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Background: 2‐Hydroxyethyl methacrylate (HEMA) was added into the European baseline series (EBS) in 2019. There is limited data regarding the frequency, relevance, and sources of exposure to HEMA. Objectives: To investigate the frequency and clinical relevance of positive reactions to HEMA in the EBS in Israel, and explore sources of exposure. Methods: Retrospective cohort study that included all patients who underwent patch testing with the EBS in a tertiary center in Israel between 2020 and 2023. Positive reactions to HEMA were stratified by sex, six age groups, and year of study. Sources of exposure to HEMA as well as occupational data were recorded. Results: A total of 1671 consecutive patients underwent HEMA patch testing, with 135 (8.1%) showing positive reactions to HEMA (130 females, 5 males). The prevalence in women (11.0%) was significantly higher compared to men (1.0%) (p < 0.001). Stratification by age and sex revealed the highest frequency of HEMA sensitivity of 16.7% among women younger than 30 years of age, with odds ratio of 2.3 (95%CI: 1.6–3.3, p < 0.001) compared to older women. There was an increase in frequency among women between the years 2022 and 2023 when compared to 2020–2021 (OR 1.7, 95%CI: 1.5–2.1, p < 0.01) attributable to COVID‐19 pandemic and social restrictions. Among men the frequency fluctuations over the study period and age categories were nonsignificant. 111 (84%) were judged to be of clinical relevance and nail cosmetics was responsible for 95% of them. Of 111 patients with relevant reaction (110 females, 1 males), 20 (18%) had occupational contact dermatitis (18 nails stylists, 2 dentists). Other culprit products included sanitary pads (n = 4), medical adhesives (n = 3), and paints (n = 2). Conclusion: We report the highest frequency of HEMA sensitivity to date of 8.1%, that was most common among young women and in vast majority of cases was attributable to nail cosmetics. Our findings reflect the popularity of nail cosmetics in Israel as well as the global trend of increasing sensitivity to (meth)acrylates. [ABSTRACT FROM AUTHOR]

Super absorbent polymers (SAPs) used in sanitary napkin are not required for water absorption capacity as high as in baby diapers and adult incontinence pads. Sanitary napkins must absorb menses, which is delivered at a significantly lower rate and overall daily amount than urines. Thus, the acrylic acid (AA) component can not be strictly necessary. By proper formulation design and processing, polysaccharide SAPs can be equally or even better performing than AA‐containing SAPs in sanitary napkins. Fully biodegradable sodium alginate (SA)‐based SAPs are prepared through ionic cross‐linking by CaCl2 and introduced in female pads. The optimal solution concentrations (SA 8% w/v, CaCl2 0.25% w/v in water) and reaction time are identified, and addition of cellulose nanocrystals (CNC) at different weight contents (0–3 w%) is tested. Morphology, physico‐chemical properties, rheology, free swelling capacity (FSC), centrifuge retention capacity, and weight loss in soil are assessed. Increasing CNC content decreases FSC. Rheology results demonstrate higher storage and loss moduli for SA‐based SAPs versus commercial SAPs. The superior SA‐SAP developed is used in varying amounts for manufacturing sanitary napkin prototypes, revealing that excellent menstrual fluid absorption, surpassing commercial pads. Replacing AA‐based with polysaccharide‐based SAPs would reduce the environmental impact of hygienic product waste. [ABSTRACT FROM AUTHOR]

Introduction: Tert‐butylphenol (TBP) derivatives, antioxidants in adhesives and diabetes devices, may provoke allergic contact dermatitis (ACD). Objectives: The objective of this study is to report sensitization to TBP derivatives in medical devices and to highlight that tert‐butylhydroquinone (BHQ) and tert‐butylcatechol (TBC) are potential screeners in this regard. Methods: Fifteen patients with ACD from adhesives and diabetes devices were patch tested to different TBPs: BHQ 1% pet., TBC 0.25% pet., BHA 2% pet., BHT 2% pet., 4‐tert‐butylphenol (TBP) 1% pet. and 2,4‐di‐tert‐butylphenol (di TBP) 1% pet. The culprit devices (medical adhesives, sanitary pads, diabetes devices) and TBP patch preparations were analysed using gas chromatography‐mass spectrometry (GC–MS). Results: BHQ (9/13), TBC (7/13), and to a lesser extent BHT (3/15), BHA (2/15) and TBP (2/13) gave positive reactions. Seven patients had developed ACD from adhesives and diabetes devices, respectively, and one patient from sanitary pads. GC–MS analyses of the medical devices and patch test materials confirmed the presence of the patch‐test positive TBPs, or chemically related derivatives, or, interestingly, tert‐butylbenzoquinones (BBQ) were found, that is, spontaneously formed, highly reactive TBP metabolites, likely (pseudo‐) cross reacting with the patch tested TBPs. Conclusion: TBPs might be overlooked sensitizers in medical devices, and BHQ and TBC are potential screeners in this regard. [ABSTRACT FROM AUTHOR]

Background: Menstrual hygiene management is a critical aspect of adolescent health. However, access to adequate menstrual hygiene products and sanitation facilities is severely restricted during times of war. There is a dearth of information about the menstrual hygiene needs of adolescent girls during humanitarian crises. This study investigated the menstrual hygiene management needs of the internally displaced adolescent girls in the war-torn region of Tigray, Ethiopia. Methods: A qualitative study was conducted in three centers for internally displaced people in Mekelle, Tigray Region. Four focus-group discussions and six in-depth interviews were conducted using the local language among 39 adolescent girls aged 13–19 years. The collected data were recorded, transcribed, translated, and analyzed using the ATLAS.ti-7.5.18 software through a qualitative thematic analysis approach. Results: Six primary themes were identified: 1) shortage of menstrual pads; 2) poor accommodation of latrine facilities; 3) silence around menstruation; 4) exchange of menstrual pads for life-saving commodities, 5) lack of privacy; 6) menstruation is a "curse" for adolescent girls living in displaced people's camps. The study highlights the significant challenges faced by internally displaced adolescent girls in managing their menstrual hygiene while living in camps for internally displaced people. Lack of access to adequate menstrual hygiene management supplies often leads them to use rags or worn-out clothing instead of menstrual pads. Conclusion: Access to adequate menstrual hygiene products and sanitation facilities is severely limited among displaced adolescent girls in Tigray. The findings emphasize the urgent need to address menstrual hygiene issues during emergencies. Supplying essential items such as sanitary pads, soap, water, sanitation infrastructure, and improved information on menstrual hygiene management should be prioritized. [ABSTRACT FROM AUTHOR]

Traditional menstrual absorbent pads typically combine cellulose fiber fluff pulp with non-biodegradable, petroleum-based superabsorbent polymers (SAPs). To eliminate the need for SAPs, this study explores foaming as a method to create a highly porous lignocellulosic fiber network capable of storing large amounts of fluid. Bamboo fibers were chosen due to their high lignin content, which is expected to help maintain the structural integrity of the porous network during liquid absorption and preventing collapse compared to 100% cellulose fibers. The bamboo fiber foams demonstrated remarkable porosity and superior absorbency compared to commercial pads, but they exhibited lower water retention when subjected to compression. Refining the fibers and incorporating microfibrillated cellulose offer promising opportunities to enhance water retention. [ABSTRACT FROM AUTHOR]

Background Menstrual Hygiene Management (MHM) is fundamental to women's health, well-being, and gender equality. The study aimed to assess the cost-effectiveness and acceptability of reusable sanitary pads among rural women in Pakistan, proposing a scalable model for improving MHM practices in low-income countries. Methods A cross-sectional study was conducted using Multi-Stage Cluster sampling to accomplish a sample size of 340 childbearing-age women from the rural areas of Sindh, Pakistan. The data was collected using a standard questionnaire regarding the affordability and accessibility of reusable versus disposable sanitary pads; further information was also gathered from Market surveys for MHM products. The biodegradability of the pads was assessed using a soil burial test. The data was analyzed using SPSS version 27. Results Our research found a significant preference for reusable sanitary pads. The biodegradability tests demonstrated that reusable pads had a superior degradation rate (1.88%) to disposable pads (1.59%) over four months. Economic assessments showed a low utilization of commercial pads (12.5%) due to affordability issues, with 87.5% using reusable cloths. Despite 70% awareness of menstrual hygiene, 48% of women showed interest in creating sanitary solutions, underscoring the feasibility of implementing locally sourced, cost-effective products across similar socio-economic landscapes. Conclusion The present study underscores the universal applicability of affordable, sustainable MHM solutions in rural communities of low-income countries, advocating for broader implementation of such models to address global menstrual hygiene challenges. [ABSTRACT FROM AUTHOR]

