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Wahl K, Albert A, Larente M, Lopez de Arbina E, Kennedy L, Sutherland JL, Imtiaz S, Orr NL, Allaire C, Yong PJ. Does menstrual health and endometriosis education affect knowledge among middle and secondary school students? A cluster randomized controlled trial. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2024:102583. [PMID: 38871121 DOI: 10.1016/j.jogc.2024.102583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/20/2024] [Accepted: 04/24/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE To evaluate whether endometriosis and menstrual health education improves knowledge and attitudes among adolescents and is acceptable. METHODS We conducted a cluster randomized controlled trial in a Canadian school district. Eligible classes were Grade 8-12, co-educational, and English. Classes were randomly assigned either to a 60-minute virtual menstrual health and endometriosis education program before (intervention) or after (waitlist control) primary data collection. The primary outcome was change in endometriosis knowledge from baseline to follow-up (∼4 weeks later, 6-item questionnaire). Secondary outcomes were changes in confidence in endometriosis knowledge, prioritization of menstrual health knowledge, and comfort discussing menstrual health, as well as intervention acceptability. The sexual health educator and statistician were masked. RESULTS In April and May 2021, two intervention classes and two control classes completed the study. 71 students enrolled, and 48 were present on both baseline and follow-up days. Mean age was 15.7 ± 1.6 years, 55% identified as non-White ethnicities, and 53% female. The knowledge score increased by 32% in the intervention classes compared with 2% in the control classes, with an estimated mean difference of 1.56 (95% CI 1.12-2.00). The intervention classes showed increased confidence in endometriosis knowledge, prioritization of menstrual health knowledge, and comfort discussing menstrual health, compared to the control classes. The mean acceptability index was 80 (SD = 10) in the intervention classes and 70 (SD = 20) in the control classes. CONCLUSION A brief menstrual health and endometriosis education program improved knowledge and attitudes among adolescents, who considered the program acceptable.
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Affiliation(s)
- Kate Wahl
- Department of Obstetrics and Gynecology, University of British Columbia (UBC), Vancouver, British Columbia, Canada
| | - Arianne Albert
- Women's Health Research Institute (WHRI), Vancouver, British Columbia, Canada
| | | | | | - Lan Kennedy
- UBC Endometriosis and Pelvic Pain Laboratory
| | | | | | - Natasha L Orr
- Department of Obstetrics and Gynecology, University of British Columbia (UBC), Vancouver, British Columbia, Canada
| | - Catherine Allaire
- Department of Obstetrics and Gynecology, University of British Columbia (UBC), Vancouver, British Columbia, Canada
| | - Paul J Yong
- Department of Obstetrics and Gynecology, University of British Columbia (UBC), Vancouver, British Columbia, Canada; Women's Health Research Institute (WHRI), Vancouver, British Columbia, Canada.
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Pouraliroudbaneh S, Marino J, Riggs E, Saber A, Jayasinghe Y, Peate M. Heavy menstrual bleeding and dysmenorrhea in adolescents: A systematic review of self-management strategies, quality of life, and unmet needs. Int J Gynaecol Obstet 2024. [PMID: 38654586 DOI: 10.1002/ijgo.15554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 03/25/2024] [Accepted: 04/09/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Heavy menstrual bleeding (HMB) and dysmenorrhea (DM) are common gynecological problems. OBJECTIVE To systematically review the needs, quality of life (QOL), and effectiveness of self-management strategies among young women (12-25 years) with DM or HMB. SEARCH STRATEGY Relevant terms were searched through PubMed, EBSCO, Google Scholar, ProQuest, and Ovid between 2010 and 2022. SELECTION CRITERIA Qualitative and quantitative studies published in peer-reviewed journals, females aged 12-25, exploring DM or HMB, reporting supportive care needs, quality of life, self-treatment strategies, and/or treatment-seeking behavior. DATA COLLECTION AND ANALYSIS Abstracts were reviewed for eligibility by two researchers. Included studies were extracted and assessed for quality independently by two authors, with discrepancies resolved through consensus or the involvement of a third researcher. Data extracted included study details, menstrual history, symptoms, self-care strategies, and quality of life. The Joanna Briggs Institute checklists were used for quality assessment. MAIN RESULTS The search returned 285 190 studies, of which 55 were eligible for inclusion. Prevalence rates of HMB and DM were in the ranges 4%-63% and 42%-94%, respectively. Over 80% of young women with DM and HMB experienced physical and psychological problems, including pelvic pain, sleep issues, mood disturbance, diarrhea, and nausea. Academic performance and daily activities were severely affected. Most (>62%) named their mothers as their primary source of information, and friends as the secondary source (10%-65%). Few studies explored needs, but they could be inferred and fell under school-related and social needs. QOL was poorer in those who had DM than those who did not. Pain was the most common issue that drove young women to find treatment. More than 70% used medication to reduce pain. More than half chose home remedies (e.g., heat therapy, massages, herbal tea, hot drinks). No studies provided information about the efficacy and dosage of medication and herbal remedies. CONCLUSIONS HMB and DM have a large impact on daily living, with large areas of unmet need. Limited access to information impairs the management of symptoms and consequent QOL.
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Affiliation(s)
- Shiva Pouraliroudbaneh
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Jennifer Marino
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Victoria, Australia
- Specialty of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| | - Elisha Riggs
- Intergenerational Health, Murdoch Children Research Institute, Parkville, Victoria, Australia
- Department of General Practice, University of Melbourne, Parkville, Victoria, Australia
| | - Ashraf Saber
- Esfarayen Faculty of Medical Sciences, Esfarayen, Iran
| | - Yasmin Jayasinghe
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
- Department of Gynaecology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Michelle Peate
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
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Mardon AK, Whitaker L, Farooqi T, Girling J, Henry C, Ee C, Tewhaiti-Smith J, Armour M. Investigational drugs for the treatment of dysmenorrhea. Expert Opin Investig Drugs 2024; 33:347-357. [PMID: 38436301 DOI: 10.1080/13543784.2024.2326627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/29/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Dysmenorrhea is the most common cause of gynecological pain among women that has considerable impact on quality of life and psychosocial wellbeing. Non-steroidal anti-inflammatory drugs (NSAIDs) and hormonal therapies are most commonly used to treat dysmenorrhea. However, given these drugs are often associated with bothersome side effects and are less effective when there is an underlying cause contributing to dysmenorrhea (e.g. endometriosis), a patient-centered approach to managing dysmenorrhea is important. Various new drugs are currently being investigated for the treatment of primary and secondary dysmenorrhea. AREAS COVERED This review provides an updated overview on new therapeutic targets and investigational drugs for the treatment of primary and secondary dysmenorrhea. The authors describe the clinical development and implications of these drugs. EXPERT OPINION Among the investigative drugs discussed in this review, anti-inflammatories show the most promising results for the treatment of dysmenorrhea. However, given some trials have considerable methodological limitations, many drugs cannot be currently recommended. Research focused on understanding the mechanisms involved in menstruation and its associated symptoms will be important to identify new therapeutic targets for dysmenorrhea. Further robust clinical trials are required to better understand the efficacy and safety of investigational drugs for treating primary and secondary dysmenorrhea.
