Dear Editor,
We extend our appreciation to Sonowal et al.[1] for their notable contribution to the subject of formulating policies concerning menstrual hygiene education of adolescent girls as well as their family members. Despite being a physiological phenomenon, menstruation is still a topic of discomfort in many societies. This results in adolescent girls entering puberty without sufficient informational care and understanding. Incomplete knowledge of menstrual hygiene not only puts the mental well-being of adolescents at risk, but also endangers their reproductive health. Reproductive tract infections (RTIs), genitourinary tract infections, cervical cancer, and other problems associated with abnormal discharge are often encountered in cases of improper menstrual hygiene.[1]
Open communication regarding menstruation helps empower young girls, as they learn the anatomy and autonomy of their bodies. However, these exchanges are only helpful when the mother is well informed about the process and management. As discussed by Sonowal et al.,[1] several studies have shown that maternal education regarding menstrual hygiene practices has proven to be effective against poor management of menses.
Denial of basic resources is one of the lesser-known facets of gender-based violence (GBV), which further extends to the denial of menstrual health education and management. Therefore, we would like to bring attention to the link between inadequate understanding of menstrual health management and its correlation to GBV. Deliberate denial of access to these basic commodities renders women deprived of sanitary products, which leads them to reusing old cloth(s), increasing the risk of RTIs and other health problems.[2] In certain parts of the world, the basic expense of sanitary products falls on men, which could instigate physical violence.[2] This has been noticeably aggravated by the economic crunch posed by coronavirus disease 2019 (COVID-19), considering that according to the United Nations Development Program (UNDP), 1.6 billion people lost 60% of their usual salary over 2020.[2] Lack of water, sanitation, and hygiene (WASH) facilities and/or inadequate access to them may force young girls to find an alternative, which is often a deserted field to change pads or a river to bathe. Given the stigmatization of the process, young girls may venture too far off to avoid being seen or shamed. This tremendously increases the risk of them getting sexually assaulted.[3] Inadequate menstrual health education appears to be a contributing factor to the above-mentioned scenarios and even to the link between menarche and early marriages. Early marriage puts both the mental and physical health of young girls in jeopardy, increasing the risk of GBV and physical aggression toward them. It must be an essential part of menstrual health education programs to state and promote that menarche is neither an indicator of marriage nor a sign of healthy childbearing.[4]
Menstrual health education programs, access to cost-effective sanitary products and sanitation facilities, and an enabling school and home environment can help effectively combat period poverty.[5] Further research is needed to explore various dimensions of this link between inadequate menstrual health education and GBV, so that steps can be taken to counter assault and violence associated with insufficient knowledge of a process that is both normal and natural.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
- 1.Sonowal P, Talukdar K, Saikia H. Sociodemographic factors and their association with menstrual hygiene practices among adolescent girls in Urban slums of Dibrugarh town, Assam. J Family Med Prim Care. 2021;10:4446–51. doi: 10.4103/jfmpc.jfmpc_703_21. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Days for Girls. Building Bridges to end gender-based violence:How prevention and menstrual equity go hand in hand. Days for Girls International. 2021. [Last accessed on 2022 Apr 09]. Available from: https://www.daysforgirls.org/blog/building-bridges-to-end-gender-based-violence-how-prevention-and-menstrual-equity-go-hand-in-hand/
- 3.Nunbogu AM, Elliott SJ. Characterizing gender-based violence in the context of water, sanitation, and hygiene:A scoping review of evidence in low- and middle-income countries. Water Security. 2022;15:100113. doi:10.1016/j.wasec. 2022.100113. [Google Scholar]
- 4.Raj A, Ghule M, Nair S, Saggurti N, Balaiah D, Silverman JG. Age at menarche, education, and child marriage among young wives in rural Maharashtra, India. Int J Gynecol Obstet. 2015;131:103–4. doi: 10.1016/j.ijgo.2015.04.044. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Casola AR, Luber K, Riley AH, Medley L. Menstrual health:Taking action against period poverty. Am J Public Health. 2022;112:374–7. doi: 10.2105/AJPH.2021.306622. [DOI] [PMC free article] [PubMed] [Google Scholar]