Female Reproductive Health: Menstrual Hygiene Management

#menstrualhygieneday #28thMay

‘Menstrual Hygiene Management (MHM) is defined as ‘Women and adolescent girls using a clean menstrual management material to absorb or collect blood that can be changed in privacy as often as necessary for the duration of the menstruation period, using soap and water for washing the body as required, and having access to facilities to dispose off used menstrual management materials’. (JMP,2012)

The Challenge

Menstrual hygiene management is a problem for most menstruating girls and women globally, especially in low-income countries. Poor menstrual hygiene management can have adverse effect on girls and women including low self esteem, shame, stigma, stress and not forgetting the various health challenges. Some of the challenges girls and women face are inadequate WASH (water, sanitation and hygiene) facilities, lack of social support, inadequate education and inability to access menstrual hygiene materials.

Inadequate WASH (water, sanitation and hygiene) facilities, especially in public such as schools, workplaces and healthcare centres is one of the problems that girls and women face during menstruation. Most of these facilities lack separate toilets with doors that can be safely closed, appropriate means to dispose used menstrual hygiene products, toilet rolls and running water and soap to wash hands. Lack of these essentials deprive women and girls from maintaining their menstrual hygiene in private, safe and dignified manner, and this contributes to causes of school absenteeism among school going girls.

Menstruation comes with it’s own problems and the society do not make it any easier, most societies and religions see menstruation as a taboo. As a result, women and girls often face discrimination, stress, stigma and a range of restrictions on some normal activities, from school attendance to cooking during menstruation, making them experience it in shame and embarrassment. School going girls are often teased by their peers which makes them avoid school. Girls are mostly unable to discuss their menstrual or health issues, or even get money from their parents because of shame and stigma, which shouldn’t be the case.

Taboos and stigma surrounding menstruation has led to an overall silence on the topic, resulting in inadequate education on menstruation and menstrual hygiene, in fact, most girls reach menarche without vital information on menstruation. The information is either provided too late, that is after their first period, after the panic and anxiety or not at all.

Menstrual hygiene products are very essential in management of menstruation but most girls, especially those in rural areas do not have access to these essentials. Inability to access appropriate menstrual hygiene products is usually because they are relatively expensive. For instance, in Ghana, there’s 20% income tax on sanitary pads as it is considered as a luxury product by the Ghana Revenue Authority. I’m still wondering why we are being ‘taxed’ for being women! Anyway, this makes sanitary pads expensive making it impossible for some girls to buy them and women and girls who can afford may be too ashamed and embarrassed to go to a shop or pharmacy to buy them because of stigma, it is even worse if the shop attendant is a male.

What Can Be Done?

Age appropriate sex education including reproductive and menstrual health education will help clear misconceptions about menstruation. Girls approaching menarche should be educated on menstruation and menstrual hygiene. Boys similarly need to be educated on the changes that their bodies undergo during puberty and that of their female peers, in fact, parents teachers, traditional and religious leaders and the community at large should be given accurate information on the changes that occur in the bodies of boys and girls. This way, they will be well equipped to help girls when they start menstruating. And community involvement will significantly change the perception, practices and stigma regarding menstruation. We need to get to a point where men can proudly go to a shop or pharmacy to buy menstrual hygiene products for their wives and young girls without feeling ashamed. Public places such as schools, workplaces and healthcare centres should provide separate toilet facilities for men and women with doors that can be closed safely. There should be toilet rolls, constant flow of water and soap as well as appropriate means to dispose off used sanitary products. This will allow women and girls to safely, comfortably and privately manage menstruation.

A number of international and national initiatives have distributed free or subsidized menstrual hygiene products to women and girls around the world, mostly in deprived communities. In 2017, President Uhuru Kenyatta of Kenya signed into law ‘The Basic Education Amendment Act’ that would allow school girls who have reached puberty to receive free sanitary pads to help reduce the number of girls missing from school during their period. Countries including Rwanda, Nigeria,Tanzania and a few others have also scrapped tax on sanitary pads, all in the bid to increase availability and affordability of menstrual hygiene products. These actions have helped reduce period poverty but there’s more work to be done. Other countries should remove taxes on menstrual hygiene products as well and if possible make them free so that every female can afford them.

