Young western women's experiences of menarche and menstruation

A qualitative approach was used to examine young women's experiences of menarche and menstruation that were included in personal stories of growing up sexually. The personal experiences were examined by cross-case analysis to learn more about the narrators' attitudes toward menarche and their menstrual-related education. This was a secondary analysis using data collected for a study of common themes in the stories gathered in a 1998 study by Beausang. The data came from 332 stories written by students taking a sexuality course in a Midwestern community college. Of 227 stories written by women, 85 stories included menstrual experiences. Eleven narrators described menarche as a positive experience. In 10 of these stories, the mother was the primary teacher. The two most frequently identified sources of information by narrators were mothers and schoolteachers, with most narrators having a primarily negative view of their menstrual education regardless of the source. Problems with menstrual-related education were described as perceptions of unwillingness by teachers to discuss menstruation, time limits for education, unclear instruction leading to misconceptions, and the presence of peers in group learning situations that lead to embarrassment.     

Women's menarche stories from a multicultural sample

This paper reports on the findings of a focus group study that examines how women have experienced menarche at the personal level and in relation to the larger cultural, religious, and societal environment. Fifty-three women from 34 different countries were recruited in 13 focus groups. On the one hand, at the personal level, menarche stories shared in this study revealed salient themes concerning feelings experienced at the time of menarche, the importance of mother's reactions to their daughter's first menstruation, difficulties around understanding the meanings attached to menarche by others, managing menstrual products, as well as making sense of formal education related to menstruation, and the age of menarche. On the other hand, the discussions concerning how women experienced menarche in relation to the larger cultural, religious, and societal environment revealed secrecy to be a defining feature of many stories. Cultural expectations of learning, and following the rules and regulations surrounding menstruation led to different reactions in women at the time of their menarche. Very few women mentioned a ritual or celebration at the time of their menarche. Findings are discussed in terms of similarities and differences in menarche stories of women from different cultural backgrounds. Limitations of the study are mentioned and suggestions for future research are provided.     

Recollections of menarche and women's subsequent experiences with menstruation

Seventy college women aged 18 to 22 and 67 older women aged 30 to 45 completed a questionnaire comprised of multiple choice and open-ended questions covering recollections of menarche, preparation for menstruation, menstrual symptoms, and current attitude. The hypothesis that menarche was a significant developmental event that would be readily recalled by a majority of women regardless of age was confirmed. Almost all of the women remembered their first menstruation and the early experiences described by both groups were similar. Most women felt they were adequately prepared and a significant relationship was found between adequacy of preparation and positive reaction to menarche among the college women. Both groups reported a similar incidence of menstrual pain, bleeding, and amenorrhea. However, the incidence of menstrual symptoms in adult women was not significantly related to preparation for menstruation or to whether or not menarche was a positive event.     

Menstruation across time: Menarche, menstrual attitudes, experiences, and behaviors

This study explored the relationship between early and current menstrual experiences. The primary hypothesis was that women who reported positive menarcheal experiences (including menstrual education and menarche) would tend to report positive current menstrual attitudes, experiences, and/or behaviors, and vice versa for women who reported negative menarcheal experiences. In this survey-based study, college-aged women (n = 327) were screened by completing a questionnaire concerning their menarcheal experiences. Women who had extremely negative ("negative group," n = 46) or extremely positive ("positive group," n = 38) early menstrual experiences returned to complete questionnaires concerning current menstrual attitudes, experiences, and behaviors. Early and current menstrual experiences were most strongly associated in the domain of menstrual attitudes. Women in the negative group reported more negative menstrual attitudes than did women in the positive group. There were additional associations between early menstrual experiences and measures of body image and health behaviors. Positive group participants reported more positive body image and better general health behaviors. Results suggest that early menstrual experiences may be related to menstrual experiences later in life. This study invites further investigation of the psychology of menstruation and suggests connecting menstruation with other women's health issues.     

