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Camas-Castillo MA, Gallardo-Alvarado N, Yánez-Sánchez P, Makuch MY, Osis MJD, Bahamondes L. Menstrual health: Inequities in a cohort of menstruating people in the Brazilian southeastern region. Int J Gynaecol Obstet 2024; 164:1160-1166. [PMID: 37922242 DOI: 10.1002/ijgo.15223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/08/2023] [Accepted: 10/17/2023] [Indexed: 11/05/2023]
Abstract
OBJECTIVE To assess menstrual hygiene management (MHM) and period poverty in a group of low- and medium-income menstruating people. METHODS A cross-sectional study was conducted at the University of Campinas, Brazil, from January to June 2022 with 535 participants aged 18-49. For data collection, we used the abbreviated version of the WHO Quality-of-Life questionnaire (WHOQOL-BREF) and a pre-tested questionnaire with items regarding MHM and period poverty. RESULTS We found an inverse relationship between the risk of no access to supplies to perform menstrual hygiene, which increased by 2.5% and each point less in the environmental domain of quality of life (QoL), and this risk increased by up to 3.1 times among participants who reported difficulty making ends meet. The risk of not having adequate conditions to perform menstrual hygiene at home increased by up to 2.6% for every one-point drop in the environmental domain of QoL. The risk of not having adequate conditions to perform menstrual hygiene outside the home increased by up to 1.3% for less points in the psychological domain of QoL, and 44.4% of those who indicated inadequate conditions for menstrual hygiene reported two or more childbirths. CONCLUSIONS Menstruating people who have an increased risk of lacking menstrual supplies and have an increased risk of inadequate conditions for MHM at home and outside the home, as well as those who have two or more deliveries and those having difficulties making ends meet, scored low on the QoL, especially in the environmental and psychological dimensions.
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Affiliation(s)
- Miriam A Camas-Castillo
- Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Campinas, SP, Brazil
| | - Negli Gallardo-Alvarado
- Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Campinas, SP, Brazil
| | - Paula Yánez-Sánchez
- Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Campinas, SP, Brazil
| | - María Y Makuch
- Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Campinas, SP, Brazil
- Campinas Center of Research in Reproductive Health (Cemicamp), Campinas, SP, Brazil
| | - María J D Osis
- Campinas Center of Research in Reproductive Health (Cemicamp), Campinas, SP, Brazil
- Department of Public Health, Faculty of Medicine of Jundiai, Jundiai, SP, Brazil
| | - Luis Bahamondes
- Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Campinas, SP, Brazil
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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. Womens Health (Lond) 2024; 20:17455057241251975. [PMID: 38738597 DOI: 10.1177/17455057241251975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [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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Sacca L, Markham CM, Gupta J, Peskin M. Corrigendum: Editorial: Period poverty. Front Reprod Health 2023; 5:1308137. [PMID: 38053786 PMCID: PMC10694433 DOI: 10.3389/frph.2023.1308137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/03/2023] [Indexed: 12/07/2023] Open
Abstract
[This corrects the article DOI: 10.3389/frph.2023.1140981.].
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Affiliation(s)
- Lea Sacca
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States
| | - Christine Margaret Markham
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Jhumka Gupta
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, VA, United States
| | - Melissa Peskin
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
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Darivemula S, Knittel A, Flowers L, Moore S, Hall B, Kelecha H, Li X, Ramaswamy M, Kelly PJ. Menstrual Equity in the Criminal Legal System. J Womens Health (Larchmt) 2023; 32:927-931. [PMID: 37535828 PMCID: PMC10510683 DOI: 10.1089/jwh.2023.0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 06/06/2023] [Indexed: 08/05/2023] Open
Abstract
Background: Menstrual equity, that is, access to menstrual products and safe menstruating environments, is a basic human right not available to many vulnerable populations. Methods: We conducted a cross-sectional survey with a convenience sample of women involved in the criminal legal system to document experiences with access to hygiene and menstrual products while incarcerated. Results: Of the 156 respondents, 62.6% had to trade or barter to receive even basic hygiene products such as soap or shampoo; food and personal favors were used as the common currency. More than half (53.8%) received less than five menstrual products at intake/initial processing; 29.5% had to trade or barter menstrual hygiene products. Almost one-quarter (23.1%) suffered negative health consequences from prolonged use of products because of limited supply. Discussion: Findings document the lack of menstrual equity among women involved in the criminal legal system. Assuring the human right of menstrual equity in this population requires changes at the legal, the policy, the institutional, and the individual level.
