Perceptions, Beliefs, and Experiences about the Menstrual Cycle and Menstruation among Young Women: A Qualitative Approach.

The experience of menstruation is often associated with negative connotations and gender stereotypes, which results in making it invisible. This research aimed to explore the perceptions, beliefs, and knowledge of young Spanish women regarding the menstrual cycle and menstruation and their impact on their lives. The study delves into their understanding, menstrual management practices, the types of menstrual products employed, and their experiences related to menstrual health. Qualitative methodology was used with discussion groups as a data collection technique. The participants comprised 45 young Spanish women, aged between 18 and 23, hailing from both rural and urban areas. The majority were university students, with some engaged in part-time work, and one participant working full-time. While many experienced menstrual pain ranging from mild to debilitating, a normalization of this pain often led them to forego seeking specialist assistance. Disposable menstrual products (DMPs) are the most used by participants, despite limited awareness of their absorption capacity. Regarding reusable menstrual products (RMPs), menstrual cup users emphasized comfort but expressed a need for proper training. Negative menstruation experiences could evoke fear and difficulties, underscoring the importance of providing comprehensive menstrual health education encompassing both theoretical and practical components.

Menstrual health inequities and "period poverty" in Canada.

Period poverty is the lack of access to menstrual products, sexual and reproductive health education, safe waste management, and adequate facilities. Despite its being a public health issue and a significant concern for numerous Canadians, there is a lack of peer-reviewed research on period poverty in Canada. Existing Canadian research has primarily been conducted by non-profit organizations/charities or industry leaders for menstrual products, resulting in incomplete data. More research is needed to explore the menstrual inequities in Canada and their impact on the well-being of Canadians. This is a critical step to ensure the menstrual needs of Canadians are appropriately addressed.

RéSUMé: La précarité menstruelle est le manque d'accès aux produits pour la menstruation, à l'éducation à la santé sexuelle et reproductive, à la gestion sûre des déchets et à des installations adéquates. Bien que ce soit un problème de santé publique et une préoccupation importante pour bon nombre de Canadiennes et de Canadiens, il n'y a pas assez de recherche évaluée par les pairs sur la précarité menstruelle au pays. La recherche canadienne existante a principalement été menée par des organismes caritatifs/à but non lucratif ou par les grandes entreprises de produits pour la menstruation, ce qui explique que les données sont incomplètes. Il faut pousser la recherche pour explorer l'iniquité menstruelle au Canada et ses effets sur le bien-être des Canadiennes et des Canadiens. C'est une étape essentielle pour pouvoir aborder convenablement les besoins menstruels de la population.

Acceso y prácticas de higiene menstrual en América Latina: revisión de alcance / Menstrual hygiene access and practices in Latin America: scoping review / Acesso e práticas de higiene menstrual na América Latina: revisão de escopo

Objetivo: sintetizar la evidencia disponible relacionada con el acceso y las prácticas de higiene menstrual en América Latina y el Caribe. Método: revisión de alcance de la literatura con protocolo de investigación registrado en el Open Science Framework, realizada en las bases de datos bibliográficas: PubMed, Scopus, Web of Science y Portal Regional da Biblioteca Virtual em Saúde. Los datos fueron analizados mediante estadística descriptiva simple y análisis temático. Resultados: se incluyeron 15 publicaciones, la mayoría de las cuales trataban sobre adolescentes en Brasil: 12 artículos, dos informes técnicos y una monografía de trabajo de conclusión de curso. Como temas recurrentes en las publicaciones se destacan: acceso a condiciones dignas para el manejo de la higiene menstrual; necesidad de acceso a información sobre el manejo de la higiene menstrual; y prácticas para el manejo de la higiene menstrual. Conclusión: adolescentes informan dificultades para acceder a baños, agua y materiales absorbentes, y falta de información sobre la salud menstrual, incluso en las escuelas, lo que lleva al ausentismo escolar. De esta manera, las lagunas en la literatura científica latinoamericana revelan desigualdades y diversidad en las experiencias menstruales interseccionadas por categorías como género, clase social y etnia.

