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Health & Place Nov 2020A growing literature attests to menstrual management difficulties of girls, women and other people who menstruate. Largely ignored are the menstruation-management needs...
A growing literature attests to menstrual management difficulties of girls, women and other people who menstruate. Largely ignored are the menstruation-management needs of people experiencing homelessness. We explored these realities in New York City through in-depth interviews with individuals living on the street and in shelters (n = 22), key informant interviews with staff at government agencies, shelters and service provider organizations (n = 15), and field audits of public toilets. This paper explores both pragmatic difficulties presented by inadequate access to toilets, bathing spaces, and laundering services, and pervasive menstrual stigma. Amplifying the difficulties was near-constant pressure "to pass," as someone who was not homeless in order to enable increased access to toilets, and as someone who was not menstruating, in order to engage in the activities of daily living. Our findings highlight the need for improved quality and accessibility of bathrooms for sheltered and street-dwelling homeless, and expedited access to bathing and laundering. Such actions are essential given the steady increase in homelessness in NYC and - under the long shadow of COVID - especially timely.
Topics: Activities of Daily Living; COVID-19; Female; Ill-Housed Persons; Humans; Menstruation; New York City; SARS-CoV-2
PubMed: 32987242
DOI: 10.1016/j.healthplace.2020.102431 -
International Journal of Environmental... Jun 2022An active lifestyle elicits many health benefits. This study’s aim is to understand the actual of leisure time physical activity (LTPA) of female university students...
An active lifestyle elicits many health benefits. This study’s aim is to understand the actual of leisure time physical activity (LTPA) of female university students in Korea who are experiencing stress due to, e.g., study and employment. LTPA is the degree of exercise participation in leisure time; it is cardiovascular and strength-based behavior occurring within recreation, exercise or sport and provides a positive effect on life satisfaction and psychological well-being. LTPA has been recommended as a method of reducing menstrual symptom severity. However, a lack of evidence exists to support a clear relationship between LTPA and menstruation in female university students. Health consciousness (HC) refers to the degree of interest in one’s health, and Korean female university students pay considerable attention to their body shape, diet habits, and LTPA. This study investigated female university students (K University in Gangwon-do, D University in Busan, and U University in Ulsan) in three metropolitan cities in Korea. Specifically, after seeking cooperation from the person in charge of each university, the purpose of this study was explained. In addition, after promising to provide coffee coupons to students who wish to respond to the survey, cooperation was sought in recruiting research subjects through the person in charge of each university. In addition, a total of 36 surveys that did not have contents filled in fully or gave inconsistent answers were excluded among all survey participants. Chi-square test, t-test and univariate one-way ANOVA, and Pearson’s correlation coefficient analysis were performed for between groups (HC, LTPA, intention to participate in LTPA). The LTPA results in relation to the menstruation patterns of Korean female college students are shown. First, there were no significant differences between menstruation (regular vs. irregular) and general LTPA during non-menstrual time periods (χ2 = 5.828, p < 0.212). However, female university students with regular menstruation patterns had higher LTPA after menstruation compared to female university students with irregular menstruation. Second, there were significant differences in the relationships among HC (p = 0.000), amount of LTPA (p = 0.002), and intention to perform LTPA (p = 0.002), according to the menstruation patterns (regular vs. irregular) of Korean female university students. In other words, those with regular menstruation patterns showed higher HC, amount of LTPA and intention to participate in LTPA than those with irregular menstruations. Third, there were significant differences in the relationship among HC (p = 0.000), amount of LTPA (p = 0.000), and intention to participate in LTPA (p = 0.000) according to LTPA of Korean female university students. Causation cannot be inferred from correlational studies. Therefore, female university students ultimately have different HC and participation in LTPA depending on menstruation regularity.
