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Babu S, Koven M, Thompson CM, Makos S. (Re)making Scales: Communicative enfranchisement in Women's Narrative Discourses About Health Dismissal. HEALTH COMMUNICATION 2024:1-11. [PMID: 39129598 DOI: 10.1080/10410236.2024.2386716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Dismissal of women's health concerns is a discursive phenomenon with social and material consequences. A burgeoning literature documents how women experience dismissal through various forms of disenfranchising talk. Yet, women are not only subjected to disenfranchising talk; they are called to respond to it. Meaning, analyses of disenfranchisement should also examine efforts toward enfranchisement. One process by which scholars can study communicative (dis)enfranchisement is through people's scalar activity, or how they contextualize experiences at different levels of social reality. Studies of scale demonstrate that the language people use to narrate their personal experiences has meaning for how they position themselves in relation to other social actors, as well as how they make statements about what matters, how much, and to whom. Drawing on 36 interviews with women whose health issues have been dismissed, we apply scale as a theoretical lens and methodological tool to study how women use language in particular, meaningful, and patterned ways in narratives about health dismissal. Our findings suggest that women's narrative discourse is enfranchising in so much as women critique, resist, and transform the contexts of their dismissal. We document how they and others scale "realness" and "normality" across narrated and narrating events. We also note how women scale up from their own experiences to women's experiences writ large, asserting truth claims about issues borne of the broader U.S. healthcare system. Findings have implications for how critical health communication researchers study how women's health issues are constructed in talk.
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Affiliation(s)
- Sara Babu
- Department of Communication, University of Illinois
| | | | | | - Shana Makos
- Department of Communication, University of Illinois
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2
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Olsson SE, Friedlich N, Bolds A, Hodge A, Jamali T, Lagomichos M. Exploring Menstrual Education via TikTok: A Descriptive Content Analysis. J Adolesc Health 2024; 75:353-357. [PMID: 38852086 DOI: 10.1016/j.jadohealth.2024.04.020] [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: 12/25/2023] [Revised: 03/16/2024] [Accepted: 04/11/2024] [Indexed: 06/10/2024]
Abstract
PURPOSE TikTok has rapidly emerged as one of the foremost social media platforms for young adults and adolescents, becoming the most-downloaded app in 2022. With its broad reach across demographics, TikTok may be leveraged as a tool for teaching and destigmatizing topics such as menstruation. This study is the first to analyze the quality of menstruation-related content on TikTok. METHODS This cross-sectional study of TikTok videos and corresponding accounts examined six pre-determined menstruation-related hashtags in May 2023. Deductive qualitative analysis was performed between three coders to identify themes and content of the available videos. RESULTS A total of 140 videos created by 107 unique accounts were identified. The videos had varying purposes including audience education (66%), entertainment (35%), and product advertisement (17%). Videos mentioned various menstrual hygiene products, menstruation-related advice, and symptoms of menses. A vast majority of videos appeared to be created by laypersons with only 8% being led by health-care professionals. DISCUSSION With TikTok's usage as a social platform among youth, it displays potential as a tool to enhance menstrual education and destigmatization. There is a need for more menstruation experts to join the platform and provide quality material for users.
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Affiliation(s)
- Sofia Eva Olsson
- Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, Texas.
| | - Nicole Friedlich
- Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, Texas
| | - Alexis Bolds
- Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, Texas
| | - Alison Hodge
- Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, Texas
| | - Taylor Jamali
- Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, Texas
| | - Melanie Lagomichos
- Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, Texas
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Casola AR, Medley L, Kunes BC, McGlone N, Silverio A. "It shouldn't be just hush-hush": A qualitative community-based study of menstrual health communication among women in Philadelphia. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2024. [PMID: 39073267 DOI: 10.1111/psrh.12277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
INTRODUCTION Although menstruation is a natural biological process, many people feel embarrassed of their menses and struggle to discuss it. To mitigate menstrual communication stigma, it is necessary to first elucidate communication experiences and perceptions. Thus, we qualitatively explore menstrual communication among cisgender women who menstruate and their family, friends, healthcare providers, and community. METHODOLOGY In partnership with No More Secrets (NMS), a Philadelphia menstrual health non-profit, we conducted a community-based participatory research (CBPR) project in Fall 2020. Cisgender, menstruating individuals ages 18-45 recruited from NMS' catchment in Philadelphia participated in semi-structured interviews about their menstrual experiences and communication (N = 20). A deductive, theory-driven approached based on the social-ecological model was used to analyze the data. RESULTS Varying emotional responses arose across social-ecological levels: communication was awkward and simplistic with family; positive and supportive with friends and community members; and uncomfortable and frustrating with healthcare providers. Participants echoed the importance of menstrual communication as a means of sharing information, feeling less alone, and decreasing menstrual stigma. DISCUSSION Findings can inform future CBPR workshops that address stigma in familial, healthcare, and community-based discussions to improve menstrual health and experiences for cisgender girls and women, transgender men, and gender non-binary individuals who menstruate.
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Affiliation(s)
- Allison R Casola
- Department of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Lynette Medley
- No More Secrets Mind Body Spirit Inc., Philadelphia, Pennsylvania, USA
| | - Brianna C Kunes
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Nya McGlone
- No More Secrets Mind Body Spirit Inc., Philadelphia, Pennsylvania, USA
| | - Alexis Silverio
- Department of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Kelly AM. Public toilets and their potential impact on an individual's health. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:538-544. [PMID: 38900669 DOI: 10.12968/bjon.2023.0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
In modern society, people engage in social interactions and activities outside their own home. When in public settings people may need to eliminate bodily waste, so public toilets are required. Accessibility, availability and adaptability are essential principles for safe, private, and purposeful visits to public toilets. A diverse range of individuals use public toilets: various age profiles, all gender groups, vulnerable individuals and people with additional needs. Public toilets essentially need to be a place of privacy, safety and cleanliness to facilitate elimination of urine, evacuation of faeces, management of menstruation, and changing/disposing of continence wear products in a secure environment.
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Affiliation(s)
- Anne Marie Kelly
- Clinical Nurse Specialist - Continence, Meath Primary Care Centre, Dublin, Ireland
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Cunningham AC, Prentice C, Peven K, Wickham A, Bamford R, Radovic T, Klepchukova A, Fomina M, Cunningham K, Hill S, Hantsoo L, Payne J, Zhaunova L, Ponzo S. Efficacy of the Flo App in Improving Health Literacy, Menstrual and General Health, and Well-Being in Women: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e54124. [PMID: 38696773 PMCID: PMC11099814 DOI: 10.2196/54124] [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: 10/30/2023] [Revised: 02/13/2024] [Accepted: 02/27/2024] [Indexed: 05/04/2024] Open
Abstract
BACKGROUND Reproductive health literacy and menstrual health awareness play a crucial role in ensuring the health and well-being of women and people who menstruate. Further, awareness of one's own menstrual cycle patterns and associated symptoms can help individuals identify and manage conditions of the menstrual cycle such as premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). Digital health products, and specifically menstrual health apps, have the potential to effect positive change due to their scalability and ease of access. OBJECTIVE The primary aim of this study was to measure the efficacy of a menstrual and reproductive health app, Flo, in improving health literacy and health and well-being outcomes in menstruating individuals with and without PMS and PMDD. Further, we explored the possibility that the use of the Flo app could positively influence feelings around reproductive health management and communication about health, menstrual cycle stigma, unplanned pregnancies, quality of life, work productivity, absenteeism, and body image. METHODS We conducted 2 pilot, 3-month, unblinded, 2-armed, remote randomized controlled trials on the effects of using the Flo app in a sample of US-based (1) individuals who track their cycles (n=321) or (2) individuals who track their cycles and are affected by PMS or PMDD (n=117). RESULTS The findings revealed significant improvements at the end of the study period compared to baseline for our primary outcomes of health literacy (cycle tracking: D̄=1.11; t311=5.73, P<.001; PMS or PMDD: D̄=1.20; t115=3.76, P<.001) and menstrual health awareness (D̄=3.97; t311=7.71, P<.001), health and well-being (D̄=3.44; t311=5.94, P<.001), and PMS or PMDD symptoms burden (D̄=-7.08; t115=-5.44, P<.001). Improvements were also observed for our secondary outcomes of feelings of control and management over health (D̄=1.01; t311=5.08, P<.001), communication about health (D̄=0.93; t311=2.41, P=.002), menstrual cycle stigma (D̄=-0.61; t311=-2.73, P=.007), and fear of unplanned pregnancies (D̄=-0.22; t311=-2.11, P=.04) for those who track their cycles, as well as absenteeism from work and education due to PMS or PMDD (D̄=-1.67; t144=-2.49, P=.01). CONCLUSIONS These pilot randomized controlled trials demonstrate that the use of the Flo app improves menstrual health literacy and awareness, general health and well-being, and PMS or PMDD symptom burden. Considering the widespread use and affordability of the Flo app, these findings show promise for filling important gaps in current health care provisioning such as improving menstrual knowledge and health. TRIAL REGISTRATION OSF Registries osf.io/pcgw7; https://osf.io/pcgw7 ; OSF Registries osf.io/ry8vq; https://osf.io/ry8vq.
