Prevalence and determinants of menstrual disorders and napkin usage among women in India using DLHS-4 data

Menstrual disorders and hygiene practices during the menstruation significantly affect the health of reproductive age-group women.

The data from nationally representative survey, DLHS-4, was used. The outcome assessed were menstrual disorders and napkin usage. The predictor variables were socio-demographic characteristics such as age group, caste, religion, marital status, and education status; reproductive characteristics such as outcome of pregnancy, condom use, IUCD usage, and vaginal discharge. The descriptive analysis and logistic regression analysis were done on 1,70,632 women.

The most common problems experienced by women were pain (5.4%), irregular periods (4.2%), followed by frequent period, prolonged bleeding, no period, scanty bleeding, excessive bleeding, and intermenstrual bleeding. A large proportion (37%) women were using cloth during menstruation. The factors significantly associated with menstrual problems were age, 36-40 years (OR 1.26, P value < 0.001), marriage before 18 years (OR 1.16, P value < 0.001), no education (OR 1.24 P value < 0.001), BPL card holders (OR 1.14, P value < 0.001), non-users of sanitary napkin (OR 1.09, P value < 0.001). The socio-demographic factors significantly associated with napkin usage were women with secondary education and higher (OR 3.52, P value < 0.001), toilet use - using flush toilet (OR 1.97, P value < 0.001), not possessing BPL card (OR 1.42, P value < 0.001), marriage after the age of 18 years (OR 1.35, P value < 0.001). The reproductive characteristics significantly associated with menstrual problems were history of spontaneous abortion (OR 1.79, P value < 0.001), history of induced abortion (OR 2.29, P value < 0.001), women never used condoms (OR 1.09, P value < 0.001), ever used IUCD (OR 1.11, P value < 0.001), history of abnormal vaginal discharge during last three months (OR 5.32, P value < 0.001).

The use of sanitary napkin should be promoted as it promotes dignity, and equality of women, apart from the public health aspect.