Menstrual health is a broad term and encompasses menstrual hygiene management practices and the interventions that link menstruation to health, well-being and gender education.
Significance in India
Before we learn more about menstruation, here’s a little note on why it is an important subject in India.
Menstruation is still considered a taboo in some Indian societies. Due to this, a lot of people lack the basic knowledge of menstrual health. As a result, they are unable to educate their future generations.
Millions of women face significant barriers and are denied a dignified and comfortable experience with menstrual hygiene management.
It is important to create awareness and educate these women on reproductive health and create a platform where information is available to all.
It is a natural fact of life and a monthly occurrence. Every month, a woman’s body starts preparing for pregnancy, the Graafian follicle located in the ovary continues to mature and eventually ruptures to release the ovum during ovulation.
If the released ovum is not fertilized once it reaches the uterus, menstruation occurs.
During menstruation, the endometrium lining of the uterus starts degenerating and its blood vessels breakdown. It is then externally discharged in the form of blood and mucosal tissues known as “menstrual flow”.
Some Important Terms
Menarche: The onset of the first menstrual flow. It occurs around the age of 11-14 years.
Menopause: The permanent cessation of the menstrual cycle. It occurs between the age of 45 and 50 years.
Menstrual Cycle – The reproductive cycle of primates (monkeys, apes, human beings etc.)
It is repeated at an average interval of 28-29 days and is divided into four phases:
Menstrual phase- It marks the beginning of the cycle and is characterized by menstrual flow, when fertilization has failed. The duration of this phase is between 3-5 days.
Follicular phase- This phase extends from the 6th day to the 13th day. During this phase, the primary follicle grows into the Graafian follicle and the endometrium of the uterine starts to regenerate. The level of estrogens is maximum.
Ovulatory phase- On the 14th day of the menstrual cycle, the luteinizing hormone (LH) and the Follicular Stimulating hormone (FHS – maintains levels of estrogen) levels are at its peak. LH surge is the maximum level of LH during mid-cycle and its indices rupture of the Graafian follicle.
Luteal phase- During this phase, the ruptured Graafian follicle enlarges and forms a yellow ball of mass called the corpus luteum. It continues to secrete progesterone for 7 days which is in turn controlled by LH.
If the released ovum is not fertilized, the corpus luteum degenerates into corpus albicans. The progesterone levels lower and the body enters the menstrual phase again.
The Difference Between Menstrual Cycle and Estrous CycleMenstrual cycle Estrous cycleIt occurs in primates such as apes, monkeys and human beings.It occurs in non-primates such as cows, dogs, reptiles etc.It is divided into four phases: menstrual, follicular, luteal and ovulatory.It is divided into two phases: Follicular and luteal.Blood flows during the menstrual phase as broken endometrium is discharged.Blood is not discharged during any phase as the degenerated endometrium is reabsorbed.There is no heat period and copulation occurs at any time.There is an estrus/heat production during ovulation and copulation occurs only at that period.
Important Menstrual Hygiene Practices
Avoid keeping the pad on for a long duration no matter how super-absorbent they are.
Use of clean products- make sure all feminine products are properly sealed and unused to prevent any infection.
Ensure proper disposal of sanitary products as it is harmful to both you and the people around you.
Ensure your genital area is clean and dry. Wet or damp area are most prone to bacterial growth.
Caption: Wash your hand after disposing of feminine products Credit: pexels
Purpose of menstrual hygiene
Reducing respiratory tract infection (RTIs): This is the most common form of infection in women of menstruating age.
Avoid Unhygienic habits like using dirty cloths or sanitary napkins longer than 5 hours. This can promote growth of bacteria and yeast like E.coli and Staphylococcus aureus.
Bacteria invade the urinary tract entirely and cause extreme pain during urination and may even cause fever.
Ensuring good reproductive health: RTIs can lead to degeneration of the reproductive tract by microbes that destroy the mucosal layer, causing serious damage to the ovaries, fallopian tube and uterine wall.
To avoid potential rashes: During menstruation the moisture level around the genital goes up. The combination of moisture and heat contributes to bacteria buildup and leads to contact dermatitis.
The skin will then be more prone to friction and the area around the genital will now become itchy, sore and inflamed.
