COVID-19 and Menstrual Health Management – All You Need to Know

With the COVID-19 engulfing all spheres of life around the world, it has impacted menstruators' lives as well. Menstrual Health Management, a topic, which itself is less acknowledged and implemented, has been at an all-time low due to the pandemic. A report conducted by Spanish NGO PLAN International in the Asia-Pacific, Africa, Latin America, Europe and North America, “Periods in a Pandemic: Menstrual hygiene management in the time of COVID-19” reflects the grave menstrual health crisis that the pandemic has caught menstruators in—

“81% (of menstruators spoken to) were concerned they would not be supported to meet their menstrual hygiene management (MHM) needs. 78% worried the pandemic would further limit freedom of movement. 75% said COVID-19 may pose increased health risks for people who menstruate, as resources, such as water, are diverted to other needs.”

The pandemic brought with itself, economic crisis, alienation, panic-driven behaviour, cynicism, misinformation and death—all of which led to a disruption in the lives of everyday menstruators.

Every month, an estimated 1.8 billion girls, women, and non-binary individuals experience menstruation. They are entitled to the best menstrual health and hygiene practices. Do they receive it? Far from it.

Even as man reaches the moon and cars become self-driving, menstrual hygiene remains a dream, and looks like it may stay so. The menstruation hygiene management situation in India, as per NDTV, is grim.

“According to Census 2011 population data, about 336 million girls and women in India are of reproductive age and menstruate for 2-7 days, every month, and yet the topic of menstruation is expected to be a hush affair and kept under wraps of the ‘black plastic bags’, which is given to most of us each time we buy sanitary napkins. National Family Health Survey 2015-2016 estimates that of the 336 million menstruating women in India about 121 million (roughly 36 percent) women are using sanitary napkins, locally or commercially produced”.

Levels of Menstrual Hygiene Management-

• Distribution of Menstrual Hygiene materials and supplies:
  For a safe and hygienic menstrual cycle with regular periods, the most important resources are access to safe, comfortable and hygienic menstrual supplies like menstrual pads, tampons, and cups. Menstrual products come in a variety of materials, promises and marketing claims—such as antibacterial menstrual products, 100% hygienic products, biodegradable products, etc. The availability of all kinds of comfortable, safe and hygienic menstrual products everywhere is the main concern of menstruators. There also exists a big gap—between the urban and the rural. Similarly, the availability of the ‘choice’ of menstrual products is less in developing countries, where menstrual health and hygiene is rarely a priority.
• Availability of storage and washing facilities:
  Many menstruators run the risk of getting diseases like fungal infections, UTI’s, urogenital infections etc, rashes, which are caused due to neglect of proper hygiene to be used while changing and using menstrual products. Further, another major problem is clean washing facilities. In many countries, lack of clean and functioning public health facilities, risks the menstrual health and hygiene of women. Since the pandemic, most educational institutes are also closed, preventing young girls from getting their supply of menstrual products.
• Dissemination of information on Menstrual health and hygiene resources:
  Because menstrual health and hygiene are still taboo subjects in most households and even public spaces, the discussion and dissemination of accurate and science-backed resources and information systems about menstrual health and hygiene is critical products, menstrual hygiene and the safe cycle is an integral part of MHH. This was done in schools and educational institutes prior to the arrival of COVID-19; however, it is now a problem where young girls are deprived of proper information and resources on the subject. same, and it makes the subject even more scrutinised in private spheres. Even basic practices such as menstrual cycle tracking are not carried out!
• Supportive environment for menstruators:
  In a lot of homes, even today, there is a stigma about periods, ‘myths’ such as menstruation makes one impure, hair should not be washed when on one’s period, girls should not enter temples and kitchens during periods, etc, are still circulated. This is called ‘fear-mongering’. Myths that have no science-backed information. Further, due to the lack of sex education especially in developing countries, women-centric issues like menstruation are hardly discussed with boys and men, which makes the situation more problematic for menstruators across. For specially-abled people, extra care and support are required in times of the menstrual cycle and this is being threatened by the COVID-19 pandemic when isolation and hygienic practices are needed.

How Covid-19 worsens things:

1. Marginal become more marginalised:
   With the COVID-19, accessibility issues that already exist seem to become worse. With quarantine measures and other regulations set in place reaching marginalised groups becomes nearly impossible. As hoards of people migrate from cities to home towns due to exclusion or lack of jobs, the availability of menstrual health products and clean toilets become a scarcity. Menstruators have expressed their concern at ‘stocks being used up’, ‘unavailability of public toilets’ and so on.
2. Healthcare workers’ curse:
   For menstruating healthcare workers, working in PPE kits in COVID-19 wards for hours together without possible pad changes becomes a major challenge. Some frontline workers have expressed concerns about regular sanitary pads failing to absorb flow for long hours and leaking inside their PPE kit.RIO Heavy Flow pads have come to the rescue of several such menstruators. “It was the peak of the second wave. I had 36 hours of duty, during which we got just two PPE kits. Taking menstrual leave was not an option,” says Dr Jayati from KEM Hospital. “I would wear four pads together and go. My things would be red, chaffed, and pained. Then I found the RIO pad. It is a little thicker than regular pads but one can wear it for 6-10 hours. It saved me.”
3. Covid-affected periods:
   Another pandemic concern was the direct effect of COVID-19. Some menstruators expressed ‘an increase in flow or a more heavy cycle after taking vaccines’. This made pads they had always used suddenly insufficient ‘as they were too thin’, ‘do not absorb well’, ‘are not of the required size’, or ‘are difficult to use’ as with menstrual cups and tampons. RIO Heavy Duty Pads For Heavy Flow, meanwhile, are super-absorbent and XXL size from every direction. RIO Heavy flow pads are built to give you a better period no matter how heavy your flow is. RIO Pads are also priced at a very affordable Rs 179 for 12 pads, which makes the menstrual experience even better.
4. Change in lifestyle and increased stress:
   COVID-19 also caused menstruators to have to deal with extra stress, hormonal changes and changing lifestyles. The pandemic increased the household load on women while requiring them to be constantly connected to work online. The inability to go out, children constantly being at home, lack of external help and the stress of uncertainties often affected their menstrual cycle, menstrual health and hygiene practices.To conclude, menstruation remains a gap in a world of male researchers and policy makers. This is evident from the lack of studies on vaccines’ effect on periods; or the failure to include menstrual products in relief packages.

   But as the pandemic continues to range for the third year in a row, it is now crucial that the world asks “what is menstrual health and how can it be better” and take a more holistic focus on menstrual health and hygiene. Menstrual health and hygiene advocates, companies who make products for menstruators, and the government together need to shift their focus on menstrual hygiene management and awareness to better reach those who need it.

Dr. Kriti Sharma,

MBBS, MS(OBGY)

SMS Medical College, Jaipur (Rajasthan)