“My mama told me it would happen”: menarche and menstruation experiences across generations

ABSTRACT

The purpose of this study was to understand women’s menarche and menstruation-related knowledge, attitudes, and behaviors across generations. Women ages 18 years and older (Mean = 49.13 ± 14.76 years; Range = 19–78 years) living in South Carolina were recruited to participate in semi-structured interviews during May-November 2016. A total of 70 interviews were conducted, which were audio-recorded and transcribed verbatim. Thematic analysis using open and axial coding techniques from grounded theory provided the framework for data interpretation. Women described vivid menarche memories; however, most women had not received proper education or preparation for what to expect prior to onset. Participants discussed their experiences with menstrual products, oral contraceptives, and medical procedures to suppress, manipulate, or manage menstruation. Findings provide practical recommendations for health professionals to develop further effective and timely messaging related to menarche and menstruation across the lifespan. Messaging should inform women about what to expect with menarche, menstruation management, and health-related impacts, as well as methods to reduce menses-related myths and stigmas.     

From Menarche to Menopause: Understanding Multigenerational Reproductive Health Milestones

Our study aims at understanding multigenerational communication among grandmothers, mothers, and daughters experiencing reproductive health transitions from menarche to menopause. Thirty women, 10 triads of grandmothers, mothers, and daughters, participated in narrative interviews to recount their menarche and menopause experiences. Analysis was read using a multilayered approach to interpret discourse positioned from self, reflexive others, and those stories informed by societal meanings. Four dialectical themes informed by generational discursive shifts in talk included (1) covert versus overt talk, (2) recollection of versus indifference to menarche, (3) bound to versus freedom from menstruation, and (4) controlling versus managing bodily changes. The theoretical significance of this piece indicates a slight, transformative change in how messages about menarche and menstruation are communicated or passed down from one generation to the next.     

陕西高职女生月经及经期保健知识调查分析

目的：了解陕西高职院校女生月经及经期保健情况,为进一步做好学生生殖健康教育提供资料支持。方法采用随机整群抽样的方法选择陕西某高职院校590名大一女生进行月经情况及月经保健知识问卷调查。结果该组大学生的平均月经初潮年龄为14．11±1．42岁;89．3％的学生月经周期及75．3％的学生经期在正常范围内。在对月经的认知方面,认为在月经期可以适当运动、认为经期可以淋浴的城市来源学生要优于农村来源学生,差异均有统计学意义（χ^2值分别为80．531、45．859,均P＜0．05）。有64．1％的学生在月经来潮期间会出现不同程度的痛经,仅有28．8％的人在月经异常时向医护人员求助。结论针对女大学生的月经状况特点,应加强对女大学生月经相关知识的健康教育,对提高女大学生的学习生活质量有重要意义。     

Psychosocial correlates of emotional responses to menarche among Chinese adolescent girls.

PURPOSE: To determine the psychosocial correlates of emotional responses to menarche among Chinese adolescent girls. METHODS: A large sample of 1573 post-menarcheal Chinese junior high school students in Hong Kong completed questionnaires on knowledge and preparation of menarche, attitudes toward menstruation, gender-role attitudes, body image, self-esteem, and emotional responses to the onset of the first menstruation. Pearson correlation and hierarchical regression analyses were conducted to determine associations among variables. RESULTS: Participants' mean age at menarche was 11.67 years. Their emotional reactions to menarche were largely negative, with almost 85% reporting feeling annoyed and embarrassed. In spite of these negative feelings, about two-thirds of the participants also reported feeling grown up and another 40% felt as if becoming more feminine. Results of the hierarchical regression analyses showed that negative emotional responses to menarche were correlated with perceptions of menstruation as a negative event, inadequate preparation for menarche, endorsement of indigenous negative menstrual attitudes, and poor self-esteem (24.5% variance explained). Positive emotional responses to menarche were correlated with perceptions of menstruation as a natural event, rejection of indigenous negative menstrual attitudes, positive body image, and adequate preparation for menarche (13.4% variance explained). CONCLUSIONS: This study illustrates the need to attend to various psychosocial and cultural factors in the understanding of Chinese adolescent girls' responses to their first menstruation. In particular, general and indigenous menstrual attitudes, which may have been internalized by Chinese adolescent girls at an early age, are found to be the most salient correlates of their emotional responses to menarche.     