Reducing risk of cervical cancer: This type of cancer causes malignant tumors on the lowermost part of the uterus known as the cervix. It is caused by the Human Papilloma Virus which is transmitted either sexually or due to unhygienic handling of menstruating waste.
This is why it is important to ensure proper disposal of sanitary products and maintain proper sanitization afterwards.
Cap: Tampons increase risk of TSS credits: pexel
Toxic shock syndrome (TSS): A Rare but Serious Condition.
The bacteria Staphylococcus aureus formed by bacterial build up during RTI often results in Toxic shock syndrome, a life-threatening complication. Women who wear tampons are at a higher risk.
Women suffering from TSS will develop high fever, rapid drop in blood pressure, diarrhea and muscle aches.
If not treated, a person’s organs such as liver and kidney may begin to fail or it could lead to seizures and heart failure. There have also been some few cases where amputations were involved.
Menstrual Hygiene Products
There are two most common types of menstrual products to absorb menstrual flow:
External products such as pad and liners are attached to the underpants and absorb menstrual flow after it leaves the body.
Internal products such as tampons and menstrual cups are inserted in the vaginal tract and absorbs menstrual flow before it leaves the body.
Both types of products have been approved by the FDA. However, there is a small risk of Toxic shock syndrome (TSS) with tampons recorded.
Caption: sanitary pads. Credit: pixabay
The Impact of Menstrual Products on the Environment
The pollution of sanitary waste has become a highly discussed topic. Over 400 million pads are manufactured in India annually.
The chemical composition in sanitary pads causes leaching, groundwater pollution and loss of soil fertility.
Moreover, there has been no clarification or distinct method of disposal as scientists are still trying to decide if it comes under the category of wet or dry waste.
As awareness starts increasing in India, people have been actively promoting the idea of sustainable menstruation and the use of menstrual cups and its advantages are being popularized.
Caption: Bell-shaped menstrual cup Credit: foter
It is a bell-shaped, flexible device made of silicone, latex or rubber that is inserted into the vagina to collect menstrual blood. Depending on the type and size of the product, it can be left in place for 4-12 hours. The biggest advantage is that the cup can be simply removed, rinsed and then inserted again, making it the most sustainable and eco-friendly feminine product. Not only is this extremely convenient but also inexpensive. It has proven to be safe and just as effective as sanitary pads and tampons. How to Use It Firstly, picking the right sized menstrual cup for your body is important to ensure a painless and comfortable experience. The cup is designed to open up inside the vagina and create a small suction force with the vaginal wall to keep it in place. Before inserting it in, make sure you read the instructions that come with it. The easiest and most convenient way to insert it is to fold the cup in half, creating a U-shaped fold. Then guiding into the vagina, rim first. To ensure that it is well placed, rotate the stem of the cup when it is half an inch away from the opening to place it higher for maximum effectiveness. This will also ensure that the cup has completely opened inside the vaginal tract. Once it is correctly placed and suctioned, there will not be any discomfort or pain.
Credits : foter Caption: Menstrual hygiene
Maintenance- Cup Cleaning and Care
Menstrual cup cleaning is easy and very low maintenance. With proper care, they can last for years.
They must be cleaned and sterilized, both during your period and between cycles. Most brands ideally provide you with a specific soap for your cup but since they are non-porous materials, any soap will suffice.
Fill the cup with soapy water and let it sit for some time. Although, keep in mind some perfume soaps can affect the vaginal ph.
Then flip the cup over and squeeze the cup, let the soapy water escape through the suction hole to ensure proper cleansing. Use a soft brush if necessary. Once it’s rinsed and dried out, it’s as good as new.
Alcohol-free and fragrance-free cleansing wipes are good alternatives and can be used in public places.
Credits: picjumbo Caption: Menstrual cups are safe to sleep in
Menstrual cups are a great alternative to wearing pads or using tampons.
The maximum number of hours one can wear a menstrual cup is 12, while for pads and tampons it is 6 and 8 respectively. Further, those bulky maxi-night pads worn at night can get extremely uncomfortable due to friction. This problem can be easily resolved with the use of a menstrual cup.
So, it is safe to say that not only is it a feasible alternative, but an advantage as menstrual cups can be worn for longer and are safer, especially during the night.