Comparison of body image and peer relations among girls with normal, early, and late menarche

BACKGROUND

The onset of menstruation is a turning point in women's sexual maturity that, unlike other stages of growth, occurs abruptly and is a critical stage in girls' lives. The present study investigated body image and peer relations among girls with early, late, and normal menarche.

MATERIALS AND METHODS

This casual-comparative descriptive study included female students aged 9-17 in Isfahan. The participants were selected using multistage cluster random sampling. Out of 5,984 students, 56, 37, and 43 were selected for the normal, early, and late menarche groups. The Body Image Concern Inventory and Index of Peer Relations were the two tools used in this study. Moreover, the data were analyzed using a covariance statistical test.

RESULTS

Girls with early menarche had better peer relations than those with late menarche (P = 0.01). In addition, there was a significant difference between adolescents with normal and late menarche in terms of body image (P = 0.01). Girls who experienced late menarche were more concerned about their body image and appearance; however, girls with early menarche experienced more impaired performance (P = 0.05).

CONCLUSION

The first menstrual cycle, or menarche, affects psychological variables such as body image and peer relations. The later the menarche, the fewer problems in regard to body image and peer relations.

Symptoms experiences and attitudes towards menstruation among adolescent girls

The study aimed to analyse the factors affecting menstrual symptoms and attitudes among adolescent girls and the relationship between them. The sample of the cross-sectional, descriptive and analytical research was composed of 604 adolescent girls studying at a university. Individual Information Form, Menstruation Symptom Questionnaire (MSQ) and Menstrual Attitude Questionnaire (MAQ) were used as data collection tool in the research. Average age of the students was 21.22 ± 1.71, and average menstrual cycle length was 29.3 ± 7.85 days. MSQ mean score was 69.84 ± 15.48 and MAQ mean score was 103.10 ± 9.84. These results are important for showing that students perceive menstruation as a natural phenomenon, despite significant menstrual symptoms.Impact statementWhat is already known on this subject? The intensity of menstrual symptoms is associated with negative menstrual attitudes. But, there have been few studies on the relationship between menstruation symptoms and attitudes and their impact on menstrual problems in Turkish adolescents.What the results of this study add? Adolescents' menstrual complaints are common, but their attitudes towards menstruation are positive. The lack of a significant relationship between menstrual symptoms and attitudes were more likely to be explained by the fact that young girls perceive menstruation as a natural phenomenon even though they have so many symptoms.What the implications are of these findings for clinical practice and/or further research? Further study should be extended to various cultures and destinations to understand the effect of culture on menstruation that rural areas may be surrounded by taboos and myths which might affect the negative attitude.

Training female adolescent students with intellectual disabilities about genital hygiene skills using peer training

PURPOSE

The study aimed to evaluate the effects of peer training of female adolescent students diagnosed with intellectual disabilities and started menses, about genital hygiene and menstrual care skills on a baby doll.

METHODS

This study was planned as a non-control group research design including pre-test, post-test and follow-up stages. It was conducted in special educational institutions. The population consisted of 68 female students between 10-18 years old. Calculation of sample size was not performed, and 65 students were included in the study. The data were collected using Socio-Demographic Form, Genital Cleansing Skill Form (GCSF), Pad Replacement Skill Analysis Form (PRSAF), and Teacher/Parent Opinion and Feedback Form. The statistical analysis of the study data was performed using Mc-Nemar test, Mann-Whitney U test, Kruskal-Wallis test and Friedman test followed by Dunn-Bonferroni post-hoc test.

RESULTS

In all follow-up periods, GCSF and PRSAF scores compared by Mann-Whitney U and Kruskal-Wallis tests did not change based upon demographic characteristics (p > 0.05). Friedman test showed that GCSF and PRSAF scores showed significant differences between the follow-up periods (p < 0.001). According to Dunn-Bonferroni post-hoc test, there was no statistically significant difference between 2nd and 3rd follow-up scores with respect to both GCSF and PRSAF (p > 0.05). However, 2nd and 3rd follow-up scores were found to be significantly higher than 1st follow-up score (p < 0.05).

