Exploring Menstrual Hygiene Practices and Awareness of Menstrual Cups Among Nursing Professionals: A Cross-Sectional Survey.

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. MATERIAL AND 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. CONCLUSION: 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.

Menstrual health and hygiene amongst adolescent girls and women of reproductive age: a study of practices and predictors, Odisha, India.

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. OBJECTIVES: 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. CONCLUSION: 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.

Precluding Menstrual Cups from the Mainstream: A Prospective Interventional Analysis Among Urban Women in India.

Introduction: 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. Methodology: 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. Results: 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. Discussion: 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. Conclusion: The foremost challenges found by this study are unique to the Indian context and continue to influence the choice of menstrual product.

Assessment of the Impact of a Short-Term Intervention on Menstrual Hygiene Practices of Adolescent Girls in Rural Parts of Central India.

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.

Menstrual Hygiene Practices in Indian Tribal Females: A Systematic Review and Meta-Analysis.

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.

The Indian perspective on the harmful substances found in sanitary napkins and their effects on the environment and human health.

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.

Study of Menstrual Hygiene Practices Among Adolescent Girls in a Tribal Area of Central India.

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.

Cost-Effectiveness and Cost-Benefit Analyses of Providing Menstrual Cups and Sanitary Pads to Schoolgirls in Rural Kenya.

Objective: To analyze the relative value of providing menstrual cups and sanitary pads to primary schoolgirls. Design: 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. Participants: Girls 14-16 years of age enrolled across 30 primary schools in rural western Kenya. Methods: 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. Results: 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). Conclusions: 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.

Women's attitudes toward certification logos, labels, and advertisements for organic disposable sanitary pads: results from a multi-city cross-sectional survey.

BACKGROUND: This cross-sectional study evaluated women's attitudes toward the certification logos, labels, and advertisements for organic disposable sanitary pads (OSPs) and investigated what could be the main reason for them. Additionally, the present study examined whether a relationship could be found between these attitudes and OSPs purchasing behavior. METHODS: This study was conducted using a self-reported online survey of Korean adult women who have purchased OSPs. The study questionnaire had four sections, covering (1) characteristics of OSP purchasing behavior, (2) attitudes toward OSP certification logos, labels, and advertisements, (3) demand on government and companies for proper management, and (4) respondent's sociodemographic information. The Cronbach's alpha value of the questionnaire was 0.857. RESULTS: A total of 500 respondents completed the questionnaire. Overall, high reliability was found for the certification logos (3.73 ± 0.61), labels on the product packaging (3.71 ± 0.63), and advertisements of OSPs (3.41 ± 0.62). Respondents indicated that these had fairly positive effects on their decision-making regarding product reliability, product image, and their own purchasing behavior. The aspects most frequently affected from the informants were safety to human health. All attitudes toward OSP certification logos, labels, and advertisements that were evaluated in this study became more positive in the direction from non-buyers to occasional buyers and to habitual buyers (all P < 0.05). The most significant demand from the respondents for OSP companies and the government was to clearly indicate hazardous ingredients on the OSP packaging (42.0%) and to strengthen the sanctions for false advertising (37.8%), respectively. CONCLUSIONS: The results of this study clearly indicate the importance of using certification logos, labels, and advertisements in the OSP market. These results can be utilized by OSP companies to improve the effectiveness of their marketing strategies or by policy makers and certifying bodies to manage the informants properly in the OSP market.

Working Alone, Limited Restroom Accessibility, and Poor Menstrual Health Among Cosmetics Saleswomen in South Korea.

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.

