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Rodríguez-Camacho MF, Sanchís-Ramón MJ, Ortiz-Barreda G, La Parra-Casado D, Gil-González D. Menarche and reproductive health in Spanish Roma women from a reproductive justice perspective: a qualitative study. Reprod Health 2024; 21:17. [PMID: 38308316 PMCID: PMC10837920 DOI: 10.1186/s12978-023-01726-5] [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: 02/27/2023] [Accepted: 12/13/2023] [Indexed: 02/04/2024] Open
Abstract
OBJECTIVES This study aimed to explore the perceptions of Roma women about their experience of menarche and reproductive health considering the principles of reproductive justice. DESIGN Qualitative study based on semi-structured interviews with Roma women ages 18 through 67 in different neighborhoods in the southeast of Spain. Using a thematic analysis, we analyzed experiences related to menarche and menstruation and their significance for reproductive health, the preparation for the phase of menarche and intergenerational support. RESULTS The Roma women interviewed shared their approach to the experiences of menarche and menstruation as children in their family environments with a focus on access to information provided by other women in the family and community for reproductive health management. In their discourses we observed that the onset of menstruation supposes a rupture in the public and private spaces of girls and women. CONCLUSIONS The results of this study suggest that women and girls do not gain access to information that contributes to their reproductive wellbeing through their experience of menarche. Access to resources and skills to manage biological changes in adolescents could contribute to reducing the impact of cultural myths, false ideas and taboos that prevent advocacy and empowerment on issues of reproductive justice.
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Affiliation(s)
- María Félix Rodríguez-Camacho
- Autonomous Federation of Roma Associations of Alicante, FAGA, Alicante, Spain.
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain.
| | | | - Gaby Ortiz-Barreda
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | | | - Diana Gil-González
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
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Munro CB, Walker EN, Schembri R, Moussaoui D, Grover SR. Periods Shouldn't Bring Any Adolescents' World to a Full Stop. Period. An Online Survey of Adolescents' Experience of Menstruation. J Pediatr Adolesc Gynecol 2024; 37:18-24. [PMID: 37722525 DOI: 10.1016/j.jpag.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 09/20/2023]
Abstract
STUDY OBJECTIVE Few studies have explored what specific outcome measures contained in assessment tools for period and pelvic pain are most relevant to adolescents. Co-design is a valuable method of ensuring input from those with lived experience. The Longitudinal Study of Teenagers with Endometriosis Periods and Pelvic Pain in Australia (LongSTEPPP) Co-Design Periods Survey comprised an anonymous online survey of adolescents' experience of menstruation to inform patient-reported outcome measures for the larger 5-year project. METHODS Adolescents aged 12-18 years whose periods had commenced at least 3 months previously and with demonstrated capacity to consent were invited to participate in an online survey. Recruitment was primarily via social media channels. RESULTS Of the 1811 adolescents who participated, 85% reported that periods had a "moderate" or greater impact on their life. Pain (90.7%), heavy flow (56.2%), and worry about leakage (49%) were common reasons for missed activities. Menstrual symptoms were wide-ranging and included cramping, nausea, poor energy, and impacts on mood. When asked where adolescents sought assistance with their periods, 39.8% had seen their general practitioner, 21.3% their school nurse, and almost 1 in 10 had consulted a mental health practitioner (9.3%). To manage menstrual symptoms, heat packs (66.0%), over-the-counter medications (55.8%), and prescription medications (28.6%) were used. CONCLUSION We found a lack of menstrual health awareness in adolescents. Periods had a significant effect on their lives, and adolescents commonly missed activities. In managing menstruation, a wide range of practitioners were consulted. Nearly a third were prescribed medication to manage their periods. These findings have directed the longitudinal study as to how best to capture outcome measures that reflect the impact of periods on adolescents.