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Affiliation(s)
- Amelia K Mardon
- NICM Health Research Institute, Western Sydney University, NSW Australia; IIMPACT in Health, University of South Australia, Australia
| | - Lucy Whitaker
- Centre for Reproductive Health, Institute for Regeneration and Repair, University of Edinburgh, UK
| | - Toobah Farooqi
- NICM Health Research Institute, Western Sydney University NSW, Australia
| | - Jane Girling
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Claire Henry
- Department of Surgery & Anaesthesia, University of Otago Wellington Aotearoa, New Zealand
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Australia
| | | | - Mike Armour
- Reproductive Health, NICM Health Research Institute, Western Sydney University, Australia
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Güven AG, Kızılkan MP, Taşar MA, Akgül S. An Assessment of the Quality of YouTube Videos as a Resource for Adolescents Experiencing Abnormal Uterine Bleeding. J Pediatr Adolesc Gynecol 2024; 37:137-141. [PMID: 38122960 DOI: 10.1016/j.jpag.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/11/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
STUDY OBJECTIVE YouTube, the largest accessible media-sharing platform, has become an important tool for pursuing health-related information. Adolescents may find it challenging to seek counseling or access adolescent-friendly services for menstruation-related problems, so YouTube may be a useful resource. The aim of this study was to examine the reliability, quality, and accuracy of YouTube videos concerning abnormal uterine bleeding in adolescents. METHODS A YouTube search using the key words "adolescent, teens, heavy period, abnormal uterine bleeding, heavy menstrual bleeding" yielded 109 videos. Video features (duration, time since upload, likes, views, comments), sources of upload, and content were recorded. All the videos were reviewed by 2 adolescent medicine specialists and scored using the Journal of the American Medical Association, the 5-point modified DISCERN tool, and the Global Quality Scale. RESULTS Fifty-eight videos met the inclusion criteria. Most (62.1%) were created by non-professionals, and a significant portion (81%) contained general descriptions. On the basis of the DISCERN classification, 50% exhibited poor quality. Similarly, the Journal of the American Medical Association assessment indicated that only 36.2% satisfied the requirements for good quality. The videos uploaded by professionals exhibited notably superior quality in comparison with those uploaded by non-professionals. Additionally, higher-quality videos were longer (P = .040) and more recent (P = .011). CONCLUSION Mot YouTube videos about adolescent abnormal uterine bleeding provide low-quality information. We believe that increasing the number of videos tailored by health care providers specializing in adolescent gynecology to address the specific physical and psychosocial needs of adolescents with menstrual problems would be beneficial.
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Affiliation(s)
- Ayşe Gül Güven
- University of Health Sciences, Ankara Training and Education Hospital, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey.
| | - Melis Pehlivantürk Kızılkan
- Division of Adolescent Medicine, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Medine Ayşin Taşar
- University of Health Sciences, Ankara Training and Education Hospital, Department of Pediatrics, Division of Social Pediatrics, Ankara, Turkey
| | - Sinem Akgül
- Division of Adolescent Medicine, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Patel U, Broad A, Biswakarma R, Harper JC. Experiences of users of period tracking apps: which app, frequency of use, data input and output and attitudes. Reprod Biomed Online 2024; 48:103599. [PMID: 38295553 DOI: 10.1016/j.rbmo.2023.103599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 10/02/2023] [Indexed: 02/02/2024]
Abstract
RESEARCH QUESTION What are the experiences of users of period tracking apps in relation to which apps they use, their frequency of use, the type of data and their attitudes to period tracking apps? DESIGN This was an observational mixed-methods study using an online survey designed using Qualtrics XM. The survey included 50 open-ended and multiple choice questions, but only specific questions were analysed in this study. The survey was promoted via social media for 22 days between 30 June and 21 July 2021. RESULTS Of the 375 total participants, 326 responses were complete and included in analysis. In the results section further down, this is explained as 330 complete responses, with 4 additional responses excluded due to data inconsistencies. The participants' age range was 14-54 years, with a mean of 26.0 (±7.81) years. Most participants (61.9%) had been using a period tracking app for 2 years or longer. Of these 85.6% entered more data when on their period, 31% at a frequency of once a day. There were approximately equivalent proportions of participants who felt that entering data into their app was either 'part of their normal routine' (43.3%) or 'not a priority' (38.0%). Thematic analysis of the participants' experiences of using period-tracking apps revealed five main themes: symptom tracking and understanding general health; concerns with period start date predictions; the problems with fertility tracking; concerns about cost; and concerns about data privacy. CONCLUSIONS The infrequency of data inputting and the wide range of symptoms tracked reflects the differing needs of participants from their period-tracking apps. This highlights the need for increased education and research into understanding the realities of variations in using apps.
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Affiliation(s)
- Uma Patel
- Institute for Women's Health, University College London, London, UK
| | - Anna Broad
- Institute for Women's Health, University College London, London, UK
| | - Rina Biswakarma
- Institute for Women's Health, University College London, London, UK
| | - Joyce C Harper
- Institute for Women's Health, University College London, London, UK..
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Munro CB, Walker EN, Schembri R, Moussaoui D, Grover SR. Periods Shouldn't Bring Any Adolescents' World to a Full Stop. Period. An Online Survey of Adolescents' Experience of Menstruation. J Pediatr Adolesc Gynecol 2024; 37:18-24. [PMID: 37722525 DOI: 10.1016/j.jpag.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 09/20/2023]
Abstract
STUDY OBJECTIVE Few studies have explored what specific outcome measures contained in assessment tools for period and pelvic pain are most relevant to adolescents. Co-design is a valuable method of ensuring input from those with lived experience. The Longitudinal Study of Teenagers with Endometriosis Periods and Pelvic Pain in Australia (LongSTEPPP) Co-Design Periods Survey comprised an anonymous online survey of adolescents' experience of menstruation to inform patient-reported outcome measures for the larger 5-year project. METHODS Adolescents aged 12-18 years whose periods had commenced at least 3 months previously and with demonstrated capacity to consent were invited to participate in an online survey. Recruitment was primarily via social media channels. RESULTS Of the 1811 adolescents who participated, 85% reported that periods had a "moderate" or greater impact on their life. Pain (90.7%), heavy flow (56.2%), and worry about leakage (49%) were common reasons for missed activities. Menstrual symptoms were wide-ranging and included cramping, nausea, poor energy, and impacts on mood. When asked where adolescents sought assistance with their periods, 39.8% had seen their general practitioner, 21.3% their school nurse, and almost 1 in 10 had consulted a mental health practitioner (9.3%). To manage menstrual symptoms, heat packs (66.0%), over-the-counter medications (55.8%), and prescription medications (28.6%) were used. CONCLUSION We found a lack of menstrual health awareness in adolescents. Periods had a significant effect on their lives, and adolescents commonly missed activities. In managing menstruation, a wide range of practitioners were consulted. Nearly a third were prescribed medication to manage their periods. These findings have directed the longitudinal study as to how best to capture outcome measures that reflect the impact of periods on adolescents.
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Affiliation(s)
- Courtney B Munro
- Department of Pediatric and Adolescent Gynecology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Emma N Walker
- Department of Neurology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
| | - Rachel Schembri
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Dehlia Moussaoui
- Department of Pediatric and Adolescent Gynecology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Sonia R Grover
- Department of Pediatric and Adolescent Gynecology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
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Wiggleton-Little J. "Just" a painful period: A philosophical perspective review of the dismissal of menstrual pain. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241255646. [PMID: 38773901 PMCID: PMC11113068 DOI: 10.1177/17455057241255646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/26/2024] [Accepted: 05/01/2024] [Indexed: 05/24/2024]
Abstract
Science and society typically respond to dysmenorrhea-or painful menstrual cramps-as a normal, natural, and inevitable part of menstruation. This normalization has greatly contributed to the systemic dismissal of painful menstrual cramps. Stigma, secrecy, and the expectation to "cope" fuel the normalization of menstrual pain. In this article, I argue that the normalization of menstrual pain restricts the ability to share an excruciating menstrual pain in a way that would otherwise elicit alarm or concern. This can cause clinicians to downgrade menstrual pain, and even menstruating persons to downgrade their own pain. I refer to the dismissal of menstrual pain as an example of a pain-related motivational deficit. A pain-related motivational deficit describes instances in which an utterance fails to motivate due to societal practices and ideas that make it difficult to recognize the import of the embodied experience being shared.
