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Introduction to women’s menstrual and reproductive health

Post by on Saturday, May 28, 2022

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 Menstrual health is defined as complete physical, mental, and social wellbeing in relation to the menstrual cycle. This definition reflects the multifaceted nature of menstruation and the many ways the lives of those who menstruate can be affected by their ability to properly manage their menstrual health. Achieving good menstrual health is not just a matter of ensuring access to menstrual products but also relies on individuals having the resources they need to participate fully in all spheres of life during their menstrual cycle. These resources might illustratively include information, supplies, sanitation facilities, supportive environments (including sensitizedteachers and work supervisors), and accessible health-care workers trained in menstrual health disorders.

Millions of women and girls worldwide experience period poverty, described as limited access to period products, menstrual education, or adequate water sanitation and hygiene facilities.

In addition, cultural norms, stigma, and taboos surrounding menstruation create further barriers to achieving menstrual health. Although people's experiences of period poverty are varied and unique, the social determinants of health and structural determinants of gender inequality act as key drivers of period poverty across the globe. Through experiencing these barriers to achieving menstrual health, all those who menstruate are being denied their basic human rights. Many of these human rights have shaped the development framework of the UN Sustainable Development Goals, including poverty, education, health, water and sanitation, and gender equality; therefore, addressing menstrual health is crucial to reaching these goals by 2030. We propose four action points for achieving menstrual health for all. 

First, there is a strong need to provide an enabling sociocultural environment for those who menstruate to manage their menstrual needs with dignity and comfort. We can transform the social environment by creating structural level changes, such as promoting messaging to challenge societal norms by including men and boys, along with those who menstruate, towards reducing menstrual stigma, which is often a product of patriarchal norms.

Second, shift the focus away from principally one of access in relation to period products. Across many countries seeking to address menstrual health, distributing period products is the priority; however, interventions should augment these efforts by providing affordable quality materials, and information on different types of products, so that individuals can make an informed choice about the product that best suits their needs. Additionally, menstrual health curricula should be available for all those who menstruate to promote understanding of the menstrual cycle within reproductive health, consideration of menstrual disorders, and reduce stigma and shame through normalizing discussion of menstruation.

Third, we need to ensure the provisioning of adequate sanitation facilities, water, changing and bathing spaces, and work with governments to support the development of waste management systems that support the disposal of used menstrual materials.

Fourth, health workers should be better trained on menstrual health, menstrual disorders, and gender-responsive approaches to understanding the needs of all the individuals who menstruate, including girls and women, people with disabilities, transgender people, and gender non-binary individuals. We need health-care systems that treat menstruation as an important sign of health and wellbeing and a key indicator of population health. 

Lastly, individuals who menstruate are often neglected, including those in emergency contexts, which directly affects their rights to health, education, non-discrimination, and gender equality. There is a need to recognize menstrual health as a key right within the right to health. This has never been clearer than during the COVID-19 pandemic, as those who menstruated faced barriers to safe, hygienic, private places to manage their menstruation, along with shortages of menstrual products, an essential item for health and dignity.

This definition of menstrual health aligns with the WHO definition of health and attends to mental and social, as well as physical well-being. We intentionally link menstrual health to the menstrual cycle. This acknowledges that menstrual-related discomforts and disorders, consequences for mental well-being, and social exclusion are not restricted to the menstrual period. Whilst the majority of those who experience a menstrual cycle are women and girls, this approach also communicates the relevance of menstrual health for all those who experience a menstrual cycle, regardless of their gender identity. Further, it recognises that many who experience a menstrual cycle may not experience regular bleeding and the absence of menstruation can be a source of anxiety and distress.

Referring to “women, girls, and all other people who experience a menstrual cycle” draws attention to the fact that people experience menstruation differently, shaped by their lived experiences, needs and circumstances. Disability, age, gender identity, place of residence, homelessness, housing instability, conditions of detention, migration, disaster, insecurity and displacement, religion, ethnicity, caste, culture and many other factors influence menstrual experiences and must be considered to adequately meet menstrual health needs. 

This does not mean that those who do not experience a menstrual cycle are not affected by social, cultural and economic aspects of menstruation or that they should not play an essential role in achieving this state for others. On the contrary, achieving a complete state of menstrual health requires education about the menstrual cycle for everyone, including men and boys, health care providersand the dismantling of harmful stigma and norms amongst society at large.

Menstrual Disorders

Menstrual disorders are a disruptive physical and/or emotional symptoms just before and during menstruation, including heavy bleeding, missed periods and unmanageable mood swings. Some women get through their monthly periods easily with few or no concerns. Their periods come like clockwork, starting and stopping at nearly the same time every month, causing little more than a minor inconvenience. However, other women experience a host of physical and/or emotional symptoms just before and during menstruation. From heavy bleeding and missed periods to unmanageable mood swings, these symptoms may disrupt a woman's life in major ways. Most menstrual cycle problems have straightforward explanations, and a range of treatment options exist to relieve your symptoms. If your periods feel overwhelming, discuss your symptoms with your health care professional. Once your symptoms are accurately diagnosed, he or she can help you choose the best treatment to make your menstrual cycle tolerable.

Menstrual disorders are problems that affect a woman's normal menstrual cycle. They include painful cramps during menstruation, abnormally heavy bleeding, or not having any bleeding.Menstruation occurs during the years between puberty and menopause. Menstruation, also called "menses" or a "period," is the monthly flow of blood from the uterus through the cervix and out through the vagina.

Reproductive health refers to mortality, morbidity and quality of life attributable to the reproductive system, process and events experienced by men and women at all ages. The World Health Organization (WHO) defines reproductive health as "a state of physical, mental and social well-being in all matters relating to the reproductive system at all stages of life." The term reproductive age group refers to the active reproductive years in women starting with menarche around 12-14 years and ending with menopause around 45-49 years. For demographic purposes, reproductive age group is usually defined as 15-49 years or 12-49 years.

Female Reproductive System

The organs and structures in the female reproductive system include the uterus which is a pear-shaped organ located between the bladder and lower intestine. The cervix is the lower portion of the uterus. It contains the cervical canal, which connects the uterine cavity with the vagina and allows menstrual blood to drain from the uterus into the vagina. The vaginal opening of the canal is called the external os. Pap smears are collected from the external. The endometrium is the inner lining of the uterus. During pregnancy it thickens and becomes enriched with blood vessels to house and nourish the growing fetus. If at the end of a menstrual cycle pregnancy does not occur, the endometrium is shed and the woman starts menstruating. Menstrual flow consists of blood and mucus from the cervix and vagina.

The uterus is a hollow muscular organ located in the female pelvis between the bladder and rectum. The ovaries produce the eggs that travel through the fallopian tubes. Once the egg has left the ovary it can be fertilized and implant itself in the lining of the uterus. The main function of the uterus is to nourish the developing fetus prior to birth.

Menstrual hygiene

Gender inequality, cultural taboos and poverty can cause menstrual health needs to go unmet. The onset of menstruation means a new phase and new vulnerabilities in the lives of adolescents. Yet, many adolescent girls face stigma, harassment and social exclusion during menstruation. Transgender men and non-binary persons also face discrimination due to their gender identity, depriving them of access to the materials and facilities they need. Gender inequality, discriminatory social norms, cultural taboos, poverty and lack of basic services like toilets and sanitary products can all cause menstrual health and hygiene needs to go unmet. Menstrual health and hygiene interventions can help overcome these obstacles. Not only do they fulfill the unmet demand for menstrual hygiene products; they also protect dignity, build confidence, and strengthen sexual and reproductive health, particularly among adolescents.

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