Topics: Exercise; Female; Humans; Leisure Activities; Menstruation; Republic of Korea; Students; Surveys and Questionnaires; Universities
PubMed: 35742739
DOI: 10.3390/ijerph19127492 -
Clinical Science (London, England :... Feb 2024The impact of COVID-19 on menstruation has received a high level of public and media interest. Despite this, uncertainty exists about the advice that women and people... (Review)
Review
The impact of COVID-19 on menstruation has received a high level of public and media interest. Despite this, uncertainty exists about the advice that women and people who menstruate should receive in relation to the expected impact of SARS-CoV-2 infection, long COVID or COVID-19 vaccination on menstruation. Furthermore, the mechanisms leading to these reported menstrual changes are poorly understood. This review evaluates the published literature on COVID-19 and its impact on menstrual bleeding, discussing the strengths and limitations of these studies. We present evidence consistent with SARS-CoV-2 infection and long COVID having an association with changes in menstrual bleeding parameters and that the impact of COVID vaccination on menstruation appears less significant. An overview of menstrual physiology and known causes of abnormal uterine bleeding (AUB) is provided before discussing potential mechanisms which may underpin the menstrual disturbance reported with COVID-19, highlighting areas for future scientific study. Finally, consideration is given to the effect that menstruation may have on COVID-19, including the impact of the ovarian sex hormones on acute COVID-19 severity and susceptibility and reported variation in long COVID symptoms across the menstrual cycle. Understanding the current evidence and addressing gaps in our knowledge in this area are essential to inform public health policy, direct the treatment of menstrual disturbance and facilitate development of new therapies, which may reduce the severity of COVID-19 and improve quality of life for those experiencing long COVID.
Topics: Female; Humans; Endometrium; Post-Acute COVID-19 Syndrome; Quality of Life; COVID-19 Vaccines; COVID-19; SARS-CoV-2; Menstruation; Uterine Hemorrhage; Menstruation Disturbances
PubMed: 38372528
DOI: 10.1042/CS20220280 -
International Journal of Environmental... Aug 2022Nearly half of Bangladeshi girls reach menarche without knowledge of menstruation and many fear seeking support due to pervasive menstrual stigma. We aimed to explore...
Nearly half of Bangladeshi girls reach menarche without knowledge of menstruation and many fear seeking support due to pervasive menstrual stigma. We aimed to explore the types of menstruation-related information and support adolescent female and male students want but may be uncomfortable verbalising. We installed a locked box in four school classrooms in rural and urban Bangladesh as part of a menstrual hygiene management pilot intervention between August 2017 and April 2018. Trained teachers provided puberty education to female and male students in classes 5-10 (ages 10-17 years) and encouraged students to submit questions anonymously to the boxes if they did not want to ask aloud. We conducted a content analysis of the 374 menstruation-related questions from a total of 834 submissions. Questions regarded experiences of menstrual bleeding (35%); menstrual symptoms and management (32%); menstrual physiology (19%); behavioural prescriptions and proscriptions (6%); concerns over vaginal discharge (4%); and menstrual stigma, fear, and social support (4%). Students wanted to understand the underlying causes of various menstrual experiences, and concern over whether particular experiences are indicative of health problems was pervasive. Ensuring comprehensive school-based menstruation education and strengthening engagement among schools, parents, and healthcare providers is important for improving access to reliable menstrual health information and may relieve adolescents' concerns over whether their menstrual experiences are 'normal'.
Topics: Adolescent; Bangladesh; Child; Female; Health Knowledge, Attitudes, Practice; Humans; Hygiene; Male; Menstruation; Students
PubMed: 36011779
DOI: 10.3390/ijerph191610140 -
Fertility and Sterility Jan 1999To provide an overview of our current understanding of exercise-induced reproductive dysfunction and an approach to its evaluation and management. (Review)
Review
OBJECTIVE
To provide an overview of our current understanding of exercise-induced reproductive dysfunction and an approach to its evaluation and management.
DESIGN
A MEDLINE search was performed to review all articles with title words related to menstrual dysfunction, amenorrhea, oligomenorrhea, exercise, and athletic activities from 1966 to 1998. The pathophysiology, proposed mechanisms, clinical manifestations, evaluation, and management of exercise-associated reproductive dysfunction were compiled.
CONCLUSION(S)
Exercise-induced menstrual irregularity appears to be multifactorial in origin and remains a diagnosis of exclusion. The underlying mechanisms are mainly speculative. Clinical manifestations range from luteal phase deficiency to anovulation, amenorrhea, and even delayed menarche. Evaluation should include a thorough history and a complete physical plus pelvic examination. Most cases are reversible with dietary and exercise modifications. Hormonal replacement in cases of a prolonged hypoestrogenic state with evidence of increased bone loss is recommended, although the long-term consequences of prolonged hormonal deficiency are ill-defined.
Topics: Exercise; Female; Hormone Replacement Therapy; Humans; Infertility, Female; Menstruation
PubMed: 9935107
DOI: 10.1016/s0015-0282(98)00392-6 -
Reproductive Health Jun 2020Menstruation, a natural biologic process is associated with restrictions and superstitious beliefs in Nepal. However, factual data on women's perspectives on menstrual...
