Current patterns of menstrual health and hygiene among adolescent and young women of 15-24 years from rural northern India: a community based cross sectional study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20251967Keywords:
Dysmenorrhea, Menarche, Menorrhagia, Menstrual hygiene, Menstruation disturbances, OligomenorrheaAbstract
Background: Menstrual health has an impact on physical, mental and social well-being of young women. Young women in rural areas may face peculiar challenges related to menstrual health and hygiene management (MHHM). In view of evolving lifestyle and behavioural changes in transitional world, there is a need for latest community-based study among young women in rural India. Therefore, we aimed to estimate the magnitude of problems associated with MHHM, and to identify the factors associated with menstrual problems and menstrual hygiene.
Methods: House visits were made in the selected villages of Ballabgarh block of Haryana, and 483 non-pregnant women aged 15-24 years were interviewed regarding socio-demographic characteristics and menstrual history (on age of menarche, irregular menstrual bleeding, sanitary pad usage, heavy menstrual bleeding, dysmenorrhea, period fatigue). Dietary diversity was assessed using women dietary diversity (WDD) scale. Multivariable logistic regression analyses were done to identify factors associated with different menstrual problems and strict sanitary pad usage.
Results: The prevalences of heavy menstrual bleeding, dysmenorrhea and period fatigue were 20.9%, 26.3%, and 32.0% respectively. Age and marital status were associated with dysmenorrhea. Low dietary diversity was associated with period fatigue. Menarche was delayed among 26.9% and early by 20.8% of the participants. More than nine out of ten participants (92.8%) strictly use sanitary pads. Heavy menstrual bleeding was associated with lesser strict use of sanitary pads.
Conclusions: Menstrual problems were common among young women in rural India, and heavy menstrual bleeding was associated with lesser strict use of sanitary pads.
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References
Thiyagarajan DK, Basit H, Jeanmonod R. Physiology, menstrual cycle. In: StatPearls. StatPearls Publishing; 2024.
Critchley HOD, Babayev E, Bulun SE, Clark S, Garcia-Grau I, Gregersen PK, et al. Menstruation: science and society. Am J Obstet Gynecol. 2020;223(5):624-64. DOI: https://doi.org/10.1016/j.ajog.2020.06.004
Laksham KB, Selvaraj R, Kar SS. Menstrual disorders and quality of life of women in an urban area of Puducherry: a community-based cross-sectional study. J Fam Med Prim Care. 2019;8(1):137-40. DOI: https://doi.org/10.4103/jfmpc.jfmpc_209_18
Kulkarni MV, Durge PM. Reproductive health morbidities among adolescent girls: breaking the silence! Stud Ethno-Med. 2011;5(3):165-8. DOI: https://doi.org/10.1080/09735070.2011.11886405
Mohite R, Mohite V, Kumbhar SM, Ganganahalli P. Common menstrual problems among slum adolescent girls of western Maharashtra, India. J Krishna Inst Med Sci Univ. 2013;2:89-97.
Attia GM, Alharbi OA, Aljohani RM. The impact of irregular menstruation on health: a review of the literature. Cureus. 15(11):e49146.
Yaliwal RG, Biradar AM, Kori SS, Mudanur SR, Pujeri SU, Shannawaz M. Menstrual morbidities, menstrual hygiene, cultural practices during menstruation, and WASH practices at schools in adolescent girls of north Karnataka, India: a cross-sectional prospective study. Obstet Gynecol Int. 2020;2020(1):6238193. DOI: https://doi.org/10.1155/2020/6238193
Bachloo T, Kumar R, Goyal A, Singh P, Yadav SS, Bhardwaj A, et al. A study on perception and practice of menstruation among school going adolescent girls in district Ambala Haryana, India. Int J Community Med Public Health. 2016;3(4):931-7. DOI: https://doi.org/10.18203/2394-6040.ijcmph20160931
Kumari S, Muneshwar KN. A review on initiatives for promoting better menstrual hygiene practices and management in India. Cureus. 15(10):e47156.