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Jones SC, Boniface ER, Boehnlein C, Jones Packham A, Baldwin MK. Menstrual Health Literacy among Adolescents and Young Adults Who Menstruate: Impact of Christian Family Background and United States Region. J Pediatr Adolesc Gynecol 2023; 36:518-524. [PMID: 37482080 DOI: 10.1016/j.jpag.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/13/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
STUDY OBJECTIVE To compare menstrual health literacy among adolescents and young adults on the basis of family religious background and United States region METHODS: We conducted a cross-sectional online survey of post-menarcheal US adolescents and young adults aged 14-24 years who identified their family religious background, including Christian or non-religious, with recruitment via the social media platform TikTok. We asked participants several questions to assess their health literacy regarding common myths about the use of gonadal steroid hormones for menstrual suppression. RESULTS From 3250 online survey respondents, 2997 met the criteria for analysis, with 1989 identifying their family as Christian (66.4%) and 1008 identifying their family as non-religious (33.6%), with equal representation by US region. Health literacy was lower among those with a Christian family background, with concerns that menstrual suppression is unhealthy (16.4% vs 10.5% with non-religious background, P < .01), is unsafe (31.4% vs 24.2%, P < .01), and could lead to infertility (32.6% vs 20.0%, P < .01). Similarly, adolescents and young adults from the US South were worried that menstrual suppression is unhealthy (31.5%; P < .01) and would lead to infertility (33.8%; P < .01). CONCLUSION Health literacy is lower among adolescents and young adults with a Christian family background and those who live in the South. These results demonstrate a need for an evidence-based national curriculum that addresses the safe and effective use of hormonal medications for menstrual suppression.
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Getahun SB, Berhe S, Mekonnen B, Melaku G. Reasons for Not Seeking Healthcare Among Students with Dysmenorrhea: A Qualitative Study. Int J Womens Health 2023; 15:1733-1744. [PMID: 38020940 PMCID: PMC10649844 DOI: 10.2147/ijwh.s437233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/08/2023] [Indexed: 12/01/2023] Open
Abstract
Background Dysmenorrhea is a significant health burden for women and a global public health issue. Despite its notable prevalence and impact, dysmenorrhea is mostly poorly identified, treated, and accepted as normal by patients themselves. To create strategies that enable care seeking and ideal symptom management for dysmenorrhea, it is vital to have a better understanding of the reasons why women do not seek medical attention. This study aimed to explore the reasons for not seeking healthcare among students with dysmenorrhea at Dilla University in 2023. Methods A qualitative phenomenological study was conducted with purposively selected Colleges of Dilla University students with dysmenorrhea. An individual in-depth interview with a semi-structured interview guide was used to collect data from March 1-30/2023. Snowball sampling was used to obtain study participants, and sampling was determined based on the level of data saturation. The interviews were conducted in a separate private room at Dilla University. Data analysis was started simultaneously with data collection and thematic analysis was performed. ATLAS. ti 9 qualitative software was used to support the data analysis and management. Results The study enrolled 20 students with dysmenorrhea, with a mean age of 21.55 years and a mean age of menarche of 14.45 years. It explored three themes for reasons for not seeking healthcare: sociocultural and personal factors, healthcare system-related perceptions and experiences, and preference for self-management of symptoms. The study also reported myths and misconceptions, negative attitudes and experiences, and self-care practices as barriers to accessing and utilizing health care services. Conclusion This study identified various reasons for not seeking healthcare among students with dysmenorrhea. Most of these reasons indicate that there is insufficient awareness and misconception of dysmenorrhea and its management. Therefore, this study advances the literature on dysmenorrhea and emphasizes the need for more awareness, education, and quality healthcare services for students with dysmenorrhea. The study also proposes future research directions to address the problem of dysmenorrhea among female students in Ethiopia.
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Affiliation(s)
- Senait Belay Getahun
- Department of Midwifery, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Semarya Berhe
- School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bazie Mekonnen
- School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Getnet Melaku
- Department of Midwifery, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
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Reinhardt A, Eitze S. Breaking the endometriosis silence: a social norm approach to reducing menstrual stigma and policy resistance among young adults. Psychol Health 2023:1-23. [PMID: 37921431 DOI: 10.1080/08870446.2023.2277838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/26/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE Endometriosis is a menstrual disorder that affects one in ten women. Diagnosis often takes several years due to low awareness and menstrual stigma. In this study, we employed a social norm approach (SNA) to investigate the effects of an educational leaflet on endometriosis knowledge, menstrual stigma, and acceptance of paid menstrual leave among women and men. METHODS The 3 × 2 online experiment tested the influence of either descriptive norm messages or both descriptive and injunctive norm messages (compared to a control group, factor 1) in an educational leaflet by taking the role of addressee's sex into account (quasi-experimental factor 2). The study included 796 German participants aged 16-35. RESULTS Men exhibited significantly poorer knowledge, stronger menstrual stigma, and weaker policy acceptance compared to women. No significant main effect of the social norm messages on menstrual stigma was found. In contrast, the combined norm messages seem to be beneficial when addressing policy acceptance. Moreover, compared to the control group, the intervention material indirectly influenced stigma and policy acceptance through increased knowledge. CONCLUSIONS Providing information about social norms appears to be an effective strategy for educating not only women but especially men about menstrual disorders like endometriosis.
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Affiliation(s)
- Anne Reinhardt
- Department of Communication, University of Vienna, Vienna, Austria
| | - Sarah Eitze
- Department of Media and Communication Science, University of Erfurt, Erfurt, Germany
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
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11
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Fooladi E, Bell RJ, Robinson PJ, Skiba M, Davis SR. Dysmenorrhea, Workability, and Absenteeism in Australian Women. J Womens Health (Larchmt) 2023; 32:1249-1256. [PMID: 37651151 DOI: 10.1089/jwh.2023.0199] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
Background: This study determined the prevalence of bothersome menstrual symptoms and their association with workability in naturally menstruating women not using hormonal contraception. Materials and Methods: A representative sample of community-dwelling Australian women aged 18-39 years selected from two large national electronic databases responded to a survey on general health. This study focuses on self-reported dysmenorrhea and menstrual bleeding and their association with workability and absenteeism in working women, assessed by the Workability Index. Results: Of 3,555 women, 1,573 (44.2% [95% CI: 42.6%-45.9%]) reported moderate to severe dysmenorrhea and 774 (21.8% [95% CI: 20.4%-23.2%]) reported heavy to very heavy bleeding. Women with dysmenorrhea were 50% more likely to report poorer work performance and twice as likely to report more days of sick leave in the past year (absenteeism) than other women. Conclusions: Despite the availability of safe and effective management options, Australian working women aged 18-39 years continue to experience bothersome dysmenorrhea and menstrual bleeding. Dysmenorrhea is associated with increased absenteeism and poorer workability. Therefore, awareness needs to be raised among women and health care providers of ways to manage dysmenorrhea and heavy bleeding and the unmet need for intervention in the community, respectively.