Objective: to synthesize available evidence related to menstrual hygiene access and practices in Latin America and the Caribbean. Method: literature scoping review with research protocol registered in the Open Science Framework, carried out in the bibliographic databases: PubMed, Scopus, Web of Science and Portal Regional da Biblioteca Virtual em Saúde. Data were analyzed using simple descriptive statistics and thematic analysis. Results: 15 publications were included, the majority of which addressed adolescents in Brazil: 12 articles, two technical reports and a course conclusion monograph. As recurring themes in the publications, the following stand out: Access to dignified conditions for managing menstrual hygiene; Need for access to information on menstrual hygiene management; and Practices for managing menstrual hygiene. Conclusion: adolescents report difficulties in accessing toilets, water and absorbent materials, and lack of information about menstrual health, including in schools, leading to school absenteeism. Thus, gaps in the Latin American scientific literature reveal inequalities and diversity in menstrual experiences intersected by categories such as gender, social class and ethnicity

Objetivo: sintetizar evidências disponíveis relacionadas ao acesso e práticas de higiene menstrual na América Latina e Caribe. Método: revisão de escopo da literatura com protocolo de pesquisa registrado no Open Science Framework, realizada nas bases de dados bibliográficas: PubMed, Scopus, Web of Science e Portal Regional da Biblioteca Virtual em Saúde. Os dados foram analisados por estatística descritiva simples e análise temática. Resultados: foram incluídas 15 publicações, cuja maioria abordava adolescentes no Brasil: 12 artigos, dois relatórios técnicos e uma monografia de trabalho de conclusão de curso. Como temas recorrentes nas publicações, destacam-se: acesso a condições dignas para o manejo da higiene menstrual; necessidade de acesso à informação sobre manejo da higiene menstrual; e práticas para manejo da higiene menstrual. Conclusão: adolescentes relatam dificuldades de acesso a sanitários, água e materiais absorventes, e falta de informação sobre saúde menstrual, inclusive nas escolas, levando ao absenteísmo escolar. Assim, lacunas na literatura científica latino-americana revelam desigualdades e diversidade nas experiências menstruais interseccionadas por categorias como gênero, classe social e etnia.

Perception on Menstrual Cup Usage Among Teens and Reproductive Age Group Women: A Cross-Sectional Study.

Introduction: One of the challenges to menstrual hygiene management in resource-limited settings is limited access to safe and affordable menstrual hygiene products. An alternative to the widely used sanitary pads is the menstrual cup, which has received less attention in low- and middle-income countries. This study was carried out to assess the perception on menstrual cup usage among teens and reproductive age group women assess attending a tertiary care institute in a rural setup in Andhra Pradesh. Methodology: A prospective cross-sectional study was conducted among 164 teenage and reproductive age group women attending the Outpatient Department of Obstetrics and Gynecology with the help of a semi-structured, pretested and pre-piloted questionnaire to assess the perception of menstrual cup usage among the participants. Data were analyzed statistically using software, menstrual cup knowledge score was calculated based on data obtained from questionnaire. Results: Most of the study participants (87.8%) were using sanitary pads during menstruation. Cloth was also used by some of the participants (11.59%). Only one participant (0.61%) was reported using menstrual cup. Majority of the participants [121 (73.7%)] reported that they had never heard of menstrual cup, whereas 43 [(26.3%)] study participants reported that they were aware of menstrual cup. Only 2(4.65%) out of 43 participants had a good knowledge on menstrual cup whose knowledge score was 12. Five (11.63%) out of 43 participants had got 0 score and remaining participants got the score between 0 and 12. Conclusion: Most of the women were not aware of menstrual cup and even if they know about it, they do not have good knowledge about it. Awareness regarding menstrual cup should be promoted through media and awareness programs to reach everyone.

A Multimodal Qualitative Approach to Understanding Menstrual Health Equity among Adolescents and Young Adults.

STUDY OBJECTIVE: Menstrual inequity-unequal access to menstrual health care or products-negatively affects well-being in relation to the menstrual cycle, a construct known as menstrual health. Few studies have explored menstrual inequities among adolescent and young adult populations in the United States. This multimodal qualitative research aimed to explore factors that influence the lived experience of menstruation among this population. METHODS: This qualitative study consisted of individual interviews among menstruators ages 13-24, recruited from an urban academic medical center. Participants (N = 20) were a mean age of 19 years; 25% previously endorsed period poverty, and 90% were publicly insured. We conducted semi-structured interviews using participant video diaries in a video elicitation exercise. Data were coded by 2 investigators using thematic analysis driven by grounded theory. RESULTS: Emergent themes included the need to normalize menstruation, the need for comprehensive menstrual health education, and the need for menstrual products to be more accessible. Twelve youth prepared video diaries, and all reported positive experiences with the video process. CONCLUSIONS: This youth-centered, multimodal study is one of the first to qualitatively explore the lived experiences of menstruation among adolescents in the United States and identified key inequities in menstrual health from their own perspectives. Thematic findings were mapped onto a proposed framework for menstrual equity that can be applied to future research and efforts around policy change. More research is needed to assess the impacts of these policies.

