Review of Menstrual Hygiene Management Practices Among Adolescent Girls: Challenges, Health Implications, and Future Directions

- Although a woman's menstruation is a normal biological process that is essential to her reproductive life, managing menstrual hygiene is still a major worldwide issue, especially for teenage girls in low-and middle-income nations. Maintaining dignity and one's physical and mental health depend on practicing proper menstrual hygiene. However, barriers to good menstrual hygiene habits persist due to cultural taboos, a lack of resources, and inadequate knowledge. Examining national and international policies targeted at resolving these concerns, this analysis examines the relationship between menstrual hygiene, adolescent health, and the right to health. The conversation emphasizes how important it is to manage menstrual hygiene in an appropriate way to prevent a girl's period from interfering with her everyday activities or undermining her self-esteem. A variety of menstruation items are assessed, with a focus on choosing the right goods to preserve hygiene, including sanitary pads, tampons, menstrual cups, and period underwear. The review also touches on the effects of menstruation problems on women's lives. The support that national and international initiatives like the Swachh Bharat Abhiyan, Beti Bachao Beti Padhao (BBBP), Rashtriya Kishor Swasthya Karyakram (RKSK), and the Scheme for Promotion of Menstrual Hygiene provide for the management of menstrual hygiene and adolescent health are examined. In order to guarantee that teenage girls may have healthy, productive lives with dignity and respect, the article emphasizes the need for ongoing efforts to enhance menstrual hygiene management via education, access to sanitary products, and the breakdown of societal taboos.


INTRODUCTION
Menstruation is a natural biological process that marks the reproductive phase in females.However, despite its natural occurrence, menstrual hygiene and practices among adolescent girls remain a significant concern globally.Proper menstrual hygiene management is crucial for maintaining physical health, mental well-being, and overall dignity.
Menstrual hygiene encompasses the practices and resources used by women and girls during menstruation to ensure cleanliness, comfort, and health.It involves the use of sanitary products, access to clean water and sanitation facilities, proper disposal methods, and education about menstrual health and hygiene.Many issues, including cultural taboos, a lack of resources, and insufficient education, make it difficult for adolescent girls, particularly in poor and medium income countries, to practise proper menstrual hygiene.

The concept of health
Health is considered as the most precious value in life and so it must be protected and enhanced a much as pos sible.Though numerous ideas are prevalent about health and illness according to individual perceptions, contemporary philosophy of health focuses on a scientific point of view.For any individual to be healthy there must be a balance between the body and the mind.A person often requires a high level wellness to have a higher level of functioning and to have a holistic integration of the body, mind, the spirit and the society (Black & Hawks, 2015).A healthy individual only can carry out all the activities of daily living and perform life enriching goals.Often Review of Menstrual Hygiene Management Practices Among Adolescent Girls: Challenges, Health Implications, and Future Directions the meaning of health is misunderstood and misinformed by many people.The health care personnel often identify abnormalities and give therapeutic care, eventhough the current trend is on preventive and promotive aspects of care (Gulani, 2013).

Right to health
The right to health implies the governments to generate conditions in which everyone can be as healthy as possible and it ensures availability of health services, safe working conditions, adequate housing and nutritious food.As per article 12 of the International Covenant on Economic, Social and Cultural rights (1966), the steps for the realization of the right to health include those that reduce infant mortality and ensure the healthy development of the child; improve environmental and industrial hygiene; prevent, treat and control diseases, and create conditions to ensure access to health care for all.

Adolescent health
A nation's youngsters and adolescents are its future.About 20% of the global population falls into the "adolescent" demographic, which includes those between the ages of 10 and 19.They number around 253 million in India alone, surpassing the combined populations of eighteen Western Asian nations.Scheduled tribe teenagers make for 9% of India's adolescent population, or 23 million people (Kumar& Singh, 2014).
The word "adolescence" may literally imply several things, including "to emerge," "to grow to maturity," and "to achieve identity."From the onset of secondary sex traits to full sexual and reproductive development, this is the time frame in question.Adolescence is a time of profound change for both the body and the mind.During this time, adolescent girls experience the start of their menstrual cycle, a shift from complete reliance on others financially to a more independent lifestyle, and, of course, rapid physical growth and development (Steinberg, 2017).

