Seeking synergies: understanding the evidence that links menstrual health and sexual and reproductive health and rights

Abstract

Global efforts to improve menstrual health and sexual and reproductive health and rights (SRHR) are fundamentally intertwined and share similar goals for improving health and well-being and increasing gender equality. Historically, however, the two fields have operated independently and missed opportunities to build upon their biological and sociocultural linkages. Biological touchpoints connecting the two fields include genital tract infections, menstrual disorders, contraception, and menopause. From a sociocultural perspective, intersections occur in relation to the experience of puberty and menarche, gender norms and equity, education, gender-based violence, and transactional sex. We describe evidence linking menstrual health and SRHR and offer recommendations for integration that could strengthen the impact of both fields.

Integration of a menstrual health intervention in a community-based sexual and reproductive health service for young people in Zimbabwe: a qualitative acceptability study

“…There is a growing body of literature looking at MHH interventions. However, programs, research, and policy continue to address MHH as a stand-alone issue and most interventions have focused on school-going girls [ 9 , 12 , 13 ]. A systematic review of MHH interventions in LMICs reports that sustainable and effective MHH interventions need to be comprehensive, contextually specific, and designed to address long-standing myths and misconceptions about menstruation and menstrual product use [ 14 ].…”

“…More recently, there has been a growing consensus that MHH and sexual and reproductive health (SRH) are intrinsically linked [ 13 ]. MHH is an important aspect of puberty and an access point for essential SRH information, services, and support structures that facilitate body autonomy from a young age, address reproductive health needs such as contraception and/or disease treatment, and improve women’s health outcomes over time [ 13 , 16 ].…”

“…More recently, there has been a growing consensus that MHH and sexual and reproductive health (SRH) are intrinsically linked [ 13 ]. MHH is an important aspect of puberty and an access point for essential SRH information, services, and support structures that facilitate body autonomy from a young age, address reproductive health needs such as contraception and/or disease treatment, and improve women’s health outcomes over time [ 13 , 16 ]. There is an opportunity to harness the intersections between MHH and SRH by using an integrated approach but there are limited data on the implementation or acceptability of interventions or services that integrate MHH and SRH [ 13 , 16 ].…”

Product-access challenges to menstrual health throughout the COVID-19 pandemic among a cohort of adolescent girls and young women in Nairobi, Kenya

“…Given similar sociocultural linkages between menstrual health and SRH, addressing risks for both SRH and menstrual health in a more synergistic manner could help mitigate the harmful impact of both. 27 …”

Global research and learning agenda for building evidence on contraceptive-induced menstrual changes for research, product development, policies, and programs

“…More research is needed to understand the full impact of CIMCs on contraceptive use, menstrual health, and quality of life 4 , 25 . There is also a substantial evidence gap in understanding the most effective programs and interventions to address CIMCs, including ideal approaches for counseling and the potential impact of integrating FP services and MH services c 26 , 27 . Finally, a lack of standardized and validated measures for different aspects of CIMCs and harmonization across the measurement of biological mechanisms, user preferences, social influences, impacts, and programs compounds the evidence gap 22 .…”