Menstrual Hygiene Problems and Challenges Faced by Adolescent Females in Rural Areas: A Narrative Review.

Menstruation is a vital sign of reproductive health and development. Menstrual hygiene practices are consequently a significant public health issue. However, menstrual practices are still tainted by taboos and other sociocultural constraints, which adversely affect health since adolescent females in rural areas are unaware of the scientific facts regarding menstrual hygiene practices. The Indian government has recognized the significance of menstrual hygiene and developed and implemented several programs and schemes for menstrual hygiene management (MHM). But due to a lack of, little, or inaccurate knowledge and cultural practices and socio-economic status, adolescent females face many obstacles and suffer from health issues. A comprehensive literature and data search was done using key databases such as PubMed and Google Scholar and other sources such as the Ministry of Health and Family Welfare (MoHFW), the United Nations International Children's Emergency Fund (UNICEF), the World Health Organization (WHO), and Google to identify the relevant articles and reviewed publications using full-text search. A total of 40 articles out of 1,461 were selected for review after the screening and elimination of repeated articles. The objective of this literature review is to assess the awareness and knowledge of the importance of menstruation, the understanding of safe menstruation practices, the significance of properly disposing of menstrual products, and the knowledge of how to guard against reproductive system infection and its consequences and also to identify the problems and challenges faced by adolescent females during their menstrual hygiene practices or management. The core of many health issues is misinformation, myths, erroneous beliefs, lack of awareness, and incomplete or incorrect knowledge about menstruation. Therefore, it is essential to teach adolescent females about hygienic behavior and safe menstrual practices.

Determinants of menstrual cup use among undergraduate medical students: A cross-sectional study.

OBJECTIVE: To identify the determinants of menstrual cup use among medical students in Brazil. METHODS: A cross-sectional study with an online survey regularly applied to matriculate women from Medical School in January 2021. RESULTS: Of 277 women, 164 participated. The mean age was 22.26 ± 3.21 years. In all 136 women preferred external pads, 60 internal pads, 28 menstrual cups, and 11 did not use. Using a 1-10 scale, price, efficacy, sustainability, practice, vaginal health status, hygiene, and importance of internal genital integrity were investigated. Thirty-seven (22.56%) women related the use of menstrual cups in the last year. Using any method to reduce menstruation had an adjusted odds ratio (aOR) of 0.310 (95% confidence interval [CI] 0.122-0.787). Concern about the environmental biodegradation had an aOR of 6.369 (95% CI 1.372-29.562); concern about intimal health had an aOR 1.996 (95% CI 1.183-3.368); and concern about internal genital integrity had an aOR of 0.824 (95% CI 0.682-0.995) for menstrual cup use. CONCLUSION: The significant independent factors for the use or adherence to menstrual cups were: women using a method to reduce their menstrual flow; concerning biodegradation; concerning vaginal health; with no concerns about manipulating their genitalia. The menstrual cup was used by 22.56% of a medical school in Brazil among undergraduate women.

The Understanding and Perception of the Menstrual Cup Among Medical Students.

Background: Menstruation and menstrual health management remains a challenge worldwide, largely owing to gender inequality, social and cultural stigma, inaccessibility, and poverty. Menstrual cups may offer solutions to the many challenges. The role of medical students in the promotion of women's health cannot be understated. Objectives: To investigate the understanding and perception of medical students on the use, safety, and efficacy of the menstrual cup as a menstrual hygiene product. Methods: This was a prospective, cross-sectional, quantitative study conducted at the University of the Witwatersrand on medical students. Questionnaires were emailed to students. The study was approved by the Wits HREC (M200885). Statistical software SPSS® 23.0 was used. Results: Two hundred and fifteen participants were recruited. One hundred and seventy-eight were included and analyzed; 58.93% had a basic understanding of the menstrual cup as a menstrual hygiene product (p < 0.001). There was an association between the gender of the respondents and knowledge of the device (p < 0.0001). Females were 7.467 times more likely to have heard about it. There was an association between gender and understanding the cost-effectiveness (p = 0.01), the year of study, and understanding of how it works (p = 0.012). The majority perceived the menstrual cup as convenient in terms of use, comfort, hygiene, and safety. Conclusion: It is important that the menstrual cup is not only introduced to society but also promoted and receives endorsement by healthcare workers. There is an understanding regarding the use, safety, and efficacy of the MC and a willingness to advise for use.

