.6 Menstrual hygiene management is defined as “Women and adolescent girls are using a clean menstrual management material to absorb or collect menstrual blood, that can be changed in privacy as often as necessary for the duration of a menstrual period, using soap and water for washing the body as required, and having access to safe and convenient facilities to dispose of used menstrual management materials. They understand the basic facts linked to the menstrual cycle and how to manage it with dignity and without discomfort or fear.”7 When you're having your periods, menstrual hygiene practices can help you stay comfortable and healthy.6

References:
1. Ram U, Pradhan MR, Patel S, et al. Factors associated with disposable menstrual absorbent use among young women in India. Int Perspect Sex Reprod Health. 2020;46:223-34.
2. United Nations Children’s Fund. Fast facts: nine things you didn’t know about menstruation. [Internet] 2018 May 25 [cited 2023 Jan 04]. Available from: https://www.unicef.org/press-releases/fast-facts-nine-things-you-didnt-know-about-menstruation
3. Alharbi KK, Alkharan AA, Abukhamseen DA, et al. Knowledge, readiness, and myths about menstruation among students at the Princess Noura University. J Family Med Prim Care. 2018;7(6):1197-202.
4. Prakash S, Bhartiya AK. Menstrual health and hygiene practices in School going adolescent girls in India. The Social Ion. 2018;7(1):11-7.
5. Dasgupta A, Sarkar M. Menstrual hygiene: how hygienic is the adolescent girl? Indian J Community Med. 2008;33(2):77-80.
6.Centers for Disease Control and Prevention. Menstrual hygiene. [Internet] 2022 Dec 01 [cited 2023 Jan 03]. Available from: https://www.cdc.gov/hygiene/personal-hygiene/menstrual.html
7. United Nations Children’s Fund. Guidance on menstrual health and hygiene. [Internet] 2019 Mar [cited 2023 Jan 23]. Available from: https://www.unicef.org/media/91341/file/UNICEF-Guidance-menstrual-health-hygiene-2019.pdf

Factors Affecting Menstrual Hygiene​

Factors-Affecting

Lack of knowledge and awareness

Mothers often feel shy discussing concerns related to periods with their daughters. Also, adult women may be unaware of good hygiene practices. Hence, they may pass on the cultural restrictions to be observed.1,2

Factors-Affecting

Lack of facilities

Practicing menstrual hygiene is often difficult for girls and women due to lack of access to proper sanitary protection products or facilities. It can be due to a lack of private space with a safe disposal method for soiled cloths or pads and the availability of water for washing hands and sanitary materials.1,2

Factors-Affecting

Lack of social support

Due to taboos related to periods, women and girls are excluded from numerous aspects of cultural and social life, and menstrual hygiene practices. Exclusion from sanitation facilities is one of the taboos. As a result, there is a lack of access to sanitation and water when required the most.1,2

Factors-Affecting

Limited sources to purchase sanitary products

Practicing healthy habits during periods include changing sanitary pads every few hours.3 However, the greatest obstacle to using sanitary pads is their cost. Most available sanitary pads are out of reach for women in the lower income group. Hence, they can't manage to buy sanitary pads every month.2,4

References:
1. Mayo Clinic. Menorrhagia (heavy menstrual bleeding). [Internet] 2022 Jun 25 [cited 2022 Dec 05]. Available from: https://www.mayoclinic.org/diseases-conditions/menorrhagia/symptoms-causes/syc-20352829
2. Gottapu K, Golagabathula S. A study of demographic profile and evaluation of menorrhagia. Indian J Appl Res. 2014;4(1):430-4.
3. Herman MC, Mol BW, Bongers MY. Diagnosis of heavy menstrual bleeding. Womens Health. 2016;12(1):15-20.
4. American College of Obstetricians and Gynecologists. Heavy menstrual bleeding. [Internet] 2022 Jun [cited 2022 Dec 06]. Available from: https://www.acog.org/womens-health/faqs/heavy-menstrual-bleeding

Impact of Poor Menstrual Hygiene​

Skin irritation

Skin irritation

When the pad is not changed frequently it becomes wet and causes skin irritation and infection.1

Hepatitis

Hepatitis B​

Not washing hands after changing sanitary products can facilitate the spread of infections like hepatitis B (viral liver infection).1

Bacterial

Bacterial vaginal infection

Unhygienic practices may lead to bacterial vaginal infection and urinary tract infections.2,3 Females who don’t wash their vagina are more susceptible to bacterial vaginal infection.3,4

Psychosocial stress

Psychosocial stress

Poor hygiene practices are linked with psychosocial stress characterised by fear of stigma, anxiety, feeling of shame, distraction, and disconnection.5

