HYDERABAD : We call them taboo topics - menstruation and reproductive health. But being termed as taboos does not simply make these essential components of women’s health disappear. Lakhs of women are tired of their stories being brushed under the carpet because they are not deemed kosher for mainstream, living room conversations.
Shame and stigma
According to a study titled 'How effective is the Menstrual Hygiene Scheme?' published in International Journal of Community Medicine and Public Health (IJCMPH), menstrual hygiene is of great concern among large proportion of rural women in India.
The current use of sanitary napkins among Indian women is low (10-11 per cent) compared to developed countries like the USA (73-90 per cent). Though ready-made napkin is not an issue for urban women, rural women still use cloth as an absorbent during menstruation
Talking to The New Indian Express, Pratibha Pandey, senior health specialist at ChildFund India, said: "Women in rural areas resort to using ashes and leaves to soak up menstrual blood. Practices such as sending the girl outside the house, not allowing her to take bath during that period and not letting her touch other family members are rampant. Our culture does not allow women to talk about it and gives out the signal that a natural bodily function is something to be ashamed of."
Dr. Jayashree Reddy, gynaecologist at Apollo Cradle & Children’s Hospital, said: "There are over 355 million menstruating women and girls in India, but millions of women across the country still face significant barriers to a comfortable and dignified experience with menstrual hygiene management (MHM). A study found that 71 per cent of girls in India report having no knowledge of menstruation before their first period."
Stating that unsanitary practices during menstruation can lead to numerous health problems, Pratibha said: "Lack of menstrual hygiene can lead to pelvic inflammatory diseases, leucorrhoea and infertility. It does not help that we still do not have sex education as part of school syllabus. Both boys and girls need to made aware of safe reproductive and sexual health practices."
"Through our organisation, we educate children in rural areas about these issues. We conduct awareness programmes on menstruation for girls between 10-14 years of age; about sexuality, contraception and safe sex for adolescents between 14-18 years," he added.
The IJPMCH study states that there are various myths linked with sanitary pads. "The cultural belief is that a sanitary napkin is an object for evil eye or magic spell that can be used on others. There is a common belief that stepping on a menstrual napkin is very harmful," the report says.
The biology of it
Explaining when girls get their period, Dr Jayashree says: "Most girls get their first period when they are around 12, but some get it between age 10 and 15 too. Every girl's body has its own schedule. There isn't one right age for a girl to get her period. But there are some clues that it will start soon: most of the time, a girl gets her period about two years after her breasts start to develop. Another sign is a mucus-like vaginal discharge that a girl might see or feel on her underwear. This discharge usually begins about six months to a year before a girl gets her first period."
When asked if a girl can get pregnant as soon as her period starts, the doctor adds: "Yes. A girl can even get pregnant right before her very first period. This is because a girl’s hormones might already be active. The hormones may have led to ovulation and the building of the uterine wall. If a girl has sexual intercourse, she can get pregnant even though she has never had a period."
What causes menstruation?
A period happens because of changes in hormones in the body. Hormones are chemical messengers. The ovaries release the female hormones estrogen and progesterone. These hormones cause the lining of the uterus (or womb) to build up. The built-up lining is ready for a fertilized egg to attach to and start developing.
If there is no fertilized egg, the lining breaks down and bleeds. Then the same process happens all over again. It usually takes about a month for the lining to build up and then break down. That is why most girls and women get their periods around once a month.