Aplicação da escala de avaliação do uso de fraldas em uma clínica médica de um hospital universitário / Application of the diaper use rating scale in a medical clinic of a university hospital / Aplicación de la escala de evaluación del uso de pañales en una clínica médica de un hospital universitario

Objectives:apply the evaluation scale for the use of diapers and absorbent products (AUFA Scale) in patients admitted to the medical clinic; identify and analyze the results of this application, the sociodemographic profile of patients in vogue as well as repercussions on the skin related to the use of sanitary pads and diapers. Method: observational, cross-sectional, descriptive and exploratory study, carried out in the medical clinic sector of the University Hospital Hospital Universitário Clementino Fraga Filho (HUCFF/UFRJ), from November 2019 to February 2020, with a convenience sample of 46 patients. There was application of a form to survey general data and, later, the application of the AUFA scale, which identified the following variables: skin conditions, skin aging, cognitive ability, motor skills and incontinence. Results: all 46 patients were using diapers, half women and the other half men, mostly elderly and without a diagnosis of incontinence. In view of the application and analysis of the AUFA scale, only 18 patients (39.14%) were indicated for diaper use. With the inappropriate use of diapers, 27 patients had skin lesions resulting from moisture, a situation that was justified by the absence of systematic care observation for the prevention and treatment of dermatitis associated with incontinence in the evaluated patients. Conclusion:the use of the AUFA scale is indicated to identify patients who need to wear diapers, delimiting care with their management and thus preventing complications and worsening of incontinence.

Objetivos:aplicar a escala de avaliação do uso fraldas e absorventes (AUFA) nos pacientes internados na clínica médica; identificar e analisar os resultados dessa aplicação, o perfil sociodemográfico dos pacientes em vogo bem como repercussões à pele relacionadas ao uso de absorventes e fraldas. Método: estudo observacional transversal, descritivo e exploratório, realizado no setor de clínica médica do Hospital Universitário Clementino Fraga Filho (HUCFF/UFRJ), no período de novembro de 2019 a fevereiro de 2020, com amostra por conveniência de 46 pacientes. Ocorreu aplicação de ficha para levantamento de dados gerais e, após, a AUFA, que identificou as seguintes variáveis: condições da pele, envelhecimento da pele, capacidade cognitiva, capacidade motora e incontinências. Resultados: todos os 46 pacientes encontravam-se em uso de fralda, sendo metade mulheres e a outra metade homens, em grande maioria composta de idosos e sem diagnóstico de incontinência. Diante da aplicação e análise da AUFA, apenas 18 pacientes (39,14%) tinham indicação para uso de fraldas. Com o uso inadequado da fralda, 27 pacientes apresentaram lesão de pele decorrente de umidade, situação que se justificou pela ausência da observação de cuidados sistematizados para prevenção e tratamento de dermatite associada à incontinência nos pacientes avaliados. Conclusão: indica-se o uso da escala AUFA para identificar os pacientes que necessitam usar fralda, delimitando cuidados com seu manejo e prevenindo, assim, complicações e agravamentos da incontinência.

Objetivos:aplicar la escala de evaluación del uso pañales y toallas sanitarias (AUFA) en los pacientes internados en la clínica médica; identificar y analizar los resultados de esta aplicación, el perfil sociodemográfico de los pacientes en estudio, así como repercusiones para la piel relacionadas al uso de toallas sanitarias y pañales. Método: estudio observacional transversal, descriptivo y exploratorio, realizado en el sector de clínica médica del Hospital Universitario Clementino Fraga Filho (HUCFF/UFRJ), en el período de noviembre del 2019 a febrero del 2020, con muestra por conveniencia de 46 pacientes. Ocurrió la aplicación de ficha para el levantamiento de datos generales y, después, la AUFA, que identificó las siguientes variables: condiciones de la piel, envejecimiento de la piel, capacidad cognitiva, capacidad motora e incontinencias. Resultados: los 46 pacientes se encontraban en uso de pañal, siendo mitad mujeres y la otra mitad hombres, en gran mayoría compuesta por ancianos y sin diagnóstico de incontinencia. Ante la aplicación y análisis de la AUFA, solamente 18 pacientes (39,14%) tenían indicación para el uso de pañales. Con el uso inadecuado del pañal, 27 pacientes presentaron lesión de piel derivada de humedad, situación que se justificó por la ausencia de la observación de cuidados sistematizados para prevención y tratamiento de dermatitis asociada a la incontinencia en los pacientes evaluados. Conclusión: se indica el uso de la escala AUFA para identificar a los pacientes que necesitan usar pañal, delimitando cuidados con su manejo y previniendo, así, complicaciones y agravamientos de la incontinencia.