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Affiliation(s)
- Ensieh Fooladi
- School of Nursing and Midwifery, Monash University, Melbourne, Australia
| | - Robin J Bell
- Women's Health Research Program and School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Penelope J Robinson
- Women's Health Research Program and School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Marina Skiba
- Monash University Clinical Trial Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Susan R Davis
- Women's Health Research Program and School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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12
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Sinclair J, Abbott J, Proudfoot A, Armour M. The Place of Cannabinoids in the Treatment of Gynecological Pain. Drugs 2023; 83:1571-1579. [PMID: 37831340 PMCID: PMC10693518 DOI: 10.1007/s40265-023-01951-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 10/14/2023]
Abstract
Cannabis sativa (L), a plant with an extensive history of medicinal usage across numerous cultures, has received increased attention over recent years for its therapeutic potential for gynecological disorders such as endometriosis, chronic pelvic pain, and primary dysmenorrhea, due at least in part to shortcomings with current management options. Despite this growing interest, cannabis inhabits an unusual position in the modern medical pharmacopoeia, being a legal medicine, legal recreational drug, and an illicit drug, depending on jurisdiction. To date, the majority of studies investigating cannabis use have found that most people are using illicit cannabis, with numerous obstacles to medical cannabis adoption having been identified, including outdated drug-driving laws, workplace drug testing policies, the cost of quality-assured medical cannabis products, a lack of cannabis education for healthcare professionals, and significant and persistent stigma. Although currently lacking robust clinical trial data, a growing evidence base of retrospective data, cohort studies, and surveys does support potential use in gynecological pain conditions, with most evidence focusing on endometriosis. Cannabis consumers report substantial reductions in pelvic pain, as well as common comorbid symptoms such as gastrointestinal disturbances, mood disorders such as anxiety and depression, and poor sleep. Substitution effects were reported, with >50% reduction or cessation in opioid and/or non-opioid analgesics being the most common. However, a substantial minority report not disclosing cannabis consumption to their health professional. Therefore, while such deprescribing trends are potentially beneficial, the importance of medical supervision during this process is paramount given the possibility for withdrawal symptoms.
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Affiliation(s)
- Justin Sinclair
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia.
| | - Jason Abbott
- Division of Obstetrics and Gynaecology, School of Clinical Medicine, Medicine and Health, UNSW, Sydney, NSW, Australia
- Gynaecological Research and Clinical Research (GRACE) Unit, Royal Hospital for Women, UNSW, Sydney, NSW, Australia
| | - Andrew Proudfoot
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia.
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia.
- Medical Research Institute of New Zealand (MRINZ), Wellington, New Zealand.
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13
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Ciccia D, Doyle AK, Ng CHM, Armour M. Indigenous Peoples' Experience and Understanding of Menstrual and Gynecological Health in Australia, Canada and New Zealand: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6321. [PMID: 37444168 PMCID: PMC10341312 DOI: 10.3390/ijerph20136321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 06/13/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023]
Abstract
There are a variety of cultural and religious beliefs and customs worldwide related to menstruation, and these often frame discussing periods and any gynecological issues as taboo. While there has been previous research on the impact of these beliefs on menstrual health literacy, this has almost entirely been confined to low- and middle-income countries, with very little information on high-income countries. This project used the Joanna Briggs Institute (JBI) scoping review methodology to systematically map the extent and range of evidence of health literacy of menstruation and gynecological disorders in Indigenous people in the colonized, higher-income countries of Australia, Canada, and New Zealand. PubMed, CINHAL, PsycInfo databases, and the grey literature were searched in March 2022. Five studies from Australia and New Zealand met the inclusion criteria. Only one of the five included studies focused exclusively on menstrual health literacy among the Indigenous population. Despite considerable research on menstrual health globally, studies focusing on understanding the menstrual health practices of the Indigenous populations of Australia, New Zealand, and Canada are severely lacking, and there is little to no information on how Indigenous beliefs of colonized people may differ from the broader society in which they live.
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Affiliation(s)
- Donna Ciccia
- NICM Health Research Institute, Western Sydney University, Sydney 2145, Australia
| | - Aunty Kerrie Doyle
- School of Medicine, Western Sydney University, Campbelltown 2560, Australia
| | - Cecilia H. M. Ng
- School of Clinical Medicine, Health and Medicine, Division of Obstetrics and Gynaecology, University of New South Wales, Sydney 2052, Australia
- Gynaecological Research and Clinical Evaluation (GRACE) Unit, Royal Hospital for Women and University of New South Wales, Randwick 2031, Australia
- Jean Hailes for Women’s Health, Melbourne 3002, Australia
- Global Women’s Health, The George Institute for Global Health, Sydney 2042, Australia
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Sydney 2145, Australia
- Medical Research Institute of New Zealand (MRINZ), Wellington 6021, New Zealand
- Translational Health Research Institute (THRI), Western Sydney University, Sydney 2145, Australia
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14
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McGawley K, Sargent D, Noordhof D, Badenhorst CE, Julian R, Govus AD. Improving menstrual health literacy in sport. J Sci Med Sport 2023:S1440-2440(23)00143-3. [PMID: 37407335 DOI: 10.1016/j.jsams.2023.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/29/2023] [Accepted: 06/14/2023] [Indexed: 07/07/2023]
Abstract
Menstrual health represents a state of complete physical, mental, and social well-being in relation to a woman's menstrual cycle. From a health literacy perspective, knowledge acquisition and expertise are dependent upon the degree to which an individual can find, access, understand, critically analyse, and apply health information. Therefore, menstrual health literacy can be used to describe the state of knowledge acquisition and application specific to menstrual health-related issues. Menstrual health literacy is low among female athletes, their coaches, and practitioners, and few evidence-informed education or implementation strategies exist to improve menstrual health literacy in sport. Moreover, athletes seldom discuss their menstrual cycles or hormonal contraceptive use with their coaches, despite experiencing menstrual symptoms and/or disturbances and perceiving their menstrual cycles/hormonal contraceptive use to affect performance. Barriers to communication about menstrual cycle- and hormonal contraceptive-related topics include a perceived lack of knowledge among athletes, coaches, and practitioners, concerns about how conversations on these issues will affect interpersonal relationships, and a lack of formal and informal discussion forums. Whilst evidence relating to the effects of the menstrual cycle phase and hormonal contraceptive use on training and performance is currently limited, with existing studies often lacking methodological rigour, impactful steps can still be made to support female athletes. This cornerstone review highlights the current state of menstrual health literacy among athletes, coaches, and practitioners, and provides recommendations for improving menstrual health literacy in sport.
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Affiliation(s)
- K McGawley
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Sweden. https://twitter.com/KerryMcGawley
| | - D Sargent
- School of Sport and Exercise, University of Gloucestershire, United Kingdom. https://twitter.com/DebbyDls4
| | - D Noordhof
- Centre for Elite Sports Research, Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Norway. https://twitter.com/DionneNoordhof
| | - C E Badenhorst
- School of Sport, Exercise and Nutrition, Massey University, New Zealand. https://twitter.com/claire_bades
| | - R Julian
- School of Sport and Exercise, University of Gloucestershire, United Kingdom; University of Münster, Institute of Sport and Exercise Sciences, Department of Neuromotor Behavior and Exercise, Germany. https://twitter.com/RossJulian88
| | - A D Govus
- Discipline of Sport and Exercise Science, Department of Sport, Exercise, and Nutrition Science, La Trobe University, Australia.
