Measuring menstrual hygiene in high-income countries: A scoping review

Despite growing recognition of menstrual hygiene management (MHM) challenges in high-income countries (HICs), validated measurement tools specific to the context and experiences of these populations are lacking, with most tools being developed in low- and middle-income countries. The lack of validated instruments makes it difficult to examine the extent of menstrual product insecurity, period poverty, and menstrual hygiene in HICs, and limits researchers' ability to evaluate trends over time.

To summarize menstrual hygiene measurement tools developed and/or used in HICs, as well as the domains covered and psychometric properties of these tools, such as validity and reliability.

Studies conducted in HICs, discuss MHM, and employ a quantitative or mixed-methods design.

Published studies were sourced from OVID Medline, Scopus, and CINAHL Plus using standardized search strategies.

Data from the included studies were charted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR).

Forty-five studies conducted in HICs between 1996 and 2024 met the inclusion criteria. Most were quantitative (n = 38), and the majority were conducted in the United States (n = 26). Across studies, 741 MHM measurement items were identified with menstrual product insecurity, psychosocial concerns, absenteeism, and menstruation-related consequences, and water, sanitation, and hygiene factors. Twelve studies reported psychometric properties; however, only five instruments were fully validated, and none comprehensively measured "period poverty." Items assessing product insecurity and absenteeism varied widely in wording, response options, and domains covered, limiting comparability across studies.

Despite growing research and policy attention, HICs lack standardized, validated tools to measure menstrual product insecurity, period poverty, and related outcomes. To advance menstrual equity, track progress, and improve menstrual health outcomes, there is an urgent need for reliable and validated measurement tools that support surveillance, policy evaluation, and intervention efforts.