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Affiliation(s)
- Courtney B Munro
- Department of Pediatric and Adolescent Gynecology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Emma N Walker
- Department of Neurology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
| | - Rachel Schembri
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Dehlia Moussaoui
- Department of Pediatric and Adolescent Gynecology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Sonia R Grover
- Department of Pediatric and Adolescent Gynecology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
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Mwalabu G, Mbewe S, Namathanga A, Masese R, Kabondo C, Katuya L, Petrucka P, Mapulanga P. Perspectives on prior preparation for menstrual experience from women and female health workers in Malawi. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241286245. [PMID: 39328123 PMCID: PMC11450560 DOI: 10.1177/17455057241286245] [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: 08/20/2023] [Revised: 08/23/2024] [Accepted: 09/04/2024] [Indexed: 09/28/2024]
Abstract
BACKGROUND While studies have explored various aspects of menstruation, an evident gap remains in the literature concerning the perspectives of young women and female health workers. By shedding light on this unexplored terrain, the study provides novel insights that can inform targeted interventions and foster a more inclusive understanding of menstrual health. As such, this investigation stands at the forefront of academic endeavour in menstrual health research, making an original and valuable impact in the field. OBJECTIVES The objective of this study was to explore the experiences of reproductive-aged women during menstruation in Malawi. The specific objectives were to examine the experiences of reproductive-age women related to menstrual preparation, identify factors influencing the choice of menstrual products for women in Malawi, and identify the public health implications of menstrual products. DESIGN This cross-sectional study employed qualitative research methods to explore the acceptance and implementation of menstrual cups as a feminine hygienic product for women in Malawi. METHODS The study involved focus group discussions and interviews with reproductive-age women aged 18-54 years and health providers at Bwaila and Mitundu family clinics and Lighthouse HIV management centres. Thematic content analysis was performed using NVivo 12. Ethical approval was obtained from the College of Medicine Research and Ethics Committee (P.08/21/3379). RESULTS Education on menstruation is provided as early as 10 years before menarche by sisters, friends, mothers, aunties and grandmothers. Parents remain silent on menstrual issues. Commonly used menstrual products include disposable pads, cloths, reusable pads and cotton wool. While a few mentioned using tampons, pieces of blankets and flex foam, the majority demonstrated widespread ignorance about menstrual cups. Mentors or counsellors, affordability, accessibility, comfort and disposal issues influence women's choice of products being used. CONCLUSION Parents need to break the silence on menstrual issues. Messages on menstruation and menstrual products are explicit in forming female adolescents what to expect with menarche, how to manage menses including health-related impacts, and ways of mitigating menses-related misconceptions, discrimination and stigma, and could be incorporated into the primary school curriculum. Safe menstrual products are accessible free of charge or at a subsidised cost.
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Affiliation(s)
- Gertrude Mwalabu
- Department of Adult Health Nursing, School of Nursing, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | | | - Annie Namathanga
- Department of Adult Health Nursing, School of Nursing, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - Rodney Masese
- Department of Community Health Nursing, School of Nursing, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - Charity Kabondo
- Department of Maternal and Child Health Nursing, School of Nursing, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | | | - Pammla Petrucka
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Patrick Mapulanga
- Library Department, Kamuzu University of Health Sciences, Lilongwe, Malawi
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Hennegan J, Caruso BA, Zulaika G, Torondel B, Haver J, Phillips-Howard PA, Valdez J, Gruer C, Okwaro N, Mahon T, Sommer M. Indicators for National and Global Monitoring of Girls' Menstrual Health and Hygiene: Development of a Priority Shortlist. J Adolesc Health 2023; 73:992-1001. [PMID: 37737755 PMCID: PMC10654045 DOI: 10.1016/j.jadohealth.2023.07.017] [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: 02/26/2023] [Revised: 06/28/2023] [Accepted: 07/07/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE Despite the importance of menstrual health and hygiene (MHH) for adolescent girls' health, education, and gender equality, few countries monitor MHH. MHH needs remain underprioritized, and progress achieved through policies, programs, or investments go unmeasured. This article reports the systematic development of an indicator shortlist to monitor adolescent girls' MHH at the national and global levels across low- and middle-income countries. METHODS A core group of MHH researchers and practitioners collaborated with stakeholders from three countries with demonstrated commitment to monitoring MHH (Bangladesh, Kenya, and the Philippines), measures experts, and a global advisory group. The approach included the following: (1) define domains for monitoring MHH; (2) review and map existing indicators and measures; (3) iteratively shortlist indicators through appraising quality, feasibility, and stakeholder input; and (4) refine the shortlist and develop guidance for use. RESULTS The shortlist comprises 21 indicators across seven domains covering menstrual materials, water, sanitation, and hygiene facilities, knowledge, discomforts and disorders, supportive social environments, menstrual health impacts, and policies. Indicators are accompanied by measures that have been tested or are expected to provide reliable data, alongside justification for their selection and guidance for use. DISCUSSION The shortlisted indicators reflect the multisectoral collaboration necessary for ensuring girls' MHH. Uptake requires integration into monitoring systems at national and global levels. Future work remains to evaluate the performance of the indicators over time and to support their widespread use. Governments and stakeholders can use these indicators to track the progress of programs and policies, monitor unmet MHH needs, identify disparities, and set targets for improvement.