Dawood YM. Dysmenorrhoea. The Global Library of Women’s Medicine. 2008. Available at: https://www.glowm.com/section-view/heading/Dysmenorrhea/item/9. Accessed on 17 August 2024. DOI: https://doi.org/10.3843/GLOWM.10009
Ghazzawi HA, Alhaj O, Bragazzi N, Alnimer L, Jahrami H. Menstrual cycle symptoms are associated with nutrient intake: Results from network analysis from an online survey. Womens Health. 2023;19:17455057231185624. DOI: https://doi.org/10.1177/17455057231185624
Food and Agriculture Organization of the United States (FAO). 2010. Guidelines for measuring household and individual dietary diversity. Available from: https://www.fao.org/4/i1983e/i1983e00.pdf. Accessed on 17 August 2024.
Bitew ZW, Alemu A, Ayele EG, Worku T. Dietary diversity and practice of pregnant and lactating women in Ethiopia: a systematic review and meta‐analysis. Food Sci Nutr. 2021;9(5):2686-702. DOI: https://doi.org/10.1002/fsn3.2228
Centre for Disease Prevention and Control. Heavy Menstrual Bleeding. 2024. Available at: https://www.cdc.gov/female-blood-disorders/about/heavy-menstrual-bleeding.html#:~:text=Heavy%20menstrual%20bleeding%2C%20or%20menorrhagia,It%20also%20can%20cause%20anemia. Accessed on 17 August 2024.
Fraser IS, Critchley HOD, Broder M, Munro MG. The FIGO recommendations on terminologies and definitions for normal and abnormal uterine bleeding. Semin Reprod Med. 2011;29(5):383-90. DOI: https://doi.org/10.1055/s-0031-1287662
Meher T, Sahoo H. Secular trend in age at menarche among Indian women. Sci Rep. 2024;14(1):5398. DOI: https://doi.org/10.1038/s41598-024-55657-7
Lacroix AE, Gondal H, Shumway KR, Langaker MD. Physiology, Menarche. In: StatPearls. StatPearls Publishing; 2023.
Pattanaik N, Kar K, Satapathy DM, Pattanaik A. Reproductive health status of adolescent slum girls, residing in the urban slums of Cuttack City, Odisha. J Reprod Healthcare Med. 2021;2(7):1-4. DOI: https://doi.org/10.25259/JRHM_34_2020
Deka C, Baishya AC, Ojah J. A study of reproductive health and health seeking behaviour of adolescent girls residing in urban slums of Guwahati city. New Indian J OBGYN. 2015;2(1):51-5.
Ahamed F, Lohiya A, Kankaria A, Silan V, Kharya P, Rizwan SA. Menstrual disorders and its determinants among married women of rural Haryana. J Clin Diagn Res. 2015;9(9):LC06-9. DOI: https://doi.org/10.7860/JCDR/2015/13101.6441
Chatterjee R, Chakrabarty S. Menstrual disorders and associated factors among rural and tribal adolescent girls in India: A systematic review and meta-analysis. Anthropol Rev. 2024;87(4):1-24. DOI: https://doi.org/10.18778/1898-6773.87.4.01
Majeed J, Sharma P, Ajmera P, Dalal K. Menstrual hygiene practices and associated factors among Indian adolescent girls: a meta-analysis. Reprod Health. 2022;19:148. DOI: https://doi.org/10.1186/s12978-022-01453-3
Quinn SD, Higham J. Outcome measures for heavy menstrual bleeding. Womens Health Lond. 2016;12(1):21-6. DOI: https://doi.org/10.2217/whe.15.85
World Health Organization. What does “Health” mean to you? Available from: https://www.emro.who.int/about-who/rc60/what-does-health-mean-to-you.html. Accessed on 12 June 2024.
Patel PA, Patel PP, Khadilkar AV, Chiplonkar SA, Patel AD. Impact of occupation on stress and anxiety among Indian women. Women Health. 2017;57(3):392-401. DOI: https://doi.org/10.1080/03630242.2016.1164273
International Institute for Population Sciences (IIPS) and Macro International. 2015-16. National Family Health Survey (NFHS-4), 2015-16: India Report.
Das P, Jungari S. Prevalence, risk factors and health-seeking behavior of menstrual disorders among women in India: a review of two-decade evidence. Glob Health Act. 2024;17(1):2433331. DOI: https://doi.org/10.1080/16549716.2024.2433331
American College of Obstetricians and Gynecologists. Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. 2015. Available at: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/12/menstruation-in-girls-and-adolescents-using-the-menstrual-cycle-as-a-vital-sign. Accessed on 17 August 2024.