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Affiliation(s)
| | | | - Kimberly Peven
- Flo Health UK Limited, London, United Kingdom
- Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | - Tara Radovic
- Flo Health UK Limited, London, United Kingdom
- Department of Psychology and Ergonomics, Technische Universitaet Berlin, Berlin, Germany
| | | | - Maria Fomina
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Katja Cunningham
- Department of Psychology, Texas Christian University, Fort Worth, TX, United States
| | - Sarah Hill
- Department of Psychology, Texas Christian University, Fort Worth, TX, United States
| | - Liisa Hantsoo
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, MD, United States
| | - Jennifer Payne
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, United States
| | | | - Sonia Ponzo
- Flo Health UK Limited, London, United Kingdom
- Institute of Health Informatics, University College London, London, United Kingdom
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Mirghafourvand M, Ebadi A, Jahanfar S, Khorashadizadeh F, Shirzadi S. Exploring the practice of Iranian adolescent females during menstruation and related beliefs: a qualitative study. BMC Public Health 2024; 24:1145. [PMID: 38658910 PMCID: PMC11040887 DOI: 10.1186/s12889-024-18600-z] [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: 04/22/2023] [Accepted: 04/15/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Menstruation is a natural occurrence that women experience during their reproductive years and may encounter many years throughout their lifespan. Many adolescent females lack accurate knowledge about menstruation, so they may face issues from receiving incorrect information from unreliable sources. Our study aimed to investigate the practices and beliefs surrounding menstruation among Iranian adolescent females. METHODS This qualitative study was conducted using conventional content analysis. A purposeful sampling method was used to select 18 adolescent females from secondary and high schools located in the three regions of Neyshabur City-Iran. Data were collected through in-depth, semi-structured interviews. RESULTS Three main themes were extracted, consisting of lifestyle and related beliefs, lake of support, and awareness and information. CONCLUSIONS misconceptions and wrong behaviors during menstruation indicate that the lake of knowledge an traditional factors influence adolescent girls' health. The study provides the basis for intervention planning in this regard and different levels (individual, intrapersonal, health systems, and community).
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Affiliation(s)
- Mojgan Mirghafourvand
- Social Determinants of Health Research Center, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Centre, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Shayesteh Jahanfar
- Department of Public Health and Community Medicine, Tufts School of Medicine, Boston, USA
| | - Fatemeh Khorashadizadeh
- Department of Epidemiology and Biostatistics, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Shayesteh Shirzadi
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran.
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Marván ML, García-Prieto C, Alcalá-Herrera V, Vacio-Muro MDLÁ. Menarcheal experience, beliefs about and attitudes toward menstruation in Mexico: Changes in the last 20 years. Health Care Women Int 2024:1-14. [PMID: 38635371 DOI: 10.1080/07399332.2024.2342474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Abstract
We explored how menarcheal experiences and attitudes toward menstruation of Mexican adolescents have changed in the last 20 years. Two questionnaires were applied to female adolescent students, and the results were compared with those obtained in 2002-3 when adolescents of the same ages were surveyed using the same questionnaires. Although some aspects of menstrual education have not changed, the secrecy surrounding menstruation has diminished. In contrast, the belief that menstruation is disabling and keeps women from their normal activities has increased. It is important that adolescents receive adequate preparation about psychosocial and physical aspects of the menstrual cycle.
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Affiliation(s)
- Ma Luisa Marván
- Instituto de Investigaciones Psicológicas, Universidad Veracruzana, Xalapa, Mexico
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Orellana M, DSouza KN, Yap JQ, Sriganeshan A, Jones ME, Johnson C, Allyse M, Venable S, Stewart EA, Enders F, Balls-Berry JE. "In our community, we normalize pain": discussions around menstruation and uterine fibroids with Black women and Latinas. BMC Womens Health 2024; 24:233. [PMID: 38610011 PMCID: PMC11010402 DOI: 10.1186/s12905-024-03008-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/28/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Uterine fibroids are non-cancerous neoplasms that arise from the uterus affecting over 75% of women. However, there is a disparity with Black women having an increased prevalence of nearly 80%. Black women also experience increased symptom burden, including younger age at the time of diagnosis and increased number and volume of fibroids. Less is known about other ethnoracially diverse women such as Latinas and the potential cultural impacts on fibroid burden and treatment. METHODS Community engagement studios were conducted to facilitate discussions with stakeholders on their uterine fibroid and menstruation experience. We recruited Black women (n = 6) diagnosed with uterine fibroids and Latinas (n = 7) without uterine fibroids. We held two virtual community engagement studios split by uterine fibroid diagnosis. The studios were not audio recorded and notes were taken by four notetakers. The notes were thematically analyzed in Atlas.ti using content analysis. RESULTS Participants felt there was a lack of discussion around menstruation overall, whether in the home or school settings. This lack of menstruation education was pronounced when participants had their first menstruation experience, with many unaware of what to expect. This silence around menstruation led to a normalization of painful menstruation symptoms. When it came to different treatment options for uterine fibroids, some women wanted to explore alternative treatments but were dismissed by their healthcare providers. Many participants advocated for having discussions with their healthcare provider about life goals to discuss different treatment options for their uterine fibroids. CONCLUSION Despite uterine fibroid diagnosis, there is silence around menstruation. Menstruation is a normal biological occurrence and needs to be discussed to help prevent delayed diagnosis of uterine fibroids and possibly other gynecological disorders. Along with increased discussions around menstruation, further discussion is needed between healthcare providers and uterine fibroid patients to explore appropriate treatment options.
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Affiliation(s)
- Minerva Orellana
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Karen N DSouza
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
| | - Jane Q Yap
- Department of Quantitative Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - M Elena Jones
- Department of Neurology, Washington University School of Medicine, 4488 Forest Park, St. Louis, MO, 63108, USA
| | - Charis Johnson
- Department of Neurology, Washington University School of Medicine, 4488 Forest Park, St. Louis, MO, 63108, USA
| | - Megan Allyse
- Department of Quantitative Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Program in Biomedical Ethics Research, Mayo Clinic, Rochester, MN, USA
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA
| | | | - Elizabeth A Stewart
- Division of Reproductive Endocrinology, Department of Obstetrics & Gynecology, Mayo Clinic, Rochester, MN, USA
- Mayo Clinic College of Medicine & Science, Rochester, MN, USA
| | - Felicity Enders
- Department of Quantitative Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Mayo Clinic College of Medicine & Science, Rochester, MN, USA
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Joyce E Balls-Berry
- Department of Neurology, Washington University School of Medicine, 4488 Forest Park, St. Louis, MO, 63108, USA.