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Affiliation(s)
- 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
| | - Bethany A Caruso
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Garazi Zulaika
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Belen Torondel
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jacquelyn Haver
- Department of Education and Child Protection, School Health and Nutrition Program, Save the Children US, Washington, D.C
| | | | - Jonathan Valdez
- Department of Education and Child Protection, School Health and Nutrition Program, Save the Children US, Washington, D.C
| | - Caitlin Gruer
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | | | - Therese Mahon
- International Programmes Department, WaterAid, London, United Kingdom
| | - Marni Sommer
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York.
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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: 4] [Impact Index Per Article: 4.0] [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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Hassan S, Ghandour R, Bakri L, Shwiki S, Safi S, Abuzaid R, Zeidan H. Menstrual health and hygiene among young Palestinian female university students in the West Bank: a cross-sectional study. BMJ Open 2023; 13:e069222. [PMID: 36997246 PMCID: PMC10069603 DOI: 10.1136/bmjopen-2022-069222] [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] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE We investigated some aspects of menstrual health and hygiene among young female students at Birzeit University in the West Bank of the occupied Palestinian territory. DESIGN Cross-sectional study in a large central university. PARTICIPANTS Out of a total of 8473 eligible female students, a calculated sample size of 400 students aged between 16 and 27 years was obtained.SettingLarge central university, West Bank, occupied Palestinian territory (oPt). MEASURES An anonymous structured international research instrument consisting of 39 questions based on the Menstrual Health Questionnaire, in addition to few questions relevant to the context, was administered. RESULTS 30.5% of participants were not informed about menstruation before menarche, and 65.3% reported that they were not ready when they got their first period. The highest reported source of information regarding menstruation was family (74.1%), followed by school (69.3%). About 66% of respondents reported that they need more information on various topics of menstruation. The most common type of menstrual hygiene products used were single-use pads (86%), followed by toilet paper (13%), nappies (10%) and reusable cloths (6%). Of the total 400 students, 14.5% reported that menstrual hygiene products are expensive, and 15.3% reported that they always/sometimes had to use menstrual products that they do not like because they are cheaper. Most (71.9%) of the respondents reported that they used menstrual products for longer time than recommended due to inadequate washing facilities at the university campus. CONCLUSIONS The findings provide useful evidence on the lack and the need for menstrual-related information for female university students, inadequate infrastructure to help them manage their menstruation with dignity and pointed to some menstrual poverty in accessing menstrual products. A national intervention programme is needed to increase awareness regarding menstrual health and hygiene among women in local communities and female teachers in schools and universities to enable them to disseminate information to and meet the practical needs of girls at home, at school and at the university.
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Affiliation(s)
- Sahar Hassan
- Department of Nursing, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine, State of
| | - Rula Ghandour
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine, State of
| | - Lamia Bakri
- Department of Nursing, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine, State of
| | - Siham Shwiki
- Department of Nursing, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine, State of
| | - Sara Safi
- Department of Nursing, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine, State of
| | - Reem Abuzaid
- Department of Nursing, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine, State of
| | - Hiba Zeidan
- Department of Nursing, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine, State of
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