Understanding Menstrual Distress
Adolescence is characterized by the beginning of various bodily changes in primary and secondary sexual characteristics. Accepting such changes in a young child requires social support from society. In young girls, adolescence is when they experience the first occurrence of Menstruation or Menarche, which characterizes their first step towards womanhood. Menarche is a part of the maturation process. Health scientists and practitioners have aimed to identify how strategies can be developed to create a good impact in providing better health care that will remediate women's personal and social livelihood (Jang & Elfenbein, 2019). Considering this as a goal, studies have been conducted to observe the challenges women/girls face and how menstrual problems can be reduced. This helps to understand the complex function of the womb of women/girls in more detail, which will significantly help in understanding other related health issues (Barron et al., 2008). However, a study by Gwartney (2016) states that women's number of periodic cycles has increased rapidly throughout history. With the advancement of medication and changes in dietary habits, women having just five-periodic cycles have risen approximately to 400-500 periodic cycles in women/girls' entire lifespan, which has led to a rise in irregular/abnormal menstrual health as compared to the previous state. As the present society is engulfed with traditional and modern ideas, women face various social challenges that affect their mental well-being. Some of the significant challenges faced by women/girls due to menstrual and premenstrual distress or abnormal menstrual cycle are interpersonal relationships (Mou et al., 2019), school absenteeism (Prakash et al., 2017), peer relations (O'Flynn, 2006), work performance (Schoep et al., 2019), and academic performance (Bernstein, 1977). This can be mainly due to insufficient knowledge about menstruation and lack of access to menstrual hygiene products like sanitary napkins. Lack of a good school and work environment promoting safe spaces like girls'/women's toilets could cause be challenging for women/girls. Apart from these factors, women/girls also face shame, guilt, and stigma attached to menstruation, as it is perceived as impure or disgusting due to cultural and societal beliefs which stop these menstruating young girls and working women from voicing their concerns.
The combination of dysmenorrhea and premenstrual syndromes could severely impact the adolescent girl/women's attention span leading to their day-to-day life. Nearly 27.5 percent of the participants reported depression due to the syndrome. Due to social taboos or shame, only 19.9 percent took medical support (Bilir et al., 2020). The prevalence of premenstrual distress is high among adolescent girls in India, where 38 percent of the girls reach their menarche before they are twelve. Data shows that girls undergo severe physiological, psychological, and social challenges, making it difficult to smooth processes in their daily lives. Girls reports major challenge to be social withdrawal (44 percent) and anger (19 percent) (Tarannum et al., 2021).
Figure 1.
Prevalent menstrual symptoms effecting young girls' health in India
Further, 66.2 percent of girls with premenstrual symptoms reported irregularity in their menstrual cycle, and 49.6 percent with abnormal bleeding during their menstrual period. Due to a lack of infrastructure, schools could not provide sanitary facilities to the girl students, affecting nearly 367 million girls worldwide. Reports state that 95 percent of girl children miss their classes due to a lack of sanitary facilities, and 70 percent negatively impact their academic performance (Sivakami et al., 2019). This leads to another question: Can parents afford sanitary napkins for their children? In India, only 12 percent of the women population uses sanitary napkins, compared to others using insanities clothes and husk sand (Sara et al., 2021).
The 2018 global census by International Labor Organization highlights that the significant working population in the coming years will be from 15 to 25, and 47 percent will comprise the female population. A healthy and supportive work culture could enormously increase the probability of women being able to share their concerns with the management or someone with whom they are comfortable. However, a 2022 study identified quite the opposite data, where 45.8 percent of women prefer not to go to work during their menstrual period. 21.7 percent miss work due to menstruation, and 16.6 percent miss due to the last menstrual period. Significant complaints circulate across the domains. Pain being one of the major complaints, 75 percent reported pain to be the primary cause of work absenteeism, followed by 37.5 percent of women who miss work due to the development of containment fear due to inadequate sanitary support. 23.6 percent of women reported fatigue, heavy bleeding, and gastrological issues during their menstrual period (Kwak et al., 2019).
Figure 2.
Prevalence of Menstrual Disorder in India
Both corporate bodies and academic institutions need to address issues limiting organizations from reaching their optimum growth level. The lack of adequate policies and a poor awareness system limits the receiver from getting what the providing stakeholders, such as the government, have provided for their upliftment. There are several challenges women experience in their daily life, whether social, physiological, emotional, or psychological. Necessary steps with effective awareness strategies could significantly help enhance women's health.