Menstruation
Hormones cause a woman's reproductive system to go through cyclical changes that get her ready for fertilisation and conception.Menstruation, the cyclical bleeding of the vagina, is the most visible sign of these changes.The Latin word "menses," meaning moon, suggests that the term "menstruation" refers to the lunar month.Periods have a dramatic impact on a girl's life.From the onset of adolescence until menopause, it happens monthly.According to Mathhur (2006), menarche is the term used to describe a girl's first period.
The beginning of one period's bleeding and the beginning of the next are the days that make up a woman's menstrual cycle.Although cycles ranging from 21 to 35 days in length are also considered typical, the average cycle length is 28 days.In the years after menarche, long cycles are typical.The typical time for blood flow is three to five days.The average amount of blood and serous fluid lost during a period is 40 millilitres (ml).It is deemed abnormal if the volume exceeds 80 ml.Most menstrual blood flows via the arterial system.It includes prostaglandins, fibrinolysis from endometrium tissue in rather significant quantities, and tissue debris.Periods might last anywhere from one day to eight days in a typical woman.A number of variables, including endometrial thickness, drugs, and disorders affecting the clotting system, influence the flow rate.Due to the release of fibrinolysin and necrotic endometrial debris, menstrual blood often does not clot.Uterine pathology may be confirmed when a clot is seen during menstruation (Mathur, 2006).
Periods reveal a lot about a person's health.Each woman's menstrual cycle is unique in terms of duration, volume, and length of flow.Therefore, keeping track of one's menstrual cycle is a good way to learn about one's own cycle norms, when ovulation occurs, and how to deal with deviations like missing periods or unusually heavy bleeding (Newcomer, 2016).The average age for a woman to start menstruating is twelve, although it may happen as early as nine or as late as fifteen.According to Karnath et al. ( 2013), there are several beliefs and taboos surrounding menarche that have an impact on women's social lives, menstrual hygiene, and overall health.

Menstrual hygiene
When people talk about hygiene, they're referring to the circumstances and activities that aid in health maintenance and illness prevention.The field of hygiene encompasses all aspects that contribute to a healthy lifestyle and is characterised as the science of health.Menstrual hygiene, then, refers to a particular set of actions related to period health preservation that women engage in when menstruating.
The In addition, it is important for the girl to make sure to dry her pads thoroughly during her period.If the pad is wet for too long and scrapes against her thighs, she runs the risk of getting pad rash.It is recommended to stick to a single technique of sanitation at a time.This will guarantee frequent changes and help avoid the spread of illness.Additionally, it is recommended that the girl take a bath at least once a day when menstruating.This will not only clean her body, but it will also alleviate period pains, backache, and enhance her mood.Consistently changing into clean clothes and pants is advised.Because it might impede the self-cleaning process, vaginal douching is unnecessary (UNICEF, 2008).

Menstrual hygiene management
Achieving gender equality requires ensuring that all women and girls can control their menstruation without embarrassment or limitations.Here, too, menstrual health education may help debunk stereotypes and dismantle social obstacles.SDG 6.2 also prioritizes universal access to clean water and sanitation.
By "effective menstrual hygiene management," we mean that periods do not interfere with a girl's ability to go about her daily life as usual, whether that's attending school, working, or taking care of household chores.Furthermore, it must to be capable of averting situations when she or her body may be embarrassed.For females' growth and success, proper management of menstrual hygiene is crucial (Menstrupedia, 2015).