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Roux F, Chih H, Hendriks J, Burns S. Mixed Method Evaluation of My Vital Cycles ®: A Holistic School-Based Ovulatory Menstrual Health Literacy Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5964. [PMID: 37297568 PMCID: PMC10252248 DOI: 10.3390/ijerph20115964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 04/18/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023]
Abstract
There is a high prevalence of ovulatory menstrual (OM) dysfunctions among adolescents, and their menstrual health literacy is poor. The OM cycle can be used as a personal health monitor provided that the skills to understand it are correctly taught. My Vital Cycles®, a holistic school-based OM health literacy program, was trialed with a Grade 9 cohort in one single-sex school in Western Australia using the Health Promoting School framework. A validated OM health literacy questionnaire was administered pre- and post-program with 94 participants. Functional OM health literacy improved overall, with 15 out of 20 items showing improvement post-program (p < 0.05). In addition, 19 out of 53 items for interactive OM health literacy, and 18 out of 25 items for critical OM health literacy improved (p < 0.05). The improvement in mood concerns (p = 0.002) was unexpected. Thematic analysis of three focus groups of 18 girls revealed four themes of increasing comfort levels; finding the program informative; inclusion of non-teaching support such as healthcare professionals; and suggestions for future refinements. Overall, this Western Australian PhD project which developed and trialed My Vital Cycles® improved OM health literacy and was positively received. Future research possibilities include understanding the program's impact on mental health and further trials in co-educational settings; amongst different populations; and with extended post-program testing.
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Affiliation(s)
- Felicity Roux
- Curtin Medical School, Curtin University, Bentley, WA 6102, Australia
| | - HuiJun Chih
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | | | - Sharyn Burns
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
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16
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Fowler CI, Koo HP, Richmond AD, Creel D, Asman K. U.S. Women's Knowledge of Reproductive Biology. Womens Health Issues 2023; 33:54-66. [PMID: 35868957 DOI: 10.1016/j.whi.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 05/19/2022] [Accepted: 05/31/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Having accurate knowledge of reproductive biology can help women to improve their general, sexual, and reproductive health and assert their sexual and reproductive rights. METHODS This cross-sectional study examined knowledge of three topics (age-related fertility decline, egg supply, fertile period) among a national probability sample of 1,779 nonsterilized, English-speaking women (aged 18-29 years) in the U.S. general population. Using bivariate and multivariable regressions, we assessed associations between knowledge of these topics and individual characteristics. RESULTS Most respondents were unmarried (63%), childless (78%), and intended to have children (65%); 51% did not know whether they would have difficulty conceiving, and 44% had discussed fertility-related topics with a health care provider. More respondents knew the age of marked fertility decline (62%) than the fertile period (59%) or that ovaries do not continuously produce new eggs (45%); 22% knew all three topics, and 13% knew none. In multivariable analysis, knowledge was positively associated (p < .001) with education, income, and having regular periods. Black and Asian respondents and those for whom religion was very important were less likely (all p values < .01) than White and nonreligious respondents to know all three topics. Knowledge was unrelated to relationship status, parity, childbearing intentions, receipt of fertility-related counseling or services, self-perceived infertility risk, or health status; the relationship with Hispanic ethnicity approached but did not reach significance (p = .08). CONCLUSIONS Young U.S. women have incomplete knowledge of aspects of their reproductive biology; these knowledge gaps could increase their risk of adverse health and reproductive outcomes. Policy-, provider-, and client-level interventions are warranted to address these knowledge gaps.
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Affiliation(s)
| | - Helen P Koo
- Independent Consultant, Durham, North Carolina
| | - Alicia D Richmond
- Office of Population Affairs, U.S. Department of Health and Human Services, Washington, District of Columbia
| | - Darryl Creel
- RTI International, Washington, District of Columbia
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17
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Shiny Irene D, Indra Priyadharshini S, Tamizh Kuzhali R, Nancy P. An IoT based smart menstrual cup using optimized adaptive CNN model for effective menstrual hygiene management. Artif Intell Rev 2022. [DOI: 10.1007/s10462-022-10308-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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18
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Supporting young women with menstrual pain – Experiences of midwives working at youth clinics. SEXUAL & REPRODUCTIVE HEALTHCARE 2022; 34:100795. [DOI: 10.1016/j.srhc.2022.100795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 10/26/2022] [Accepted: 11/08/2022] [Indexed: 11/14/2022]
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Armour M, Parry K, Curry C, Ferfolja T, Parker MA, Farooqi T, MacMillan F, Smith CA, Holmes K. Evaluation of a web-based resource to improve menstrual health literacy and self-management in young women. J Psychosom Res 2022; 162:111038. [PMID: 36179421 DOI: 10.1016/j.jpsychores.2022.111038] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 09/07/2022] [Accepted: 09/10/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE Menstrual cycle-related conditions, such as dysmenorrhea and heavy bleeding, are common amongst those under 25 years. Despite having significant impact on work, education, and social activities, most do not seek medical advice, preferring to self-manage their symptoms. We aimed to determine if access to a web-based resource was a feasible and acceptable method for improving menstrual health literacy and encouraging health seeking behavior. METHODS People were eligible to participate if they were currently living in Australia, aged 14-25 years, and had menstruated for at least 12 months. Access to the resource, comprising evidence-based information on the menstrual cycle, the Period ImPact and Pain Assessment (PIPPA) tool, and guidance on self-management options, was provided for three menstrual cycles. RESULTS Seventy-five participants with a mean age of 20.4 years were enrolled with 56 (75%) providing pre and post measures. Recruitment rate and retention rates met pre-specified criteria for feasibility. Eighty five percent of the participants reported the web-based resource was easy to use, and 90% reported they found the information provided 'very helpful'. Just under half (48%) reported the resource changed what they thought was a 'normal' period. Forty-three percent visited their doctor regarding their menstrual symptoms during the study period, with 84% indicating that they made the appointment due to the resource; over half (56%) who visited their doctor received a referral to a gynecologist. CONCLUSION Access to a web-based resource on menstrual health literacy was found to be acceptable and feasible to young people and may encourage health-seeking behavior.
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Affiliation(s)
- Mike Armour
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia; Translational Health Research Institute (THRI), Western Sydney University, Penrith, New South Wales, Australia; Medical Research Institute of New Zealand (MRINZ), Wellington, New Zealand.
| | - Kelly Parry
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Christina Curry
- Centre for Educational Research, Western Sydney University, Penrith, New South Wales, Australia
| | - Tania Ferfolja
- Centre for Educational Research, Western Sydney University, Penrith, New South Wales, Australia
| | - Melissa A Parker
- Canberra Endometriosis Centre, Department of Obstetrics and Gynaecology, ACT Health, Canberra, Australian Capital Territory, Australia
| | - Toobah Farooqi
- School of Medical Sciences, The University of New South Wales, Kensington, New South Wales, Australia
| | - Freya MacMillan
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, New South Wales, Australia; School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
| | - Caroline A Smith
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia; Translational Health Research Institute (THRI), Western Sydney University, Penrith, New South Wales, Australia
| | - Kathryn Holmes
- Centre for Educational Research, Western Sydney University, Penrith, New South Wales, Australia
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20
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Ní Chéileachair F, McGuire BE, Durand H. Coping with dysmenorrhea: a qualitative analysis of period pain management among students who menstruate. BMC Womens Health 2022; 22:407. [PMID: 36199106 PMCID: PMC9533282 DOI: 10.1186/s12905-022-01988-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 09/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dysmenorrhea, or period pain, affects up to 95% of menstruating individuals and is a common cause of educational absenteeism among students who menstruate worldwide. Evidence suggests that students may lack sufficient knowledge about their menstrual health, which may impede self-management. The aim of the current study was to explore pain management strategies used by students in Ireland with painful periods and to identify their unaddressed needs across physical, psychological, educational, and social domains. METHODS This study used a qualitative, interpretive design and opportunity sampling approach to collect and interpret individual accounts of dysmenorrhea from third-level students in Ireland. Data from 21 students were collected using semi-structured online one-to-one interviews and analysed using reflexive thematic analysis. RESULTS Analysis resulted in the construction of five themes: (1) Pain management is self-directed trial-and-error, (2) Home as safe haven, (3) Prioritising productivity over pain, (4) We're missing an option between 'normalise' and 'medicalise', and (5) Cycle of censorship and concealment. Overall, limited formal education on dysmenorrhea and prevailing negative attitudes towards menstruation create an unsupportive environment for students to learn adequate coping skills. Beyond education, menstrual stigma may also restrict the availability of clear management guidance in domestic and medical spheres. Experiences of dysmenorrhea were also influenced by the COVID-19 pandemic, where work-from-home measures were viewed favourably by individuals with dysmenorrhea. CONCLUSIONS This study indicates that students in Ireland are inadequately prepared to cope with dysmenorrhea. The current findings have substantial implications for evaluating and reforming current menstrual education standards, in addition to clarifying the negative effects of social stigma on menstrual health literacy.