Study of Adaptability and Efficacy of Menstrual Cups in Managing Menstrual Health and Hygiene: A Descriptive Longitudinal Study.

Introduction Menstrual cup is a device made up of silicon for menstrual hygiene. Despite its being safe, eco-friendly, cheap, and durable its non-acceptability may be due to higher adoption barriers. We conducted this study to assess the adaptability and efficacy of menstrual cups. Methods It was a descriptive longitudinal study, conducted in a tertiary care institute in eastern India. Women of 18-50 years of age, educated till secondary level were included in the study, to be conducted over three months. The quantitative response for the satisfaction with the menstrual cup was measured on a five-point Likert scale after each menstrual cycle. Side effects, the quantity of blood flow and frequency of cleaning the menstrual cup, and how many participants will continue to use it were also asked. Results After the third menstrual cycle, 68.9% of participants stated that they would continue the menstrual cup usage. The mean total satisfaction score improved from 5.4 (first cycle) to 12.6 (third cycle) (p<0.001). The majority (67%) had no side effects, 10% had irritation and leakage, and 13% had an unpleasant odor. Conclusions The study shows that menstrual cups are a better alternative. Adaptability increases gradually through proper counseling, peer support, and practice.

Menstrual hygiene management and its determinants among adolescent girls in low-income urban areas of Delhi, India: a community-based study.

OBJECTIVES: Menstrual hygiene management (MHM) in developing countries is linked to human rights, social justice, and the education and empowerment of young girls. The objective of this study was to assess menstrual hygiene practices and their determinants among adolescent girls, including school dropouts, and the effects of pad distribution programs in urban resettlement areas of Delhi, India. METHODS: A cross-sectional study was conducted from March 2019 to February 2020 in urban resettlement colonies and 2 villages of Delhi among 1,130 adolescent girls aged 10 to 19 years, who were interviewed face to face. RESULTS: In total, 954 participants (84.4%) used only disposable sanitary pads, 150 (13.3%) used both sanitary pads and cloths, and 26 (2.3%) used only cloths (n=1,130). Most school-going girls utilized the scheme for pad distribution, but only two-thirds of the girls who were out of school utilized the scheme. In the adjusted analysis, girls with lower educational status, those who had dropped out of school, and those from the Muslim religious community were more likely to use cloths for MHM. CONCLUSION: More than 4 out of 5 adolescent girls in Delhi in low-income neighborhoods preferred sanitary pads for MHM. The government free pad scheme reached near-universal utilization among school-going girls (97%), but the subsidized pad scheme for girls who did not attend school was insufficiently utilized (75%).

Menstrual hygiene products: A practice evaluation.

OBJECTIVE: The choice and use of a type of hygienic protection depends on many factors. Due to growing media interest, the field of hygienic protection is evolving, however, to date no study has been carried out on this subject in France. The objective of this study was to evaluate women's practices regarding the use of hygienic protection. MATERIAL AND METHODS: From 2 June 2019 to 4 January 2020, 1,153 patients responding to a self-report questionnaire were included in a prospective, cross-sectional, observational, single-center study. The aim of the study was to describe women's practices with regard to menstrual hygiene products and the factors determining their choices, as well as their knowledge of the potential risks associated with these protections and their sources of information. RESULTS: Disposable sanitary pads were preferred by 930/1148 (81%) of patients, and menstrual tampons were used half as much (525/1150 (45.6%) of women surveyed)). The new menstrual hygiene products (washable sanitary pads, menstrual panties, and menstrual cups) were used by only 51/1150 (4.4%); 20/1149 (1.7%); 108/1150 (9.4%) of the patients; however, among the 92/1136 (8.1%) of the patients who had recently changed the type of protection, these new protections were the most popular because they were considered more ecological and less harmful to health. Menstrual hygiene products were perceived as a health risk for 924/1129 (81.8%) of patients. Menstrual toxic shock syndrome was knowledeg in only 473/1133 (41.7%) of patients. This lack of knowledge could lead to risky behavior. The majority of patients said they were not informed about hygiene protection, with only 151//1108 (13.6%) having discussed the subject with a health professional, yet 973/1067 (91.2%) wanted more information. CONCLUSION: This is the first French study on menstrual hygiene products. It showed that traditional sanitary protection was still the most widely used, but there was a growing awareness among patients about the products they used and their potential health risks as well as the consequences for the environment. Patients wanted to receive information on the subject from health professionals as well as manufacturers in order to be able to choose the product deemed the most suitable and in which they have confidence.