Products that may reduce menstrual flow from the endometrial cavity to the vagina (i.e. tampons and menstrual cups) could facilitate retrograde menstruation and the spillage of blood into the myometrium, two mechanisms which could be major determinants in endometriosis and adenomyosis pathogenesis. The aim of this narrative review is to summarize the evidence regarding the mechanical role menstrual products may have in the pathogenesis of these two conditions. Evidence in this regard is inconclusive. While Darrow and colleagues observed that 14 or more years of tampon use were associated with endometriosis (OR 3.6; 95% CI, 1.04–13.5); in Meaddough and colleagues' retrospective study, the percentage of women using pads only was significantly higher among those with endometriosis than among those without the condition (31% vs 22%). Three further groups failed to find an association between endometriosis/adenomyosis and any type of menstrual product. The only case that may be considered as a sort of proof-of-concept of the association between products potentially reducing anterograde menstrual flow and endometriosis was reported by Spechler and colleagues, who described the case of a 41 year-old who developed endometriosis after having used a menstrual cup on a regular basis. However, the number of studies on the subject is scarce, study populations are exiguous and a greater attention to temporality of endometriosis onset in relation to when women started habitually using a specific menstrual product is needed. Confounding variables including type and quantity of endocrine disruptors contained in menstrual products should also be addressed. At the present moment, no recommendation can be provided on the safety of one type of menstrual product compared to another. [ABSTRACT FROM AUTHOR]

Background: Women in Himachal Pradesh encounter various restrictions impacting their reproductive health practices, including menstrual hygiene, breastfeeding, and complementary feeding. This qualitative survey aimed to explore these practices, beliefs, and challenges to inform targeted interventions. Methods: A qualitative survey was conducted from March 2021 to August 2022 across 20 selected blocks in 11 districts of Himachal Pradesh. Focus group discussions (FGDs) included a diverse range of participants, such as women of reproductive age, lactating mothers, Anganwadi workers, ASHAs, and other stakeholders. Thematic analysis identified common themes and patterns related to menstrual hygiene, breastfeeding, and complementary feeding. Results: Thematic analysis revealed key findings in each area. Menstrual hygiene practices included the continued use of cloth instead of sanitary pads, improper disposal of menstrual products, and prevalent social and religious taboos and myths. Despite awareness of breastfeeding benefits, misconceptions about alternative feeding methods persisted. Complementary feeding practices were generally well understood, but certain communities held beliefs against nonvegetarian foods and relied on commercially prepared products. Conclusion: The study underscores the need to address cultural beliefs, provide accurate information, and promote evidence-based practices to enhance reproductive health in Himachal Pradesh. Targeted interventions, education programs, and community-based awareness campaigns are essential to dispel myths, promote positive practices, and empower women to make informed decisions. [ABSTRACT FROM AUTHOR]

AbstractMenstruation is considered an off-limits subject in India where menstruating woman continue to face silence, discrimination and isolation. A mesh of patriarchal cultural practices surrounding the subject of menstruation places restrictions on girls and women who are menstruating. This paper explores the menstrual experiences and challenges experienced by teachers from a village located in a Kishangarh block in rural Rajasthan. Informed by qualitative research, the study reveals the irony in thrust to distribute disposable menstrual pads to adolescent girls in school while ignoring the needs of teachers. The study calls for the inclusion of teachers as key stakeholders in the design of school based menstrual hygiene management and awareness initiatives and programmes. [ABSTRACT FROM AUTHOR]

The Rohingya people are the most marginalized minorities in the world. Being female refugees in Malaysia, they are vulnerable to many challenges which may impact their menstrual hygiene. Currently, not much is known about their menstrual health practices and needs in Malaysia in which this knowledge gap needs to be addressed. This study aimed to identify the menstrual health practices and needs among Rohingya women refugees and determine the relationship between their socio-demographic profile and menstrual experiences. A cross-sectional study involving 18 to 55 years old Rohingya women attending QFFD Clinic managed by IMARET in Selayang, Selangor between April to November 2022 was conducted. The MPQ and MPNS-36 were included in the self-administered questionnaire. 70 respondents completed the questionnaire. Majority of respondents had used disposable sanitary pad and able to wash hands every time after changing (n = 65, 92.9%), as well as preferred to use bathroom (n = 50, 71.4%) and household bin (n = 68, 97.1%) as location to change and dispose their menstrual materials when at home. The study had also found that only 47.1% (n = 33) of respondents had positive menstrual experiences with the husband’s education level to be statistically significantly associated with respondents’ menstrual experiences. This study provides a preliminary data on menstrual health practices and needs of Rohingya women in Malaysia. Nevertheless, they performed poorly in addressing their menstrual experiences. Thus, there is a need to include menstrual health programmes in humanitarian crisis. [ABSTRACT FROM AUTHOR]

Background: A menstrual cup is a menstrual hygiene device which is inserted into the vagina, made of silicone can be reused for 10 yrs. Today in the era of reduce, reuse and recycle, menstrual cup provides a suitable, safe, and feasible option for sustainable menstruation. This study aimed to assess the awareness, acceptability, and feasibility of menstrual cup among student population. Materials and methods: A descriptive longitudinal study done including the female medical and dental undergraduates. All eligible participants consenting to participate were provided with a predesigned questionnaires. The data collected were entered in MS Excel and analyzed into descriptive statistics like percentages. Results: 462 female students received the questionnaire, out of which 459 completed the questionnaire. Of the total participants, 93.5% were aware of the cup as a menstrual sanitary product with social media as the leading source of information (75%). In the study, 5.9% were active cup users. The main reason cited for not using the cup was lack of information regarding the correct insertion and removal techniques (45%) and the fear of insertion (31%). Among the cup users, the common problem faced was difficulty in insertion and removal (66.6%), while 46% of the users did not face any problems or difficulties with usage of the cup. About 75% of the non-users showed a willingness to change over to cup. Conclusion: From our study, it can be inferred that though the awareness regarding availability and safety of the cup is on the rise in the last few years, the popularity is still low. Thus, more awareness programs regarding proper usage technique, safety, and additional benefits of the menstrual cup needs to be arranged particularly focusing on the student population. [ABSTRACT FROM AUTHOR]

Background: Menstrual hygiene management is integrally associated with reproductive health of women. Menstrual health and hygiene needs, particularly of tribal women still remain unmet for many reasons. Inappropriate menstrual behaviour leads to adverse health consequences. Objectives: This study aimed to ascertain the menstrual hygiene behaviour of tribal married women aged 15 to 49 years and its correlates. Methods: A descriptive cross‑sectional study was conducted from May 2019 to April 2020 in the Barabani block of Paschim Bardhaman district, West Bengal. A calculated sample of 530 women was selected randomly from 10 tribal villages of the study area; they were interviewed through a pre‑designed schedule for socio‑demographic and menstrual hygiene behaviour characteristics. Menstrual hygiene management score was derived based on five essential components‑ hygienic absorbents, hygienic disposal of absorbents, frequency of changing of absorbents, cleaning of external genitalia and source of water for cleaning; menstrual hygiene behaviour was categorised as favourable and unfavourable. Bivariate and multivariable logistic regression was performed using SPSS v. 20. Results: All 530 women were Hindu and belonged to Santhal ethnicity; 53.4% were illiterate. Sanitary pads were used by 43.8% of women; 63% practised indiscriminate throwing for disposal of absorbents; 86% practised appropriate changing of absorbents. Overall, 63% had favourable menstrual hygiene management behaviour, and the literacy status of women was found to be a significant predictor. Conclusion: Unfavourable menstrual practices are still widely prevalent among tribal women, mainly attributable to lack of knowledge. Awareness generation should be focused on improving those practices, which would also result in the improvement of general health conditions. [ABSTRACT FROM AUTHOR]

