Women’s health defines population health. The World Health organisation (WHO) defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
According to health experts, many women face acute discrimination beginning from their birth till leaving this world . Women have many unique health concerns like menstrual cycles, pregnancy, birth control, menopause and many more.
Dr Rifat Ara, Head of the Department of Gynecology and Obstetrics SKIMS Medical College and Hospital, Srinagar, said in the present era, adolescent girls go through a lot of factors that take a toll on their health which should be carefully dealt with by the parents and other family members through maintaining a healthy relationship.
“Proper counseling should be given regarding reproductive hygiene, especially before menarche (menstruation for the first time). Use of sanitary napkins, especially in the rural areas, should be encouraged to avoid various infections,” she said.
Dr Rifat said during the first one or two years after menarche, irregular cycles are common as the body is adapting to the hormonal changes. She said Polycystic Ovarian Syndrome (PCOS) has now become a common problem however it should not be ignored.
“It is a metabolic disorder which is often characterized by amenorrhea or irregular menstruation, excessive facial hair growth, and obesity. It can be diagnosed by different investigations and is treatable by changing lifestyle and through various medications,” she said.
Dr Rifat said another common health problem in women is a condition called endometriosis which is characterized by extremely painful menstruation and if not treated on time it may lead to infertility in future.
The onset of menstruation is one of the most important physiological changes occurring in girls during the adolescent years. Menstruation heralds the onset of physiological maturity in girls. It becomes the part and parcel of their lives until menopause. Apart from personal importance, this phenomenon also has social significance.
Menstrual hygiene is a hygienic practice during menstruation which can prevent women from infection in the reproductive and urinary tract. In India, menstruation is surrounded by myths and misconceptions with a long list of ‘do’s” and “don’ts’ for women.
Menstruation and menstrual practices are still clouded by taboos and socio-cultural restrictions resulting in adolescent girls lacking knowledge and remaining ignorant of the scientific facts and hygienic health practices, which sometimes results in adverse health outcomes.
Hygiene-related practices of women during menstruation are of considerable importance, as it may increase vulnerability to Reproductive Tract Infections (RTI’s).
As per doctors, poor menstrual hygiene is one of the major reasons for the high prevalence of RTIs in the country and contributes significantly to female morbidity.
Lack of knowledge regarding menstruation and menstrual hygiene leads to poor attitude and practice. There are various issues like awareness, availability and quality of napkins, regular supply, privacy, water supply, disposal of napkins, reproductive health education and family support which needs simultaneous attention for promotion of menstrual hygiene.
Dr Auqfeen Nisar, Medical Officer J&K Health Services said menstruation is a monthly event in the life of women in their reproductive years, which is often shrouded in secrecy.
“This silence towards this topic has led to less required communication. The needs of women during this period aren’t talked about, discussed and debated. Improper menstrual management is known to expose women to infections,” she said.
The doctor said good hygiene during menstruation is essential for ensuring good health of women while lack of hygiene can lead to infections, which are often not treated.
“Besides its effect on health, improper menstrual management can curtail the opportunities of education and employment. Due to the lack of hygienic methods, a significant proportion of girls are likely to miss out on school during their menstrual days or even completely drop out of the school, post-menarche,” she said.
While a substantial number of women in urban areas are using sanitary napkins, the situation becomes grave in urban slums and rural areas where women are still clinging to traditional methods like used cloth rags.
“Lack of awareness regarding use of hygienic products is a missing link, even in those women who are aware, the use is prohibited by lack of availability in places they feel comfortable to access, exorbitant pricing, lack of disposal facilities and generalized embarrassment towards anything to do with menstruation,” she said.
Many women in India, especially from urban slums, can not afford sanitary napkins and they ignore the health consequences and run the risk of infections and diseases.
“This adversely affects the health of these poor women and pushes them further into the vicious cycle of disease. Though the government has started with free sanitary napkins distribution in some states, the scheme is plagued by a lack of supplies, poor quality and an absent demand from users,” Auqfeen said.
As per UNICEF, every month, 1.8 billion people across the world menstruate. Millions of these girls, women, transgender men and non-binary persons are unable to manage their menstrual cycle in a dignified and healthy way.
Auqfeen said the education sector plays an important role in a child’s growth and development by allowing them to respond to changes and challenges they are facing in day to day life.
“But it avoids issues related to menstruation and menstrual hygiene management by considering it one’s personal matter,” she said.
The doctor who has worked for menstrual hygiene said girls should be educated about proper hygiene practices and also bring them out of traditional beliefs, misconceptions and restrictions regarding menstruation.
She suggests that awareness campaigns should be conducted where both men and women should be educated regarding menstruation to overcome false beliefs and taboos related to it.
“Government’s intervention is much needed in this regard. It is important that sustained public health programs are developed for women through the involvement of key stakeholders such as family members, school teachers, civil society and healthcare providers,” she said.
Auqfeen said that subsidy should be given on menstrual products so that every girl or woman can afford them easily keeping in mind their quality.
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.