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Dong Y, Zhang L, Lam C, Huang Z. Counteracting sexual and reproductive health misperceptions: Investigating the roles of stigma, misinformation exposure, and information overload. PATIENT EDUCATION AND COUNSELING 2024; 120:108098. [PMID: 38101090 DOI: 10.1016/j.pec.2023.108098] [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: 04/24/2023] [Revised: 10/23/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE Sexual and reproductive health (SRH) misperceptions constitute a critical precursor to undesired health outcomes for women. Drawing on the model of stigma management communication and exposure effects, we aimed to investigate the underlying processes of SRH misperceptions. METHODS A nationwide survey was conducted via quota sampling with Chinese women (N = 1000). Structural equation modeling with maximum likelihood estimation and 5000 bootstrapping resamples were used to test the hypotheses. RESULTS Stigma perceptions positively predicted information avoidance (β = 0.207, p < 0.001), which, in turn, was positively associated with misperceptions (β = 0.195, p < 0.001). Misinformation exposure significantly predicted misperceptions (β = 0.607, p < 0.001), and this relationship was mediated by information avoidance (β = 0.020, 95% CI [0.007, 0.040]). Moreover, information overload strengthened the relationship between misinformation exposure and information avoidance (β = 0.153, p < 0.001) as well as the relationship between misinformation exposure and misperceptions (β = 0.077, p = 0.006). CONCLUSION Stigma and misinformation exposure play prominent roles in the formation of SRH misperceptions. Information overload facilitates the misinformation-misperception transformation. PRACTICE IMPLICATIONS To counteract SRH misperceptions, health education should alleviate SRH stigma perceptions and strategically design messages to avoid information avoidance and overload.
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Affiliation(s)
- Yujie Dong
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Lianshan Zhang
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China.
| | - Chervin Lam
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Bia-Echo Asia Centre for Reproductive Longevity & Equality (ACRLE), Singapore
| | - Zhongwei Huang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Bia-Echo Asia Centre for Reproductive Longevity & Equality (ACRLE), Singapore
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Schreiber T, Solebo AL. The Experience of Menarche for Young People With Sensory and Motor Impairments: A Systematic Review. J Adolesc Health 2024; 74:223-231. [PMID: 37815768 DOI: 10.1016/j.jadohealth.2023.08.014] [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: 02/17/2023] [Revised: 08/08/2023] [Accepted: 08/08/2023] [Indexed: 10/11/2023]
Abstract
Young people with disabilities may face barriers to optimal management of menstrual health, including the management of menarche, a unique stage of development. This systematic review examined the barriers to and facilitators of a positive experience of menarche for young people with visual, hearing, or mobility impairments. The MEDLINE, Embase, PsychINFO bibliographic databases, and grey literature were systematically searched in February 2022 to identify relevant research. Thematic synthesis of the extracted study findings was undertaken, using a team-based approach. A total of seven primary qualitative, and 1 mixed method studies were eligible for inclusion. The themes identified through metasynthesis were: timeliness of pre-menarcheal access, with many being unaware of menarche before it occurred, leading to fear and shock at their first period; resonance, with individuals reporting positive impacts of guidance from those with similar disabilities; and frame, the impact of surrounding societal narratives on the experience of menarche. Families, and those involved in the care of children with visual, hearing, and mobility impairments should be made aware of the importance of timely and resonant menarcheal support and guidance for these individuals and of broadcasting positive surrounding narratives of menarche. This should enable a positive experience of menarche for these vulnerable young people, supporting a good trajectory for later-life menstrual health.
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Affiliation(s)
- Tamar Schreiber
- Population, Policy and Practice Research and Teaching Department, UCL GOS Institute of Child Health, London, United Kingdom
| | - Ameenat Lola Solebo
- Population, Policy and Practice Research and Teaching Department, UCL GOS Institute of Child Health, London, United Kingdom; Department of Opthamology, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom.
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Kumar A, Dhadwal Y, Yadav V, Sharma B. A cross-sectional study of knowledge, taboos, and attitudes towards menstruation. ETHNICITY & HEALTH 2024; 29:208-219. [PMID: 38117236 DOI: 10.1080/13557858.2023.2293450] [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: 07/29/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND The level of knowledge and comprehension surrounding puberty and menstruation. It can substantially impact women's overall health. This cross-sectional study is conducted to get insights about menstrual knowledge, attitudes and taboos among college and university female students in Haryana. METHODS A survey was conducted to investigate the experiences of menstruation among female students from government universities and colleges. Respondents were categorized on the basis of age, education qualification, and background setting. Random sampling was used to ensure participation from six administrative zones. The chi-square test was used to determine statistical significance, and the analysis was built around the p-value. RESULTS The data reveals that there is no significant association between the age of the participants and their awareness of menstruation, scientific knowledge related to menstruation, or their personal relationships with mother, father, or family members. Similarly, there is no significant association between the participants' scientific knowledge and their level of education. However, there is a significant association between participants' personal relationships and level of education (p = .025). Additionally, a significant association was observed between taboos and level of education (p = .025). CONCLUSION Age, residential area, and educational levels do not seem to significantly impact participants' awareness and knowledge. This study highlights the influence of personal equations and education on attitudes and beliefs surrounding menstruation. The significant association between personal relationships and education underscores the importance of a supportive family. The persistence of menstrual taboos among undergraduates suggests that there is still a need for comprehensive and inclusive menstrual health education. This study also addressed the sustainable developmental goals for good health and well-being. Future studies should focus on exploring cultural factors such as religious beliefs and cultural norms in more detail to develop interventions that may help improve menstrual health outcomes among college and university students.
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Affiliation(s)
- Ashok Kumar
- Department of Journalism and Mass Communication, Central University of Haryana, Mahendergarh, India
| | - Yukti Dhadwal
- Institute of Mass Communication and Media Technology, Kurukshetra University, Kurukshetra, India
| | - Vinit Yadav
- Institute of Mass Communication and Media Technology, Kurukshetra University, Kurukshetra, India
| | - Bindu Sharma
- Institute of Mass Communication and Media Technology, Kurukshetra University, Kurukshetra, India
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12
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Casola AR, Pando O, Medley L, Kunes B, McGlone N, Rea O. Examining menstrual health experiences in Philadelphia, PA: A qualitative investigation. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241251975. [PMID: 38738597 PMCID: PMC11092546 DOI: 10.1177/17455057241251975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 04/10/2024] [Accepted: 04/15/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND While menstruation is a physiologic process, it remains highly stigmatized. Despite the sheer number of menstruators, menstruation is a highly individualized experience, with wide variation in duration, symptoms, and management. This wide variability lends itself to large disparities in access to menstruation management products and subsequently the lived experience of menstruators. OBJECTIVES The research team sought to understand lived menstrual experiences, symptoms, management tactics, and commonly used and desired resources among 20 cisgendered women aged 18-45 years in Philadelphia. DESIGN This project was a qualitative research study. METHODS We used a collaborative, community-based participatory research approach with No More Secrets, a Philadelphia-based grassroots sexuality awareness and menstrual health hub. Semi-structured telephone interviews were used to gain insight into general menstruation-related experiences, communication, worries, and concerns, with subsequent thematic analysis via Key Words in Context approach. RESULTS Four themes emerged following analysis: cycle characteristics, menstruation management, coping resources, and future resources. Participants largely spoke about their menses as a negative experience, asked for more comprehensive, verified sources of information and needed greater access to menstrual management supplies. CONCLUSION Menstruation is a highly individualized experience with a large variety in knowledge, menstrual product use, and individual needs. Despite the individuality of menstruation, our community-based research shows that there is a dire need for interventions that promotes knowledge and access to menstrual care.
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Affiliation(s)
- Allison R Casola
- Department of Family & Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Oriana Pando
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Lynette Medley
- No More Secrets Mind Body Spirit Inc., Philadelphia, PA, USA
| | - Brianna Kunes
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Nya McGlone
- No More Secrets Mind Body Spirit Inc., Philadelphia, PA, USA
| | - Olivia Rea
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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Basinger ED, Quinlan MM, Rawlings M. Memorable Messages About Fat Bodies Before, During, and After Pregnancy. HEALTH COMMUNICATION 2023; 38:3069-3079. [PMID: 36199193 DOI: 10.1080/10410236.2022.2131982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Weight bias is prevalent for people in large bodies who are trying to conceive, pregnant, or postpartum. Using the theory of memorable messages as a framework, we explored the sources, valence, and content of messages that fat individuals (N = 237) recalled about their bodies before pregnancy through the postpartum stage. The most common source of memorable messages was healthcare providers, and most (77.2%) messages were negatively valenced. Thematic analysis revealed four overarching themes (fat mothers are bad mothers, denial of competent treatment, weight-normative commentary on fat bodies, and weight-inclusive counter-narratives). Our findings illuminate the significance of patient-practitioner communication across the pregnancy trajectory and highlight how counter-narratives can disrupt negative messages about fat pregnancy.