In low- to middle-income communities, the lack of affordability of conventional sanitary products during menstrual cycles can cause psychological and health issues, ultimately affecting their quality of life. It is crucial to develop alternative products that are affordable and accessible to all while also promoting menstrual health and hygiene. Super absorbent polymers (SAPs) are a vital component in current disposable sanitary pads and nappies. However, these SAPs are often non-biodegradable and non-biocompatible. Therefore, the use of eco-friendly materials for the production of SAPs is gaining popularity in the hygiene industry, as it offers a means to reduce the carbon footprint and environmental impact associated with traditional SAPs made from non-renewable petroleum-based materials. SAPs made from polysaccharides often have naturally occurring antibacterial properties, making them appealing for commercial applications in sanitary products such as sanitary pads. In addition, the move toward reusable sanitary pads with antibacterial properties can significantly reduce waste generated by single-use products and prevent the growth of bacteria, improving the safety and hygiene of the product. Furthermore, computational modeling and artificial intelligence are now important tools in SAP synthesis, providing advantages such as predicting polymer properties, rationalizing synthesis pathways, and improving quality control. These tools can reduce synthesis costs by eliminating the need for trial-and-error approaches in polymer synthesis, ultimately promoting more affordable products for end users. Overall, these advancements in polymer synthesis and material design can help to create a more sustainable industry and promote menstrual hygiene and product accessibility to those who need it most. [ABSTRACT FROM AUTHOR]

Background: For a specific purpose involving the pH of menstrual blood and the pH of the vagina during menstruation, the current work describes the development of pH-responsive superadsorbent polymer (SAP)-coated menstrual pads. Acrylic acid (AA) and methyl methacrylate (MMA) were used to create a pH-responsive polymer, which was then applied layer by layer to sanitary napkins. Using FTIR, the chemical composition and structure were examined. By examining tests for absorbent capacity, swelling capacity, water retention, sorption under load, strike through, wicking height, and re-wetness under load, the performance studies of coated pads were contrasted with those of menstrual pads that are sold commercially. Additionally, the coated pad's pH response was examined to determine how stable the polymer was against pH variation. Results: The use of SAP in this study resulted in a higher free swelling capacity (102.22 g/g) for tap water and absorption under load in sanitary napkins. The absorption capacity of SAP ranges from 8 to 24 h, with values ranging from 14.84 to 132.41 g/g. Similarly, wet back and striking through analysis indicated superior outcomes in comparison with commercial products. The pH of the prepared SAP helps to maintain the necessary acidity level (pH 3.02) for the vagina during menstruation. Conclusions: Based on comparison results from FTIR, absorbency capacity, rewet, strike-through, and pH, the report recommends using the pH-responsive SAP to coat the top layer of feminine napkins. [ABSTRACT FROM AUTHOR]

Background: From menarche until menopause, the average menstruator will use over 11 000 tampons or sanitary pads. Vaginal and vulvar tissue is highly permeable, and chemicals are absorbed without undergoing first‐pass metabolism. Objectives: To conduct a review of the literature to determine exposure to environmental chemicals in menstrual products. Search strategy: This review identified 15 papers over the past 10 years. Selection criteria: Papers that measured chemicals in menstrual products and that measured human biomarkers of chemical exposure were included. Papers had to also be available in English. Data collection and analysis: Reviewers assessed the articles and data provided. Multiple chemical groups were found. Main results: Phthalates, volatile organic compounds, parabens, environmental phenols, fragrance chemicals, dioxins and dioxin‐like compounds were detected in menstrual products. Research gaps were identified, including the lack of studies on newer products such as menstrual underwear and cups/discs. In addition to measuring chemicals in these products, future research should focus on clarifying the exposure per menstrual cycle to these chemicals to understand how menorrhagia and cycle length influence exposure from menstrual products. Conclusion: Menstrual products contained measurable levels of a range of endocrine disrupting chemicals including phthalates, phenols and parabens. This reflects a potentially important route of exposure to chemicals that can impact women's reproductive health. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Almost 70% of women residing in urban areas and 48% of women in rural areas use sanitary napkins in India. According to menstrual health alliance India (MHAI), single sanitary pad will take about 500-800 years to decompose as the plastic used in manufacturing is nonbiodegradable and causes severe noxious effects contributing to global warming through the production of planet warming fuels which eventually have severe impact on environment sustainability. Hence, the study was undertaken to contribute the evidence for the "Clean and Green India". Aim: To know the perception and practice of disposal of sanitary napkins among young college-going females in India. Materials and Methods: A cross-sectional study was conducted throughout the country employing a self-administered questionnaire using a survey link sent through social media. Data collected were analyzed and interpreted using SPSS version 20.0. Result: The study population comprised 484 young college girls with a mean age of 20.92 ± 1.86 years and 96.9% of them are using sanitary napkins as menstrual absorbent aids. The most common method employed for the disposal of sanitary napkins was dumping them in the bin (87.4%). About 63.2% of them had no knowledge about sanitary napkin-burning machines. Around 92% think that improper disposal of sanitary napkins can cause health problems. Conclusion: The findings from the study revealed that a significant number of women were practicing noneco-friendly disposal methods and menstrual hygiene aids which are a bane to the ecosystem. Study warrants the education and training of females to achieve a green and clean sustainable India. [ABSTRACT FROM AUTHOR]

Objectives: The primary objectives were to determine the proportion of modern menstrual method (MMM) users among college going women in Coimbatore district, Tamil Nadu; and to estimate the unmet needs associated with use of MMMs in comparison with other menstrual hygiene methods (MHMs). We also assessed the factors that determine MMM use among college going women. Methods: This was a descriptive cross-sectional study conducted among college going women in Coimbatore district, Tamil Nadu, India between October 2022 and January 2023 using a purpose predesigned, pretested, semi-structured proforma that included validated Menstrual Practice Needs Scale (MPNS-36). Results: Only 1.4% of the study participants used MMMs – menstrual cups (1.3%) and tampons (0.1%). Sanitary pads were the most common MHM of choice (96.3%); of which majority (98.6%) used disposable pads and more than half (50.4%) used non-biodegradable pads. Importantly, one in six (16.5%) were not aware of nature of sanitary pads (biodegradable or nonbiodegradable) used. The unmet needs associated with MMMs (menstrual cups and tampons) were significantly lower than that for other MHMs (including sanitary pads), in particular, the unmet material and home environment needs, unmet material reliability concerns, unmet reuse needs and unmet reuse insecurity. However, we found no significant difference between MMMs, sanitary pads and other MHMs in terms of unmet transport, college environment, change and disposal insecurity needs. The significant predictors of use of MMMs were age (more than 21 years of age), residence (urban), type of stay (off campus including home), socioeconomic status (upper), fathers' and mothers' education (high school and above), and presence of personal income. Discussions with friends (or peers) both before and after menarche regarding menstruation resulted in higher adoption of modern menstrual methods. Conclusion: MMMs provided comparative advantage with lesser unmet needs for material reliability and reuse insecurity concerns, particularly in home environment. However, none of the MHMs fulfilled the user expectations for transport and disposal insecurity concerns, particularly outdoors. [ABSTRACT FROM AUTHOR]

• It is rare for women to choose to use the menstrual cup even though they know it. • Social media is an effective resource for providing information about the menstrual cup. • Many women experience difficulties in using a menstrual cup. To evaluate the knowledge, attitudes, and behaviors of Turkish women of reproductive age toward menstrual cup. This descriptive study was conducted via online platforms with 301 Turkish women between March-June 2023. The Participant Information Form was used to collect the data. A p value of <0.05 was considered. The mean age of the participants was 26.42 ± 7.81 years. The most common used menstrual hygiene product was sanitary pad. Of the women, 72.1 % have heard of the menstrual cup before, however, only 6.6 % of the women used menstrual cups. The 42.9 % of the women who use the menstrual cup had difficulty in using it. The most common concern of women who did not use menstrual cups was that they thought they were uncomfortable and did not know how to use them. Factors such as age, marital status, place of residence, occupation, previous pregnancy and finding the menstrual hygiene product used comfortable was found statistically significantly correlated with the menstrual cup usage. In our study, very few of the women use menstrual cups, and nearly half of them stated that they had difficulty in using it. The participants who did not use the menstrual cup most frequently did not know how to use the cup and did not use it because they thought the cup was uncomfortable. It is essential to increase the awareness of reproductive age women about the menstrual cups. [ABSTRACT FROM AUTHOR]

