Menstrual Hygiene: Time to end the taboo.

By Dr Amit Singh
Lusaka (22-03-2023-Zambia24) – Menstruation is a natural fact of life and a monthly occurrence for the 1.8 billion girls, women, and non-binary persons of reproductive age.
Yet millions of menstruators across the world are denied the right to manage their monthly menstrual cycle in a dignified, healthy way.
The onset of menstruation coincides with new opportunities and vulnerabilities, that arise during adolescence.
Shortly after the beginning of puberty in girls, and usually about 2 years after the development of breasts, menstruation starts.
While menstruation usually begins between ages 12 and 13, it may happen at a younger or older age.
The first menstrual period is called “menarche.
The first period can be met with either celebration, fear, or concern.
For every girl, this signifies an important transition to womanhood.
It is even celebrated in some parts of the globe.
Many girls do not have complete and accurate understanding of menstruation as a normal biological process.
It is a regular, monthly, normal physiological process.
Educating girls before their first period and, importantly, boys on menstruation, builds their confidence, contributes to social solidarity, and encourages healthy habits.
Such information should be provided at home and at school.  
The first period may last from two to seven days.
Then, there might be 21 to 40 days or even longer gap before another period.
Next period might be heavier or lighter than the first.
There is no need to worry if early periods have longer cycles or it don’t follow a schedule.
This irregularity is normal for at least the first 2 years.
Periods should become more regular within two years after the start of menstruation.
Some teens have a 28-day cycle; some have a 24-day cycle; others have a 30-to-34-day cycle.
All of these are normal. For young teens, cycles can range from 21 to 45 days.
For adults, it can be 21-35 days. Premenstrual syndrome happens to many teens right before their periods start. Mild breast tenderness,
Fluid retention, Anxiety, Dietary cravings, Irritability, difficulty sleeping or excessive sleeping are some of the symptoms of the same. During period teens may have cramps, aching in the upper thighs along with lower back pain.
Some also notice nausea, diarrhoea, irritability, headaches, and fatigue, among other symptoms.
To ease cramping, applying heat to the abdomen with a heating pad or hot water bottle can be useful.
Taking a warm bath may also help. Some teens find that exercise helps relieve cramps. 
Exercise improves blood flow and produces endorphins, the body’s natural painkillers.
Antispasmodics and pain killers are also available in the market for the same but should be used after taking advice from the doctor.
Teens can use tampons, pads, or both during their period.
Tampons are worn inside the vagina and come in a variety of sizes with different absorbencies.
It is important to change a tampon at least every four to 8 hours to avoid leakage and serious bacterial infections. Pads are usually self-adhesive and worn inside the underwear.
Change pads at least every four hours to avoid leakage and odour.
It is important to understand personal requirement,
Girls who participate in sports may find tampons less bulky and restrictive than pads. 
Girls can swim with tampons. Still, other girls think tampons are uncomfortable and prefer to use pads.
It may take a while to find the right product.
Whether tampons or pads, keep extras in school bag or in a side pocket of the purse.
Change the tampon or pad more frequently on heavy days to avoid stain on the clothes.
If ever there is trouble taking a tampon out, see your health care practitioner immediately.
Tampon use increases risk for toxic shock syndrome compared to pad use, especially if it is not changed frequently enough or use highest absorbency tampons on the lightest flow days.
Toxic shock syndrome is a life-threatening disease related to toxins from bacteria. use of non-absorbent and uncomfortable menstrual cloth should be discouraged; Poor menstrual hygiene can pose physical health risks and has been linked to reproductive and urinary tract infections.
Many girls and women have limited options for affordable menstrual materials.
Providing access to private facilities with water and safer low-cost menstrual materials could reduce urogenital diseases.
About half of the schools in low-income countries lack adequate drinking water, sanitation, and hygiene crucial for girls and female teachers to manage their period.
Inadequate facilities can affect girls’ experience at school, causing them to miss school during their period. All schools should provide running water, safe and clean toilets for adolescent girls.
Many things, such as the stress of examinations or an illness like the flu, can cause skip of a period. If there are continuous irregularities be sure to talk to your doctor.
If a teen is 16 or above and still not attended menarche, need to see a doctor. There is lot of myth and belief which are not correct at all “No meat, no rice, no vegetables, no sour foods, no drinking cold water, no sitting on wet ground, and no washing.
These are some of the common myths surrounding menstruation in Afghanistan, where the topic is taboo and girls learn to see it as something negative, shameful, or dirty.
In some communities, “even women in the family don’t talk with the ones who have their period,”
More than half of adolescent girls in Ethiopia do not receive any education about menstruation before their first periods. One common misconception is that girls are no longer virgins when they begin menstruating.
In Zambia also the natural process of menstruation is a taboo and dealt with secretly.
Information and knowledge about menstruation and menstrual hygiene among adolescent girls is inadequate, there is an urgent need to talk and educate the adolescent boys and girls that it is a normal physiological process and there should not be any restriction on the routine activities.
The author is Dean in the School of Medicine at Texila American University