I could not help noticing that the girl looked quite pale and wanted to tell me something but was somewhat hesitant. After persuading for sometime, Tara revealed that she suffers from itching and white discharge from her vagina. On inquiring, I was shocked to learn that she used cloth and did not maintain appropriate hygiene during her menses.
I did a preliminary examination and discharged her after prescribing medicines along with a haemoglobin estimation test. With passing time I became busy again and forgot about Tara. She recovered with medicines. However this is the story of most adolescent girls of India. Most of them do not know about the need for menstrual hygiene and are quite hesitant to discuss anything owing to the social taboos associated with menstruation.
Menstruation is a natural phenomenon unique to the female gender. The onset of menstruation is one of the most important changes during the adolescent years. The first menstruation (menarche) occurs between 11 and 15 years with a mean of 13 years. However it is regarded as something unclean and dirty in Indian society which results in neglect of adolescent girls making them vulnerable to various reproductive tract infections.
Hygiene-related practices during menstruation are of considerable importance, as it has a health impact in terms of increased vulnerability to reproductive tract infections. Adolescent girls constitute a vulnerable group. The reaction to menstruation depends upon awareness and knowledge about the subject. The manner in which a girl learns about menstruation and its associated changes may have an impact on her response to the event of menarche. Although menstruation is a natural process, it is linked with several misconceptions and practices, which sometimes result into adverse health outcomes such as sexually transmitted infections, fungal infections and risk of transmission of blood borne diseases like hepatitis B, HIV etc.
The unhygienic practice of using dirty clothes or other insets during menses can cause local bacterial infections and these can even spread through the vagina to the uterus. Changing pads infrequently can cause fungal infections resulting in white discharge and itching. Wiping from back to front can cause a spread of bacteria from the bowel and can cause urinary tract infections. Unsafe sexual practice can increase the risk of spread of sexually transmitted diseases, hepatitis B, HIV etc. Lack of washing hands after changing and unsafe disposal of pads can spread infections like thrush and hepatitis B.
Thus proper menstrual hygiene and a correct perception is very necessary for adolescent girls. Before bringing any change in menstrual practices, the girls should be educated about the facts of menstruation, its physiological implications, about the significance of menstruation and development of secondary sexual characteristics, and above all about proper hygienic practices with selection of disposable sanitary menstrual absorbent.
Some of the basic hygienic practices are:
1. Washing the genitals with soap and water every day
2. One should bathe everyday during menses.
3. Keeping unused pads or clothes clean (wrapped in a plastic packet or tissue) for further use.
4. Sanitary napkins should be changed after every four hours and hand washing should be done before and after changing pads.
5. Cleaning the genitals using soft tissue paper and wiping from front to back to prevent contamination with bacteria from bowel.
6. Keeping the area between the legs dry to prevent soreness and chaffing.
7. Not suppressing the urge to urinate as doing this can cause urinary tract infections.
Along with proper hygiene, girls should have a good nutritious diet during menses along with proper rest. They should also have plenty of water to prevent urinary infections. Use of hot water compresses to relief abdominal pain and yoga are other healthy practices during menstruation.
Menstruation is still a taboo in India and it is common for people across society to feel uncomfortable about the subject. To ensure that adolescent girls and women have the necessary support and facilities, it is important that the wider society, communities and families challenge the status quo and break the silence around menstruation. Ensuring proper hygiene and nutrition is vital for proper health of adolescent girls for a better future.
Dr. Rajashree Sharma,
Obstetrician & Gynaecologist,
Department of Obstetrician and Gynaecology,
Guwahati Medical College and Hospital
Also Watch: