Beyond menstrual hygiene: addressing vaginal bleeding throughout the life course in low and middle-income countries

Abstract

Girls and women experience numerous types of vaginal bleeding. These include healthy reproductive processes, such as menstruation and bleeding after childbirth, but also bleeding related to health conditions, such as fibroids or cancer. In most societies, the management of menstruation is handled covertly, something girls are often instructed about at menarche. The management of other vaginal bleeding is often similarly discreet, although behaviours are not well documented. In many societies, cultural taboos frequently hinder open discussion around vaginal bleeding, restricting information and early access to healthcare. Additionally, the limited availability of clean, accessible water and sanitation facilities in many low and middle-income countries augments the challenges girls and women face in conducting daily activities while managing vaginal bleeding, including participating in school or work, going to the market or fetching water. This paper aims to highlight the key vaginal bleeding experiences throughout a woman’s life course and the intersection of these bleeding experiences with their access to adequate water and sanitation facilities, information and education sources, and supplies. The aim is to address the silence around girls and women’s vaginal bleeding and their related social, physical and clinical management needs across the life course; and highlight critical gaps that require attention in research, practice and policy around this neglected topic of health and gender equality.

Making the Case for a Female-Friendly Toilet

“…In addition to covering their own costs, women sometimes must cover the cost of their children's access to such toilets, adding an additional financial burden that may limit their own usage [6,9]. Furthermore, water, which is essential for cleaning both after defecating (as anal cleansing remains common in Asian contexts) and during menstruation, is also often inconveniently located from the placement of rural latrines (e.g., such as a water source being located a sizable distance from a toilet), resulting in additional stress for the procurement of water by girls and women prior to toilet usage [1,3,8,27,28].…”

The Link Between Human Menstruation and Placental Delivery: A Novel Evolutionary Interpretation

“…Half of the World's human population menstruates, and the total time experiencing menstruation is at least a quarter of each woman's reproductive years. Menstruation has long been a taboo subject for different religions and cultures, based on ignorance, prejudice, and false information . Many women experience physical and emotional discomfort during menstruation, and this malaise may be amplified by prevailing archaic social attitudes towards menstruating women.…”

Review on Menstrual Hygeine.

“…(11) Other Problem faced by menstruating women is menstrual stress such stress is due to scarce guidance especially during bleeding episodes and it is not amenably discussed and women of low income background are not properly educated regarding irregular menstrual flow and these women doesn't have knowledge and acquaintance to manage heavy blood flow. (12) Current apprehension for MHM has focused in Ameliorating lavatories in schools thus providing privacy , MHM products in schools, separate Lavatories for girls where water along with other cleansing material are available and dustbins for proper disposal of sanitary pads. (13) Incineration is another way for discarding of menstrual waste especially in worksites and schools .It is very effective for pathogen cure and helps in waste reduction.…”