Menstrual Hygiene Practices and Constraints in Availing Government Sanitary Pad Provision among Adolescents in Rural Puducherry: A Mixed Method Study.

CONTEXT: Although free and subsidized sanitary pads are provided by the government, proportion of adolescents availing this service remains low. AIMS: The aim of the study was to determine the proportion of adolescent girls availing supply of sanitary napkins from a rural health training center (RHTC) in Puducherry; to assess the level of satisfaction with government supply; and to identify reasons for not accessing the same. SUBJECTS AND METHODS: The mixed-method cross-sectional study done in July 2017 included 240 adolescent girls living in the RHTC service area of a tertiary care institute. Quantitative data were collected house to house with a pretested semi-structured questionnaire and qualitative data from a focused group discussion. RESULTS: Sanitary pads were used by all of the participants who achieved menarche. Of them, 87 (40.2%) used pads purchased outside and 127 (58.8%) used both government supply and private purchase. Reasons for not availing government supply were insufficient quantity and low quality, lack of information about the government provision, and accessibility issues. CONCLUSIONS: Ensuring better quality and adequate quantity of sanitary pads supplied by the government along with increased awareness about the government provision can increase the utilization of the same by rural adolescents.

Use of Menstrual Sanitary Products in Women of Reproductive Age: Korea Nurses' Health Study.

OBJECTIVES: The use of menstrual hygiene products and its effect on women's health remains under studied. Patterns of menstrual hygiene product use and the rationale behind choices among Korean women aged 18-45 years were examined. METHODS: This cross-sectional study was a part of the Korea Nurses' Health Study. A total of 20,613 nurses participated, and 8,658 nurses participated in Module 7 which included a menstrual hygiene products-related survey. The data were collected through the mobile survey using a self-reported questionnaire. Participants' use of menstrual hygiene products and related characteristics were analyzed using frequency (percentage) or mean (SD). RESULTS: The most common types of menstrual hygiene products across all age groups were disposable menstrual pads (89.0%), followed by cloth menstrual pads (4.5%), tampons (4.2%), and only 1.6% used a menstrual cup. Disposable menstrual pads were the most common across all age groups, but in those aged under 30 years this was followed by tampon use (6%). The most important criteria when choosing a menstrual hygiene product was comfort for disposable menstrual pads (31.3%) and tampons (41.5%), natural ingredients or organic products for cloth menstrual pads (51.4%), and custom fit for the menstrual cup (50.7%). However, for all menstrual hygiene products (except cloth menstrual pads), there was a higher proportion of anxiety than perception of safety, and low awareness of toxic shock syndrome. CONCLUSION: It is important for women to use menstrual hygiene products with confidence. More research is needed to better understand potential health effects of menstrual hygiene products.

Avaliação da segurança e conforto no uso do coletor menstrual durante a prática esportiva: um estudo de coorte prospectivo / Evaluation of the safety and comfort of menstrual cup during physical exercise: a prospective cohort study

Objetivos: Avaliar o conforto no uso do coletor menstrual durante o exercício físico. Métodos: Foi realizado um estudo prospectivo com uma coorte de 49 jogadoras de handebol universitário. As participantes foram convidadas a usar o coletor menstrual descartável Softcup® durante três ciclos menstruais. O desfecho primário foi a satisfação geral no uso do coletor. Os desfechos secundários incluíram: facilidade de inserção e remoção do dispositivo, dor, desconforto nas relações sexuais, vazamento de sangue e/ou perda durante o exercício físico. Resultados: A idade média das participantes foi de 22 ± 2 anos. O grau de satisfação geral durante o esporte foi alto (82%). A inserção e a remoção do dispositivo menstrual foram consideradas fáceis pela maioria das usuárias e o grau de satisfação aumentou nos ciclos subsequentes. A queixa de vazamento do fluxo menstrual durante o esporte ocorreu em 63,3% das atletas no primeiro ciclo e caiu para 42,9% no último ciclo (p > 0,05). Houve perda do dispositivo durante o exercício em 36,7% das atletas no primeiro ciclo, 30,6% no segundo e 26,5% no terceiro ciclo (p > 0,05). Das atletas que tiveram relações sexuais com o uso do coletor menstrual, 90,9% não apresentaram desconforto. Conclusão: O conforto no uso do coletor menstrual durante o exercício físico foi elevado. Vazamento menstrual e perda do dispositivo tendem a diminuir com ciclos subsequentes.(AU)