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Affiliation(s)
- Fódhla Ní Chéileachair
- School of Psychology, University of Galway, Galway, Ireland ,Centre for Pain Research, University of Galway, Galway, Ireland
| | - Brian E. McGuire
- School of Psychology, University of Galway, Galway, Ireland ,Centre for Pain Research, University of Galway, Galway, Ireland
| | - Hannah Durand
- School of Psychology, University of Galway, Galway, Ireland ,Centre for Pain Research, University of Galway, Galway, Ireland ,grid.11918.300000 0001 2248 4331Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, Scotland, UK
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21
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Armour M, Avery J, Leonardi M, Van Niekerk L, Druitt ML, Parker MA, Girling JE, McKinnon B, Mikocka-Walus A, Ng CHM, O’Hara R, Ciccia D, Stanley K, Evans S. Lessons from implementing the Australian National Action Plan for Endometriosis. REPRODUCTION AND FERTILITY 2022; 3:C29-C39. [PMID: 35928674 PMCID: PMC9346321 DOI: 10.1530/raf-22-0003] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 06/30/2022] [Indexed: 11/30/2022] Open
Abstract
Abstract Endometriosis is a common yet under-recognised chronic disease with one in nine (more than 830,000) women and those assigned female at birth diagnosed with endometriosis by the age of 44 years in Australia. In 2018, Australia was the first country to develop a roadmap and blueprint to tackle endometriosis in a nationwide, coordinated manner. This blueprint is outlined in the National Action Plan for Endometriosis (NAPE), created from a partnership between government, endometriosis experts and advocacy groups. The NAPE aims to improve patient outcomes in the areas of awareness and education, clinical management and care and research. As researchers and clinicians are working to improve the lives of those with endometriosis, we discuss our experiences since the launch of the plan to highlight areas of consideration by other countries when developing research priorities and clinical plans. Historically, major barriers for those with endometriosis have been twofold; first, obtaining a diagnosis and secondly, effective symptom management post-diagnosis. In recent years, there have been calls to move away from the historically accepted 'gold-standard' surgical diagnosis and single-provider specialist care. As there are currently no reliable biomarkers for endometriosis diagnosis, specialist endometriosis scans and MRI incorporating artificial intelligence offer a novel method of visualisation and promising affordable non-invasive diagnostic tool incorporating well-established technologies. The recognised challenges of ongoing pain and symptom management, a holistic interdisciplinary care approach and access to a chronic disease management plan, could lead to improved patient outcomes while reducing healthcare costs. Lay summary Endometriosis is a chronic disease where tissue like the lining of the uterus is found in other locations around the body. For the 830,000 people living with endometriosis in Australia, this often results in an immense burden on all aspects of daily life. In 2018, Australia was the first country to introduce a roadmap and blueprint to tackle endometriosis in a nationwide coordinated manner with the National Action Plan for Endometriosis. This plan was created as a partnership between government, endometriosis experts and advocacy groups. There are several other countries who are now considering similar plans to address the burden of endometriosis. As researchers and clinicians are working to improve the lives of those with endometriosis, we share our experiences and discuss areas that should be considered when developing these national plans, including diagnostic pathways without the need for surgery, and building new centres of expertise in Endometriosis and Pelvic Pain.
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Affiliation(s)
- Mike Armour
- NICM Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, New South Wales, Australia
- Medical Research Institute of New Zealand (MRINZ), Wellington, New Zealand
| | - Jodie Avery
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Mathew Leonardi
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Leesa Van Niekerk
- School of Psychological Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Marilla L Druitt
- University Hospital Geelong, Deakin University, Victoria, Australia
| | - Melissa A Parker
- Canberra Endometriosis Centre, Department of Obstetrics and Gynaecology, ACT Health, Canberra ACT, Australia
| | - Jane E Girling
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Brett McKinnon
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, Brisbane, Queensland, Australia
| | - Antonina Mikocka-Walus
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - Cecilia H M Ng
- Jean Hailes for Women’s Health, Melbourne, Victoria, Australia
- School of Women’s and Children’s Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Rebecca O’Hara
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Donna Ciccia
- NICM Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
- Endometriosis Australia, Sydney, Australia
| | | | - Subhadra Evans
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
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Roux F, Burns S, Chih H, Hendriks J. The Use of a Two-Phase Online Delphi Panel Methodology to Inform the Concurrent Development of a School-Based Ovulatory Menstrual Health Literacy Intervention and Questionnaire. Front Glob Womens Health 2022; 3:826805. [PMID: 35677755 PMCID: PMC9168325 DOI: 10.3389/fgwh.2022.826805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/08/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction There are a high prevalence of ovulatory-menstrual (OM) dysfunction and low levels of menstrual health literacy in adolescents, yet few evidence-based OM health education resources for schools. Method This two-phase study used an online Delphi methodology to build consensus across thirty-five purposively selected professionals from the diverse professions of health and education. The panellists were tasked to inform the development of a school-based OM health literacy resources. Results In Round One, 86% of panellists determined the scope of these resources using guided and open-ended questions. The study then split into two phases which ran concurrently. In the first phase informing the intervention's development, 57% of panellists participated in Round Two, and 29% reviewed selected lessons. In the second phase informing the questionnaire's development, 51% of panellists participated in Round Two, and 69% in Round Three. The overall consensus reached for the intervention phase and questionnaire phase were 82% and 84%, respectively. The Panel's recommendations included a strengths-based position to counter menstrual stigma, teaching accurate self-report of cycle biomarkers, addressing multiple menstrual dysfunctions and adopting a whole-school approach. Conclusion Although time-consuming and requiring a sustained interest, this two-phase Delphi methodology offered anonymity to panellists from distinct professions which facilitated their independent contribution to developing OM health literacy school resources.
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Dysmenorrhea across the lifespan: a biopsychosocial perspective to understanding the dysmenorrhea trajectory and association with comorbid pain experiences. Pain 2022; 163:2069-2075. [PMID: 35420567 DOI: 10.1097/j.pain.0000000000002649] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/01/2022] [Indexed: 11/26/2022]
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Impact of the Menstrual Cycle Phases on the Movement Patterns of Sub-Elite Women Soccer Players during Competitive Matches. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084465. [PMID: 35457332 PMCID: PMC9025339 DOI: 10.3390/ijerph19084465] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 12/04/2022]
Abstract
The purpose of this study was to evaluate the influence of the menstrual cycle phases on the movement patterns of sub-elite women soccer players during competitive matches over three consecutive seasons. Individual movement data were analyzed and compared in eight players from the second French League at the early follicular (EF), late follicular (LF) and mid-luteal (ML) phases of their menstrual cycle, determined by the calendar method. The movement patterns, expressed as meters per minute, were recorded during competitive matches using devices placed on the player’s ankle. Our results showed significantly lower distances covered at moderate and high velocity in the EF phase than in the LF and ML phases (Cohen’s d effect size = 1.03 and 0.79, respectively). The total distance covered during matches and the number of sprints also were reduced during EF compared with LF (d = 0.78 and 0.7, respectively). Overall, the total distance and distance covered at low velocity were significantly lower during the second half-time of the matches (d = 1.51), but no menstrual cycle phase × game period interaction was noted. In conclusion, our study suggests that EF may impact the movement pattern of sub-elite women soccer players during competitive matches, without any modulation of this effect by the playing time. Despite the low sample size, these results can be useful for coaches and support staff to modulate training loads and player rotation during soccer games.
