Menstrual-related changes expected by premenarcheal girls living in rural and urban areas of Mexico

The relationship between women's breastfeeding empowerment and conformity to feminine norms

BACKGROUND

Women empowerment is effective in successful breastfeeding. Hence,identifying the relationship between psychosocial factors, such as acceptance of feminine norms, and empowerment can be beneficial in designing interventions.. Therefore, this study aimed to determine the relationship between breastfeeding empowerment and conformity to feminine norms.

METHODS

This cross-sectional study was conducted on 288 primiparous mothers in the postpartum period using validated questionnaires of conformity to gender norms and breastfeeding empowerment in the following domains: "sufficient knowledge and skills for breastfeeding," "a sense of breastfeeding competence," "conscious belief in the value of breastfeeding," "overcoming breastfeeding problems," "negotiation and obtaining family support" and "self-efficacy in breastfeeding" which were completed through the self-report method. Data were analyzed using the multivariate linear regression test.

RESULTS

The mean score of 'conformity to feminine norms' and 'breastfeeding empowerment' were 142.39 and 144.14, respectively. The score of breastfeeding empowerment was positively related to conformity to feminine norms (p = 0.003). Among the dimensions of breastfeeding empowerment, 'mothers' adequate knowledge and skills for breastfeeding' (p = 0.001), 'belief in the value of breastfeeding' (p = 0.008), and 'negotiation and obtaining family support' (p = 0.01) were positively related to conformity to feminine norms.

CONCLUSIONS

The results indicate a positive relationship between the level of conformity to feminine norms and breastfeeding empowerment. Accordingly, it is recommended that supporting breastfeeding as a valuable role of women be considered in programs designed to improve breastfeeding empowerment.

Mapping the knowledge and understanding of menarche, menstrual hygiene and menstrual health among adolescent girls in low- and middle-income countries

Background

Menstruation is a natural physiological process that requires proper management. Unlike other normal bodily processes, menstruation is linked with religious and cultural meanings that can affect the perceptions of young girls as well as the ways in which the adults in the communities around them respond to their needs.

Objectives

This review aims to answer the following questions: (1) how knowledgeable are adolescent girls in low- and middle-income countries about menstruation and how prepared are they for reaching menarche, (2) who are their sources of information regarding menstruation, (3) how well do the adults around them respond to their information needs, (4) what negative health and social effects do adolescents experience as a result of menstruation, and (5) how do adolescents respond when they experience these negative effects and what practices do they develop as a result?

Methods

Using a structured search strategy, articles that investigate young girls’ preparedness for menarche, knowledge of menstruation and practices surrounding menstrual hygiene in LMIC were identified. A total of 81 studies published in peer-reviewed journals between the years 2000 and 2015 that describe the experiences of adolescent girls from 25 different countries were included.

Results

Adolescent girls in LMIC are often uninformed and unprepared for menarche. Information is primarily obtained from mothers and other female family members who are not necessarily well equipped to fill gaps in girls’ knowledge. Exclusion and shame lead to misconceptions and unhygienic practices during menstruation. Rather than seek medical consultation, girls tend to miss school, self-medicate and refrain from social interaction. Also problematic is that relatives and teachers are often not prepared to respond to the needs of girls.

Conclusion

LMIC must recognize that lack of preparation, knowledge and poor practices surrounding menstruation are key impediments not only to girls’ education, but also to self-confidence and personal development. In addition to investment in private latrines with clean water for girls in both schools and communities, countries must consider how to improve the provision of knowledge and understanding and how to better respond to the needs of adolescent girls.

Attitudes toward menstruation, menstrual-related symptoms, and premenstrual syndrome among adolescent girls: a rural school-based survey

Folk culture surrounding menstrual-related matters has considerable implications for symptom expression and treatment-seeking behavior. A cross-sectional survey of 1,295 rural adolescent girls aged 13 to 19 years was conducted between February 4 and April 16, 2009 to examine these associations. With a higher score indicating a more positive attitude toward menstruation, the mean attitude score was 3.84 (SD ± 1.62) out of a maximum of six. No significant association was observed between the severity of menstrual symptoms and attitudes. Most (63.1%) of the participants identified themselves as having premenstrual symptoms, and 61.1% viewed premenstrual symptoms as a normal part of menstrual cycle. Participants with a higher severity of symptoms in the premenstrual (OR 1.05, 95% CI 1.01-1.10) and menstrual phase (OR 1.04, 95% CI 1.01-1.07), were more likely to consult a physician for premenstrual symptoms, and having a divorced/separated parents was associated with a reduced odds of consulting a physician compared to those having parents that were married (OR 0.19, 95% CI 0.05-0.83). The findings imply the need for education to help adolescent girls manage menstrual symptoms and increase awareness of the benefit of treating them. Given that menstrual-related information was widely available from mothers, family, and social culture are potentially important in shaping good menstrual attitudes.

Premenstrual syndrome and dysmenorrhea: urban-rural and multiethnic differences in perception, impacts, and treatment seeking

BACKGROUND

Attitudes toward menarche and menstruation are largely influenced by sociological, cultural, and family environmental factors. Recognizing the influential effects that these factors might have on shaping adolescents' attitudes is crucial in designing a more effective means of transmitting health information.

AIMS

This study aimed to gather an in-depth understanding of perceptions, impacts, and treatment seeking on menstruation-related issues from an ethnically mixed group of rural and urban girls.