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Affiliation(s)
- Shilpa Darivemula
- University of North Carolina School of Medicine, Department of Obstetrics and Gynecology, Chapel Hill, North Carolina, USA
| | - Andrea Knittel
- University of North Carolina School of Medicine, Department of Obstetrics and Gynecology, Chapel Hill, North Carolina, USA
| | - Lisa Flowers
- Emory University School of Medicine, Department of Obstetrics and Gynecology, Atlanta, Georgia, USA
| | - Shawana Moore
- Emory University School of Nursing, Doctor of Nursing Practice Program, Atlanta, Georgia, USA
| | - Bianca Hall
- Montefiore Medical Center and Albert Einstein College of Medicine, Department of Obstetrics and Gynecology and Women's Health, New York, New York, USA
| | - Hebron Kelecha
- Northwestern University School of Medicine, Department of Obstetrics and Gynecology, Evanston, Illinois, USA
| | - Xinyang Li
- University of Kansas Medical Center, Department of Sociology, Kansas City, Kansas, USA
| | - Megha Ramaswamy
- University of Kansas Medical Center, Department of Sociology, Kansas City, Kansas, USA
| | - Patricia J. Kelly
- Thomas Jefferson University School of Nursing, Department of Research Development, Philadelphia, Pennsylvania, USA
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Casola AR, Luber K, Riley AH. Period Poverty: an Epidemiologic and Biopsychosocial Analysis. Health Promot Pract 2023:15248399231192998. [PMID: 37605547 DOI: 10.1177/15248399231192998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
In the United States, approximately one in five persons experience period poverty, defined as the inability to obtain resources needed for healthy, safe, and dignified menstrual management. Limited access to an inadequate number of menstrual supplies may lead to longer-than-recommended use, which can increase skin chafing, disruption of vaginal flora, and intravaginal toxin overgrowth. However, period poverty goes beyond simply having enough menstrual products and can encompass the embarrassment, stigma, shame, and barriers in conversation surrounding menstruation. Discussion and critical examination of the multilayered attributes surrounding period poverty have been intermittent in academic literature, particularly from a domestic lens. Thus, this narrative review and theoretical analysis aimed to describe the epidemiology of period poverty and analyze its biological, socio-emotional, and societal implications. We applied a descriptive epidemiology approach of person, place, and time, and employed a social-ecological lens to examine risk factors. Our findings describe the incidence, distribution, and possible ways to alleviate period poverty. Practitioners, medical providers, and public health professionals may have limited knowledge of period poverty, what it entails, and who it impacts, but they have great potential to address it and associated menstrual inequities in their work. With its widespread implications for psychosocial and community-level health, this phenomenon needs urgent attention to promote menstrual equity as an issue of human rights and social justice. We conclude with research and policy recommendations for alleviating period poverty.
