BACKGROUND: Menstrual hygiene management poses significant challenges globally, with widespread reliance on disposable sanitary pads contributing to health risks and environmental degradation. Sustainable alternatives like menstrual cups offer promising solutions but face barriers to adoption, including myths and misconceptions. Educational interventions are crucial in promoting eco-friendly menstrual hygiene practices.
METHODS: A descriptive cross-sectional survey was conducted at All India Institute of Medical Sciences (AIIMS), Nagpur (Central India) among nursing officers from January to February 2022. A structured questionnaire assessed the demographic characteristics, menstrual hygiene practices, knowledge of menstrual cups, and attitude toward their use.
RESULTS: Of the 101 participants, the majority were between the age group of 25 and 40 years (71, 70.3%) and were educated up to a Bachelor of Science degree in nursing (79, 78.21%). Overwhelmingly, 97 (96.03%) of the nursing officers used non-biodegradable sanitary pads. Frequent need to change and staining were cited as common difficulties. Although 97 (96.04%) of the participants had heard of menstrual cups, knowledge gaps existed regarding suitability for nulliparous women, material composition, cost, and lifespan. Despite expressing a desire for better alternatives by 56 (55.4%) participants, only one (0.99%) reported current menstrual cup usage, with 60 (59.4%) participants indicating future readiness to use.
CONCLUSIONS: Discovering nurses\' menstrual hygiene habits, this study sheds light on their reliance on disposable pads over menstrual cups. Improving the acceptability of menstrual cups hinges on addressing current knowledge gaps such as their feasibility for use by nulliparous women, ease of insertion, cost, and environmental sustainability. Despite hurdles like misinformation, participants show openness to embracing new options with the right guidance and education.

BACKGROUND: Menstruation is a major physiological change in a woman\'s life, but lack of knowledge, poor practices, socio-cultural barriers, poor access to products and their improper disposal have significant consequences on health, dignity and well-being of women and adolescent girls.
OBJECTIVE: This study aimed to assess the knowledge and practices related to menstrual health and hygiene amongst females of 10-49 years of age; explore the experiences and challenges of women during menstruation; and identify the key predictors of healthy menstrual health and hygiene.
METHODS: Using a cross-sectional study design, we adopted a mixed methods approach for data collection. For quantitative household survey, a total of 921 respondents were selected from three districts of Odisha. Qualitative findings through focus group discussions and in-depth interviews supplemented the survey findings and helped to identify the barriers affecting good menstrual practices. Epi data version 2.5 and R 4.2.2 was used for data entry and data analysis, respectively. Descriptive statistics was used to calculate proportion, mean and standard deviation; Chi square test was used to measure the association between categorical variables. Bivariate and multivariate logistics analyses were done to identify predictors of healthy menstrual health and hygiene. For qualitative data analysis, thematic analysis approach was adopted using software Atlas.ti 8.
RESULTS: For 74.3% respondents, mothers were the primary source of information; about 61% respondents were using sanitary pad. The mean age at menarche was 12.9 years and almost 46% of respondents did not receive any information about menstruation before menarche. Lower age and education up to higher secondary level or above had statistically significant associations with the knowledge about menstruation. Age, caste, respondent\'s education, mother\'s education, sanitation facility, availability of water, accessibility and affordability for sanitary pads were found to be strongly associated with good menstrual hygiene practices.
CONCLUSIONS: Traditional beliefs regarding menstruation still persists at the community level. Educating mothers, increasing awareness about safe menstrual hygiene, providing adequate water and sanitation facilities and ensuring proper disposal of menstruation products need priority attention.

UNASSIGNED: Menstrual cups are considered a viable alternative to other menstrual hygiene products in many developed countries yet majority of women in India use pads and cloth for their menstrual hygiene.
UNASSIGNED: This prospective interventional questionnaire-based study was conducted among 100 women who tried cups for three menstrual cycles with the aim of highlighting the challenges posed by socio-cultural factors in India which prevent menstrual cups from becoming a mainstream menstrual hygiene product.
UNASSIGNED: Familiarity with pads delayed the switch to menstrual cups even among women who were aware of their benefits. The thought of vaginal insertion was the foremost deterrent along with uncertainty of cup size, need for privacy to sanitise the cup, fear of leakage and infections and familial disapproval. Adaptations to the nuances of cup use were fast and undemanding. No major health concerns were reported with the use of cups.
UNASSIGNED: Cultural factors in India pose various challenges to menstrual cup usage. Yet majority of women are likely to continue using menstrual cups after trying them. Women well-versed with sexuality and reproductive health face fewer difficulties and show better compliance.
UNASSIGNED: The foremost challenges found by this study are unique to the Indian context and continue to influence the choice of menstrual product.

