In developing countries, especially in India, menstrual problems are always an issue. A large number of women is unaware of periods and thinks that even talking about it is a social taboo. As a result, girls are skipping their schools. They are often shunned from the school, once in a month, whenever they are menstruating. Most importantly, they also they don’t even have the proper means to deal with periods. A 2014 report by the NGO  DASRA named Spot On! found that 23 million girls drop out of their school during puberty and faces many health problems due to menstruation.

Swapna Mazumdar, writing in The Tribune , says, “Talking about menstruation has been a taboo even among planners. It received the attention of the Ministry of Health only in 2011. Close to 70% per cent of Indian women risk getting severe infection, at times causing death, due to poverty, ignorance and shame attached to their menstruation cycle”.

According to the UNICEF report of the same year, in Tamil Nadu, 79% of the women population are unaware of menstruation hygiene. The percentage was 66% in Uttar Pradesh, 56% in Rajasthan and 51% in West Bengal. This is a disturbing figure which shows the poor condition of women in rural India.

Health Risks That Can Occur Due To Poor Menstrual Hygiene:-

1. Reproductive Tract Infections(RTIs)
Polluted products used to contain menstrual blood are the breeding grounds of bacteria like Salmonella, Staphylococcus and E.coli. The common symptoms women suffer are genitalia itching, back pain, abdominal pain, pustules over genitalia and irregular genitalia discharge.

2. Cervix Cancer
Human Papilloma Virus causes cervical cancer. Poor menstrual hygiene may increase the risk of cervix cancer.

3. Urinary Tract Infection

When harmful bacteria invade the urinary tract, it can cause infections in the mucous regions. It can increase the risk of UTIs if not treated.

4. Yeast Infections
A vaginal infection is a fungal infection that causes irritation, discharge, and intense itchiness in the vaginal areas.Poor menstrual hygiene causes Candidias bacteria in the urinary tract . This can affect 75% of women of reproductive stage and is mostly asymptomatic.

5. Hepatitis B
Women need to wash their hands before and after changing their sanitary napkins.

Menstrual Health Management

As defined by the Wikipedia, “Menstrual Hygiene Management (MHM) is a way to access to menstrual hygiene products to absorb or collect menstrual blood, privacy to change the materials, and access to facilities to dispose of used menstrual management materials”.

In India, due to lack of information, menstrual hygiene can be challenging management for women where traditional cultures and social taboos restricts women to access relevant and vital information about hygiene. In a 2014 study, however, approximately 42% of women did not know about sanitary napkins.

Menstrual waste is largely ignored by many developing countries. Only 46- 47 percent of schools have access to water and sanitation for girls worldwide. There isn’t any bin to throw the used sanitary napkins even is the sanitation is clean.


Things to use during menstrual cycle

1. Sanitary Napkins:- Sanitary napkins are first things that are introduced to girls after getting their first period.

  •   How to use a sanitary pad– Using a sanitary pad is pretty easy. First of all, remove the paper from the back side and place it on the underwear. Ans secondly, remove the paper from the wings. Wrap it on the both sides of the underwear and press firmly.
  • How to dispose off the used napkin- 

By following the right steps for disposal, you can help waste collectors easily identify and segregate sanitary waste. 

    • When to change a sanitary napkin- Girls need to change napkins in every few hours to avoid bad odour and uncomfortable feeling. It is very important to know that the blood, vaginal mucus and other impurities that the body is throwing out should be in contact with the skin for a long time. Hence, change  of pads in every 4 to 5 hours is necessary.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    2. Tampons- tampon is a hygiene product designed to absorb the menstrual flow by insertion into the vagina during menstruation.  These are available in several absorbency ratings. The average woman may use approximately 11,400 tampons in her lifetime.
    • How to use a tampon- First of all, wash your hands and get into a comfortable position. You can squat or sit on the toilet and put the knees apart. Then insert the tampon into the vagina using an applicant or your finger.
    • How to dispose off the tampon – Throw the wrapper and the applicant into the dustbin .(Note: Do not flush it).
    • When to change the tampon- It is best to change tampons within 4 to 8 hours. Don’t keep it in for more than 8 hours a day.                                                                                                                                                                                                                                                                     3. Menstrual cup – A menstrual cup is a hygiene device that is inserted into the vagina during menstruation. Its purpose is to collect menstrual fluid (blood from uterine lining) and prevent its leaking onto clothes. Menstrual cups are usually made of flexible medical grade silicon and shaped like a bell with a stem. The bell-shaped cup seals against the vaginal wall just below the cervix. Just one menstrual can be used for almost 10 years in contrast to tampons and sanitary napkins.
  • How to use a menstrual cup- Menstrual cup is first folded or pinched and then inserted into the vagina. It will normally unfold automatically and create a light seal against the vaginal walls. In some cases, the user may need to twist the cup or flex the vaginal muscles to ensure the cup is fully open. The cup shouldn’t leak or cause any discomfort if correctly inserted. The stem should be completely inside the vagina. If lubrication is necessary for insertion, it should be water based, as silicon lubricant can be damaging to the silicone.                                                          
  • How to remove the cup- Firstly, you need to practice this technique quite a bit. Then you need to find a comfortable position to remove it. This will cause the cup to ‘dent’ and the suction seal will be broken or released. The cup forms a suction seal with the vaginal walls and this is what helps prevent leaking.

 When to change the cup-  The cup can be kept in for 4-12 hours a day, depending upon the flow.

Menstrual cup is the best thing that happen to an adolescent girl. Menstrual cups were invented in the mid 20th century, but women of 2020 are still suspicious about it. Unlike pads and tampons, one menstrual cup can be used for 10 years. By that time so many pads and tampons will be used.

Menstrual cups are much more hygienic that sanitary napkins. Women are also suspicious about where they can get can these cups. There is hardly any advertisements about these. Menstrual cups can be of different shapes and sizes. And since pharmacies dont have them, girls can buy them online-  Boondh cup , She cup and others.


Girls from rural areas are not aware of proper sanitation. Most women dispose their used sanitary napkins or other menstrual materials in the open due to lack of awareness. Women dispose their menstrual waste into pit latrines as burning and burial were difficult due to limited privacy space.

When being at home, a woman’s behaviour regarding disposal is different than away from home. In urban areas women get the privilege of clean toilets, dustbins,, etc; at home. But outside, especially in public toilets, they flush them in the toilets or wrap and throw them in the dustbins. Where dustbins are not placed they leave the soiled pads wrapped or unwrapped in the toilet corners. This makes the toilets dirty, breeding place for flies and mosquitoes, and also unhygienic for other toilet users and cleaners. In many cities, the persons who manage the public toilets always complain of blockage of sewage system because of flushing of sanitary pads or rags in the toilet. As sanitation system was only designed for urine and feces, they are unable to cope with the inorganic materials like sanitary napkins. They often choke the pipelines.

Organic materials like tampons,  cotton wool, etc; does not choke pipelines. In rural areas, pit latrines once full they were covered with soil and new pit was dug but due to space limitations this was not practiced in urban areas. 



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