Menstrual Hygiene Products

Menstrual hygiene products are the materials used to absorb or catch menstrual flow. These products can either be disposable such as tampons or reusable such as menstrual cups, either way, they are very essential in the management of menstruation. In general reusable menstrual hygiene products are environmentally friendly and save cost because they can be used for a number of years or months and so generate less waste and you spend less money on them. They are also a healthier option and are sanitary because they do not leak easily. Disposable ones on the other hand generate large amount of waste, are relatively more expensive and may pose health risks, tampons for instance pose a risk of toxic shock syndrome. Disposable menstrual hygiene products are less sanitary because they leak easily.

Disposable Menstrual Hygiene Products

Sanitary Pads are disposable pads that are worn in the underwear to absorb menstrual blood. They are the most common products and are meant for single use. They come in different sizes and shapes with different capacities to absorb. For days of heavy bleeding, thicker and longer ones are necessary, thinner and shorter ones maybe okay for days of light bleeding.

Tampons are absorbent materials made from cotton or rayon or a combination of both that are designed to absorb menstrual blood by insertion into the vagina, they expand with moisture, reducing leakage and are for single use. They come in different sizes, with or without an applicator. Tampons are associated with the risk of toxic shock syndrome, a rare but potentially fatal disease, using tampons with the lowest absorbency may lower the risk because you’ll get to change often.

Reusable Menstrual Hygiene Products

Reusable Sanitary Pads are reusable pads worn in the underwear to absorb menstrual blood and are held in place by snaps. They are made of soft and sturdy materials with a slit for inserting an absorbent liner, which can be adjusted by adding multiple liners to increase your level of protection on days of heavy bleeding. They can be used for approximately one year. They are washed and dried after each use. As unappealing as it may sound, they are environmentally friendly.

Menstrual Cups are bell-shaped nonabsorbent reusable cups made of medical grade silicone. They are inserted into the vagina to collect menstrual blood. They need to be emptied every 6-12 hours, after which they are rinsed and reinserted. Menstrual cups are boiled for 5- 10 minutes after every menstrual cycle and are reusable for 5-10 years.

Period or menstrual underwear are leak proof panties that can be worn without tampons or pads and are designed to absorb menstrual blood. They are thicker than normal panties so you can bleed straight into them without staining your dress.

Menstrual discs are flexible funnel shaped cup made of rubber or silicone that are inserted into the vagina to collect menstrual blood, they collect more blood than any of the products and can be safely used for up to 12 hours. Most menstrual discs are discarded after a single use, some are reusable.

Menstrual Hygiene Practices

We can experience happy and healthy periods with these hygiene practices.

Change sanitary products regularly. Disposable sanitary pads and tampons need to be changed every 4-6 hours and menstrual cups and reusable menstrual discs need to be emptied every 6-12 hours, disposable menstrual discs need to be changed every 6-12 hours as well, Changing often will curb the growth of microorganisms that can cause irritation, rashes and infections.

Wash yourself regularly. Bath at least twice a day, wash and clean your vagina properly and avoid cleaning from back to front to prevent the transmission of bacteria from the anus to the vaginal and urethral openings leading to infections.

Discard used pads or tampons properly, wrap them nicely and put them in a bin to prevent the spread of infections. Do not flush them down the toilet, this can block pipes and cause water to back up in the toilet.

Clean and change your underwear everyday. Wash reusable sanitary pads or cloth pads and dry them in the sun. Wash your hands with soap and water after using menstrual hygiene products.

Also, do not use soaps and vaginal hygiene products to clean the vagina. The vagina has a way of cleaning itself with the help of good bacteria, using soaps and vaginal hygiene products can tamper with this process leading to bacterial growth and infections.

Periods must be experienced with pride