Understanding Period Poverty: Socio-Economic Inequalities in Menstrual Hygiene Management in Eight Low- and Middle-Income Countries.

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.

Waste management and environmental impact of absorbent hygiene products: A review.

Absorbent hygiene products (AHP) have received much interest due to the notion that their end-of-life (EoL) stage has high environmental impacts. Since the use of AHP will continue to rise in the foreseeable future, information that helps with a reduction in the environmental impacts of AHP through their life cycle is needed. This research presents an estimation of AHP in municipal waste, and it also reviews and discusses waste management options, available treatments at bench, pilot or full scale, and life cycle assessments (LCAs) available in the literature. Municipal waste of countries belonging to the Organization for Economic Co-operation and Development contains on average 2.7% of baby nappies, 4.8% of adult nappies and 0.5% of sanitary pads (in weight), whereas that of Latin-American countries have 7.3%, 3.3%, and 0.9%, respectively. Management options for AHP waste in developed countries are landfilling and incineration, while in developing countries AHP are disposed of in dumpsites and landfills. Most LCAs identify significant environmental impacts in the production of raw materials, while EoL scenarios involving incineration and landfill were found to have a significant contribution to global warming potential. Substitution with alternative products has been suggested as a way of decreasing environmental impacts; however, their use frequently causes a trade-off on different impact categories. Municipalities could use a wide range of policy tools, such as extended producer responsibility systems, bans, levies, ecolabelling, or a combination of these, to reduce the environmental and economic burden of AHP waste.

Sensitizing fragrances in absorbent hygiene products.

BACKGROUND: Allergenic fragrances are present in a wide range of products but they are not regulated in all industries to the same extent. In Europe, absorbent hygiene products (AHPs) are only covered by the general product safety directive and therefore fragrances can be used freely, whereas in cosmetics and toys the use of these ingredients is regulated. METHOD: An analytical method was developed to evaluate the presence of 24 sensitizing fragrances in AHPs. This method allows simultaneous identification and quantification and was validated using the total error approach with an acceptance value of ±15%. RESULTS: The validated method was applied to evaluate 10 scented AHPs consisting of four tampons, three panty liners, and three sanitary pads. Eight allergenic fragrances were identified in these products and five products contained at least one allergen above 10 µg/g. CONCLUSION: The presence of these allergens is not communicated to the consumer. This is, however, a strict requirement in other industries (eg, cosmetics, toys) to ensure adequate consumer protection. Knowing that the exposed area is more susceptible to allergens and irritants, the presence of these allergens should be disclosed.

MR-guided focused ultrasound surgery: A novel non-invasive technique in the treatment of adenomyosis -18 month's follow-up of 12 cases.

BACKGROUND: Adenomyosis is a gynecological condition of the uterus, characterized by the presence of ectopic endometrial tissue in the myometrium. Hysterectomy, uterine artery embolization, and endometrial ablation therapy are the various surgical treatment options available for adenomyosis. A novel and globally upcoming technique is MR-guided focused ultrasound surgery "MRgFUS," which is a promising non-invasive surgical treatment option. This study was carried out to determine the effectiveness of MRgFUS in the symptomatic management of adenomyosis. SUBJECTS AND METHODS: This study was carried out as a long-term follow-up study among 12 cases of adenomyosis, which were treated by MR-guided focused ultrasound. In all these participant's, three parameters - symptom severity score (SSS), menstrual pain score accessed using visual analogue score (VAS), and number of approximate pads used during menstruation were recorded prior to the treatment and on follow-up at 3, 9, and 18 months, respectively. The Friedman's test was used to test the difference in the values of scores before and after treatment. RESULTS: There was a significant improvement in the SSS, VAS, and the numbers of sanitary napkins used after surgery and sustained during the long-term follow-up. These values were statistically significant (P < 0.05). CONCLUSION: MRgFUS can be used in successful treatment of adenomyosis/focal adenomyoma by careful selection of the participant, good planning, and proper monitoring of the technique during ablation.