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Hawkey A, Chalmers KJ, Micheal S, Diezel H, Armour M. “A day-to-day struggle”: A comparative qualitative study on experiences of women with endometriosis and chronic pelvic pain. FEMINISM & PSYCHOLOGY 2022. [DOI: 10.1177/09593535221083846] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Chronic pelvic pain (CPP) in women is a term that encompasses a range of conditions, including endometriosis, vulvodynia, painful bladder syndrome and adenomyosis. Given the impact on penetrative sex, fertility and potentially motherhood, CPP may also impact on women's identities as a wife or partner, a mother, and a woman. The aim of this study was to explore similarities and differences in experiences of women with endometriosis and non-endometriosis related CPP. A total of 17 participants aged between 21 and 48 years old participated in three focus groups. Using reflexive thematic analysis three main themes were found: the struggling woman, the unheard woman and the self-silenced woman. Women, regardless of the cause of their CPP, reported significant impacts on their intimate relationships, fertility, and parenting but those with non-endometriosis CPP often reported greater trouble communicating about pelvic pain in the workplace due to the “taboo” nature of discussing their vulval pain. Many participants described how a societal normalisation of pelvic pain resulted in women silencing their experiences, rendering their pain invisible. While women wanted to resist such silencing through information and support seeking, women with non-endometriosis CPP described fewer avenues to accessing credible informational resources or networks for support.
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An Aotearoa New Zealand survey of the impact and diagnostic delay for endometriosis and chronic pelvic pain. Sci Rep 2022; 12:4425. [PMID: 35292715 PMCID: PMC8924267 DOI: 10.1038/s41598-022-08464-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/08/2022] [Indexed: 01/24/2023] Open
Abstract
Chronic pelvic pain (CPP) causes important negative effects on quality of life. Endometriosis is the most common cause of CPP in females, and diagnostic delay is over six years internationally. Data remain scarce for CPP impact or diagnostic delay in Aotearoa New Zealand. This study used an online survey to explore the impact of CPP on various life domains for those aged over 18. Additionally, for those with an endometriosis diagnosis, diagnostic delay and factors affecting this over time were explored. There were 800 respondent (620 with self-reported endometriosis). CPP symptoms, irrespective of final diagnosis, started prior to age 20 and negatively impacted multiple life domains including employment, education, and relationships. Mean diagnostic delay for those with endometriosis was 8.7 years, including 2.9 years between symptom onset and first presentation and 5.8 years between first presentation and diagnosis. Five doctors on average were seen prior to diagnosis. However, there was a reduction in the interval between first presentation and diagnosis over time, from 8.4 years for those presenting before 2005, to two years for those presenting after 2012. While diagnostic delay is decreasing, CPP, irrespective of aetiology, continues to have a significant negative impact on the lives of those affected.
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Sinclair J, Armour S, Akowuah JA, Proudfoot A, Armour M. "Should I Inhale?"-Perceptions, Barriers, and Drivers for Medicinal Cannabis Use amongst Australian Women with Primary Dysmenorrhoea: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031536. [PMID: 35162564 PMCID: PMC8835209 DOI: 10.3390/ijerph19031536] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/15/2022] [Accepted: 01/19/2022] [Indexed: 01/27/2023]
Abstract
Objective: This study sought to investigate the perceptions, barriers, and drivers associated with medicinal cannabis use among Australian women with primary dysmenorrhea. A qualitative study via virtual focus groups involving 26 women experiencing regular, moderate, or greater menstrual pain explored categories including cost, associated stigma, current drug driving laws, community and workplace ethics, and geographical isolation within the context of patient access under current Australian laws and regulations. Results: A qualitative descriptive analysis identified that dissatisfaction with current management strategies such as over-the-counter analgesic usage was the key driver for wanting to use medicinal cannabis. A number of significant barriers to use were identified including patient access to medical prescribers, medical practitioner bias, current drug driving laws, geographic location, and cost. Community and cultural factors such as the history of cannabis as an illicit drug and the resulting stigma, even when prescribed by a medical doctor, still existed and was of concern to our participants. Conclusion: Whilst medicinal cannabis is legal in all states and territories within Australia, several barriers to access exist that require government regulatory attention to assist in increasing patient adoption, including possible subsidisation of cost. The high cost of legal, medicinal cannabis was a key factor in women’s choice to use illicit cannabis. Overall, the concerns raised by our participants are consistent with the broader findings of a recent Australian Senate inquiry report into barriers to patient access to medicinal cannabis in Australia, suggesting many of the issues are systematic rather than disease-specific. Given the interest in use of medicinal cannabis amongst women with primary dysmenorrhea, clinical trials in this area are urgently needed.
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Affiliation(s)
- Justin Sinclair
- NICM Health Research Institute, Western Sydney University, Penrith 2571, Australia; (S.A.); (A.P.)
- Correspondence: (J.S.); (M.A.); Tel.: +61-414679635 (J.S.)
| | - Susanne Armour
- NICM Health Research Institute, Western Sydney University, Penrith 2571, Australia; (S.A.); (A.P.)
| | - Jones Asafo Akowuah
- Agricultural Economics, Agribusiness and Extension, Kwame Nkrumah University of Science and Technology, Kumasi 0233, Ghana;
| | - Andrew Proudfoot
- NICM Health Research Institute, Western Sydney University, Penrith 2571, Australia; (S.A.); (A.P.)
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Penrith 2571, Australia; (S.A.); (A.P.)
- Translational Health Research Institute, Western Sydney University, Penrith 2571, Australia
- Medical Research Institute of New Zealand (MRINZ), Wellington 6012, New Zealand
- Correspondence: (J.S.); (M.A.); Tel.: +61-414679635 (J.S.)
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Broad A, Biswakarma R, Harper JC. A survey of women’s experiences of using period tracker applications: Attitudes, ovulation prediction and how the accuracy of the app in predicting period start dates affects their feelings and behaviours. WOMEN'S HEALTH 2022; 18:17455057221095246. [PMID: 35465788 PMCID: PMC9047811 DOI: 10.1177/17455057221095246] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction: Using an online survey, the aim of this study was to ask women about their
real-life experiences of using period tracker apps, their attitudes towards
using their app, the information the app provided regarding ovulation and
how the accuracy of the app in predicting period start dates affects their
feelings and behaviours if their period comes earlier or later than
predicted. Methods: This mixed-methods observational study was conducted by an online survey of
50 multiple-choice and open-ended questions. The survey was generated with
Qualtrics XM® and promoted via social media. It was open to any
person who had used a period tracker. Results: From 375 total responses, 330 complete responses were obtained, giving a
completion rate of 88.0%. Respondents were aged between 14 and 54, with a
mean age of 26.0 (±7.81). When asked what was the best thing about using the
app, 29.7% (98/330) of respondents selected ‘To know when I’m ovulating’.
