“Health is a state of complete physical, mental and social well being, and not merely the absence of disease or infirmity. Unequal development in different countries in the promotion of health and control of diseases is a common danger.” – WHO
Sustainable development goals 2 and 5 focus on good health, well being, and gender equality. But in a democratic country like India, whose principle is “Unity in diversity“, women face a great degree of discrimination and challenging issues in the field of menstrual health management.
Sexual and Reproductive Health is an important yet neglected part of women’s health throughout the ages. Starting from menstruation, the reproductive organ performs multiple functions, fights with infections and suffers from diseases. It has to go through the journey of pregnancy and its complication, abortion, delivery. Various kinds of infections, infertility, side effects of contraception, preterm birth, low birth weight infant etc. are some other issues.
So women need proper education, facility, care and support to manage with the regular change process of their body, that is, menarche and menstruation. To attain the SDGs and to enhance the democratic value, different schemes and programmes have been implemented by the government of India. The Menstrual Hygiene Scheme and adolescent-friendly health clinics under Rashtriya Kishor Swasthya Karyakram are to name a few.
These schemes are meant for the health and overall development of women. But menstrual hygiene management has remained in the dark due to various socio-cultural aspects associated with it.
Menstruation is a biological process. But the stigmas associated with it make it an unnatural and unacceptable thing for society. Besides, the poor economic condition, lack of proper education and awareness, less debate on it, unavailability of proper infrastructure for MHM, creates great danger for the women’s health and well being.
Menstruation not only brings physical change but other side-effects like fatigue, irritation, menstrual cramps etc. If these are not appropriately managed, they can cause chronic diseases in future. Consumption of contraception pills like emergency contraceptive pills, oral contraceptive pills and Norethisterone (a period delay tablet) can also create hormonal imbalance in the body.
Due to the lack of hygienic menstrual products, women and girls generally use old dirty clothes. They can’t maintain proper hygiene due to lack of MHM facilities both at home and in any institution or public places.
Poor menstrual hygiene can lead to many issues such as bacterial infections of the reproductive tract and urinary tract. Irritation of the skin causes discomfort and can result in dermatitis (a medical condition, in which the skin swells, turns red and at times becomes sore). If such infections are not diagnosed and appropriately treated in time, they can increase the chances of cervical cancer, infertility, and abortion.
Though blood is lost from the body every month for 3-5 days, a balanced diet with sufficient iron intake is highly essential to reduce the chances of anaemia. But either due to unavailability of sufficient food or stigma or unawareness, menstruators don’t take a proper diet.
Unfortunately, 54% of adolescent girls, 53% of women of reproductive age and 50% of pregnant women and seriously 58% of children (5-59 month) are anaemic in India (NFHS-4). This results in the increased status of IMR, MMR, NMR, CBR, which are the key health indicators of any country.
Menopause is also one of the most critical components relating to menstruation. Though many organisations and activists are working in this field to ensure the availability of better MHM facilities for the menstruator, very few people talk about it.
Generally, menopause occurs at the age of 48-55 in a menstruator’s life. It is an important phase because many physical and psychological changes occur during this process. This process occurs with associated symptoms like night sweat, frequent urination, vaginal dryness, low sex drive, mood fluctuation, insomnia, weight gain, decreased bone density, painful intercourse etc.
But very few people have any understanding of it. This again makes women more vulnerable. Because without having information and support, with a large amount of other responsibility and decreasing bodily strength, it can influence their mental health gravely.
On addressing a training programme on MHM, Sadhvi Bhagawati Saraswatiji, Secretary-General of GIWA said, “On average, a woman spends seven years of her life span menstruating. If you were sending your sister, daughter or wife somewhere for seven years, wouldn’t you make sure it was as safe, healthy and comfortable as possible?”
We must ensure menstrual health for all. We need to openly discuss menstrual safety and break our silence so that our daughters and sisters can be provided with a safe sanitation environment. This clearly shows her call for men’s participation in the process and practice of providing a conducive environment to women for better management of menstrual hygiene.