This article aims to analyze the transdimensional theme of the dignity of people who menstruate, which has a double facet: on the one hand it brings a universal aspect of dignity, being innate to human beings, with rational content, which distances them from reification or invisibility of people and on the other hand it brings a sense of citizenship to be achieved, with a clear provisional nature to be conferred by the State and other members of organized society. Based on these two pillars of understanding dignity, using the hypothetical-deductive method, the article develops to find out whether not valuing menstrual dignity, in addition to causing harm to health, can have repercussions in the school environment, causing a state of inequalities between vulnerable people who menstruate and others. The article seeks to verticalize the theme by pointing out that, once the state of educational inequalities is proven, the loss of these people is inevitable from the beginning of the competition of life, ceasing to be effective the equality of resources professed by Ronald Dworkin, in his work Sovereign Virtue (2000). The work also presents the initial efforts that have been carried out at the legislative level in Brazil, concluding with the hypothesis of a broader approach to the valorization of menstrual dignity with a bias towards educational and human development that goes far beyond the free delivery of sanitary pads and scarves [ABSTRACT FROM AUTHOR]

The use of hygienic materials (sanitary napkins, locally prepared napkins, tampons, and menstrual cups) during menstruation among adolescent women in India has improved over the years, yet a significant rural–urban gap in the usage persists at the national level. This study investigates how this rural-urabn gap varies across different states and union territories (UTs) of India and uses Fairlie decomposition to quantify the contribution of various factors to this gap. The study uses data on 114,805 adolescent women (aged 15–19 years) from the fifith round of National Family Health Survey (2019–21). The utilization of hygienic materials during menstruation among adolescent women in rural India stood at 43%, whereas in urban areas, it was 68%, indicating a significant 25 percentage point (pp) difference between the two. The rural–urban gap in the hygienic material use varied significantly across Indian states and UTs. The gap exceeded 20 pp in Madhya Pradesh (36 pp), Odisha (26 pp), Jammu and Kashmir (25 pp), Assam (25 pp), Uttar Pradesh (23 pp), Jharkhand (22 pp), Chhattisgarh (21 pp), and Rajasthan (21 pp). In contrast, the gap in Tamil Nadu, Himachal Pradesh, and Telangana was less than 10 pp. The decomposition analysis of the rural–urban gap (25 pp) revealed that the variables included in the anlaysis explained about 70% of the gap. The difference in the household wealth between rural and urban areas contributed about 69% of the explained gap. Other significant contributors to the explained gap were 'transportation to health facility' (5.6%), 'mass-media exposure' (4.9%), and 'level of education (4.4%). The findings underscore the necessity for state-specific interventions aimed at vulnerable groups, particularly individuals from economically disadvantaged backgrounds, those with lower levels of education, and limited exposure to mass media, in order to reduce the existing rural–urban disparity in hygienic material use among adolescent women. [ABSTRACT FROM AUTHOR]

Background: Menstrual hygiene remains clouded by misconceptions, posing challenges for adolescent girls. This study aims to identify myths surrounding menstrual hygiene among young girls in Islamabad and recognize the challenges they face in maintaining proper menstrual hygiene. Methods: A descriptive cross-sectional study was conducted in three government schools in Islamabad, involving adolescent girls aged 13-18 years in grades 8-12 over a six-month period. Simple random sampling was used to enroll 600 participants, and data were collected using a self-structured, pre-tested questionnaire. Statistical analysis was performed using SPSS version 25. Results: Of the 600 participants, 47% were in the age group of 13-15 years, and 53% were in the age group of 16-18 years. Mothers were the primary source of information for 85.8% of the girls. Common myths included 69% of girls avoiding baths based on advice from elders and 58.2% avoiding washing their groin during menstruation. Challenges reported by adolescent girls included 38.8% finding menstrual products unaffordable, 56.6% lacking sanitary pads at school, and 54.8% feeling embarrassed about asking for menstrual products. Additionally, 56.5% of girls were hesitant to discuss genital issues due to social taboos. Conclusion: This study highlights prevalent myths and challenges undermining menstrual hygiene practices among adolescent girls. Debunking these myths and providing necessary facilities are essential to enhance menstrual health and overall quality of life for adolescent girls. [ABSTRACT FROM AUTHOR]

Background: Allergic contact dermatitis from (meth)acrylic monomers (ACDMA) in manicure products is increasing. Objective: To evaluate the prognosis, work performance impairment and sequelae of a cohort of beauticians and manicure consumers with ACDMA sensitized from the exposure to manicure products. Methods: We conducted a telephone survey with patients diagnosed with ACDMA. Results: One hundred and six patients were evaluated, including 75 (70.8%) beauticians and 31 (29.2%) consumers. All were women with a mean age of 39 (19–62). Thirty‐seven of 75 beauticians (49.3%) continued to work. Twenty‐seven of 106 (25.5%) patients continued to use manicure products with (meth)acrylates regularly. Seventeen of 51 (33.3%) patients who discontinued the exposure described ongoing nail/periungual changes. Nine of 58 (15.5%) patients who required dental restoration, orthodontic or occlusal splint materials recalled reactions from them; and, 25 of 96 (26%) who used sanitary napkins recalled intolerance to them starting after the diagnosis of ACDMA. Fifteen of 25 (60%) discontinued the use of sanitary napkins. Conclusion: 49.3% beauticians continued to work; most patients stopped wearing acrylic manicure materials; reactions from dental materials were not uncommon, however, removal of dental materials was never required; and, reactions to sanitary napkins developing after the diagnosis of ACDMA were common most leading to discontinuation of use. [ABSTRACT FROM AUTHOR]

Background and objective: To ascertain the local prevalence of reproductive tract infections. To research the impact of various factors on the prevalence of genital infections. To research the incidence of RTI symptoms during the intervention period. To evaluate the outcomes in light of a preintervention study carried out in 1996-1997. Method: Every married woman between the ages of 15 and 45 was the subject of a cross-sectional community-based study that was conducted at Department of Community Medicine, Narayana Medical College, Nellore, Andhra Pradesh, India from February 2022 to January 2023 and evaluated by questionnaire, laboratory test, and physical examination to identify reproductive tract infections. To conduct the study, approval was requested. The health assistant went to the 412 women who were included in the study population, described how the examination would work, got their permission, and offered them to participate. Result: There were 70 abortions total, of which 12 were induced and 58 were spontaneous. Seven of the induced abortions used dilatation and curettage, two used injections, and three used tablets. 98 (22%) of the women had primary infertility. The variables for RTIs had a p value less than 0.2: housewife, intervention arm, tubectomy, sanitary napkins, husband's agricultural work, respondent's education, socioeconomic level, and husband's education. The intervention arm, the usage of sanitary napkins, the presence of a spouse who serves in the military, and the level of education of the respondent were all STIs factors with a p value less than 0.2. Conclusion: A comprehensive community-based intervention approach reduced reproductive tract infections in this study. Health-aides and female doctors were used. RTIs and STIs decreased postintervention. Health-aide and doctor arms fell significantly. Education was found to affect RTIs. Symptomatic RTI diagnosis was unreliable. Prioritise female literacy and school health instruction. Health-seeking couples should talk. Clinical examination and limited laboratory tests like wet preparation are needed to diagnose. [ABSTRACT FROM AUTHOR]

The article discusses the prevalence of period poverty among women and girls globally, highlighting the economic and health challenges it poses. It emphasizes the benefits of sustainable menstrual products like menstrual cups and reusable pads in reducing financial strain, environmental waste, and health risks associated with traditional disposable products. The Indian government has launched various initiatives to improve menstrual hygiene, but more efforts are needed to address affordability issues. The article calls for collaborative efforts from governments, NGOs, and communities to make sustainable menstrual products accessible to all, promoting menstrual equity and empowering women and girls worldwide. [Extracted from the article]