Introduction Menstruation affects many young girls in a negative way in relation to their physical and psychological health despite being a reasonably common issue in daily life. Their health relies on their learning about fundamental menstruation hygiene. They have a significant risk of developing ailments due to their lack of education in this area. Young girls can avoid several preventable illnesses by being educated about menstruation hygiene and practices. Therefore, our study aimed to assess the impact of a health education intervention on the knowledge, attitude, and practice of teenage girls about menstrual hygiene. Materials and methods The current educational interventional study design evaluates the impact of an educational intervention on menstrual hygiene in teenage females. Adolescent girls were educated about the practices and taboos related to menstruation. They were assessed using a pretest and post-test after the intervention. The results of the pre- and post-study tests were compared, and the effect of the intervention was determined. Result A noteworthy observation of the study was that only 87 (34.8%) teenage girls were aware of hygienic practices before menarche. The didactic lecture had a favorable impact, and after two months, 2.40% of the 6.80% of females who changed their reusable pads just once a week began replacing them every two days. Additionally, a shift in hygiene behaviors was noted; 17.20% of the 33.60% of individuals started washing their hands with soap and water after changing their menstruation pads, which was significant (p=0.05). Conclusion The study assessed the impact of a short-term intervention on the menstrual habits practiced by adolescent girls. We concluded that an intervention in the form of educational counseling can significantly impact the menstrual hygiene practices of adolescent girls. Teaching teenage females resulted in a considerable improvement in their menstruation habits, which has a beneficial overall effect.

India is native to many tribal communities: Bharia (Madhya Pradesh), Bihl (Rajasthan), Santhal (Bihar, Jharkhand), Bodo (Assam, West Bengal), and many more. They reside in isolated geographical regions, which poses challenges in reaching out to them. In addition, they still have firm beliefs and taboos regarding menstruation. Knowledge about menstrual health and hygiene is one of the most important aspects of tribal health. Therefore, it is important to synthesize the results of menstrual hygiene data from the Indian tribal population. We have calculated the pooled prevalence of sanitary pad use, dustbin disposal, and hygienic reuse of menstrual materials. Online databases, namely PubMed, Cochrane Central, CINAHL, Pan African Journals, EBSCO, and Google Scholar, were searched. After the removal of duplicates, a quality check, and screening of cross-references, 19 articles were selected for final review. Statistical analysis was done by Revman 5.4 and STATA 17.0. A p-value of <0.05 was considered statistically significant. PRISMA guidelines were followed. The protocol registration number was CRD42022331376. This is a non-funded article. The pooled prevalence of sanitary pad use in Indian tribal females was 2% (95% CI 1 to 3). The pooled prevalence of dustbin disposal of menstrual material was 1% (95% CI: 0.00 to 0.02). The pooled prevalence of hygienic reuse of menstrual materials was 1%. Sanitary menstrual hygiene practices are very less prevalent in Indian tribal females. Awareness programs and tribal health policies need to be accelerated for the promotion of menstrual hygiene. Also, literature on the use, disposal, and storage of menstrual adsorbents is scarce in Indian tribes. Health research in this area needs to be emphasized.

In this study, hazardous substances in 5 different brands of sanitary napkins being used in India have been analysed through gas chromatography mass spectroscopy (GCMS). Concentration of chemicals such as volatile organic chemicals (VOCs) (acetone, iso propyl alcohol, toluene), persistent organic pollutant (dioxins and furans), phthalates and total chlorine present in sanitary napkin have been reported. Furthermore, amounts of plastic present per sanitary napkin and total plastic waste generation potential have been calculated. Additionally, data analysis was done to understand the health impacts of these hazardous chemicals on users and the environment. It has been found that Indian sanitary pads have higher concentration of hazardous chemicals, as compared to similar product being sold in developed countries like - USA, Europe and Japan. The values of total chlorine observed in 5 different brands were found to be in the range of 170 to 460 ppm; dioxins varied from 0.244 to 21.419 pg/g; furans varied from 0.07 to 0.563 pg/g; acetone varied from 351 to 429 ppm; isopropyl alcohol varied from 125 to 184 ppm; toluene varied from 2.91 to 3.21 ppb; concentration of two phthalates, DBP and DEHP varied from 57.3 to 127.8 and from 146.2 to 188.5, respectively. Plastic pollution potential of this waste is approximately 33,210 tons/year. Daily exposure volume (DEV) of dioxins varied from 2.295 to 2.266 pg TEQ/g and furan from 0.0616 to 0.0738 pg TEQ/kg/day, compared to safe TDI value < 0.7 TEQ/kg/day. Dioxin\'s value is around 3 times higher than the accepted TDI value, whereas furan is within acceptable limit. Daily exposure doses (DED) of DBP were observed in-between 4.24 and 9.47 μg/kg-bw/day, whereas the DEHP value varied from 0.541 to 0.698 μg/kg-bw/day.