Respondents were asked if their period ever started earlier than the app
predicted; 54.9% (189/330) said it had and 72.1% (238/330) said it had
started later than predicted. When asked how they felt if their period
arrived earlier or later than expected, thematic analysis of periods
starting earlier revealed four themes: feeling unaffected, being
frustrated/unprepared, feeling anxious/stressed and feeling
confused/intrigued. Thematic analysis when their period arrived later
revealed six themes: anxious/concerned about pregnancy, disappointed about
pregnancy, seeking advice/informing healthcare professionals, thoughts about
menopause, feeling unaffected and being better prepared. Conclusion: Period trackers need to be clearer on their intended use and reliability,
especially for period due date and ovulation. Qualitative analysis shows the
impact of inaccurate predictions on aspects of the users’ health. This study
calls for period tracker app companies to update their apps to provide
transparency to their users about their intended use and capabilities.
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Affiliation(s)
- Anna Broad
- EGA Institute for Women’s Health, University College London, London, UK
| | - Rina Biswakarma
- Institute for Education, University College London, London, UK
| | - Joyce C Harper
- EGA Institute for Women’s Health, University College London, London, UK
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Durand H, Monahan K, McGuire BE. Prevalence and Impact of Dysmenorrhea Among University Students in Ireland. PAIN MEDICINE (MALDEN, MASS.) 2021; 22:2835-2845. [PMID: 33822197 PMCID: PMC8666000 DOI: 10.1093/pm/pnab122] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Primary dysmenorrhea (PD), or painful menstruation, is a common gynecological condition that can cause intense pain and functional disability in women of reproductive age. As a nonmalignant condition, PD is relatively understudied and poorly managed. The purpose of this study was to estimate the prevalence and impact of PD among third-level students in Ireland. DESIGN A cross-sectional observational design was used. METHODS Students (n = 892; age range = 18-45 years) completed an online survey on menstrual pain characteristics, pain management strategies, pain interference, and pain catastrophizing. RESULTS The prevalence of PD was 91.5% (95% confidence interval = 89.67-93.33). Nonpharmacological management strategies were most popular (95.1%); of these, heat application (79%), rest (60.4%), hot shower/bath (40.9%), and exercise (25.7%) were most common. Perceived effectiveness of these methods varied between participants. Analgesic use was also common (79.5%); of these, paracetamol was most used (60.5%) despite limited perceived effectiveness. Pain catastrophizing was a significant predictor of variance in both pain intensity and pain interference scores such that those with higher pain catastrophizing scores reported more intense pain and greater interference with daily activities and academic demands. CONCLUSIONS This article presents the first investigation into PD among third-level students in Ireland. Poorly managed menstrual pain may impact functional ability across several domains. Future research should focus on improving menstrual pain management education and support and promoting menstrual health literacy for women affected by PD.
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Affiliation(s)
- Hannah Durand
- Centre for Pain Research, National University of Ireland, Galway, Ireland
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Katie Monahan
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Brian E McGuire
- Centre for Pain Research, National University of Ireland, Galway, Ireland
- School of Psychology, National University of Ireland, Galway, Ireland
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Arentz S, Smith C, Redmond R, Abbott J, Armour M. A cross-sectional study of traditional Chinese medicine practitioner's knowledge, treatment strategies and integration of practice of chronic pelvic pain in women. BMC Complement Med Ther 2021; 21:174. [PMID: 34167548 PMCID: PMC8229696 DOI: 10.1186/s12906-021-03355-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/01/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Chronic pelvic pain (CPP) in women is persistent, intermittent cyclical and non-cyclical lower abdominal pain, lasting for more than 6 months. Traditional Chinese Medicine (TCM) is a popular treatment option for women's health conditions, but little is known about how treatment for CPP is delivered by TCM practitioners. The aim of this survey was to explore practitioners understanding and treatment of women with CPP, and how they integrate their management and care into the health care system. METHOD An online cross-sectional survey of registered TCM practitioners in Australia and New Zealand between May and October 2018. Survey domains included treatment characteristics (e.g. frequency), evaluation of treatment efficacy, referral networks, and sources of information that informed clinical decision making. RESULTS One hundred and twenty-two registered TCM practitioners responded to this survey, 91.7% reported regular treatment of women with CPP. Treatment decisions were most-often guided by a combination of biomedical and TCM diagnosis (77.6%), and once per week was the most common treatment frequency (66.7%) for acupuncture. Meditation (63.7%) and dietary changes (57.8%) were other commonly used approaches to management. The effectiveness of treatment was assessed using multiple approaches, most commonly pain scales, (such as the numeric rating scale) and any change in use of analgesic medications. Limitations to TCM treatment were reported by over three quarters (83.7%) of practitioners, most commonly due to cost (56.5%) and inconvenience (40.2%) rather than safety or lack of efficacy. Sources informing practice were most often Integration within the wider healthcare system was common with over two thirds (67.9%) receiving referrals from health care providers. CONCLUSION TCM practitioners seeing women with various CPP symptoms, commonly incorporate both traditional and modern diagnostic methods to inform their treatment plan, monitor treatment progress using commonly accepted approaches and measures and often as a part of multidisciplinary healthcare for women with CPP.
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Affiliation(s)
- Susan Arentz
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Caroline Smith
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Rebecca Redmond
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
- Office of Research, Endeavour College of Natural Health, Fortitude Valley, QLD, Australia
| | - Jason Abbott
- School of Women's and Children's Health, University of New South Wales, Barker Street, Randwick, NSW, 2031, Australia
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
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Women's Cognition and Attitude with Eco-Friendly Menstrual Products by Consumer Lifestyle. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115534. [PMID: 34064156 PMCID: PMC8196694 DOI: 10.3390/ijerph18115534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 11/17/2022]
Abstract
With rapid technology developments and the convenient and fast pace of life in recent years, many people are using disposable products, which cause environmental and ecological damages. A variety of eco-friendly menstrual products have been launched on the market, and "menstrual pads" now have a large market share in Taiwan's menstrual product industry. This study interviewed experts and collected questionnaires for qualitative and quantitative investigation and analysis. The results show that women have positive and open concepts regarding sustainability, as well as a good understanding of their body and are very interested in the performance and usage efficiency of products. The results also indicate that consumers purchase based on their lifestyles; most women collected enough product information before purchasing while overcoming the difficulties in dealing with the environment and learning to adapt them, and the majority of consumers attach importance to comfort, volume, and duration of blood absorption. The results suggest that the government and private enterprises should increase and improve sanitation education and sanitary facilities and guide the approach and serve as an important reference index for the promotion of eco-friendly menstrual products for environmental benefits.
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Adolescent Menstrual Health Literacy in Low, Middle and High-Income Countries: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052260. [PMID: 33668788 PMCID: PMC7956698 DOI: 10.3390/ijerph18052260] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/14/2021] [Accepted: 02/20/2021] [Indexed: 11/27/2022]
Abstract
Background: Poor menstrual health literacy impacts adolescents’ quality of life and health outcomes across the world. The aim of this systematic review was to identify concerns about menstrual health literacy in low/middle-income countries (LMICs) and high-income countries (HICs). Methods: Relevant social science and medical databases were searched for peer-reviewed papers published from January 2008 to January 2020, leading to the identification of 61 relevant studies. Results: A thematic analysis of the data revealed that LMICs report detrimental impacts on adolescents in relation to menstrual hygiene and cultural issues, while in HICs, issues related to pain management and long-term health outcomes were reported more frequently. Conclusions: In order to improve overall menstrual health literacy in LMICs and HICs, appropriate policies need to be developed, drawing on input from multiple stakeholders to ensure evidence-based and cost-effective practical interventions.
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