BACKGROUND
Menstruation, a natural biologic process is associated with restrictions and superstitious beliefs in Nepal. However, factual data on women's perspectives on menstrual practices and restrictions are scarce. This study aimed to assess socio-cultural perceptions of menstrual restrictions among urban Nepalese women in the Kathmandu valley.
METHODS
Using a clustered random sampling, 1342 adolescent girls and women of menstruating age (≥15 years) from three urban districts in the Kathmandu valley completed a survey related to menstrual practices and restriction. This was a cross-sectional survey study using a customized program allowing pull-down, multiple choice and open-ended questions in the Nepali language. The self-administered questionnaire consisted of 13 demographic questions and 22 questions related to menstruation, menstrual hygiene, socio-cultural taboos, beliefs and practices. Univariate descriptive statistics were reported. Unadjusted associations of socio-cultural practices with ethnicity, education, four major social classes, three major religions, marital status and family type were assessed using logistic regression models.
RESULTS
More than half (59%) of the participants were aged between 15- < 25 years. The majority were Hindus (84.5%), reported not praying during menstruation (83.1%) and were encouraged by their mothers (72.1%) to practice a range of menstrual restrictions. Purifying either the kitchen, bed, bedsheets or other household things on the fourth day of menstruation was reported by 66.1% of the participants, and 45.4% saw menstruation as a "bother" or "curse." There were differences among social classes, where participants of the Janajati caste, an indigenous group, were more likely to enter places of worship [OR (95%CI): 1.74 (1.06-2.86)] and pray [OR (95%CI): 1.79 (1.18-2.71)] while menstruating, compared to the Brahmins. Participants with a master's degree were more likely to pray while menstruating, compared to participants with less than a high school education [OR (95%CI): 2.83 (1.61-4.96)].
CONCLUSION
This study throws light on existing social discriminations, deep-rooted cultural and religious superstitions among women, and gender inequalities in the urban areas of Kathmandu valley in Nepal. Targeted education and awareness are needed to make changes and balance between cultural and social practices during menstruation.
Topics: Adolescent; Adult; Cross-Sectional Studies; Culture; Educational Status; Female; Health Knowledge, Attitudes, Practice; Humans; Hygiene; Menstruation; Nepal; Religion; Social Class; Socioeconomic Factors; Young Adult
PubMed: 32487096
DOI: 10.1186/s12978-020-00935-6 -
Tidsskrift For Den Norske Laegeforening... Jan 2013
Topics: Contraceptives, Oral, Hormonal; Female; Humans; Menstruation
PubMed: 23344585
DOI: 10.4045/tidsskr.12.1453 -
Women's Health (London, England) 2022There has been increased attention to university students' experiences of menstrual disorders, and access to menstrual products, in high-income countries. Less attention...
OBJECTIVES
There has been increased attention to university students' experiences of menstrual disorders, and access to menstrual products, in high-income countries. Less attention has been directed to other aspects of their menstrual experience, including confidence for menstrual management. This study aimed to understand the factors affecting university students' confidence to manage menstruation at university.
METHODS
An online survey was completed by 410 participants (age range: 16-46 years, mean = 20.1 years) who menstruate and study at an Australian university. Participants reported demographic characteristics, confidence to manage menstruation at university, and personal, physical and environmental factors. A Mann-Whitney U-test analysed differences in confidence between groups of students. Pearson's correlation coefficient and bivariate linear regressions determined associations between factors and confidence. Statistically significant associations were inputted into a multiple linear regression model. P-values less than 0.05 were considered significant.
RESULTS
A minority of students (16.2%) felt completely confident to manage their menstruation at university. Menstrual knowledge, positive perceptions of menstruation and comfort to discuss menstruation with others positively predicted confidence. Physical menstrual symptoms, negative perceptions of menstruation, perceived stigma and using a menstrual cup or period underwear predicted lower confidence. In multiple regression, private and clean and sanitary university bathroom facilities, changing menstrual products at university, perceived stigma and negative perceptions of menstruation remained significant predictors.
CONCLUSION
Most students did not have complete confidence to manage their menstruation at university. Several personal, physical and environmental factors were related to students' confidence to manage menstruation. Assessment of these factors in future research with university students is recommended to enable a comprehensive understanding of their menstrual needs, and inform interventions aimed at improving their menstrual management confidence at university.