Introduction Menstruation is an essential phenomenon in an adolescent girl\'s life. In India, females who are menstruating are considered impure and teenage girls are not allowed to undertake home chores or engage in religious or cultural events during their period. Up-to-date knowledge about menstruation, beginning in early adolescence, would improve safe practices and relieve the distress of millions of women. Material and methods A cross-sectional study was conducted among adolescent girls (10-19 years) residing in a tribal area of Nagpur District from January to March 2022. Three tribal residential schools (Ashram Shala) were selected from a total of six in Hingana Taluka of Nagpur District, using simple random sampling to fulfill the required sample size of 272. Demographic details, age at menarche, awareness of menstruation, sources of information about menstruation, menstrual hygiene practices, and restrictions observed during menstruation were assessed. Results The average age at menarche was 13.04+0.96 years (range 11-16 years). Only 45.17% of girls were aware of the menarche and menstrual cycle before its onset. The duration of the menstrual cycle ranged from 21-35 days in most of the girls (90.69%), and it was regular in 85.86% of girls. Duration of bleeding was two to six days for the majority of the girls (87.93%). Around 73.79% of girls were using sanitary pads, while 26.21% of girls were using clothes. The most important restrictions imposed on the girls during menstruation were not being allowed to attend religious functions (97.93%), followed by not being allowed to attend classes (65.86%). The use of sanitary pads was significantly more in late adolescent girls than in early adolescent girls (ꭓ2=14.97, p=0.0001), girls who have literate mothers than girls with illiterate mothers (ꭓ2=5.17, p=0.02), and girls belonging to higher socioeconomic classes (class I, II, III) than lower ones (class IV, V) (ꭓ2=44.23, p<0.0001). Conclusion The tribal adolescent girls still don\'t exercise proper hygiene throughout their periods. During menstruation, the majority of girls are still subjected to various restrictions.

UNASSIGNED: To analyze the relative value of providing menstrual cups and sanitary pads to primary schoolgirls.
UNASSIGNED: Cost-effectiveness and cost-benefit analyses of three-arm single-site open cluster randomized controlled pilot study providing menstrual cups or sanitary pads for 1 year.
UNASSIGNED: Girls 14-16 years of age enrolled across 30 primary schools in rural western Kenya.
UNASSIGNED: Cost-effectiveness analysis was conducted based on the health effects (reductions in disability-adjusted life years [DALYs]) and education effects (reductions in school absenteeism) of both interventions. The health and education benefits were separately valued and compared with relative program costs.
UNASSIGNED: Compared with the control group, the cost of menstrual cups was estimated at $3,270 per year for 1000 girls, compared with $24,000 for sanitary pads. The benefit of the menstrual cup program (1.4 DALYs averted, 95% confidence interval [CI]: -4.3 to 3.1) was higher compared with a sanitary pad program (0.48 DALYs averted, 95% CI: -4.2 to 2.3), but the health effects of both interventions were not statistically significant likely due to the limited statistical power. Using point estimates, the menstrual cup intervention was cost-effective in improving health outcomes ($2,300/DALY averted). The sanitary pad intervention had a cost-effectiveness of $300/student-school year in reducing school absenteeism. When considering improvements in future earnings from reduced absenteeism, the sanitary pad program had a net benefit of +$68,000 (95% CI: -$32,000 to +$169,000).
UNASSIGNED: The menstrual cup may provide a cost-effective solution for menstrual hygiene management in low-income settings. This study outlines a methodology for future analyses of menstrual hygiene interventions and highlights several knowledge gaps that need to be addressed. Trial registration: ISRCTN17486946.

Menstrual hygiene management (MHM) at work has been neglected in occupational health research despite its importance for female workers\' health. This study investigated the association between hours of working alone and poor menstrual health among 740 cosmetics saleswomen in South Korea. Hours of working alone in a day were classified into 4 categories. MHM was measured by asking \"Over the past six months, have you ever experienced that you could not change your sanitary pad when you need to change it at work?\" We also measured the experience of dermatopathy due to unchanged sanitary pads. Cosmetics saleswomen who worked alone for 3 h or more in a day reported a higher prevalence of ever being unable to change the sanitary pads (prevalence ratio [PR] 1.84, 95% confidence interval [CI]: 1.37-2.46) and dermatopathy due to unchanged sanitary pads (PR 2.06, 95% CI: 1.18-3.59) than those who worked alone less than 1 h in a day.

Menstrual hygiene management and health is increasingly gaining policy importance in a bid to promote dignity, gender equality and reproductive health. Effective and adequate menstrual hygiene management requires women and girls to have access to their menstrual health materials and products of choice, but also extends into having private, clean and safe spaces for using these materials. The paper provides empirical evidence of the inequality in menstrual hygiene management in Kinshasa (DRC), Ethiopia, Ghana, Kenya, Rajasthan (India), Indonesia, Nigeria and Uganda using concentration indices and decomposition methods. There is consistent evidence of wealth-related inequality in the conditions of menstrual hygiene management spaces as well as access to sanitary pads across all countries. Wealth, education, the rural-urban divide and infrastructural limitations of the household are major contributors to these inequalities. While wealth is identified as one of the key drivers of unequal access to menstrual hygiene management, other socio-economic, environmental and household factors require urgent policy attention. This specifically includes the lack of safe MHM spaces which threaten the health and dignity of women and girls.