METHODOLOGY

In total, 27 focus group discussions (172 participants) were conducted between November 2008 and April 2009. Participants were adolescent girls aged 13-19 years, recruited from 7 public secondary schools in the Federal Territory of Kuala Lumpur and 4 public secondary schools from the rural districts of Kelantan, in Malaysia.

RESULTS

Many participants revealed that they were not given or had not received detailed information about the mechanism or physiology of menstruation prior to its onset. Thus, many described the onset of menarche as shocking, an event for which they were unprepared, and which has had a tremendous impact on their emotions. More positive acceptance of menarche was reported in the urban than with the rural groups. Despite the high prevalence of premenstrual syndrome and dysmenorrhea, participants across urban-rural and ethnic groups perceived the problems as completely normal, hence they relied on self-care methods and did not want to seek professional treatment. More rural girls compared to urban girls were embarrassed to talk to their mothers or consult their physicians regarding menstruation-related problems.

CONCLUSION

Menstruation-related education would have a positive impact in improving adolescent girls' knowledge and in nurturing a positive attitude toward menstruation-related matters at home, at school, and in the community.

Menstrual characteristics: a study of the adolescents of rural and urban West Bengal, India

BACKGROUND

It has been observed that menstrual characteristics are generally influenced by lifestyle, socio-cultural and biological factors.

AIM

The present study examines: (a) variation in menstrual characteristics between rural and urban adolescents; and (b) whether these characteristics can be predicted from various socio-economic variables related to place of residence.

SUBJECTS AND METHODS

The sample of the present study constituted 715 adolescent girls from rural (325) and urban (390) areas of West Bengal, a State of India. These girls belong to a Bengali-speaking Hindu ethnic group. Data on socio-economic variables and menstrual characteristics were collected using pretested questionnaires.

RESULTS

Rural and urban adolescents differed significantly (p < or = 0.05) with respect to age at menarche, skipped and irregular cycles, premenstrual syndrome, duration of menstrual discharge, mean number of days of peak discharge and problems related to menstrual discharge. Place of residence was found to be a significant predictor of age at menarche (beta = 0.27, p < 0.01). Significant association was observed between some of the socio-economic variables and various menstrual characteristics among the study participants.

CONCLUSIONS

Menstrual characteristics differ significantly between rural and urban adolescents. Moreover, various socio-economic variables pertaining to place of residence significantly affect the menstrual characteristics among adolescents.

Attitudes toward menstrual suppression and conformity to feminine norms in young and middle-aged Mexican women

Seventy seven college students and 66 middle-aged Mexican women completed an adapted questionnaire of attitudes toward menstrual suppression and the Conformity to Feminine Norms Inventory. Participants showed a great interest in menstrual suppression, but few were familiar with this issue. Young women would like to have longer menstrual cycles than monthly and were more supportive of menstrual suppression than middle-aged women. Women who would prefer to have longer menstrual cycles showed less conformity to feminine norms. These findings are discussed in light of differences between age cohorts, and the relationship between the studied variables and attitudes toward menstruation.

Menstrual health care behavior and associated factors among female elementary students in the Hualien region

The purposes of this study were to measure menstrual knowledge, assess menstrual health care behavior and investigate the factors associated with menstrual health care behavior among fifth and sixth grade female students. The subjects were 417 female students from 12 elementary schools in the Hualien region of Taiwan. The stratified cluster random sampling method was adopted. The questionnaire used in the study consisted of three sections: personal information, a menstrual knowledge questionnaire, and a menstrual health care behavior questionnaire. The results of this study show that the majority of the respondents felt that menstruation had an influence on their emotions (74.8%), daily life (73.1%), schoolwork (61.6%), and social interaction (50.1%). The total correct response rate for the menstrual knowledge questionnaire was 45.1%. There was a significant difference between aboriginal and non-aboriginal female students in terms of the correct answer rate for the menstrual knowledge questionnaire. The mean score for menstrual health care behavior was 2.66 (SD = 0.82). Elementary level female students who had better menarche preparation scored higher on the menstrual knowledge questionnaire, and those whose first period had already occurred felt more confident in their ability to execute proper menstrual health care behavior. The results prompted the recommendation to families and elementary schools to encourage students to improve their menstrual health care behavior during menses.

A qualitative investigation of women's experiences of the self and others in relation to their menstrual cycle

OBJECTIVES

This study aimed to compare and contrast detailed accounts of a community sample of women, with prospectively defined low or high premenstrual symptoms, highlighting differences/similarities.

METHODS

Semi-structured interviews were conducted with 16 women (9 with 'low' and 7 with 'high' symptom levels) and analysed using template analysis.

RESULTS

'Low symptom' women perceived themselves as generally laid back but demonstrated a need for organization and control in the family environment. They accepted less than perfect relationships, compared themselves favourably to others and perceived themselves as having strong support networks. There was a negative perception of the introduction to menarche but this was coupled with strong maternal support. 'High symptom' women showed patterns of perfectionism, an emphasis on self-sacrifice and unfavourable comparison of self with others. They reported feeling alone, overwhelmed by tasks and experienced relationships as characterized by unresolved tensions. Menarche was viewed as a positive experience but accompanied by low maternal support. Both groups viewed their symptoms as irrational and controllable outside the home, but vented on partner, close family and children. There was acknowledgement of difference from 'normal' ('low') with an emphasis on the all-encompassing nature of symptoms ('high').

CONCLUSIONS

Women with high and low menstrual cycle symptoms viewed aspects of themselves and their relationships with others in both similar and different ways. A major issue for high symptom women was that they struggled to tolerate imperfections, both in their own performance or in their relationships with others, potentially emphasizing the role of cognitive appraisals in interventions.