On average, women menstruate for approximately half of their lives. Little is known about whether and how health-related quality of life (HRQOL) differs across users of different types of menstrual products. To answer this question, this study collected data from 1,245 female university students in Taiwan through an anonymous online survey and compared users of different types of menstrual products in four HRQOL domains. Multivariate linear regression analysis revealed significant differences in all four domains. For instance, regarding physical health, tampon users reported better HRQOL (β =.054) than pad users; regarding social health, tampon (β =.059) and menstrual cup (β =.071) users both reported better HRQOL than pad users. Furthermore, factors influencing HRQOL also differed between pad and tampon users. For example, having many premenstrual symptoms affected both pad (β = -.115) and tampon (β = -.172) users' physical HRQOL; while pad users with many premenstrual symptoms also had worse psychological (β = -.085), social (β = -.100), and environment (β = -.104) HRQOL, their tampon-using counterparts were not significantly affected. Bisexual tampon-using college women reported worse social HRQOL (β = -.149) than their heterosexual peers. In addition, relationship status and varsity team membership had differential significant associations with the four domains. Future menstrual health education could focus more on introducing the different features of various menstrual products. Our empirical findings can help empower women to make informed decisions about which menstrual products could best suit their needs and improve their HRQOL. [ABSTRACT FROM AUTHOR]

Background: Deplorable and unconducive conditions in prisons present serious challenges to menstrual hygiene management. However, little is known about menstrual hygiene among incarcerated women in Uganda. Our study explored the behaviors and practices of incarcerated women regarding menstrual hygiene management in a large government prison in Uganda. In addition, we explored the barriers to menstrual hygiene management in this population. Methods: In this phenomenological qualitative study, we conducted in-depth interviews with incarcerated women aged 20–49 years and key informant interviews with female prison officers (wardresses) at Luzira Prison in Kampala, Uganda. The data were analyzed using content analysis and the findings were presented using themes/sub-themes along with participant quotes. Results: We interviewed 15 incarcerated women aged 20–49 years (mean age, 29.5 ± 8.7 years) and five key informants aged 30–50 years (mean, 42.6 ± 4.9) about menstrual hygiene behaviors and practices, including barriers to menstrual hygiene. Five sub-themes emerged concerning behaviors and practices of menstrual hygiene among incarcerated women. Findings reveal the behaviors and practices of menstrual hygiene management were characterized by infrequent change of menstrual pads, lack of privacy during menstrual hygiene practices, use of poor-quality menstrual hygiene materials, and improper disposal of used sanitary products. However, bathing with soap and water during menstruation was frequent and non-restricted. Three sub-themes emerged as barriers to menstrual hygiene practices, largely at the institutional level, and they included unhygienic sanitary facilities, unreliable access to clean water, and insufficient sanitary products. Conclusions: Behaviors and practices of incarcerated women fall short of desired standards and they face several barriers to practicing menstrual hygiene. The prison authorities should provide sufficient sanitary products like pads, and knickers including soap, construct more sanitary facilities, educate about the safe disposal of used sanitary products, and provide sufficient clean water to promote good menstrual hygiene management among incarcerated women. [ABSTRACT FROM AUTHOR]

Background: In 2017 WHO reported that due to a lack of menstrual hygiene management (MHM) facilities, high costs, and ignorance, 2.3 billion girls and women worldwide do not manage their menstruation properly. This leads to the use of other options, such as old clothes or other unhygienic materials, which may make them a risk group for infections and other health consequences. Despite the significant role of appropriate menstrual hygiene practices, it is still a missed opportunity to address the hygienic practice of menstruation among girls in many low-and middle-income countries, including Ethiopia. Objective: Primarily, this study was aimed at investigating menstrual hygiene management (MHM) practice and determinant factors among young adolescent school girls in eastern Ethiopia, Gursum District 2021. Method: An institutional-based cross-sectional survey was conducted among adolescent school girls in Gursum, Eastern Ethiopia, in 2021. 577 girls participated in this study and a multi-stage sampling procedure was employed so as to select a fair and representative sample of female students who experienced menarche. After controlling for confounding variables, binary logistic regression was fitted to identify factors affecting MHM among adolescent girls. Result: This study revealed that 58.41% of adolescent school girls practice unsafe MHM practices. It was also reported that 193(33.45%) of the girls use reusable sanitary pads. Of those, 182(31.5%) of them keep the pads in hidden places as it is a shame to be seen Seventy-six (13.17%) of the respondents had experienced vaginal infections during menarche. Having knowledge about menstruation prior to experiencing menstruation [AOR 0.28 CI: (0.1476132, 0.5613692)], being over 15 years old [AOR 1.56, CI: (1.020577, 2.387646)], living in rural areas [AOR 1.23 CI: (1.1563013, 1.3562546)], and having infection around their vagina during menarche [AOR 4.6 CI: (2.633405, 8. 273,883)] were significant determinants of MHM practice. Conclusion: The majority of the adolescent girls who participated in this study practice unsafe MHM practices. Results suggest that school health education focusing on improving the hygienic practices of adolescent girls during menstruation should be provided. [ABSTRACT FROM AUTHOR]

This paper empirically explores the impact of COVID‐19 pandemic and its accompanying lockdown on adolescent girls' and women's access to sanitary pads in India. We have used the National Health Mission's Health Management Information System (NHM‐HMIS) data for the study, which provides data on pads' distribution on a district level. The empirical strategy used in the study exploits the variation of districts into red, orange, and green zones as announced by the Indian Government. To understand how lockdown severity impacts access to sanitary pads, we used a difference‐in‐difference (DID) empirical strategy to study sanitary pads' access in red and orange zones compared to green zones. We find clear evidence of the impact of lockdown intensity on the provision of sanitary pads, with districts with the strictest lockdown restrictions suffering the most. Our study highlights how sanitary pads distribution was overlooked during the pandemic, leaving girls and women vulnerable to managing their menstrual needs. Thus, there is a requirement for strong policy to focus on the need to keep sanitary pads as part of the essential goods to ensure the needs of the girls and women are met even in the midst of a pandemic, central to an inclusive response. [ABSTRACT FROM AUTHOR]

Background In this study, we wanted to assess the menstrual awareness among urban and rural adolescent girls and compare the menstrual hygiene practices among them. Methods This was a hospital based cross-sectional study conducted among 170 adolescent girls attending the OPD of Gynaecology, Paediatrics and General Medicine at Government Medical College, Thrissur District, Kerala. It was carried for a period of one year after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. They were provided with a validated questionnaire to assess menstrual awareness hygiene practice among them. Results Majority (89.4%) from the urban area of residence believed that it was physiological, while majority (54.1%) from the rural areas didn't know the actual cause for menstruation. This difference between the rural and urban areas on awareness about the cause of menstruation was found to be statistically significant. More than half of the subjects used sanitary pads during menstruation. The frequency of changing pads at school was less in both urban and rural groups. The reusage of pads was almost similar among rural and urban study subjects with around 23.5% and 22.4% of them reusing the pads respectively in both the groups. Awareness regarding menstrual cup was more in urban group compared to rural. But restrictions during menstruation was practised more in rural group that is 70% compared to urban group which was roughly 52%. Conclusion Menstrual health forms the most important stepping stone to women's sexual and reproductive health. One third of the study population was not at all aware of the cause of menstruation. There was significant difference in various menstrual hygiene practices among urban and rural girls. Many restrictions were practiced during menstruation more in rural group. A concerted effort from parents, educational institutions and existing healthcare institutions along with media may ensure safe and secure reproductive health prospects for adolescents in the region. [ABSTRACT FROM AUTHOR]

In this paper, a kind of superabsorbent resin (SAR) with superior quality for hygiene products was developed using Fructus Aurantii Immaturus pectin (FAIP) from Citrus aurantium L.. FAIP-g-AM/AMPS SAR was established by free radical graft co -polymerization with FAIP as skeleton structure, N, N′-Methylene-bis (acrylamide) (MBA) as the cross-linker. Meanwhile, the functional monomers of acrylamide (AM) and 2-acrylamido-2-methylpropane sulfonic acid (AMPS) were introduced. The structure and morphology of FAIP-g-AM/AMPS were characterized by FTIR, 13C NMR, XRD, SEM and TG-DSC analysis. The results confirmed that the AFIP-g-AM/AMPS SAR was successfully prepared, which exhibited a three-dimensional (3D) network structure and an excellent thermal stability. The absorption and retention capacity of FAIP-g-AM/AMPS was comparable to or even better than commercial diapers and sanitary napkins. Significantly, FAIP-g-AM/AMPS itself exhibited excellent antibacterial and safety. FAIP-g-AM/AMPS has an inhibition ratio of 97.1 % for Escherichia coli (E. coli) and 98.5 % for Staphylococcus aureus (S. aureus), and was non-irritating and non-allergic to the skin. In addition, FAIP-g-AM/AMPS presented amazing biodegradability and a weight loss reached 37.1 % after 30 days by soil burial test. The research provides a safe and high-performance SAR, which expected to be used in hygiene products such as baby diapers, adult incontinence pads and sanitary napkins. [Display omitted] • Natural macromolecule pectin was employed to prepare SAR with superior properties. • SAR shown excellent salt resistance, antibacterial, nonirritant and biodegradability. • Inhibition ratio was 97.1 % for E. coli and 98.5 % for S. aureus. • Degradation ratio reached 37.1 % after 30 days by soil burial test. • A safe and high-performance SAR has bright prospect in hygiene products. [ABSTRACT FROM AUTHOR]