Maximizing semen extraction from sanitary pads by chemical and shredding treatments.

Evidence of sexual aggression may be obtained from superabsorbent polymer (SAP) sanitary pads, which are used by forensic laboratories for semen evaluation. Semen can be extracted from their upper layers, which are free of SAPs. However, our previous results showed a need to optimize the protocol for semen analysis by considering its extraction from the lower core, often composed of sodium polyacrylate SAPs. SAPs generate a hydrogel, which traps the cellular components, hindering the possibility of obtaining cells and hence their genetic material. Simple filtration has been tried previously, but further maximization by application of a treatment has never been attempted. In this paper, we compare both chemical and physical shredding treatments for maximizing gel-trapped sperm and male cell DNA recaptures from hygienic superabsorbent substrates in sanitary pads, panty-liners or diapers. Our findings suggest that the lower core should be treated to induce a dewaterisation of the SAP hydrogels in order to maximize the extraction of bodily fluids.

Risk assessment of volatile organic compounds (VOCs) detected in sanitary pads.

Disposable sanitary pads are a necessity for women's health, but safety concerns regarding the use of these products have created anxiety. The aim of this study was to conduct a risk assessment of 74 volatile organic compounds (VOCs), which were expected to be contained within sanitary pads. Of the 74 VOCs, 50 were found in sanitary pads retailed in Korea at concentrations ranging from 0.025 to 3548.09 µg/pad. In order to undertake a risk assessment of the VOCs, the toxicological database of these compounds in the United States Environmental Protection Agency (USEPA), Agency for Toxic Substances and Disease Registry (ATSDR), National Toxicology Program (NTP) and World Health Organization (WHO) was searched. Ethanol was found to exhibit the highest reference dose (RfD) while 1,2-dibromo-3-chloro-propane displayed the lowest RfD. Consequently, a worst-case exposure scenario was applied in this study. It was assumed that there was the use of 7.5 sanitary napkins/day for 7 days/month. In the case of panty liners or overnight sanitary napkins, the utilization of 90 panty liners/month or 21 overnight sanitary napkins/month was assumed, respectively. In addition, 43 kg, the body weight of 12 to 13-year-old young women, and 100% VOCs skin absorption were employed for risk assessment. The systemic exposure dose (SED) values were calculated ranging from 1.74 (1,1,2-trichloroethane) ng/kg/day to 144.4 (ethanol, absolute) µg/kg/day. Uncertainty factors (UFs) were applied ranging from 10 to 100,000 in accordance with the robustness of animal or human experiments. The margin of exposure (MOE) of 34 VOCs was more than 1 (acceptable MOE > 1). Applicable carcinogenic references reported that the cancer risk of five VOCs was below 10-6. Based on our findings, evidence indicates that the non-cancer and cancer risks associated with VOCs detected in sanitary pads currently used in South Korea do not pose an adverse health risk in women.

Sanitary pads and diapers contain higher phthalate contents than those in common commercial plastic products.

Sanitary pads and diapers are made of synthetic plastic materials that can potentially be released while being used. This study measured the amounts of volatile organic compounds (VOCs) (methylene chloride, toluene, and xylene) and phthalates (DBP, DEHP, DEP, and BBP) contained in sanitary pads and diapers. In sanitary pads, 5,900- and 130-fold differences of VOC and phthalate concentrations were seen among the brands. In the diapers, 3- and 63-fold differences of VOC and phthalate concentrations were detected among the brands. VOC concentrations from the sanitary pads and diapers were similar to that of the residential air. However, phthalate concentrations of sanitary pads and diapers were significantly higher than those found in common commercial plastic products. As sanitary pads and diapers are in direct contact with external genitalia for an extended period, there is a probability that a considerable amount of VOCs or phthalates could be absorbed into the reproductive system.