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Affiliation(s)
- Erin D Basinger
- Department of Communication Studies, University of North Carolina at Charlotte
| | - Margaret M Quinlan
- Department of Communication Studies, University of North Carolina at Charlotte
| | - Margaret Rawlings
- Department of Communication Studies, University of North Carolina at Charlotte
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14
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Francis L, Meraj S, Konduru D, Perrin EM. An Update on State Legislation Supporting Menstrual Hygiene Products in US Schools: A Legislative Review, Policy Report, and Recommendations for School Nurse Leadership. J Sch Nurs 2023; 39:536-541. [PMID: 36217851 DOI: 10.1177/10598405221131012] [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] [Indexed: 11/16/2022] Open
Abstract
Access to menstrual products is important to support adolescent health. Advocacy to increase access to menstrual products in schools is growing; however, ideal access requires policies that will require schools to support the menstrual health of menstruating students. We conducted a legislative review on the existence and status of state legislation related to the provision of menstrual products in US schools and categorized by state's political control (political party affiliation of governors and state legislature). Of 50 states and 6 territories, 21 had legislation to support menstrual products in schools, 7 had bills pending, 10 had bills failed, and 18 states had no policies introduced in the state legislature. States with Democrat control have significantly more menstrual product state laws compared to states with Republican control [z = 2.54, p = 0.01]. There is a need, especially in Republican states, to accelerate efforts to pass laws that will support menstrual product access in schools.
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Affiliation(s)
- Lucine Francis
- Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA
- Center for Community Programs, Innovation, and Scholarship, Johns Hopkins School of Nursing, Baltimore, MD 21205, USA
- Johns Hopkins Consortium for School-Based Health Solutions, Baltimore, MD, USA
| | - Shafkat Meraj
- Johns Hopkins University Homewood Campus, Baltimore, MD, USA
| | - Divya Konduru
- Johns Hopkins University Homewood Campus, Baltimore, MD, USA
| | - Eliana M Perrin
- Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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15
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de Oliveira VC, Pena ÉD, de Andrade GN, Felisbino-Mendes MS. Menstrual hygiene access and practices in Latin America: scoping review. Rev Lat Am Enfermagem 2023; 31:e4028. [PMID: 37878965 PMCID: PMC10594935 DOI: 10.1590/1518-8345.6736.4028] [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: 03/08/2023] [Accepted: 07/27/2023] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE to synthesize available evidence related to menstrual hygiene access and practices in Latin America and the Caribbean. METHOD literature scoping review with research protocol registered in the Open Science Framework, carried out in the bibliographic databases: PubMed, Scopus, Web of Science and Portal Regional da Biblioteca Virtual em Saúde. Data were analyzed using simple descriptive statistics and thematic analysis. RESULTS 15 publications were included, the majority of which addressed adolescents in Brazil: 12 articles, two technical reports and a course conclusion monograph. As recurring themes in the publications, the following stand out: Access to dignified conditions for managing menstrual hygiene; Need for access to information on menstrual hygiene management; and Practices for managing menstrual hygiene. CONCLUSION adolescents report difficulties in accessing toilets, water and absorbent materials, and lack of information about menstrual health, including in schools, leading to school absenteeism. Thus, gaps in the Latin American scientific literature reveal inequalities and diversity in menstrual experiences intersected by categories such as gender, social class and ethnicity. HIGHLIGHTS (1) Lack of access to hygiene products, toilets and water for personal hygiene. (2) Invisibility of the problem of period poverty in Latin America. (3) Lack of physical structure in schools aggravates and leads to school absenteeism. (4) Menstrual health literacy was insufficient for the demands of adolescents. (5) Primary studies on menstrual hygiene in Latin America are scarce.
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Affiliation(s)
| | - Érica Dumont Pena
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo Horizonte, MG, Brasil
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16
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Hintz EA. "It's All in Your Head": A Meta-Synthesis of Qualitative Research About Disenfranchising Talk Experienced by Female Patients with Chronic Overlapping Pain Conditions. HEALTH COMMUNICATION 2023; 38:2501-2515. [PMID: 35694781 DOI: 10.1080/10410236.2022.2081046] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Interactions between female patients with chronic pain and their medical providers in which providers question or contest the "realness" or nature of their illness experience (e.g. "It's all in your head") have been reported extensively in the extant qualitative literature, particularly for poorly understood ("contested") chronic pain syndromes. Many terms have been offered to describe this talk (e.g. invalidating, dismissive), resulting in conceptual fragmentation and isolated silos of research which together report about one communicative phenomenon. To rectify this fragmentation, the present study offers a meta-synthesis which explores, analyzes, and integrates the findings of 82 qualitative interview studies representing the patient-provider communication experiences of 2,434 female patients living with one or more of 10 chronic overlapping pain conditions (COPCs). COPCs are costly, gendered, and poorly understood. From the meta-synthesis, three key concepts are identified: (1) Functions of disenfranchising talk: Discrediting, silencing, and stereotyping; (2) Effects of disenfranchising talk: Harmed agency, credibility; access to care, support, and resources; and perception of patient-provider relationship; and (3) Responses to disenfranchising talk: Submission, critique, and resistance. Findings confirm the centrality of gender in the experience of disenfranchising talk, underscore the need to adopt an intersectional approach to the study of this talk along additional axes of race and class, and offer heuristic value toward conceptually unifying research about female COPC patients' experiences of disenfranchising talk from providers.
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17
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Giese N, Gilbert E, Hawkey A, Armour M. Unmet Needs of Australians in Endometriosis Research: A Qualitative Study of Research Priorities, Drivers, and Barriers to Participation in People with Endometriosis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1655. [PMID: 37763774 PMCID: PMC10536628 DOI: 10.3390/medicina59091655] [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: 07/28/2023] [Revised: 09/04/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: Endometriosis causes significant personal and societal burden. Despite this, research funding lags behind other chronic conditions. Determining where to prioritise these limited funds is therefore vital. Research priorities may also differ between individuals with endometriosis and clinicians/researchers. The aim of this research project is to explore research priorities and factors shaping participation in endometriosis research from the perspective of people with endometriosis in Australia. Materials and Methods: Four focus groups involving 30 people with endometriosis were conducted and analysed using qualitative inductive content analysis. Results: Two categories were developed from the data: unmet research needs and motivators and barriers to participation in endometriosis research. Participants expressed interest in developing non-invasive diagnostic tools and a more multidisciplinary or holistic approach to treatment. Participants urgently desired research on treatment options for symptom management, with many prioritising non-hormonal treatments, including medicinal cannabis and complementary medicine. Others prioritised research on the causes of endometriosis over research on treatments to assist with prevention and eventual cure of the disease. The main drivers for participating in endometriosis research were hope for symptom improvement and a reduction in time to diagnosis. Research design features that were important in supporting participation included ease of access to testing centres (e.g., for blood tests) and sharing test results and automated data collection reminders, with simple stra-tegies to record data measurements. Research incentives for younger people with endometriosis and a broad dissemination of information about research projects was considered likely to increase participant numbers. Barriers included time commitments, a lack of flexibility around research appointments for data collection, travel or work commitments, concerns about the safety of some products, and trying to conceive a child. Conclusions: People with endometriosis were open to participating in research they felt aligned with their needs, with a significant focus on diagnostic tools and symptom relief. However, researchers must co-design approaches to ensure convenience and flexibility for research participation.
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Affiliation(s)
- Nora Giese
- Praxis für Chinesische Medizin, 53113 Bonn, Germany;
| | - Emilee Gilbert
- School of Psychology, Western Sydney University, Penrith, NSW 2751, Australia;
| | - Alexandra Hawkey
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW 2751, Australia;
| | - Mike Armour
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW 2751, Australia;
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
- Medical Research Institute of New Zealand (MRINZ), Wellington 6021, New Zealand
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18
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Basinger ED, Delaney AL, Williams C. Uncertainty Management in Online Sexual Health Forums. HEALTH COMMUNICATION 2023; 38:875-884. [PMID: 34605355 DOI: 10.1080/10410236.2021.1980253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Sexual health is critical to overall well-being, yet it is challenging and uncomfortable to discuss. Individuals frequently encounter uncertainty about their sexual health as they experience bodily changes, navigate romantic or sexual relationships, and explore their identities. In this study, we called on uncertainty management theory to guide an investigation of sexual health uncertainty. Specifically, we asked how people use social support to manage their sexual health uncertainty in online forums. Grounded theory analyses revealed that negative emotions, avoidance, and pursuing medical care prompted people to seek emotional and informational support online, and support served three functions: integrating information, assessing risk, and strategizing communication. The results point to stigma as a driving force in sexual health discussions online and imply practical recommendations for sexual education, communication about sexual topics, and patient-provider relationships.