Objective: To evaluate the safety and comfort of menstrual cup during physical exercise. Methods: A prospective cohort study was setting analysing a total of 49 female handball players with a mean age of 22 ± 2 years. The participants were invited to use Softcup® disposable menstrual during three menstrual cycles. The main outcome measures was overall satisfaction. Secondary outcomes included ease of insertion and removal of the device, pain, discomfort in sexual intercourse, blood leakage and/ or loss of the menstrual cup during sport. Results: The degree of overall satisfaction during sport was high (82%). The insertion and removal of the menstrual cup was considered easy by most users, and the degree of satisfaction increased in subsequent cycles. The complaint of menstrual flow leakage during sport occurred in 63.3% of the athletes in the first cycle and fell to 42.9% in the last cycle (p > 0.05).(AU)

Piloting an acceptable and feasible menstrual hygiene products disposal system in urban and rural schools in Bangladesh.

BACKGROUND: Access to washroom facilities and a place to dispose of menstrual waste are prerequisites for optimal menstrual hygiene management in schools. Like other low- and middle-income countries, Bangladeshi schools lack facilities for girls to change and dispose of their menstrual absorbents. We explored existing systems for disposing of menstrual absorbent wastes in urban and rural schools of Bangladesh and assessed the feasibility and acceptability of alternative disposal options. METHODS: We explored how girls dispose of their menstrual products, identified girls' preferences and choices for a disposal system and piloted four disposal options in four different schools. We then implemented one preferred option in four additional schools. We explored girls', teachers', and janitors' perspectives and evaluated the acceptability, feasibility, and potential for sustainability of the piloted disposal system. RESULTS: Barriers to optimal menstrual hygiene management included lack of functional toilets and private locations for changing menstrual products, and limited options for disposal. Girls, teachers, and janitors preferred and ranked the chute disposal system as their first choice, because it has large capacity (765 L), is relatively durable, requires less maintenance, and will take longer time to fill. During implementation of the chute disposal system in four schools, girls, teachers, and janitors reported positive changes in toilet cleanliness and menstrual products disposal resulting from the intervention. CONCLUSIONS: The chute disposal system for menstrual products is a durable option that does not require frequent emptying or regular maintenance, and is accepted by schoolgirls and janitors alike, and can improve conditions for menstrual hygiene management in schools. However, regular supervision, motivation of girls to correctly dispose of their products, and a long-term maintenance and management plan for the system are necessary.

Acceptability and safety of the menstrual cup: A systematic review of the literature / Aceptabilidad y seguridad de la copa menstrual: revisión sistemática de la literatura

Objectives: To conduct a systematic review of the literature and assess the acceptability and safety of the menstrual cup as a feminine hygiene product. Materials and methods: A search was conducted in the PubMed, Cochrane Library, Scopus, PopLine and Google Scholar databases for publications be- tween 1966 and July 2019. The terms ("Menstrual" AND "Cup") OR ("Copa" AND "Menstrual") were used. Quantitative, qualitative and mixed studies were included, as well as case series and case reports published in English and Spanish assessing the menstrual cup in women in childbearing age. The studies were selected and the data extracted by two reviewers working independently. Acceptability and safety were assessed as the primary result. The summary of the information is presented in narrative form. Results: Overall, 737 titles were found for initial review and, in the end, 38 studies were included in this work. The acceptability of the menstrual cup ranges between 35 % and 90 %. Between 10 to 45 % of women found it difficult to use. It was described as more comfortable when compared to tampons and pads. Continued use of the cup ranges between 48 and 94 %. In terms of safety, there was one case of toxic shock syndrome, one case of mechanical entrapment, and another case of allergy; and a higher risk of expulsion was found among intrauterine device users. Conclusion: The menstrual cup appears to be a comfortable, safe and efficient option for menstrual hygiene. Further randomized controlled studies and long-term prospective cohort studies are needed in order to determine the risk of complications due to excess bacterial colonization or retrograde menstruation.