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Affiliation(s)
| | - Kierstin Luber
- Thomas Jefferson University, Philadelphia, PA, USA
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
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Affiliation(s)
- Lea Sacca
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States
| | - Christine Margaret Markham
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Jhumka Gupta
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, VA, United States
| | - Melissa Peskin
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
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Holst AS, Jacques-Aviñó C, Berenguera A, Martínez-Bueno C, Munrós-Feliu J, Pinzón-Sanabria D, Valls-Llobet C, López-Jiménez T, García-Egea A, Vicente-Hernández MM, Medina-Perucha L. Menstrual health and management during the COVID-19 syndemic in the Barcelona area (Spain): A qualitative study. Womens Health (Lond) 2023; 19:17455057231166644. [PMID: 37092568 PMCID: PMC10126749 DOI: 10.1177/17455057231166644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND Available evidence suggests that menstrual health and management have been impaired during the COVID-19 syndemic. However, research in this area is scarce, and it is failing to voice the experiences of women and people who menstruate regarding their menstrual experiences. OBJECTIVES This study aimed to explore the experiences of menstrual health and menstrual management among women and people who menstruate in the Barcelona area (Spain) during the COVID-19 syndemic. DESIGN This is a qualitative study, conducted taking a critical feminist approach, is embedded in the 'Equity and Menstrual Health in Spain' project. METHODS It includes photo-elicitation individual interviews with 34 women and people who menstruate in the area of Barcelona (Spain). Data were collected in person and through telephone calls between December 2020 and February 2021. Analyses were performed using Thematic Analysis. RESULTS Main findings navigated through the menstrual changes experienced by some participants, especially women living with long COVID-19, and the barriers to access healthcare and menstrual products during COVID-19. While some participants experienced menstrual poverty, this did not appear to be exacerbated during COVID-19. Instead, access to menstrual products was compromised based on products' availability and mobility restrictions. Menstrual management and self-care were generally easier, given that menstrual experiences were almost exclusively relegated to private spaces during lockdown periods. CONCLUSIONS Our findings highlight the need to further research and policy efforts towards promoting menstrual health and equity, considering social determinants of health, and taking intersectional and gender-based approaches. These strategies should be further encouraged in social and health crises such as the COVID-19 syndemic.
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Affiliation(s)
- Anna Sofie Holst
- Fundació Institut Universitari per a la Recerca a L'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Constanza Jacques-Aviñó
- Fundació Institut Universitari per a la Recerca a L'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Anna Berenguera
- Fundació Institut Universitari per a la Recerca a L'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
- Departament d'Infermeria, Universitat de Girona, Girona, Spain
| | - Cristina Martínez-Bueno
- Servei d'Atenció a la Salut Sexual i Reproductiva (ASSIR), Direcció Assistencial d'Atenció Primària, Institut Català de la Salut, Barcelona, Spain
- Sexual and Reproductive Health Care Research Group (GRASSIR), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - Jordina Munrós-Feliu
- Sexual and Reproductive Health Care Research Group (GRASSIR), Barcelona, Spain
- Atenció a la Salut Sexual i Reproductiva (ASSIR) Muntanya/La Mina, Institut Català de la Salut, Barcelona Spain
| | | | | | - Tomàs López-Jiménez
- Fundació Institut Universitari per a la Recerca a L'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Andrea García-Egea
- Fundació Institut Universitari per a la Recerca a L'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | | | - Laura Medina-Perucha
- Fundació Institut Universitari per a la Recerca a L'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
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Lane B, Perez-Brumer A, Parker R, Sprong A, Sommer M. Improving menstrual equity in the USA: perspectives from trans and non-binary people assigned female at birth and health care providers. Cult Health Sex 2022; 24:1408-1422. [PMID: 34365908 PMCID: PMC9912750 DOI: 10.1080/13691058.2021.1957151] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 07/14/2021] [Indexed: 06/13/2023]
Abstract
Menstruation research has largely focused on addressing menstrual management barriers facing cisgender women and girls in low and middle-income countries. Scant literature has assessed the menstrual management needs of trans and non-binary people assigned female at birth. To better understand these frequently invisibilised menstruation-related needs, we conducted a multi-method qualitative study in New York City which included: 17 in-depth interviews across trans and non-binary people (n = 10) and health care providers who serve them (n = 7); and seven anonymous post-interview participatory writing responses with trans and non-binary participants to further elucidate their lived experiences with menstrual management. Lack of health care provider transgender competency, public toilet design (i.e. gaps in cubicle doors and lack of in-cubicle menstrual product disposal bins), and the social dynamics of public toilets (i.e. work and school) were identified as significant barriers to managing menstruation safely and accessibly for trans and non-binary people. These findings have important implications for healthcare policy, public toilet legislation and advancing menstrual equity in the USA.
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Affiliation(s)
- Benjamin Lane
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Amaya Perez-Brumer
- Division of Social and Behavioural Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Richard Parker
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
- Institute for the Study of Collective Health, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Brazilian Interdisciplinary AIDS Association, ABIA, Rio de Janeiro, Brazil
| | - Amelia Sprong
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Marni Sommer
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
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