CONCLUSION

The study demonstrated that menstrual care skills of female adolescent students with intellectual disabilities improved after training and peer training was found to be effective. Peer training can be useful when used as continuing training to help individuals achieving a higher criterion of mastery.

Menarche and Menstruation in Rural Adolescent Girls in Maharashtra, India

Background:

Menarche and menstrual experiences play a critical role in adolescent girls’ life. These not only significantly influence their sexual and reproductive health but also possess much social and educational impact. This study qualitatively explores the perceptions, practices and experiences related to menarche and menstruation among rural Indian adolescent girls which has been less studied in the past literature.

Methods:

A convenience sampling method was used to select 32 adolescent girls (eight girls who did not reach menarche and 24 girls who attained menarche) from rural Maharashtra in India. Information about the perceptions, practices and experiences of menarche and menstruation among the participants was obtained through focus group discussions and was analyzed using thematic analysis.

Findings:

Most of the participants, especially girls without menarche lacked adequate knowledge about menstruation and its processes. All communications regarding menstruation were between friends, whereas mothers were found to be playing a limited role. Some of the girls were using sanitary pads, while most girls still use old cloths. Financial concerns and difficulty in obtaining sanitary pads were major obstructions for their use. Lack of awareness and appropriate care for menstrual morbidities were reported among these girls, which put impact on their educational attainment.

Conclusions:

Suitable strategy needs to be developed for providing correct knowledge about menstruation among adolescent girls, such as inclusion of adolescent friendly services in school curriculum and training of mothers and teachers to provide friendly counselling to the girls. Further, menstrual pad vending machines could be installed in schools and colleges, for easy access of sanitary pads at subsidized rate. Special care and support during menstruation can prevent several adverse events from occurring in adolescent girls’ lives.

A cross-sectional study of the beliefs and attitudes towards menstruation of Chinese undergraduate males and females in Hong Kong

AIMS AND OBJECTIVES

To explore the beliefs and attitudes towards menstruation of Chinese undergraduates in Hong Kong and to compare those of (1) male and female undergraduates with those of (2) undergraduates studying health-related vs. nonhealth-related programmes.

BACKGROUND

Menstruation is typically viewed as a forbidden topic or a troublesome experience. These negative beliefs and attitudes result from existing myths and taboos associated with cultural factors and health education levels.

DESIGN

A cross-sectional survey was conducted in all universities in Hong Kong. Undergraduates were invited through convenience sampling to complete a questionnaire assessing their attitudes and beliefs towards menstruation.

METHODS

A questionnaire on 'beliefs about and attitudes towards menstruation' was adopted. Questionnaires were self-administered by the respondents.

RESULTS

A total of 450 questionnaires were distributed, and a response rate of 96.6% was obtained; 416 completed questionnaires were collected and analysed. Many Chinese undergraduates agreed that menstruation is annoying, causes disability, involves prescription and proscription and is not pleasant. When comparing the beliefs and attitudes towards menstruation of Chinese male undergraduates with those of female undergraduates, females tended to disagree that menstruation should be maintained secret, but tended to agree that it was annoying. When comparing the beliefs and attitudes towards menstruation of Chinese undergraduates studying health-related programmes with those under nonhealth-related programmes, the latter group exhibited a higher level of belief in prescription and proscription for menstruation than the former group.

CONCLUSION

Chinese undergraduates in Hong Kong were influenced by the traditional Chinese culture and social environment, resulting in negative attitudes towards menstruation. This study recommends that sex education, especially reproductive health education, be extended to tertiary education.

RELEVANCE TO CLINICAL PRACTICE

This study provides relevant information on planning the content of sex education or reproductive health education for Chinese undergraduates.

Cultural practices relating to menarche and menstruation among adolescent girls in Taiwan--qualitative investigation

STUDY OBJECTIVE

The aim of this study was to qualitatively record the cultural attitudes and practices associated with menarche and menstruation in Taiwanese girls, particularly with respect to coping mechanisms.

PARTICIPANTS

Forty-eight adolescent girls participated.