TITULO: ACEPTABILIDAD Y SEGURIDAD DE LA COPA MENSTRUAL: REVISIÓN SISTEMÁTICA DE LA LITERATURA. OBJETIVO: Realizar una búsqueda sistemática de la literatura para evaluar la aceptabilidad y seguridad de la copa menstrual como producto de higiene genital femenina. METODOS: Se realizó búsqueda en las bases de datos PubMed, Cochrane Library, Scopus, PopLine y Google Scholar, desde 1966 hasta julio de 2019. Se utilizaron los términos: "Menstrual" AND "Cup" OR "Copa" AND "Menstrual". Se incluyeron estudios cuantitativos, cualitativos y mixtos, series y reportes de caso publicados en inglés y español que hubieran evaluado la copa menstrual en mujeres en edad reproductiva. Los estudios fueron selecciona- dos y los datos fueron extraídos por dos evaluadores de manera independiente. Como resultado primario se evaluó la aceptabilidad y seguridad. La síntesis de información se presenta de manera narrativa. RESULTADOS: Se encontraron 737 títulos para revisión inicial. Finalmente, se incluyeron 38 estudios. La copa menstrual tiene una aceptabilidad que varía entre el 35 y el 90 %. Del 10 al 45 % la encontraron difícil de usar. Fue descrita como más cómoda comparada con el tampón y la toalla higiénica de fabricación industrial. La continuidad de su uso está entre el 48 y el 94 %. En cuanto a la seguridad se presentó un caso de síndrome de choque tóxico, uno de atrapamiento mecánico, uno de alergia al producto y mayor riesgo de expulsión en usuarias del dispositivo intrauterino. CONCLUSIONES: La copa menstrual es una alternativa cómoda, segura y eficiente para la higiene mens- trual. Se requieren más estudios controlados alea- torizados y cohortes prospectivas a largo plazo para determinar el riesgo de complicaciones por una exagerada colonización bacteriana o menstruación retrógrada.

Acceptability and safety of the menstrual cup: A systematic review of the literature / Aceptabilidad y seguridad de la copa menstrual: revisión sistemática de la literatura

RESUMEN Objetivo: realizar una búsqueda sistemática de la literatura para evaluar la aceptabilidad y seguridad de la copa menstrual como producto de higiene genital femenina. Materiales y métodos: se realizó búsqueda en las bases de datos PubMed, Cochrane Library, Scopus, PopLine y Google Scholar, desde 1966 hasta julio de 2019. Se utilizaron los términos: "Menstrual" AND "Cup" OR "Copa" AND "Menstrual". Se incluyeron estudios cuantitativos, cualitativos y mixtos, series y reportes de caso publicados en inglés y español que hubieran evaluado la copa menstrual en mujeres en edad reproductiva. Los estudios fueron selecciona- dos y los datos fueron extraídos por dos evaluadores de manera independiente. Como resultado primario se evaluó la aceptabilidad y seguridad. La síntesis de información se presenta de manera narrativa. Resultados: se encontraron 737 títulos para revisión inicial. Finalmente, se incluyeron 38 estudios. La copa menstrual tiene una aceptabilidad que varía entre el 35 y el 90 %. Del 10 al 45 % la encontraron difícil de usar. Fue descrita como más cómoda comparada con el tampón y la toalla higiénica de fabricación industrial. La continuidad de su uso está entre el 48 y el 94 %. En cuanto a la seguridad se presentó un caso de síndrome de choque tóxico, uno de atrapamiento mecánico, uno de alergia al producto y mayor riesgo de expulsión en usuarias del dispositivo intrauterino. Conclusión: la copa menstrual es una alternativa cómoda, segura y eficiente para la higiene mens- trual. Se requieren más estudios controlados alea- torizados y cohortes prospectivas a largo plazo para determinar el riesgo de complicaciones por una exagerada colonización bacteriana o menstruación retrógrada.

ABSTRACT Objective: To conduct a systematic review of the literature and assess the acceptability and safety of the menstrual cup as a feminine hygiene product. Materials and methods: A search was conducted in the PubMed, Cochrane Library, Scopus, PopLine and Google Scholar databases for publications be- tween 1966 and July 2019. The terms ("Menstrual" AND "Cup") OR ("Copa" AND "Menstrual") were used. Quantitative, qualitative and mixed studies were included, as well as case series and case reports published in English and Spanish assessing the menstrual cup in women in childbearing age. The studies were selected and the data extracted by two reviewers working independently. Acceptability and safety were assessed as the primary result. The summary of the information is presented in narrative form. Results: Overall, 737 titles were found for initial review and, in the end, 38 studies were included in this work. The acceptability of the menstrual cup ranges between 35 % and 90 %. Between 10 to 45 % of women found it difficult to use. It was described as more comfortable when compared to tampons and pads. Continued use of the cup ranges between 48 and 94 %. In terms of safety, there was one case of toxic shock syndrome, one case of mechanical entrapment, and another case of allergy; and a higher risk of expulsion was found among intrauterine device users. Conclusion: The menstrual cup appears to be a comfortable, safe and efficient option for menstrual hygiene. Further randomized controlled studies and long-term prospective cohort studies are needed in order to determine the risk of complications due to excess bacterial colonization or retrograde menstruation.