Menstruation is the blood that comes out of a woman’s cervix through the vagina at a certain time, and is not the cause of childbirth. The onset of menstruation is one of the signs of a woman’s puberty. In fact, puberty is a new challenge, especially for women, because it requires careful personal hygiene, whether before, during, or after menstruation. In Malaysia, women still suffer from period poverty and cannot afford sanitary pads due to financial constraints. This causes greater harm to women. Therefore, the main objective of this article is to identify the issues and challenges faced by women due to period poverty, especially during the Covid-19 pandemic. In this qualitative study, a document analysis from journal articles, books, and related materials was conducted. Findings suggest that women face significant challenges when it comes to period poverty. These include lack of affordable menstrual products, disadvantages in menstrual hygiene infrastructure, and negative stigma in the community. The implication of this study is to help women cope with the challenges of period poverty and to prepare for the onset of menstruation with sufficient knowledge and needs. [ABSTRACT FROM AUTHOR]

Objective. To understand the sexual and reproductive health (SRH) experiences of migrant women and girls of reproductive age (15--49 years) from the Northern Triangle of Central America (El Salvador, Guatemala and Honduras) during their journey to the United States. Methods. A descriptive, qualitative research design included 39 in-depth interviews with migrant women and unaccompanied migrant girls from El Salvador, Guatemala and Honduras from January to June 2022. Participants were recruited using purposive sampling. Interviews were transcribed, coded and analyzed using thematic analysis. Results. Migrant women and girls lack information and resources to manage their SRH during migration. The SRH of those traveling with smugglers is compromised due to their limited access to menstrual pads, water and sanitation services; the risks of transactional sex and sexual violence; the high risk of sexually transmitted infections; the inability to report sexual violence; the lack of access to SRH and prenatal services; and limited knowledge about their sexual and reproductive rights. Conclusions. There is a significant need for improved interventions during the predeparture phase of migration to inform migrant women and girls about the SRH risks they may encounter and to provide information and resources to support their SRH throughout their journey. Special attention should be directed towards trying to reach girls and women who will travel with smugglers. [ABSTRACT FROM AUTHOR]

This study came into consideration following reported cases of women and girls using unhygienic materials such as old towels to keep themselves dry during their menses. The materials can be improved in quality and usability. The polymer that replaced wood pulp is not environmentally friendly. Water hyacinth and maize stalks have proven high absorbency properties, which are from ancient and current research. The objective was to optimize the hydroscopic properties of maize stalk and water hyacinth pulp and subsequent use in the design of sanitary pad. The methodology was done according to the standard KS 507:2005. The process of extraction was done using the alkaline method, and rinsing was done to remove excess NaOH. The pulp was studied for hydroscopic properties that included the retention capacity, absorbency rate and moisture content followed by the design of the sanitary pad. The absorbency rate and the retention capacity of maize are 50% and 150 s, respectively. The absorbency properties of maize internal tissue pulp are high, and it is feasibly viable. The retention and moisture content indicate over 50% and 57%, respectively. Water hyacinth pulp has a high absorbency rate (106 s). Also, the water retention and moisture content of water hyacinth pulp is over 50% and 59%, respectively. Upon blending, the water retained and held, and absorption rate improved to 50% in 24 h, 50% (25 ml) and 2 min. The significance levels for absorbency were 15 ml to 40 ml per minute and it holds and retains up to 500 times its weight. [ABSTRACT FROM AUTHOR]

With economic and social development, there is a growing focus on menstrual hygiene, and traditional sanitary napkins are no longer sufficient to meet women's needs. In this study, quercetin (QC) was efficiently and uniformly ultrasonic sprayed on thermally bonded chitosan nonwovens (CS) to prepare a multifunctional surface layer of sanitary napkins (QC X @CS). CS sprayed with 3 layers of QC (QC 3 @CS) exhibits excellent mechanical properties and high antibacterial rates against Escherichia coli (99.51 %) and Staphylococcus aureus (99.87 %), respectively. Besides, QC 3 @CS demonstrates strong free radical scavenging abilities, which have great potential to reduce the effects of reactive oxygen species on immune and metabolic functions during menstruation. QC 3 @CS demonstrates strong deodorizing abilities, with rates of 87.22 % for acetic acid and 90.88 % for ammonia, which could effectively eliminate the unpleasant odor associated with menstruation. Moreover, QC 3 @CS ensures excellent water absorption, anti-return properties, and cytocompatibility. This study may provide valuable insights into developing functional sanitary napkin materials based on natural extracts. [Display omitted] [ABSTRACT FROM AUTHOR]

Environmental concerns about sanitary napkins are the main pushing force for upgrading new insights into sustainable materials for hygiene. Pineapple leaf fiber (PALF) is a high textile grade fiber having high demand in the global market whose potential still needs to be explored in the hygiene sector, like sanitary napkins. The present research intends to design biodegradable sanitary napkins from PALF pulp. The present study characterized the physical, chemical, thermal, antimicrobial, and water absorption properties of PALF. Two different pulping conditions, Alkaline (NaOH-Sodium hydroxide) and herbal (Soap nut), were used to obtain PALF pulp. Based on the free swell capacity, the pulp with high water absorption properties was selected and subjected to prototype development. The sanitary napkin designed from NaOH pulp and Soap nut pulp was designated Prototype A and B, respectively. The tests related to hygienic napkins, such as total absorbent capacity, ability to withstand pressure, vertical wicking, strikethrough rate, pH, wet back, leakage proof, disposability, bioburden test, presence of skin and uterine pathogen, and in-vitro cytotoxicity study was carried out according to the standard and compared with commercially available napkins. The results demonstrated that prototype A performed better than commercial sanitary pads. The results of our study prove that the PALF could be a better perspective as an absorbent core in disposable feminine hygiene products having a global impact shortly. • Pineapple Leaf fiber (PALF) is converted to a pulp by NaOH and soap nut pulping. • The absorption rate of PALF pulp from 8 hours of NaOH cooking is higher than soap nut cooking. • PALF pulps have high water absorption compared to commercial wood pulp. • The absorbent core of sanitary napkin is developed from NaOH-cooked pulp • The sanitary napkin from PALF was superior to commercial pads. [ABSTRACT FROM AUTHOR]

This article analyzes period poverty based on interviews with six girls living in a region on the outskirts of the city of Porto Alegre (Brazil). The results of the qualitative study reveal some realities that are behind the numbers. The lack of information about menstrual health, menstrual cycles, and the limited self-awareness about the body became evident. All the interviewed adolescents who sought health services due to any menstrual or body-related issues during puberty received a racist, sexist, or ageist treatment or a combination of these prejudices. Their accounts regarding access to menstrual hygiene products and sanitation infrastructure do not fully correspond to the data on period poverty: the girls have access to disposable sanitary pads during menstruation, clean water, and bathrooms in usable conditions. The stories told by the teenagers expand the discussion about period poverty as they highlight cultural factors related to their menstrual experiences. Their accounts also show that initiatives and public policies to combat menstrual precariousness cannot be limited to the material field and point to the need for systemic cultural changes to combat racism, sexism, and ageism. [ABSTRACT FROM AUTHOR]