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Affiliation(s)
- Erin D Basinger
- Department of Communication Studies, University of North Carolina at Charlotte
| | | | - Carter Williams
- Department of Communication Studies, University of North Carolina at Charlotte
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19
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Schmitt ML, Dimond K, Maroko AR, Phillips-Howard PA, Gruer C, Berry A, Nash D, Kochhar S, Sommer M. "I stretch them out as long as possible:" U.S. women's experiences of menstrual product insecurity during the COVID-19 pandemic. BMC Womens Health 2023; 23:179. [PMID: 37060006 PMCID: PMC10104689 DOI: 10.1186/s12905-023-02333-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 04/05/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND A growing body of evidence highlights how the COVID-19 pandemic has exacerbated gender inequalities in the US. This resulted in women being more vulnerable to economic insecurity and decreases in their overall well-being. One relevant issue that has been less explored is that of women's menstrual health experiences, including how inconsistent access to menstrual products may negatively impact their daily lives. METHODS This qualitative study, conducted from March through May 2021, utilized in-depth interviews that were nested within a national prospective cohort study. The interviews (n = 25) were conducted with a sub-sample of cis-gender women living across the US who had reported challenges accessing products during the first year of the pandemic. The interviews sought to understand the barriers that contributed to experiencing menstrual product insecurity, and related coping mechanisms. Malterud's 'systematic text condensation', an inductive thematic analysis method, was utilized to analyze the qualitative transcripts. RESULTS Respondents came from 17 different states across the U.S. Three key themes were identified: financial and physical barriers existed to consistent menstrual product access; a range of coping strategies in response to menstrual product insecurity, including dependence on makeshift and poorer quality materials; and heightened experiences of menstrual-related anxiety and shame, especially regarding the disclosure of their menstruating status to others as a result of inadequate menstrual leak protection. CONCLUSIONS Addressing menstrual product insecurity is a critical step for ensuring that all people who menstruate can attain their most basic menstrual health needs. Key recommendations for mitigating the impact of menstrual product insecurity require national and state-level policy reform, such as the inclusion of menstrual products in existing safety net basic needs programs, and the reframing of menstrual products as essential items. Improved education and advocacy are needed to combat menstrual stigma.
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Affiliation(s)
- Margaret L Schmitt
- Mailman School of Public Health, Columbia University, 722 W 168Th St, New York, NY, 10032, USA.
| | - Katie Dimond
- Mailman School of Public Health, Columbia University, 722 W 168Th St, New York, NY, 10032, USA
| | - Andrew R Maroko
- Institute for Implementation Science in Population Health, City University of New York (CUNY), New York City, NY, USA
| | | | - Caitlin Gruer
- Mailman School of Public Health, Columbia University, 722 W 168Th St, New York, NY, 10032, USA
| | - Amanda Berry
- Institute for Implementation Science in Population Health, City University of New York (CUNY), New York City, NY, USA
| | - Denis Nash
- Institute for Implementation Science in Population Health, City University of New York (CUNY), New York City, NY, USA
| | - Shivani Kochhar
- Institute for Implementation Science in Population Health, City University of New York (CUNY), New York City, NY, USA
| | - Marni Sommer
- Mailman School of Public Health, Columbia University, 722 W 168Th St, New York, NY, 10032, USA
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20
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Sánchez López S, Barrington DJ, Poveda Bautista R, Moll López S. Spanish menstrual literacy and experiences of menstruation. BMC Womens Health 2023; 23:161. [PMID: 37016318 PMCID: PMC10074887 DOI: 10.1186/s12905-023-02293-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/20/2023] [Indexed: 04/06/2023] Open
Abstract
There is growing recognition of the important role menstrual health plays in achieving health, education, and gender equity. Yet, stigmatisation and taboo remain present and negative emotions like fear and shame dominate the narrative when speaking about periods. This paper analyses how formal and informal menstrual education is received in Spain, to understand the role of menstrual health literacy in the way menstruation is experienced, and to identify what information would be useful to integrate into formal menstrual education. An online survey with more than 4000 participants (aged between 14 and 80, both people who will/do/have previously menstruate/d and those who do not menstruate) was conducted. Data was gathered using the digital platform Typeform, descriptive and inferential statistical analyses were performed with SPSS software and qualitative data was thematically analysed using Nvivo. Many participants declared not having received sufficient information on menstruation prior to menarche, particularly about how to physically manage it. Furthermore, negative emotions like shame, worry, and fear were recurrently reported to describe menarche; this has not changed between generations. Interestingly, we saw an increase in stress and sadness with an increase in perceived knowledge of the reproductive role of menstruation. We did observe a reduction in negative emotions when people who menstruate perceived they had sufficient information on how to manage their first bleeding. It is recommended that menstrual education beyond reproductive biology, particularly including how to physically manage periods, is integrated into school curricula. Menstrual education of everyone - including those who do not menstruate-can improve how periods are experienced in Spain.
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21
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Cooke-Jackson A, Rubinsky V, Gunning JN. "Wish I Would Have Known that before I Started Using It": Contraceptive Messages and Information Seeking among Young Women. HEALTH COMMUNICATION 2023; 38:834-843. [PMID: 34544296 DOI: 10.1080/10410236.2021.1980249] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In recent decades, women's use of contraception has evolved. Women not only utilize contraceptives to prevent pregnancy, but also to manage menstruation and other factors related to their personal agency. Despite an abundance of available contraceptive options, many women struggle to navigate and address their contraceptive needs. A hundred and thirty-four female participants responded to an open-ended questionnaire about contraceptive messages and decision making in an online survey. Using Uncertainty Management Theory as a framework, we illustrate how the women make sense of and manage uncertainty from multiple contraceptive messages. Results highlighted the absence of desired information, and identified messages that women wish they had received from healthcare providers and others. Our findings suggest that women's understanding of contraceptives' side effects is a communicative process in which anecdotal evidence is often treated as medical fact and healthcare providers are viewed as ineffective and dismissive in relaying and addressing information about contraception. In the absence of satisfying healthcare interactions, women seek information elsewhere to make their contraceptive choices.
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22
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Schmitt ML, Hagstrom C, Gruer C, Nowara A, Keeley K, Adenu-Mensah NE, Sommer M. “Girls May Bleed Through Pads Because of Demerits”: Adolescent Girls’ Experiences With Menstruation and School Bathrooms in the U.S.A. JOURNAL OF ADOLESCENT RESEARCH 2022. [DOI: 10.1177/07435584221139342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The aim of this study was to better understand the role of school bathrooms in shaping the menstrual experiences of adolescents in the U.S.A. The participants were Black and Latina, low-income adolescent girls (15–19) and adults interacting closely with youth in three U.S.A. cities (Chicago, Los Angeles, New York City). Data collection methods included: (1) Participatory Methodologies (PM) sessions with adolescent girls ( n = 73); (2) In-depth interviews (IDI) with adolescent girls ( n = 12); and (3) Key Informant Interviews (KII) with adults ( n = 23). Malterud’s “systematic text condensation,” an inductive thematic analysis method, was utilized to analyze the various data types (field notes, in-depth interviews, drawings). Key findings include, one, that menstruating girls experience embarrassment and a need for secrecy when accessing school bathrooms; two, the social and physical environments of school bathrooms, including poor design and maintenance, heighten girls’ discomfort, especially while menstruating; and three, school policies restricting students’ bathroom access are problematic for many menstruating students, especially those experiencing heavy and/or unpredictable bleeding. Schools and policymakers need to consider holistic approaches when addressing the menstrual needs of adolescents in U.S.A. schools, including better prioritizing issues related to menstrual stigma, school bathroom design and bathroom access policies.
