Recap of our Instagram Live with Dr. Jaishree Sharad
Menstruation is a normal physiological cycle in every female from menarche to menopause. It is regulated by hormones whereby the lining of the endometrium thickens and it is shed along with blood, mucus and vaginal secretions for about 3-7 days every month. Menarche marks the onset of thee reproductive phase of a woman’s life and is an important biological milestone. It is imperative that a young girl be educated about menstruation and menstrual hygiene. There should be no sense of embarrassment when it comes to menstrual management.
Menstrual hygiene comprises of three things: to maintain intimate hygiene, to be able to use the right kind of absorbents and to be able to dispose the menstrual waste correctly.
Maintaining intimate Hygiene : The external part of the female genitals is known as the vulva. The vulva includes the lips known as labia majora and labia minora, the clitoris and the vaginal opening.
The vulva can be cleaned with warm water and a non foamy mild fragrance free soap or an intimate wash. Intimate washes containing lactic acid and lactoserum are safe. They should not contain fragrance or harsh chemicals. Make sure you wash the anus, as well as the perineum, which is between the anus and the vulva. Always move front to back, starting with the vulva and moving back toward the anus, so that you don’t accidentally push bacteria from the anus forward into the vagina. After washing, pat dry the area with a clean napkin or towel. Never over wash the area with soap. The pH of the vulva and vagina is acidic. Over washing or use of soaps will increase the pH making the skin dry and susceptible to allergies and infections.
The vagina is an internal organ richly endowed with blood vessels , and a plethora of good bacteria which protect the vagina and the internal organs from the harmful microorganisms. Like all other internal organs, the vagina does not require cleaning. The vaginal wall or epithelium is highly water permeable in a way our skin is not. So using harsh chemicals, fragrance based products, soaps and sprays and douches can not only throw the vaginal pH out of balance, they can also permeate through the mucosa, increasing the risk of infections, irritation, allergies and unpleasant odors.
Vaginal douching leads to an increased risk of bacterial and yeast infections, pelvic inflammatory disease, increased transmission of sexually transmitted infections and even cervical cancer.
Maintaining menstrual Hygiene : Sanitary protection material ranges from sanitary pads to tampons to reusable cloths depending on personal choice, cultural acceptability, economic status, and availability in local market.
Changing sanitary material with clean hands is mandatory to prevent any kind of infection. Wearing clean dry lingeries is equally important. Fungal infections, bacterial vaginosis , yeast infections and anaerobic infections are often a result of poor hygiene. It is a good practice to carry hand sanitizers with you should you need to change pads or tampons when you are on the go.
Sanitary Napkins: Out of the 336 million menstruating women in the country , 36% use sanitary napkins. Sanitary napkins should be changed every 4 to 6 hours in order to prevent bad odor and infections even if the menstrual flow is less and the entire pad does not get soaked. Sanitary Napkins can also lead to red rashes or allergic contact dermatitis in the groin which may be itchy or burn or cause discomfort. Commercial sanitary napkins are not environment friendly. They are made of
Super Absorbent Polymer (SAP) as an absorbent material, with Polyethylene (PE) as the back cover, making them waterproof. They may also be laced with dioxins, petrochemicals, GMO (Genetically Modified Organisms) and fragrances, all of which can cause allergies & reactions. Dioxins are carcinogenic in nature hence the risk of cancer increases with regular exposure over a period of time. Sanitary napkins are non-biodegradable and are thus increase the risk of potential environmental hazards.
Biodegradable organic sanitary napkins made of bamboo, water hyacinth and banana fibre are now available and their use should be encouraged.
Tampons: Tampons are better than sanitary napkins but are more expensive. Tampons should be changed every four to six hours. Leaving the tampons in the vagina for long may lead to serious complications such as toxic shock syndrome. Use cotton tampons which are unscented and do not contain dioxins. Sea sponge tampons are natural , biodegradable and better than synthetic tampons.
Reusable cloth pads: Clean reusable cloth pads are a sustainable sanitary option but must be hygienically washed and dried in the sunlight. The sun’s heat is a natural sterilizer and drying the cloths/cloth pads under it sterilizes them for future use. They also need to be stored in a clean dry place for reuse to avoid contamination. These cloth pads are reusable so they are cost-effective, easily available, and eco-friendly.
Menstrual Cup: They are cups made of medical grade silicone rubber and are practical, safe and environment friendly. They should be sterilized by soaking them in boiling water for at least fifteen minutes. Then cool them to room temperature and use them. The cup can be easy to folded and inserted into the vagina to collect menstrual blood. It can be worn up to 6–12 hours depending upon the amount of menstrual flow. Once full, it needs to be removed, emptied into the toilet pot and washed with lukewarm water. Avoid using soap. Once the entire menstrual cycle is over, clean the cup in hot water, use a mild soap. Dry it and store it in a clean place inside a clean bag. Cups are less likely to cause reactions or allergies unless one is allergic to latex.
Disposal of sanitary waste:
Menstrual products should be wrapped and disposed in specific waste bags . Schools , colleges, public places should install sanitary napkin vending machines in toilets and also have separate dust bins for sanitary waste. Soiled pads wrapped or unwrapped in the toilet corners become a breeding place for flies, mosquitoes and bacteria and are extremely unhygienic for other toilet users and cleaners. Even today, sewage system gets routinely blocked at many places because of flushing of sanitary pads or rags in the toilet. Girls and women should be educated against these unhygienic practices.
Most of the times, sanitary pads and tampons or cloths become a part of the domestic solid wastes which are occupational hazards for rag pickers. Deodorized sanitary products contain chemicals used in bleaching such as organochlorines which when buried in the soil disturb the soil microflora and decomposition takes time. Hence, the government should make provision for disposal of menstrual wastes just as they have made for solid or biomedical wastes.
Incinerators are a better option for disposal of sanitary waste products but should be operated in a controlled environment so that harmful gases emitted will not harm the surroundings.
Menstruation, menstrual hygiene management, importance of toilets, hand washing, diseases related to reproductive tract due to poor hygiene should be emphasized and educated among not just women but men too.