With more and more research happening in the various dimensions of all the sanitary napkin components, various sanitary napkins are available in the market with enhanced functionalities. The increasing consumer awareness on eco-friendliness and the demanding expectations on disposable products to maintain a healthy environment have been the driving forces to initiate the research on improving the eco-friendliness of disposable hygienic product and producing low-cost sanitary napkins. The reasons for non-penetration of sanitary napkins in all strata of Indian markets are mainly due to financial non-affordability, lack of awareness about health, and hygiene etc. The efforts by the Government in the form of creating awareness and offering subsidiaries and supplying raw materials at low cost, low cost sanitary napkins are now available in the market. All these efforts will together guarantee the low cost of the sanitary napkin but still the quality is not ensured, the main reason for this is the higher cost of the testing apparatus. This project focuses on fabricating an economic and indigenous instrument for the accurate evaluation of selected performance properties of sanitary napkin. Varieties of sanitary napkins have been tested in this fabricated performance tester (SANPER tester) and analyzed. [ABSTRACT FROM AUTHOR]

Background: Exclusive use of hygienic methods (sanitary napkins, locally prepared napkins, tampons, and menstrual cups) to prevent the visibility of bloodstains during menstruation is still considerably low among adolescent women in rural India. However, no prior research has explored the prevalence and determinants of exclusive hygienic methods among rural Indian adolescent women. To address this gap, this study examines the factors affecting adolescent women's exclusive use of hygienic methods in rural India. Additionally, this study explores state- and district-level geographical disparities in the exclusive use of hygienic methods among adolescent women in rural India.Methods: Information on 95,551 adolescent women from rural India from the latest round of National Family Health Survey (NFHS-5) was analyzed. Bivariate statistics and multilevel logistic regression analysis were used to assess the Individual- and community-level factors associated with exclusive use of hygienic methods among adolescent women in rural India. Choropleth maps were used to discern the geographical disparities in the exclusive use of hygienic methods.Results: In rural India, only 42% of adolescent women exclusively used hygienic methods, with substantial geographic disparities at the state and district levels. At the state level, the exclusive use of hygienic methods varied from 23% in Uttar Pradesh to 85% in Tamil Nadu. Even greater variation was observed at the district level. There was a clear north-south divide in the exclusive use of hygienic methods among adolescent women in rural India. The results of multilevel logistic regression indicated a considerable amount of variation in the exclusive use of hygienic methods at community level which further reduced when controlled for individual and community-level factors. Rural Indian adolescent women with higher education (AOR:3.20, 95% CI: 2.81-3.64), from general category (AOR: 1.14, 95% CI: 1.07-1.21), with medium mass media exposure (AOR: 1.43, 95% CI: 1.35-1.51), and from richest wealth quintile (AOR: 3.98, 95% CI: 3.69-4.30) were more likely to use hygienic methods exclusively.Conclusion: Wide differential across biodemographic and socioeconomic groups, and substantial geographic disparities at state- and district-level in the exclusive use of hygienic methods suggests a need to adopt context-specific interventions for adolescent women in rural India. Distribution of subsidized or free menstrual hygiene methods to disadvantaged adolescent women, and in the low-prevalence districts may increase the level of exclusive use of hygienic methods remarkably. [ABSTRACT FROM AUTHOR]

Objectives: The study assessed menstrual hygiene management (MHM) inequalities among public and private in‐school adolescents in Badagry, southwest Nigeria. Also assessed was the impact of available water, sanitation and hygiene (WASH) facilities on MHM within the school premises. Methods: For this descriptive cross‐sectional study, 420 students were selected via multi‐stage sampling and data were obtained via a validated semi‐structured questionnaire and observational checklist. Data were analysed at 95% confidence limit. Results: The students had a mean age of 15.3 ± 1.6 years. All the private schools had functioning WASH facilities whereas only 50% of public schools did. The toilet to student ratios for the private and public schools were 1:155 and 1:296, respectively. Over two‐thirds (67.1%) of the students reportedly use sanitary napkins for MHM, followed by tissue (17.1%) and clothes (15.5%). Additionally, the private school students were two times less likely to use alternatives to sanitary napkins and 9.8 times more likely to obtain sanitary materials at school if required (p < 0.001). A significantly higher proportion of public‐school menstruating in‐school adolescents changed their sanitary towels in the bush (p = 0.003) due to lack of privacy and took their used sanitary materials home (p < 0.001) for management due to reduced access to sanitary bins. Conclusion: Even though the situation in the public schools was worse, both public and private schools lack the enabling environment for MHM. School health promotion interventions, such as provision of subsidised/affordable menstrual pads and basic WASH facilities and campaigns to break the culture of silence are required for the wellbeing of girls. [ABSTRACT FROM AUTHOR]

Objective. To evaluate the effect of hemp cotton sanitary pads on the vaginal microecology. Methods. A randomized controlled field trial was used to recruit 1002 community-based women of childbearing age. The women were randomly divided into experimental and control groups. The experimental group used hemp cotton sanitary pads, while the control group used two types of cotton sanitary randomly chosen from the top five sanitary pads in terms of market share in China. The vaginal microecology was compared between the two groups after three months. Results. According to the vaginal microecologic examination results at baseline, 1002 women were included in 3 groups: normal vaginal microecologic, vaginal microecological disorders, and suspected vaginal infections. The number of patients in three groups were 39 (3.9%), 652 (65.1%), and 311 (31%), respectively. Three months later, the vaginal microecologic status and vaginal pH value of the suspected vaginal infection group were not significantly different between the experimental group and control group. The experimental group outperformed the control group with respect to vaginal cleanliness and vaginal microecology status in the women without a vaginal infection (normal vaginal microecology or microecological disorders group). The rate of abnormal cleanliness in the experimental group was lower than the control group (31.95% [108/338] vs. 43.62% [154/353]). The incidence of suspected vaginitis in the experimental group was lower than the control group (15.29% [51/338] vs. 23.51% [83/353]). Conclusion. For women without vaginal inflammation, the use of hemp cotton sanitary pads during menstruation can help maintain the balance of the vaginal microecology to prevent reproductive tract infections. [ABSTRACT FROM AUTHOR]

Background: The onset of menstruation is an important event in a woman's lifecycle. It is associated with taboos and sociocultural restrictions. Faulty hygienic practices increase the risk of reproductive tract infections (RTI), leading to further complications if left untreated. With this background, the study was planned to assess adolescent school girls' knowledge of menstruation and menstrual hygiene as well as their practices of menstrual hygiene. Materials and Methods: A community-based cross-sectional study was conducted in Nagaon, Barpeta district, Assam, among 170 adolescents aged between 10 and 19 years, using a convenient sampling technique. A predesigned, pretested, semi-structured questionnaire was used to collect the information from the study participants. Data analysis was done using SPSS version 17 and the results were expressed in percentages. Results: The study reveals that 91.76% of the adolescents knew that menstruation was normal. About 27.65% of the study participants did not know the cause of menstruation, and 54.12% did not know about the source of menstrual bleeding. Only 33.53% knew that uterus is the source of bleeding. About 61.76% of the study participants knew about the duration of a normal menstrual period. Regarding practices, 74.12% of the adolescents use sanitary pads during menstruation, 18.82% use cloth, and 7.06% use both cloth and sanitary pads. In about 63.53%, the method of disposal of used absorbent was throwing with domestic waste. Conclusion: The current study has revealed that menstruation and menstrual hygiene knowledge is poor among adolescent girls and practices regarding menstrual hygiene are not optimal. [ABSTRACT FROM AUTHOR]

International development institutions, governments, and social entrepreneurs have become increasingly enthusiastic about 'inclusive innovation' which, to solve problems in low- and middle-income countries, focuses on the development of technologies for and by the poor. Inclusive innovation differs from previous development efforts by focusing on devices instead of infrastructure, claiming to be based on scientific evidence, and relying on market logics to achieve humanitarian ends. Proponents argue that, informed by grassroots efforts, these interventions have enormous potential to catalyze economic, social, and political change. How are the market and technological imperatives of inclusive innovation shaping the international development agenda? What do inclusion and innovation mean in this context? What can inclusive innovation tell us about the proliferation of initiatives that promote technology for public good, from responsible innovation to public interest technology? This article examines these questions through a case study of menstrual hygiene management (MHM) innovation in India. Rather than providing solutions to self-evident development problems, inclusive innovation shapes both development problems and solutions simultaneously, in areas where scientific and market ways of knowing converge. These ways of knowing claim to be legitimate because they are rooted in local knowledge and expertise. MHM in India became a problem, and low-cost disposable sanitary pads an inclusive innovative solution, because of the involvement of Indian researchers and innovators, and Indian girls and women as consumers and producers. However, in the process they reinforced narrow understandings of both inclusion and innovation in international development. Inclusion efforts may be wrapped up in political economies that shape and limit their transformational power by prioritizing scientific, technical, and market expertise. [ABSTRACT FROM AUTHOR]

