Introduction
For females, the menstrual cycle is a singularly natural phenomena. It occurs on a monthly schedule and in a consistent way. It begins throughout puberty and lasts till menopause. The menstrual cycle is brought on by certain bodily hormones that increase and fall over the course of the month. 98% of females typically have menarche at age 15. Menstrual hygiene has always been a problem, particularly in impoverished countries.1, 2
The adjustment to menstrual hygiene is influenced by social, cultural, and religious variables. Regarding menstrual blood and menstrual hygiene, there are many myths, misunderstandings, superstitions, and cultural and/or religious taboos. For example, in Judaism, bleeding women and whatever they touch is viewed as impure.3 Menstruation is regarded as filthy in Hinduism, and limitations during menstruation are associated with luck and good fortune.4 Due to the belief that menstrual blood pollutes the home, certain communities in Nigeria require menstruating women to segregate themselves in menstruation huts. 3 Such taboos have a significant negative influence on women's thinking, way of life, emotional condition, and—most importantly—health.5
Socioeconomic position, environmental restrictions, stress and embarrassment, a lack of awareness, a lack of utilities like water, the shame associated with menstruation, gender norms in the restroom, and lack of privacy are other variables that might affect menstrual hygiene.6 According to one Saudi Arabian study, females only receive a little amount of information from their moms, sisters, and religious texts.7
According to a research, 71% of Indian females said they were unaware about menstruation before to their first period. According to the National Family Health Survey 2015–2016, just 36% of women use sanitary napkins. Many females wear unclean, unwashed clothing and rags. Infections of the reproductive and urinary tract are caused by improper menstrual hygiene.8
Menstruation and menstrual hygiene concerns persist despite efforts by WHO, UNICEF, and the national government, such as Kishori Shakti Yojana (KSY), to address them, and they continue to have an impact on adolescent girls' health. Poor menstrual hygiene has been one of the issues that hasn't received enough attention in Patna, Bihar.9 The present study was undertaken to evaluate knowledge and practises related to menstruation and menstrual hygiene among teenage girls because it was noted that there was little information available on these subjects.10
Materials and Methods
To evaluate the knowledge and practises related to menstrual hygiene among teenage girls, a descriptive cross-sectional study using a non-experimental research technique was carried out in selected schools in Patna, Bihar. The Institute Ethics Committee granted authorization to conduct research, and the Head of Schools granted ethical clearance. After giving parents a thorough parent information document, written informed permission was acquired from them. Data was gathered using a self-structured questionnaire that was approved by nine subject-matter experts.
Nine nursing industry professionals received the instrument for validation. CVI (Content Validity Index) calculation result was 0.87. The questionnaire asked on sociodemographic information, teenage girls' understanding of menstrual hygiene, and menstrual hygiene practises. 192 teenage females from selected schools' classes of ninth through twelfth were enrolled using the total enumeration sample approach. The girls who were open to taking part and who could understand either Punjabi, Hindi, or English were included. Girls were excluded if they did not reach menarche or if they had amenorrhea for longer than three months. To protect their comfort and privacy, participants were required to sit in a separate area. The surveys were given out, and respondents had 45 minutes to complete them. After all of the participants' questions were answered, the data gathering was stopped. The statistical package for the social sciences (SPSS)-16's descriptive and inferential statistics were used to code the data and analyse it.
Results
Table 1 shows teenage girls' and mothers' socio-demographics. 57.27% were 15-17 years old, whereas 42.73% were 12-14. 53.18% were 5.1-5.5 feet tall and 88.18% were 40-50 kg. 38.18% were in 11th grade and 20.91% in 9th. 48.64% were in the 5000-10000 income range, while 66.36% were rural. 85.45% were nuclear families. 59.55% of moms were under 40 and 35.00% had primary education.
Table 2 shows participants' menstrual hygiene knowledge and sources. Menstruation was considered physiological by 63.0%, abnormal by 24.2%, and cursed by 10.3%. 61.9% reported monthly menstruation. 36.1% said the hypothalamus regulates menstruation. 38.7% estimated 40-50ml blood loss. 53.6% correctly recognised the vagina as the menstrual organ.
45.4% of participants knew all about menstruation hygiene, including using sanitary pads and washing the perineal region. 20.1% of respondents used the internet for menstrual hygiene information. 45.9% of individuals identified itching, odd smelling vaginal discharge, and infection as menstrual hygiene symptoms.
41.2% said menstrual hygiene prevents infection, while 56.2% said it cleans the perineum. 67.5 percent knew that menstruating women needed an iron-rich diet, and 35.1% knew they needed a healthy diet and 6-8 hours of sleep. 32.0% believed menstrual sexual activity was possible.
Discussion
The current study aimed to assess the knowledge and practices related to menstruation and menstrual hygiene among adolescent girls in schools of Patna, Bihar. The findings reveal that there is a significant lack of awareness and understanding among teenage girls regarding menstruation and related hygiene.11
Only 11.5% of girls reported using the front-to-back approach to clean the perineal region, which is an essential practice to prevent infections. Additionally, nearly half of the girls dried their knickers in direct sunshine, which may not be the most hygienic method.12 The study also found that less than half of the girls felt comfortable discussing menstruation with their mothers, possibly due to cultural or religious taboos surrounding the topic. Parental education on sexuality and reproductive health remains a sensitive area for discussion.13
The study highlighted the limited sources of knowledge for adolescent girls, with mothers being the primary source, followed by sisters, fathers, and friends.
Table 1
Socio-demographic variables of adolescent girls and their mothers
Table 2
Knowledge and source of information regarding menstruation and menstrual hygiene
Books were not commonly used as a source of information, indicating the need for better educational resources on menstruation. These findings align with prior research, which also emphasized the role of mothers in imparting knowledge about menstruation to their daughters.14
Regarding menstrual products, while the study showed that girls preferred using sanitary pads, availability was a challenge, consistent with national data indicating limited access to sanitary napkins in India. Many girls still relied on non-hygienic methods such as cloth, similar to findings in other studies conducted in different parts of the country.15
Despite the lack of comprehensive knowledge, girls in the current study generally perceived menstruation as a natural process. However, their practices of perineal care differed, with more girls cleaning their perineum with water alone instead of using soap and water. This highlights the need for proper education on menstrual hygiene practices.16
The study also revealed the presence of various behaviors and rituals associated with menstruation, including self-imposed limitations on food intake and social interactions. Girls engaged in specific dietary preferences and practices to alleviate menstrual discomfort. These findings align with research conducted in other underdeveloped countries, where a lack of information and awareness about menstruation is prevalent.17
Conclusion
In conclusion, the study highlights the urgent need for comprehensive menstrual health education among adolescent girls in Patna, Bihar. There is a lack of awareness about menstrual hygiene and practices, and girls often rely on traditional or non-hygienic methods for managing menstruation. Implementing educational programs that address cultural taboos, promote proper menstrual hygiene practices, and provide access to affordable menstrual products is crucial to ensure the well-being and health of millions of young women in the region.
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