Menstrual product
Menstrual products are items designed to absorb or collect menstrual blood during menstruation.They come in various forms to suit individual preferences and needs.Here are some common types of menstrual products: Sanitary Pads: Rectangular absorbent pads called sanitary napkins or pads stick to the inside of pants to collect period fluids.To accommodate differing flow levels, they are available in a range of sizes, thicknesses, and absorbencies.
Tampons: Inserted into the vagina, tampons are cylindrical devices crafted from absorbent materials like cotton that soak up menstrual blood.You may insert and remove them with ease with the included applicator.You may get tampons in a variety of sizes and absorbency levels.
Menstrual Cups: To collect menstrual blood, women insert flexible, bell-shaped cups made of medical-grade silicone or rubber into the vagina.They prevent vaginal leaks by sealing against the vaginal walls.Menstrual cups are reusable and can last for several years with proper care.
Menstrual Discs: Menstrual discs are similar to menstrual cups but are shaped like discs or saucers.They are inserted into the vaginal fornix, where they collect menstrual blood.Menstrual discs can typically hold more blood than tampons or menstrual cups and are designed to be worn during sexual activity.
Cloth Pads: Cloth pads, also known as reusable cloth pads or cloth menstrual pads, are made of layers of absorbent fabric, such as cotton or bamboo, and are secured to underwear with snaps or wings.They can be washed and reused, making them an eco-friendly alternative to disposable pads.
Period Underwear: Specifically made underwear with layers of absorbent material to soak up period blood is called period underwear.Pair them with other menstruation protection items or wear them on Review of Menstrual Hygiene Management Practices Among Adolescent Girls: Challenges, Health Implications, and Future Directions their own for further peace of mind.Menstrual pants may be washed and reused.
Disposable Panty Liners: Panty liners are thin, absorbent pads that are used for light flow days or as backup protection with tampons or menstrual cups.They are similar in design to sanitary pads but thinner and less absorbent.
There are pros and negatives to using different menstruation products; ultimately, the best option will depend on personal taste, lifestyle, flow intensity, and environmental factors.It's important for individuals to explore different options to find the menstrual product that works best for them.

Menstrual Disorder
Menstrual disorders are problems related to a woman's normal menstrual cycle.They are one of the most common reasons women visit their gynecologist.
Menstrual disorders and their symptoms can disrupt a woman's daily life.They can also affect her ability to become pregnant.
Menstrual disorders such as dysmenorrhea, menorrhagia, and irregular cycles are common among women in reproductive age group and they are responsible for physical, behavioral, and emotional changes around the time of menstruation.

Programmes and Policy for Adolescent Health and Development
Many programs focusing on the needs of adolescence are in operation at national and international levels.In order to promote the health and development of young

School Health Programme
Schools form a basic platform to ensure adolescent health as more than half of them are in schools.Education is an elementary vehicle for human resource development in India.School children, 6-14 years, are the most captive group and their behaviour can be moulded.They can be used as resource for communication of ideas and values to their families and neighbourhood.
School health aims at inculcating healthy habits and lifestyles, protecting children from specific di ea e, promoting health seeking behaviour, trainjng of teacher for school health activities, establishing regular contacts with parents for counseling and promoting healthy environment in school with active participation of school children, which include safe water of wastes (Singh, 2012).

Schemes for adolescent girls
Mainly two schemes have been designed exclusively for adolescent girls: girl to girl approach and balika mandal.Girl to girl approach is for those within 11-15 years, belonging to families having an annual income of less than 6400/-rupees and for urban and rural school drop outs.Three girls selected per Anganwacli are given training for six months, who will act as the resource persons for training other girls in their neighbourhood.Balika Manda} scheme identifies 20 girl in the age group of 11-18 years, irrespective of their income status through Anganwadis.The programme envisages strategies like provision of supplementary nutrition, training on areas like personal hygiene, environmental sanitation, family life, child care and many others and sharing of experiences and discussions on issues that affect their lives (GOI, 2000).

Figure 1 :
Figure 1: Menstruation An additional pack of period pads, some paper tissues, hand sanitizer, and a clean pouch are all good things to have on hand in case of an emergency.Various sanitary products, such as tampons, menstrual cups, cloth pads, and sanitary napkins, are available for the girls to pick from.Regular changes of these protections are required; tampons and sanitary pads should be replaced every two hours and every six hours, respectively.Urinary tract and reproductive tract infections may develop after menstrual blood has left the body due to contamination with the body's inherent microbes.Skin rashes are another possible outcome.The use of tampons has the potential to cause toxic shock syndrome (TSS), a potentially fatal illness.
ability to hygienically regulate menstrual bleeding is vital for females, since it is a component of the female reproductive cycle that begins when girls reach sexual maturity during puberty.Half of the world's women are considered to be of childbearing age, and over a quarter of those women will be menstruation at any one moment.Menstruation is a normal part of a woman's life, but it requires particular attention from a physiological and