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Affiliation(s)
| | | | | | | | - Katie Keeley
- Ann & Robert H. Lurie Children’s Hospital of Chicago, IL, USA
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23
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Schmitt ML, Gruer C, Hagstrom C, Ekua Adenu-Mensah N, Nowara A, Keeley K, Sommer M. “It always gets pushed aside:” Qualitative perspectives on puberty and menstruation education in U.S.A. schools. FRONTIERS IN REPRODUCTIVE HEALTH 2022; 4:1018217. [PMID: 36339773 PMCID: PMC9635341 DOI: 10.3389/frph.2022.1018217] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022] Open
Abstract
Adolescent girls in the U.S.A. often lack sufficient education on pubertal and menstrual health topics. This educational gap may be growing given the current decline in American elementary and middle schools' delivery of sexual health education. Furthermore, little is known about the actual scope and quality of existing menstruation and puberty education in U.S.A. schools. This paper provides insights into some of the challenges with the delivery of menstruation and puberty education in schools. Qualitative and participatory research methodologies were utilized with Black and Latina girls ages 15–19 and adults working with youth in three U.S.A. cities (Chicago, Los Angeles, and New York City), exploring experiences of menstruation within school and family contexts. Findings revealed tension between school responsibility and family authority in providing menstruation and puberty education in schools, school- and teacher-related delivery challenges, and inadequate and disengaging menstruation and puberty content. Further research is needed on the effectiveness and best practices for providing this education in schools, including improved understanding on student and parent preferences, delivery mediums and the scope of content.
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Affiliation(s)
- Margaret L. Schmitt
- Mailman School of Public Health, Columbia University, New York City, NY, United States
- Correspondence: Margaret L. Schmitt
| | - Caitlin Gruer
- Mailman School of Public Health, Columbia University, New York City, NY, United States
| | - Christine Hagstrom
- Mailman School of Public Health, Columbia University, New York City, NY, United States
| | | | - Azure Nowara
- Mailman School of Public Health, Columbia University, New York City, NY, United States
| | - Katie Keeley
- Office of Clinical and Community Trials, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Marni Sommer
- Mailman School of Public Health, Columbia University, New York City, NY, United States
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24
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Thorpe S, Iyiewuare P, Ware S, Malone N, Jester JK, Dogan JN, Hargons CN. "Why Would I Talk To Them About Sex?": Exploring Patient-Provider Communication Among Black Women Experiencing Sexual Pain. QUALITATIVE HEALTH RESEARCH 2022; 32:1527-1543. [PMID: 35758050 PMCID: PMC11214809 DOI: 10.1177/10497323221110091] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Ineffective patient-provider communication poses a potential health risk to Black women if medical providers are not addressing their needs or concerns. Additionally, less than half of OBGYNs report asking their patients about sexual difficulties, which limits women's opportunities to disclose their experiences of sexual pain. The purpose of this qualitative study is to explore Black women's experiences of patient-provider communication about sexual pain (reoccurring unwanted genital pain). Specifically, we aimed to describe the pathway from sexual pain disclosure to treatment among N = 25 premenopausal Black women living in the southern United States who were experiencing sexual pain. Using constructivist grounded theory, open-ended responses to six interview questions related to healthcare experiences, treatment, and patient-provider communication were qualitatively analyzed and categorized to form a conceptual framework of patient-provider communication about sexual pain. Five key categories emerged related to Black women's experiences with their medical providers regarding sexual pain: (1) provider preferences, (2) healthcare experiences, (3) reasons for non-disclosure, (4) provider responses to sexual pain, and (5) treatment for sexual pain. Useful strategies to improve patient-provider communication are presented for both patients and providers.
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Affiliation(s)
- Shemeka Thorpe
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Praise Iyiewuare
- Department of Psychological Science, The University of Vermont, Burlington, VT, USA
| | | | - Natalie Malone
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Jasmine K. Jester
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Jardin N. Dogan
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Candice N. Hargons
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
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25
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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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26
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Sommer M, Phillips-Howard PA, Gruer C, Schmitt ML, Nguyen AM, Berry A, Kochhar S, Gorrell Kulkarni S, Nash D, Maroko AR. Menstrual Product Insecurity Resulting From COVID-19‒Related Income Loss, United States, 2020. Am J Public Health 2022; 112:675-684. [PMID: 35319956 PMCID: PMC8961817 DOI: 10.2105/ajph.2021.306674] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To identify key effects of the pandemic and its economic consequences on menstrual product insecurity with implications for public health practice and policy. Methods. Study participants (n = 1496) were a subset of individuals enrolled in a national (US) prospective cohort study. Three survey waves were included (March‒October 2020). Menstrual product insecurity outcomes were explored with bivariate associations and logistic regression models to examine the associations between outcomes and income loss. Results. Income loss was associated with most aspects of menstrual product insecurity (adjusted odds ratios from 1.34 to 3.64). The odds of not being able to afford products for those who experienced income loss was 3.64 times (95% confidence interval [CI] = 2.14, 6.19) that of those who had no income loss and 3.95 times (95% CI = 1.78, 8.79) the odds for lower-income participants compared with higher-income participants. Conclusions. Pandemic-related income loss was a strong predictor of menstrual product insecurity, particularly for populations with lower income and educational attainment. Public Health Implications. Provision of free or subsidized menstrual products is needed by vulnerable populations and those most impacted by pandemic-related income loss.(Am J Public Health. 2022;112(4):675-684. (https://doi.org/10.2105/AJPH.2021.306674).
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Affiliation(s)
- Marni Sommer
- Marni Sommer, Caitlin Gruer, and Margaret L. Schmitt are with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Penelope A. Phillips-Howard is with the Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK. Angela-Maithy Nguyen is with the Interdisciplinary Division, School of Public Health, University of California‒Berkeley. Amanda Berry, Shivani Kochhar, Sarah Gorrell Kulkarni, and Denis Nash are with the Institute for Implementation Science in Population, City University of New York (CUNY), New York. Andrew R. Maroko is with the Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, CUNY
| | - Penelope A Phillips-Howard
- Marni Sommer, Caitlin Gruer, and Margaret L. Schmitt are with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Penelope A. Phillips-Howard is with the Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK. Angela-Maithy Nguyen is with the Interdisciplinary Division, School of Public Health, University of California‒Berkeley. Amanda Berry, Shivani Kochhar, Sarah Gorrell Kulkarni, and Denis Nash are with the Institute for Implementation Science in Population, City University of New York (CUNY), New York. Andrew R. Maroko is with the Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, CUNY
| | - Caitlin Gruer
- Marni Sommer, Caitlin Gruer, and Margaret L. Schmitt are with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Penelope A. Phillips-Howard is with the Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK. Angela-Maithy Nguyen is with the Interdisciplinary Division, School of Public Health, University of California‒Berkeley. Amanda Berry, Shivani Kochhar, Sarah Gorrell Kulkarni, and Denis Nash are with the Institute for Implementation Science in Population, City University of New York (CUNY), New York. Andrew R. Maroko is with the Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, CUNY
| | - Margaret L Schmitt
- Marni Sommer, Caitlin Gruer, and Margaret L. Schmitt are with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Penelope A. Phillips-Howard is with the Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK. Angela-Maithy Nguyen is with the Interdisciplinary Division, School of Public Health, University of California‒Berkeley. Amanda Berry, Shivani Kochhar, Sarah Gorrell Kulkarni, and Denis Nash are with the Institute for Implementation Science in Population, City University of New York (CUNY), New York. Andrew R. Maroko is with the Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, CUNY
| | - Angela-Maithy Nguyen