Background: India accounts for a quarter of the world cervical cancer burden. Cervical cancer is highly preventable. However, low level of participating women in screening is one of the major issues. The aim of this work was to study the factors that influence women to participate in cervical cancer screening by providing menstrual pads for human papillomavirus (HPV) testing. Methods: Menstrual clothes were collected from two different populations from the rural areas of Maharashtra state for HPV testing to screen for cervical cancer. For this study, out of 945 participated women, 557 (58.9%) provided their menstrual pads. Multivariate logistic regression was applied to calculate the odds ratio (OR) and 95% confidence interval (95% CI). Results: The probability of providing the menstrual pads was high among the women who were highly educated compared to those with less education (OR: 1.4; 95% CI: 1.0–1.9), having mobile phone facilities as compared to those with no mobile phones (OR: 1.4; 95% CI: 1.0–2.0), who were using new cloths as menstrual pads compared to those who did not use the same (OR: 8.5; 95% CI: 5.0–14.3), who did not have tobacco habit as compared to those who had tobacco habit (OR: 1.4; 95% CI: 1.1–1.9) and in the village where health worker was stationed as compared to the village where health worker was not stationed (OR: 1.8; 95% CI: 1.4–2.5). Conclusion: Factors including health worker availability, using mobile phones for communication and high education level facilitate women’s participation. To improve the participation, there is need to apply special strategies for older age group, less educated women and women having tobacco habit. [ABSTRACT FROM AUTHOR]

Introduction: Clitoral adhesions occur when the epithelial skin surfaces of the prepuce and glans clitoris become adherent. The severity of clitoral adhesions is best documented during full prepucial retraction using vulvoscopy with photography; mild, moderate, and severe clitoral adhesions occur when there is >75%, 25-75%, and <25% visualization of the glans clitoris, respectively. Clitoral adhesions are associated with a closed compartment with inadequate clearance of keratinaceous sloughed material from the epithelial surfaces of the prepuce and glans clitoris. This trapped material may form keratin pearls resulting in local inflammation and glans hypersensitivity/pain. In one study of 614 evaluable individuals with vulvas who presented to a sexual medicine clinic for various sexual dysfunctions, 23% demonstrated clitoral adhesions based on vulvoscopy with photography (mild 44%, moderate 34%, and severe 22%) of which 14% complained of clitoral hypersensitivity/pain. We observe symptomatic and asymptomatic clitoral adhesions occurring in women presenting with entry dyspareunia, severe allodynia and hyperalgesia, who are clinical suspected and pathologically conformed to have neuroproliferative vestibulodynia (NPV). Surgical management of the NPV involves complete vestibulectomy with vaginal advancement flap. For those patients who also have clitoral adhesions, lysis of clitoral adhesions may be performed at the time of vestibulectomy. Objective: To examine the association between clitoral adhesions and NPV. Methods: A retrospective chart review of patients with NPV who underwent vestibulectomy and lysis of clitoral adhesions concomitantly between January 1, 2021 and October 31, 2023 was performed. History, physical examination, pre-op vulvoscopy with photographs, operative records and patient outcome data were collected. Results: Sixty-three patients with NPV, (mean age 29, range 19 – 64 years), underwent vestibulectomy surgery. A total of 34 (54%) of these patients underwent concomitant lysis of (mild (38%), moderate (50%), or severe (12%) clitoral adhesions. Multiple keratin pearls were removed in 91% of cases. More than half (53%) of these patients with NPV and clitoral adhesions complained of glans hypersensitivity/pain during pre-op vulvoscopy. The majority (88%) of this cohort reported "somewhat better" or "very much better" on PGI-I after lysis of adhesions. No negative side effects following the lysis of clitoral adhesions were noted. Conclusions: There is a high prevalence of symptomatic clitoral adhesions in patients with NPV (53%) compared to women who presented to a sexual medicine clinic for other sexual concerns (14%). While clitoral adhesions are not always symptomatic, we hypothesize the high prevalence in patients with NPV may be due any of the following: i) pain/stress resulting in peripheral nerves releasing neurotransmitters that stimulate proliferation/differentiation of prepucial sebaceous glands and upregulate prepucial sebaceous cell lipid synthesis, ii) infrequency of clitoral tissue engorgement from sexual activity, iii) limitation or aversion to touching or retracting clitoral prepucial tissue, iv) increased frequency of wearing menstrual pads rather than tampons, v) severe genital pain perceived as co-existing in both vestibule and clitoris and vi) the patient is already scheduled for surgery under anesthesia so the patient conveniently agrees to also undergo lysis of adhesions. Clinicians should be aware of this high association. Disclosure: No. [ABSTRACT FROM AUTHOR]

Introduction: Clitoral adhesions occur when the epithelial skin surfaces of the prepuce and glans clitoris become adherent. The severity of clitoral adhesions is best documented during full prepucial retraction using vulvoscopy with photography; mild, moderate, and severe clitoral adhesions occur when there is >75%, 25-75%, and <25% visualization of the glans clitoris, respectively. Clitoral adhesions are associated with a closed compartment with inadequate clearance of keratinaceous sloughed material from the epithelial surfaces of the prepuce and glans clitoris. This trapped material may form keratin pearls resulting in local inflammation and glans hypersensitivity/pain. In one study of 614 evaluable individuals with vulvas who presented to a sexual medicine clinic for various sexual dysfunctions, 23% demonstrated clitoral adhesions based on vulvoscopy with photography (mild 44%, moderate 34%, and severe 22%) of which 14% complained of clitoral hypersensitivity/pain. We observe symptomatic and asymptomatic clitoral adhesions occurring in women presenting with entry dyspareunia, severe allodynia and hyperalgesia, who are clinical suspected and pathologically conformed to have neuroproliferative vestibulodynia (NPV). Surgical management of the NPV involves complete vestibulectomy with vaginal advancement flap. For those patients who also have clitoral adhesions, lysis of clitoral adhesions may be performed at the time of vestibulectomy. Objective: To examine the association between clitoral adhesions and NPV. Methods: A retrospective chart review of patients with NPV who underwent vestibulectomy and lysis of clitoral adhesions concomitantly between January 1, 2021 and October 31, 2023 was performed. History, physical examination, pre-op vulvoscopy with photographs, operative records and patient outcome data were collected. Results: Sixty-three patients with NPV, (mean age 29, range 19 – 64 years), underwent vestibulectomy surgery. A total of 34 (54%) of these patients underwent concomitant lysis of (mild (38%), moderate (50%), or severe (12%) clitoral adhesions. Multiple keratin pearls were removed in 91% of cases. More than half (53%) of these patients with NPV and clitoral adhesions complained of glans hypersensitivity/pain during pre-op vulvoscopy. The majority (88%) of this cohort reported "somewhat better" or "very much better" on PGI-I after lysis of adhesions. No negative side effects following the lysis of clitoral adhesions were noted. Conclusions: There is a high prevalence of symptomatic clitoral adhesions in patients with NPV (53%) compared to women who presented to a sexual medicine clinic for other sexual concerns (14%). While clitoral adhesions are not always symptomatic, we hypothesize the high prevalence in patients with NPV may be due any of the following: i) pain/stress resulting in peripheral nerves releasing neurotransmitters that stimulate proliferation/differentiation of prepucial sebaceous glands and upregulate prepucial sebaceous cell lipid synthesis, ii) infrequency of clitoral tissue engorgement from sexual activity, iii) limitation or aversion to touching or retracting clitoral prepucial tissue, iv) increased frequency of wearing menstrual pads rather than tampons, v) severe genital pain perceived as co-existing in both vestibule and clitoris and vi) the patient is already scheduled for surgery under anesthesia so the patient conveniently agrees to also undergo lysis of adhesions. Clinicians should be aware of this high association. Disclosure: No. [ABSTRACT FROM AUTHOR]