Systematic Review on Sanitary Pads and Female Health / 이화의대지

The majority of South Korean females use sanitary pads, which contain various organic solvents which could be excreted before and during their menstruation. However, they are not provided with findings from studies about the health effects of sanitary pads. Therefore, this study aims to establish a list of potential health hazards of sanitary pads and address the need for further extensive research by pointing out the limitations of the previous literature. A systematic review was adopted to conduct quantitative and qualitative reviews based on the PRISMA (preferred reporting items for systematic reviews and meta-analyses). Studies from electronic databases such as PubMed, RISS, and Google Scholar were retrieved for the final analyses. In accordance with our findings, we proposed a set of limitations of the previous studies. A systematic review revealed that there were effects of sanitary pads on vaginal or vulvar skin, endometriosis, and vaginal microflora. The review also revealed that organic solvents, which sanitary pads are composed of, bring potential harmful effects on pregnancy, autoimmune disease, cardiovascular disease, and neurological development. Social environments such as hygiene use or puberty education also turned out to affect female health. It was inferred that a lack of non-occupational and domestic studies reflecting the distinguishing features of sanitary pads with a reliable sample size remains as an important limitation. This study suggests that organic solvents in sanitary pads may increase some health risks bringing reproductive, autoimmune, cardiovascular, and neurological effects. Due to a lack of studies, a more extensive study can contribute to the public health of South Korean females.

Status of Use of Menstrual Hygiene Products and Genital Organ Hygiene Management in Unmarried Women.

PURPOSE: The purpose of this study was to investigate the status of use of menstrual hygiene products and genital organ hygiene management in unmarried women. METHODS: Data from 161 unmarried women were used for analysis. The instruments consisted of self-reported questionnaires that included 40 items: 20 on General Characteristics & Sexual Health Related Characteristics, 8 on Using Status of Menstrual Hygiene Products, 12 on Genital Organ Hygiene Management. RESULTS: The subjects used disposable sanitary napkin as the most frequently but the satisfaction was low, while the use of reusable sanitary napkin and tampons were few, but satisfaction was high. Sixty-seven percent of the unmarried women had sex experience, and more than 60% experienced abnormal symptoms in the genital organ. There was a significant difference in genital organ hygiene management according to sex experience. Among subjects of this study, 44.1% wanted to use menstrual cup, and 98.8% wanted to have education for their menstrual hygiene products. CONCLUSION: Based on results of this study, a nationwide survey of the demand for menstrual hygiene products used by Korean women is needed, it is necessary to educate about the proper use of menstrual hygiene products and genital organ hygiene management.

Status of Use of Menstrual Hygiene Products and Genital Organ Hygiene Management in Unmarried Women

PURPOSE: The purpose of this study was to investigate the status of use of menstrual hygiene products and genital organ hygiene management in unmarried women. METHODS: Data from 161 unmarried women were used for analysis. The instruments consisted of self-reported questionnaires that included 40 items: 20 on General Characteristics & Sexual Health Related Characteristics, 8 on Using Status of Menstrual Hygiene Products, 12 on Genital Organ Hygiene Management. RESULTS: The subjects used disposable sanitary napkin as the most frequently but the satisfaction was low, while the use of reusable sanitary napkin and tampons were few, but satisfaction was high. Sixty-seven percent of the unmarried women had sex experience, and more than 60% experienced abnormal symptoms in the genital organ. There was a significant difference in genital organ hygiene management according to sex experience. Among subjects of this study, 44.1% wanted to use menstrual cup, and 98.8% wanted to have education for their menstrual hygiene products. CONCLUSION: Based on results of this study, a nationwide survey of the demand for menstrual hygiene products used by Korean women is needed, it is necessary to educate about the proper use of menstrual hygiene products and genital organ hygiene management.