- Marni Sommer, Caitlin Gruer, and Margaret L. Schmitt are with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Penelope A. Phillips-Howard is with the Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK. Angela-Maithy Nguyen is with the Interdisciplinary Division, School of Public Health, University of California‒Berkeley. Amanda Berry, Shivani Kochhar, Sarah Gorrell Kulkarni, and Denis Nash are with the Institute for Implementation Science in Population, City University of New York (CUNY), New York. Andrew R. Maroko is with the Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, CUNY
| | - Amanda Berry
- Marni Sommer, Caitlin Gruer, and Margaret L. Schmitt are with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Penelope A. Phillips-Howard is with the Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK. Angela-Maithy Nguyen is with the Interdisciplinary Division, School of Public Health, University of California‒Berkeley. Amanda Berry, Shivani Kochhar, Sarah Gorrell Kulkarni, and Denis Nash are with the Institute for Implementation Science in Population, City University of New York (CUNY), New York. Andrew R. Maroko is with the Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, CUNY
| | - Shivani Kochhar
- Marni Sommer, Caitlin Gruer, and Margaret L. Schmitt are with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Penelope A. Phillips-Howard is with the Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK. Angela-Maithy Nguyen is with the Interdisciplinary Division, School of Public Health, University of California‒Berkeley. Amanda Berry, Shivani Kochhar, Sarah Gorrell Kulkarni, and Denis Nash are with the Institute for Implementation Science in Population, City University of New York (CUNY), New York. Andrew R. Maroko is with the Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, CUNY
| | - Sarah Gorrell Kulkarni
- Marni Sommer, Caitlin Gruer, and Margaret L. Schmitt are with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Penelope A. Phillips-Howard is with the Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK. Angela-Maithy Nguyen is with the Interdisciplinary Division, School of Public Health, University of California‒Berkeley. Amanda Berry, Shivani Kochhar, Sarah Gorrell Kulkarni, and Denis Nash are with the Institute for Implementation Science in Population, City University of New York (CUNY), New York. Andrew R. Maroko is with the Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, CUNY
| | - Denis Nash
- Marni Sommer, Caitlin Gruer, and Margaret L. Schmitt are with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Penelope A. Phillips-Howard is with the Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK. Angela-Maithy Nguyen is with the Interdisciplinary Division, School of Public Health, University of California‒Berkeley. Amanda Berry, Shivani Kochhar, Sarah Gorrell Kulkarni, and Denis Nash are with the Institute for Implementation Science in Population, City University of New York (CUNY), New York. Andrew R. Maroko is with the Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, CUNY
| | - Andrew R Maroko
- Marni Sommer, Caitlin Gruer, and Margaret L. Schmitt are with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Penelope A. Phillips-Howard is with the Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK. Angela-Maithy Nguyen is with the Interdisciplinary Division, School of Public Health, University of California‒Berkeley. Amanda Berry, Shivani Kochhar, Sarah Gorrell Kulkarni, and Denis Nash are with the Institute for Implementation Science in Population, City University of New York (CUNY), New York. Andrew R. Maroko is with the Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, CUNY
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Scott KD, Hintz EA, Harris TM. "Having Pain is Normal": How Talk about Chronic Pelvic and Genital Pain Reflects Messages from Menarche. HEALTH COMMUNICATION 2022; 37:296-306. [PMID: 36112920 DOI: 10.1080/10410236.2020.1837464] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Chronic pelvic and genital pain conditions (CPGPCs) often go undiagnosed and untreated in women for years after symptom onset. This is due, in part, to communication challenges experienced by patients such as difficulties describing pain and the stigmatized nature of CPGPCs. However, studies have yet to explore how early messages about menstruation, a context similar in its stigmatized and painful nature, may contribute to undertreatment and diagnostic delays for adult women experiencing CPGPCs by normalizing pelvic and genital pain when they are young girls. Guided by critical feminist theorizing (CFT) and sensitized by an existing typology of negative messages communicated by mothers to daughters about menstruation, this study analyzes interviews with 17 women with CPGPCs to explore how features of negative messages about menstruation (i.e., information restriction and omission) appear and recur in women's descriptions of their later CPGP experiences. Findings suggest that early life talk about menstruation forms a communicative precedent for young girls which later constrains how they talk about CPGP in adulthood. Findings also problematize early-life communication about menstruation, which normalizes women's pain, and suggest connections to outcomes (e.g., diagnostic delays) for women with CPGPCs. Theoretical and practical implications are offered. Limitations and future directions are described.
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Affiliation(s)
- Katie D Scott
- Shelter Advocate and Rapid Rehousing Coordinator, Project Safe, Inc
| | | | - Tina M Harris
- Douglas L. Manship Sr.-Dori Maynard Race, Media, and Cultural Literacy Endowed Chair, Manship School of Mass Communication
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28
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Schmitt ML, Booth K, Sommer M. A Policy for Addressing Menstrual Equity in Schools: A Case Study From New York City, U.S.A. FRONTIERS IN REPRODUCTIVE HEALTH 2022; 3:725805. [PMID: 36303999 PMCID: PMC9580679 DOI: 10.3389/frph.2021.725805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/22/2021] [Indexed: 12/03/2022] Open
Abstract
There has been a growth in menstrual equity policy advancements in the U.S.A. in recent years; with much of the new legislation prioritizing the needs of adolescent girls in schools. New York City, a predecessor of this movement, was the first U.S.A. locality to pass such legislation in 2016. The aim of this case study was to better understand the various factors which led to the development, passage and initial implementation of New York City's Menstrual Equity in Schools Policy. Data collection methods included a desk review and qualitative assessment with several actors involved across the policy and introduction phases. Key findings included (1) the utility of community narratives and a pilot project as a means for overcoming initial skepticisms, proving feasibility, and generating support; (2) the importance of policy champions for overcoming fiscal objections and navigating political discourse; and (3) lessons learned from early implementation efforts, including variance in awareness and distribution models. This case study yields valuable insights into the practical considerations when designing or implementing policies aimed at tackling issues of menstrual equity within school settings.
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Affiliation(s)
- Margaret L. Schmitt
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
- *Correspondence: Margaret L. Schmitt
| | - Kathleen Booth
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Marni Sommer
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
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Wilbur J, Morrison C, Iakavai J, Shem J, Poilapa R, Bambery L, Baker S, Tanguay J, Sheppard P, Banks LM, Mactaggart I. "The weather is not good": exploring the menstrual health experiences of menstruators with and without disabilities in Vanuatu. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 18:100325. [PMID: 35024657 PMCID: PMC8661049 DOI: 10.1016/j.lanwpc.2021.100325] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Menstrual health is essential for gender equality and achieving the sustainable development goals. Though currently lacking, understanding and addressing menstrual health and social related inequalities requires comparison of experiences between menstruators with and without disabilities. METHODS We completed a mixed-methods population-based study of water, sanitation and hygiene, disability and menstrual health in TORBA and SANMA Provinces, Vanuatu. Methods included a census, nested case-control study, in-depth interviews (IDIs), focus group discussions (FGDs), PhotoVoice and structured observations. We undertook a population census of 11,000+ households and recruited 164 menstruators with and 169 without disabilities (aged 10-45) into a nested case-control study. 20 menstruators across both groups were selected for the qualitative component. FINDINGS Menstruators with disabilities were five times (adjusted Odds Ratio [aOR] 5.5, 95% Confidence Interval 1.8 - 16.5) more likely to use different bathing facilities to others in the household, nearly twice as likely (1.8, 1.1 - 3.1) to miss social activities, and three times (3.0, 1.6 - 5.7) more likely to eat alone during menstruation. Menstrual restrictions were widespread for all, but collecting water and managing menstrual materials was harder for menstruators with disabilities, particularly those requiring caregivers' support. These factors negatively impacted menstruators with disabilities' comfort, safety and hygiene, yet they reported less interference of menstruation on participation. INTERPRETATION Negative factors affecting all menstruators disproportionately impact those with disabilities, compounding existing inequalities. Menstruators with disabilities may have reported less interference because they are accustomed to greater participation restrictions than others. FUNDING Australian Government's Water for Women fund and public donations.