Topics: Adolescent; Adult; Australia; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Menstruation; Middle Aged; Students; Universities; Young Adult
PubMed: 35001743
DOI: 10.1177/17455065211070666 -
International Journal of Environmental... Feb 2021The menstrual cycle remains neglected in explorations of public health, and entirely remiss in occupational health literature, despite being a problematic source of...
The menstrual cycle remains neglected in explorations of public health, and entirely remiss in occupational health literature, despite being a problematic source of gendered inequalities at work. This paper proposes the new concept of blood work to explain the relationship between menstruation (and associated gynaecological health conditions) and employment for women and trans/non-binary people. We build on and extend health and organisational literature on managing bodies at work by arguing that those who experience menstruation face additional work or labour in the management of their own bodies through the menstrual cycle. We discuss how this additional labour replicates problematic elements that are identifiable in public health initiatives, in that it is individualised, requiring individual women and trans/non-binary people to navigate unsupportive workplaces. We present findings from an analysis of qualitative survey data that were completed by 627 participants working in higher education, revealing that employees' blood work comprises distinct difficulties that are related to the management of painful, leaking bodies, access to facilities, stigma, and balancing workload. We suggest developing supportive workplaces and public health policies, which refocus the responsibility for accessible, equal workplaces that accommodate menstruating employees, and those with gynaecological health conditions.
Topics: Employment; Female; Humans; Menopause; Menstruation; Occupational Health; Workplace
PubMed: 33671403
DOI: 10.3390/ijerph18041951 -
Journal of Global Health Jun 2019Lack of menstrual knowledge, poor access to sanitary products and a non-facilitating school environment can make it difficult for girls to attend school. In India,...
Effect of menstruation on girls and their schooling, and facilitators of menstrual hygiene management in schools: surveys in government schools in three states in India, 2015.
BACKGROUND
Lack of menstrual knowledge, poor access to sanitary products and a non-facilitating school environment can make it difficult for girls to attend school. In India, interventions have been developed to reduce the burden of menstruation for school girls by government and non-governmental organizations (NGOs). We sought to identify challenges related to menstruation, and facilitators of menstrual management in schools in three states in India.
METHODS
Surveys were conducted among menstruating school girls in class 8-10 (above 12 years of age) of 43 government schools selected through stratified random sampling in three Indian states (Maharashtra, Chhattisgarh, Tamil Nadu) in 2015. For comparison, ten model schools supported by NGOs or UNICEF with a focussed menstrual hygiene education program were selected purposely in the same states to represent the better-case scenario. We examined awareness about menarche, items used for menstruation, and facilitators on girls' experience of menstruation in regular schools and compared with model schools. Factors associated with school absence during menstruation were explored using multivariate analysis.
FINDINGS
More girls (mean age 14.1 years) were informed about menstruation before menarche in model schools (56%, n = 492) than in regular schools (36%, n = 2072, < 0.001). Girls reported menstruation affected school attendance (6% vs 11% in model vs regular schools respectively, = 0.003) and concentration (40% vs 45%, = 0.1) and was associated with pain (31% vs 38%, = 0.004) and fear of stain or smell (11% vs 16%, = 0.002). About 45% of girls reported using disposable pads in both model and regular schools, but only 55% and 29% of pad-users reported good disposal facilities, respectively ( < 0.001). In multivariate analysis, reported absenteeism during menstruation was significantly lower in Tamil Nadu (adjusted prevalence ratio (APR) 95% confidence interval (CI) = 0.24, 0.14-0.40) and Maharashtra (APR 0.56, CI = 0.40-0.77) compared to Chhattisgarh, and halved in model compared to regular schools (APR 0.50, CI = 0.34-0.73). Pain medication in school (APR 0.71, CI = 0.51-0.97) and use of disposable pads (APR 0.57, CI = 0.42-0.77) were associated with lower absenteeism and inadequate sanitary facilities with higher absenteeism during menstruation.
CONCLUSIONS
Menstrual hygiene education, accessible sanitary products, pain relief, and adequate sanitary facilities at school would improve the schooling-experience of adolescent girls in India.
Topics: Absenteeism; Adolescent; Female; Health Knowledge, Attitudes, Practice; Humans; Hygiene; India; Menstrual Hygiene Products; Menstruation; Public Sector; Schools; Surveys and Questionnaires
PubMed: 30546869
DOI: 10.7189/jogh.09.010408