Menstrual Disorders and Its Determinants Among Married Women of Rural Haryana

Exploratory systematic review and meta-analysis on period poverty

BACKGROUND

Period poverty is a global health and social issue that needs to be addressed. It has been reported that many females compromise their education, employment, and social commitments during their menstruation days due to a number of reasons, including lack of access to toilets or menstrual products.

AIM

To provide a comprehensive understanding on period poverty, including outcomes associated with menstruation.

METHODS

All observational and randomised clinical trials reporting menstruation challenges, menstrual poverty and menstrual products were included. Our search strategy included multiple electronic databases of PubMed, Web of Science, ScienceDirect, ProQuest and EMBASE. Studies published in a peer review journal in English between the 30^th of April 1980 and the 30^th of April 2022 were included. The Newcastle-Ottawa Scale was used to assess the risk of bias of the systematic included studies. Pooled odds ratios (ORs) together with 95% confidence intervals (CIs) are reported overall and for sub-groups.

RESULTS

A total of 80 studies were systematically selected, where 38 were included in the meta-analysis. Of the 38 studies, 28 focused on children and young girls (i.e., 10-24 years old) and 10 included participants with a wider age range of 15-49 years. The prevalence of using disposable sanitary pads was 45% (95%CI: 0.35-0.58). The prevalence of menstrual education pre-menarche was 68% (95%CI: 0.56-0.82). The prevalence of good menstrual hygiene management (MHM) was 39% (95%CI: 0.25-0.61). Women in rural areas (OR = 0.30, 95%CI: 0.13-0.69) were 0.70 times less likely to have good MHM practices than those living in urban areas.

CONCLUSION

There was a lack of evidence, especially from low- and middle- income countries. Further research to better understand the scope and prevalence of period poverty should be considered. This will enable the development of improved policies to increase access to menstrual products and medical support where necessary.

Health, Psychology and Economic Status: Impact of Early Marriage

BACKGROUND: Early marriage is a global problem that harms teenagers. The occurrence of early marriage in rural areas is a common practice. AIM: This study aims to determine the impact of early marriage on aspects of health, psychology, and economic status comprehensively based on the causes of early marriage in rural area. METHODS: This study used a cross-sectional study design. The sampling unit of this study was early marriage families from three sub-districts in the Ponorogo district, namely Sawoo, Ngrayun, and Pulung. The number of samples used as many as 75 families. The variables in this study consisted of health, husband’s psychology, wife’s psychology, and economic status. The statistical test used polychoric Principle Component Analysis (PCA) analysis to obtain health, psychological and economic status variables derived from several indicators. RESULTS: The results of this study indicate that in the healthcare variable, it appears that most of the respondents do not experience bleeding, do not have abdominal pain, and do not hurt on contact. Based on the emotion variable, the wife is more emotional than the husband. The results of polychoric PCA are based on scores that are divided into two categories. The results of the polychoric PCA analysis show that most of the early married couples have worse health and economic conditions, namely, 55% and 65%, respectively. Meanwhile, in the psychological condition of husband and wife, most of them have good conditions, namely, 75% and 83%. CONCLUSION: The impact of early marriage which shows poor results is on the health and economic aspects.

Prevalence and determinants of menstrual disorders and napkin usage among women in India using DLHS-4 data

Introduction:

Menstrual disorders and hygiene practices during the menstruation significantly affect the health of reproductive age-group women.

Methods:

The data from nationally representative survey, DLHS-4, was used. The outcome assessed were menstrual disorders and napkin usage. The predictor variables were socio-demographic characteristics such as age group, caste, religion, marital status, and education status; reproductive characteristics such as outcome of pregnancy, condom use, IUCD usage, and vaginal discharge. The descriptive analysis and logistic regression analysis were done on 1,70,632 women.

Results:

The most common problems experienced by women were pain (5.4%), irregular periods (4.2%), followed by frequent period, prolonged bleeding, no period, scanty bleeding, excessive bleeding, and intermenstrual bleeding. A large proportion (37%) women were using cloth during menstruation. The factors significantly associated with menstrual problems were age, 36-40 years (OR 1.26, P value < 0.001), marriage before 18 years (OR 1.16, P value < 0.001), no education (OR 1.24 P value < 0.001), BPL card holders (OR 1.14, P value < 0.001), non-users of sanitary napkin (OR 1.09, P value < 0.001). The socio-demographic factors significantly associated with napkin usage were women with secondary education and higher (OR 3.52, P value < 0.001), toilet use - using flush toilet (OR 1.97, P value < 0.001), not possessing BPL card (OR 1.42, P value < 0.001), marriage after the age of 18 years (OR 1.35, P value < 0.001). The reproductive characteristics significantly associated with menstrual problems were history of spontaneous abortion (OR 1.79, P value < 0.001), history of induced abortion (OR 2.29, P value < 0.001), women never used condoms (OR 1.09, P value < 0.001), ever used IUCD (OR 1.11, P value < 0.001), history of abnormal vaginal discharge during last three months (OR 5.32, P value < 0.001).

Conclusion:

The use of sanitary napkin should be promoted as it promotes dignity, and equality of women, apart from the public health aspect.