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Affiliation(s)
- Jane Wilbur
- International Centre for Evidence in Disability (ICED), London School of Hygiene & Tropical Medicine, Keppel Street, London WCE 7HT, UK
| | - Chloe Morrison
- World Vision Vanuatu, Rue Artoi M/S, P.O Box 247, Port Vila, Vanuatu
| | - Judith Iakavai
- Vanuatu Society for People with Disability, PO Box 373, Port Vila, Vanuatu
| | - Jeanine Shem
- World Vision Vanuatu, Rue Artoi M/S, P.O Box 247, Port Vila, Vanuatu
| | - Relvie Poilapa
- World Vision Vanuatu, Rue Artoi M/S, P.O Box 247, Port Vila, Vanuatu
| | - Luke Bambery
- World Vision Vanuatu, Rue Artoi M/S, P.O Box 247, Port Vila, Vanuatu
| | - Sally Baker
- Melbourne School of Population Health, University of Melbourne, 207 Bouverie St, Carlton, VIC 3053, Australia
| | - Jamie Tanguay
- Vanuatu National Statistics Office, Port Vila, Vanuatu
| | - Philip Sheppard
- International Centre for Evidence in Disability (ICED), London School of Hygiene & Tropical Medicine, Keppel Street, London WCE 7HT, UK
| | - Lena Morgon Banks
- International Centre for Evidence in Disability (ICED), London School of Hygiene & Tropical Medicine, Keppel Street, London WCE 7HT, UK
| | - Islay Mactaggart
- International Centre for Evidence in Disability (ICED), London School of Hygiene & Tropical Medicine, Keppel Street, London WCE 7HT, UK
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30
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Höök M, Bergström M, Sæther SA, McGawley K. "Do Elite Sport First, Get Your Period Back Later." Are Barriers to Communication Hindering Female Athletes? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212075. [PMID: 34831828 PMCID: PMC8623003 DOI: 10.3390/ijerph182212075] [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] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/06/2021] [Accepted: 11/12/2021] [Indexed: 11/16/2022]
Abstract
Competitive female athletes perceive their hormonal cycles to affect their training, competition performance and overall well-being. Despite this, athletes rarely discuss hormonal-cycle-related issues with others. The aim of this study was to gain an in-depth understanding of the perceptions and experiences of endurance athletes and their coaches in relation to barriers to athlete-coach communication about female hormonal cycles. Thirteen Swedish national-/international-level female cross-country skiers (age 25.8 ± 3.6 y) and eight of their coaches (two women and six men; age 47.8 ± 7.5 y) completed an online survey relating to their educational background, prior knowledge about female hormonal cycles and a coach-athlete relationship questionnaire (CART-Q). They then participated in an online education session about female hormonal cycles and athletic performance before participating in semi-structured focus-group interviews. Thematic analyses revealed three main barriers to communication: knowledge, interpersonal, and structural. In addition, the results suggested that a good coach-athlete relationship may facilitate open communication about female hormonal cycles, while low levels of knowledge may hinder communication. To overcome the perceived barriers to communication, a model is proposed to improve knowledge, develop interpersonal relationships and strengthen structural systems through educational exchanges and forums for open discussion.
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Affiliation(s)
- Martina Höök
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, 831 25 Östersund, Sweden; (M.H.); (M.B.)
- Swedish Ski Association, 791 31 Falun, Sweden
| | - Max Bergström
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, 831 25 Östersund, Sweden; (M.H.); (M.B.)
| | - Stig Arve Sæther
- Department of Sociology and Political Science, Norwegian University of Science and Technology, NTNU, Dragvoll, 7491 Trondheim, Norway;
| | - Kerry McGawley
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, 831 25 Östersund, Sweden; (M.H.); (M.B.)
- Correspondence:
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31
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Barrington DJ, Robinson HJ, Wilson E, Hennegan J. Experiences of menstruation in high income countries: A systematic review, qualitative evidence synthesis and comparison to low- and middle-income countries. PLoS One 2021; 16:e0255001. [PMID: 34288971 PMCID: PMC8294489 DOI: 10.1371/journal.pone.0255001] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/07/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND There is growing recognition of the importance of menstruation in achieving health, education, and gender equality for all. New policies in high income countries (HICs) have responded to anecdotal evidence that many struggle to meet their menstrual health needs. Qualitative research has explored lived experiences of menstruating in HICs and can contribute to designing intervention approaches. To inform the growing policy attention to support people who menstruate, here we review and synthesise the existing research. METHODS AND FINDINGS Primary, qualitative studies capturing experiences of menstruation in HICs were eligible for inclusion. Systematic database and hand searching identified 11485 records. Following screening and quality appraisal using the EPPI-Centre checklist, 104 studies (120 publications) detailing the menstrual experiences of over 3800 individuals across sixteen countries were included. We used the integrated model of menstrual experiences developed from studies in low- and middle-income countries (LMICs) as a starting framework and deductively and inductively identified antecedents contributing to menstrual experiences; menstrual experiences themselves and impacts of menstrual experiences. Included studies described consistent themes and relationships that fit well with the LMIC integrated model, with modifications to themes and model pathways identified through our analysis. The socio-cultural context heavily shaped menstrual experiences, manifesting in strict behavioural expectations to conceal menstruation and limiting the provision of menstrual materials. Resource limitations contributed to negative experiences, where dissatisfaction with menstrual practices and management environments were expressed along with feelings of disgust if participants felt they failed to manage their menstruation in a discrete, hygienic way. Physical menstrual factors such as pain were commonly associated with negative experiences, with mixed experiences of healthcare reported. Across studies participants described negative impacts of their menstrual experience including increased mental burden and detrimental impacts on participation and personal relationships. Positive experiences were more rarely reported, although relationships between cis-women were sometimes strengthened by shared experiences of menstrual bleeding. Included studies reflected a broad range of disciplines and epistemologies. Many aimed to understand the constructed meanings of menstruation, but few were explicitly designed to inform policy or practice. Few studies focused on socioeconomically disadvantaged groups relevant to new policy efforts. CONCLUSIONS We developed an integrated model of menstrual experience in HICs which can be used to inform research, policy and practice decisions by emphasising the pathways through which positive and negative menstrual experiences manifest. REVIEW PROTOCOL REGISTRATION The review protocol registration is PROSPERO: CRD42019157618.
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Affiliation(s)
- Dani Jennifer Barrington
- School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
- School of Civil Engineering, University of Leeds, Leeds, West Yorkshire, United Kingdom
| | - Hannah Jayne Robinson
- School of Civil Engineering, University of Leeds, Leeds, West Yorkshire, United Kingdom
| | - Emily Wilson
- Irise International, Sheffield, South Yorkshire, United Kingdom
| | - Julie Hennegan
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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32
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Casola AR, Kunes B, Jefferson K, Riley AH. Menstrual Health Stigma in the United States: Communication Complexities and Implications for Theory and Practice. J Midwifery Womens Health 2021; 66:725-728. [PMID: 33619886 DOI: 10.1111/jmwh.13216] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 12/29/2020] [Accepted: 01/11/2021] [Indexed: 12/30/2022]
Affiliation(s)
- Allison R Casola
- Department of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Brianna Kunes
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Karen Jefferson
- Midwifery and Women's Health Programs, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Amy Henderson Riley
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, Pennsylvania
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33
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Schmitt ML, Hagstrom C, Nowara A, Gruer C, Adenu-Mensah NE, Keeley K, Sommer M. The intersection of menstruation, school and family: Experiences of girls growing up in urban cities in the U.S.A. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2021. [DOI: 10.1080/02673843.2020.1867207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Margaret L. Schmitt
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Christine Hagstrom
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Azure Nowara
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Caitlin Gruer
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Nana Ekua Adenu-Mensah
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Katie Keeley
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, United States
| | - Marni Sommer
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
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34
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Secor-Turner M, Huseth-Zosel A, Ostlund R. Menstruation Experiences of Middle and High School Students in the Midwest: A Pilot Study. J Sch Nurs 2020; 38:504-510. [PMID: 33207994 DOI: 10.1177/1059840520974234] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The purpose of this pilot study was to expand understanding of the experience of menstruation for girls in the United States and its impact in the school setting. A qualitative approach was used to gather data from focus group interviews. Descriptive content analysis was used to categorize the range and types of menstruation experiences described by 12 participants aged 12-16 years. Findings revealed four main themes: (1) learning about menstruation, (2) experiencing menstruation, (3) managing menstruation, and (4) social norms and meaning of menstruation. Participants described multiple challenges faced learning about and experiencing menstruation, especially in the school setting. Participants described the limited understanding of menstruation experiences and confusion about the use of menstrual hygiene products. Challenges experienced at school included not having adequate access to menstrual hygiene products, limited time for changing products, fear of leaking menstrual blood, and impacts on school attendance. School nurses are well-positioned to contribute to creating school environments that are supportive of menstruation.
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Affiliation(s)
| | | | - Rachel Ostlund
- School of Nursing, North Dakota State University, Fargo, ND, USA
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