INTERVENTION

Adolescent girls were individually interviewed to investigate the effects of their cultural practices, coping mechanisms, and physiological symptoms during menarche and menstruation.

MAIN OUTCOME MEASURE(S)

The qualitative investigation revealed mixed reactions to menstruation, such as eating chocolate, using sanitary napkins, and feeling irritable or embarrassed. Cluster construction suggested that adolescents were prepared for menarche but required emotional support; in addition, the new generation employed the Internet to learn how to cope.

RESULTS

A phenomenological approach showed that menarche and menstrual attitudes among Taiwanese adolescents were comprised in 4 dimensions: self-perception, information, and cultural practices with regard to menarche; physiological symptoms and psychological reactions during menstruation; coping mechanisms during menarche and menstruation; and methods for coping and cultural practices for menstruation. Cultural beliefs and the Internet have changed cross-cultural contacts.

CONCLUSIONS

Educators and health professionals should seek to understand this generation of girls, who perceive the world as more flexible and available and have more creativity and new eating behaviors and hobbies.

Pubescent male students' attitudes towards menstruation in Taiwan: implications for reproductive health education and school nursing practice

AIM

To explore male students' attitudes towards menstruation.

BACKGROUND

Menstruation is a biological event that is often surrounded by secrecy and social stigma that causes anxiety amongst many young girls. A key element of this is the attitudes of young males towards this reproductive health issue. However, the literature around what young males think and feel about menstruation is limited.

DESIGN

Qualitative.

METHODS

A sample of 27 male students aged between 10-12 years participated in five focus groups. Data were then subject to a thematic analysis.

RESULTS

Five themes emerged from the data analysis that reflected the boys' feelings, experiences and attitudes towards menstruation: 'A silent topic', 'An unimportant issue', 'Errant information about menstruation'. In addition, according to their experience, participants gradually came to see menstruation from the 'menstrual stereotype' viewpoint. In their social life, they made choices that resulted in gradually regulating their behaviour that affected their 'relationships with girls'.

CONCLUSION

Young boys have misguided knowledge about menstruation and this helps to perpetuate the stigma surrounding this element of reproductive health. Boys also express a desire to learn more but are often restricted in this by home and school. School nurses are the best placed professionals to address this issue.

RELEVANCE TO CLINICAL PRACTICE

Menstrual education with boys should take a greater prominence than it often does in sexual health education in schools. Such inclusion will provide boys with a balanced and accurate knowledge base and therefore help towards reducing the social stigma around menstruation that is often experienced by young girls.

Sex during menstruation: Race, sexual identity, and women’s accounts of pleasure and disgust

While much research has addressed negativity surrounding women’s menstruation, surprisingly little research has interrogated the relationship between menstruation and sexuality. This study used inductive thematic analysis of qualitative interviews with 40 women across a range of age, race and sexual orientation backgrounds to examine women’s experiences with sex during menstruation. Results showed that, while 25 women described negative reactions — and two described neutral reactions — 13 women described positive reactions to menstrual sex. Negative responses cohered around four themes: women’s discomfort and physical labor to clean ‘messes’, overt partner discomfort, negative self-perception and emotional labor to manage partner’s disgust. Positive responses cohered around two themes: physical and emotional pleasure from sex while menstruating, and rebellion against anti-menstrual attitudes. Notable race and sexual identity differences appeared, as white women and bisexual or lesbian-identified women described positive feelings about menstrual sex more than women of color or heterosexual women. Bisexual women with male partners described more positive reactions to menstrual sex than did heterosexual women with male partners, implying that heterosexual identity related to negative menstrual sex attitudes more than heterosexual behavior. Those with positive menstrual sex attitudes also enjoyed masturbation more than others. Implications for sexual identity and racial identity informing body practices, partner choice affecting women’s body affirmation, and women’s resistance against common cultural ideas about women’s bodies as ‘disgusting’ were addressed.

A systematic review and meta-ethnography of the qualitative literature: experiences of the menarche

AIM

This article is a report of a systematic review and meta-ethnography of women's experience of menarche.