Fungal Infections

Fungal infections

Young girls and women who practice improper menstrual cloth maintenance can develop fungal infections. Recurrent infections result in severe reproductive tract infections and increase susceptibility to various health problems.1

Urogenital

Urogenital (urinary and genital) infections

Poor hygiene practices related to the use, washing, drying, and storage of sanitary products can be associated with adverse health outcomes such as urogenital infections.55

References:
1. WaterAid. Menstrual hygiene matters. A resource for improving menstrual hygiene around the world. [Internet] 2012 [cited 2023 Jan 03]. Available from: https://washmatters.wateraid.org/sites/g/files/jkxoof256/files/Menstrual%20hygiene%20matters%20low%20resolution.pdf
2. Das P, Baker KK, Dutta A, et al. Menstrual hygiene practices, WASH Access and the risk of urogenital infection in women from Odisha, India. PLoS One. 2015;10(6):e0130777. ​
3. WebMD. Bacterial vaginosis. [Internet] 2022 Nov 06 [Cited 2023 Feb 01]. Available from: https://www.webmd.com/women/what-is-bacterial-vaginosis​
4. Abou Chacra L, Fenollar F, Diop K. Bacterial vaginosis: what do we currently know? Front Cell Infect Microbiol. 2022;11:672429.​
5. Das P, Lisnek D, Sahoo KC, et al. Identifying risk factors for lower reproductive tract infections among women using reusable absorbents in Odisha, India. Int J Environ Res Public Health. 2021;18(9):4778.​

Health and Hygiene Practices During Periods

Background
Background

WEAR LIGHTWEIGHT BREATHABLE CLOTHING

Tight fabric can trap moisture and heat, supporting the growth of microorganisms. Hence, wearing cotton underwear can be helpful.1

Proper disposable methods

If you wear a pad or period underwear for an extended period, you may develop a rash or an infection. Trapped moisture serves as a breeding ground for bacteria and fungi.1 It is recommended to change your pads every four to five hours and tampons should be changed after every eight hours.2

KEEP YOUR GENITAL AREA CLEAN

Use only water to wash the outside part of your vagina. The vagina is an organ that can clean itself, but if you use chemicals to cleanse it, it changes the natural pH balance and may result in a bacterial or yeast infection.1

USE UNSCENTED SANITARY PRODUCTS

Scented sanitary products can irritate the skin and affect normal pH balance.1

Proper disposable methods

You should throw your used disposable sanitary products properly. You should wrap them with a tissue or other material and then throw them in the dustbin. Do not flush them in the toilet.1

KEEP YOURSELF HYDRATED

Drink water, as it helps in keeping your body hydrated.3 It also helps in flushing away the bacteria that cause infection of the urinary tract,4 and helps prevent infections, like vaginal candidiasis.1

Track and monitor periods

Your period is an important indicator of your overall health. Period irregularities can be a sign of conditions, including diabetes, thyroid issues, etc.1

Get moving

Avoid sitting still or staying in bed for a longer time. Get up and move around normally. Sitting still will make you conscious of your condition. On the other hand, keeping yourself involved in any movement will keep your mind off the worries about your periods.3

Limit caffeine intake

Caffeine consumption can cause prolonged, heavy, irregular and inconsistent bleeding. Thus, it is advisable to limit consumption of coffee.5

Consume fresh food

Avoid junk foods, as it may cause indigestion and make periods more painful. Consume fresh food and drinks during your periods to maintain energy levels.3

Focus on self-care

Try to pamper yourself with your favourite cuisine, a massage, or another indulgence to make you feel special.3

References:

1. Centers for Disease Control and Prevention. Menstrual hygiene. [Internet] 2022 Dec 01 [cited 2023 Jan 03]. Available from: https://www.cdc.gov/hygiene/personal-hygiene/menstrual.html
2. ePainAssist. Tampons vs sanitary pads: which is better? [Internet] 2020 Dec 04 [cited 2023 Jan 09]. Available from: https://www.epainassist.com/women/tampons-vs-sanitary-pads-which-is-better
3. ePainAssist. Dos and don’ts for period. [Internet] 2018 March 09 [cited 2023 Jan 03]. Available from: https://www.epainassist.com/women/dos-and-donts-for-period
4. Everyday Health. 8 Home Remedies for Urinary Tract Infection (UTI) Symptoms. [Internet] 2020 Feb 21 [cited] 2023 Jan 23. Available from: https://www.everydayhealth.com/urinary-tract-infections/helpful-home-remedies-for-urinary-tract-infections.aspx
5. Mahmoud AZ, Makhdoom AN, Mufti LA, et al. Association between menstrual disturbances and habitual use of caffeine. Journal of Taibah University Medical Sciences. 2014;9(4):341-4.