BACKGROUND

Adolescents may experience menarche at different ages, but menarche remains an important milestone in the female maturation process, representing the transition from childhood to womanhood.

DESIGN

Systematic review and meta-ethnography.

METHODS

Electronic databases were systematically searched and supplemented with reference lists searching. Qualitative studies of women's experience of menarche were purposely selected and questions proposed by the critical appraisal skills programme was adapted and used to assess papers prior to synthesis. Key themes and concepts were extracted and synthesised using meta-ethnography.

RESULTS

Fourteen studies on menarche experience were identified. The majority of studies were descriptive. Five key concepts were identified from all 14 papers as being descriptive of women's experience of menarche. These included: menarche preparation, significant others' response to menarche, physical experience of menarche, psychological experience of menarche and social-cultural perspective of menarche.

CONCLUSIONS

Menarche experience had a major impact on women. Women went through physical, psychological and social-culture changes when their first menstrual flow came. Menarche preparation has been shown to have a beneficial impact on the menarcheal woman. School nurses have accurate knowledge about sexual health; they can and should provide appropriate menstrual education.

RELEVANCE TO CLINICAL PRACTICE

The findings can be used by school nurses working with adolescents as the basis for a framework of intervention strategies directed towards helping adolescents to better accept their menarche and transition into womanhood.

Menstrual-related attitudes and symptoms among multi-racial Asian adolescent females

BACKGROUND

Menstruation has important implications on the physical and emotional well-being of adolescents' reproductive health.

PURPOSE

This study aimed to investigate the perception towards menstruation and premenstrual syndrome (PMS), to provide insight into menstrual-related education information in order to help adolescent girls manage the physical and psychological changes associated with menstruation.

METHODS

This cross-sectional study included 1,092 adolescent females from 94 schools in the Federal Territory of Kuala Lumpur, Malaysia. A self-administered semi-structured questionnaire was used in the data collection.

RESULTS

The results showed the mean scores on the menstrual attitude questionnaire to be 2.80 (SD ±1.88) out of six. A total of 80.7% and 83.6% of the participants experienced one or more affective and somatic symptoms respectively in the premenstrual phase. Irritability, mood swing and tension were the three most frequently reported affective symptoms, while fatigue and menstrual cramps were highly prevalent somatic symptoms in both the premenstrual and menstrual phases. The effects on functional impairment and quality of life, in order of importance, include poor class concentration, restriction of social and recreational activities, difficulty to mingle with friends, and poor class performance. Despite the evident impact, only 10.3% of adolescent girls consulted doctors for PMS symptoms, while one-third did nothing about their condition. There were ethnic differences in the seeking of treatment for PMS.

CONCLUSION

The study calls for an education program related to PMS and menstrual-related disorders to provide information and support to adolescents. This will help them to cope better with menstrual-related problems, and encourage positive attitudes to menstruation.

Menstrual health care behavior and associated factors among female elementary students in the Hualien region

The purposes of this study were to measure menstrual knowledge, assess menstrual health care behavior and investigate the factors associated with menstrual health care behavior among fifth and sixth grade female students. The subjects were 417 female students from 12 elementary schools in the Hualien region of Taiwan. The stratified cluster random sampling method was adopted. The questionnaire used in the study consisted of three sections: personal information, a menstrual knowledge questionnaire, and a menstrual health care behavior questionnaire. The results of this study show that the majority of the respondents felt that menstruation had an influence on their emotions (74.8%), daily life (73.1%), schoolwork (61.6%), and social interaction (50.1%). The total correct response rate for the menstrual knowledge questionnaire was 45.1%. There was a significant difference between aboriginal and non-aboriginal female students in terms of the correct answer rate for the menstrual knowledge questionnaire. The mean score for menstrual health care behavior was 2.66 (SD = 0.82). Elementary level female students who had better menarche preparation scored higher on the menstrual knowledge questionnaire, and those whose first period had already occurred felt more confident in their ability to execute proper menstrual health care behavior. The results prompted the recommendation to families and elementary schools to encourage students to improve their menstrual health care behavior during menses.