少数民族女大学生月经相关症状的流行病学调查

目的了解少数民族女大学生月经相关症状的流行情况,为针对性地开展女大学生的生殖健康教育和健康促进工作提供依据。方法选取7所民族大学,整群抽取二～三年级少数民族女大学生进行问卷调查,对7905份问卷进行分析。结果痛经是少数民族女大学生中最常见的月经症状,发生率为90.9%;烦躁易怒、忧郁、精神不集中的发生率依次为44.8%,23.7%和25.7%;以上症状均以彝族女生的发生率最高。学习生活受月经相关症状影响的调查对象占44.4%。34.8%的调查对象精神压力较大或很大,藏族、维吾尔族与哈萨克族女生精神压力较大。仅39.0%的调查对象月经异常时去医院治疗。结论月经相关症状在少数民族女大学生中普遍存在,对学习和生活影响较大。需要做好女大学生的健康教育工作,提高医疗服务的可及性。     

Attitudes Toward Menstruation,Menstrual-Related Symptoms,and Premenstrual Syndrome Among Adolescent Girls: A Rural School-Based Survey

Folk culture surrounding menstrual-related matters has considerable implications for symptom expression and treatment-seeking behavior. A cross-sectional survey of 1,295 rural adolescent girls aged 13 to 19 years was conducted between February 4 and April 16, 2009 to examine these associations. With a higher score indicating a more positive attitude toward menstruation, the mean attitude score was 3.84 (SD ± 1.62) out of a maximum of six. No significant association was observed between the severity of menstrual symptoms and attitudes. Most (63.1%) of the participants identified themselves as having premenstrual symptoms, and 61.1% viewed premenstrual symptoms as a normal part of menstrual cycle. Participants with a higher severity of symptoms in the premenstrual (OR 1.05, 95% CI 1.01–1.10) and menstrual phase (OR 1.04, 95% CI 1.01–1.07), were more likely to consult a physician for premenstrual symptoms, and having a divorced/separated parents was associated with a reduced odds of consulting a physician compared to those having parents that were married (OR 0.19, 95% CI 0.05–0.83). The findings imply the need for education to help adolescent girls manage menstrual symptoms and increase awareness of the benefit of treating them. Given that menstrual-related information was widely available from mothers, family, and social culture are potentially important in shaping good menstrual attitudes.     

‘This is a natural process’: managing menstrual stigma in Nepal

Menstrual stigma has been demonstrated in many societies. However, there is little research on menstrual attitudes in South Asia, despite religiously-based menstrual restrictions imposed on women. To understand menstrual stigma in this context, we conducted qualitative research with women in Nepal. Nepali Hinduism forbids menstruating women to enter a temple or kitchen, share a bed with a husband or touch a male relative. During menstruation, women are ‘untouchable’. There has been virtually no research on how Nepali women make meaning of these practices. The current study employed focus groups and individual interviews to understand how some Nepali women experience menarche and menstrual stigma. We explored how women describe their experiences and the strategies they adopt to manage age-old stigma in a rapidly modernising society where they have multiple roles as workers, wives and mothers. Participants reported they experienced menarche with little preparation, which caused distress, and were subjected to ongoing stigmatisation as menstruating women. They described coping strategies to reduce the effects of this stigma. This study provides a unique perspective on coping with menstrual stigma in South Asia.     

山东省日照市已婚育龄妇女月经情况流行病学研究

目的:探讨日照市已婚育龄妇女月经初潮时间、月经的规律性、月经周期时间及产后月经恢复情况,进而了解日照市已婚育龄妇女的生育能力,指导产后育龄妇女及时落实避孕节育措施提供参考。方法:根据我国不育症发生率3%左右的水平估计样本量,日照市调查时点22～44岁已婚育龄妇女总人数为449 504人,按3%计算需抽取样本量为14 000对夫妇,按照所设计的表格进行问卷式调查。结果:在调查的13 514名妇女中,月经初潮时间最早10周岁,最晚25周岁,以13～17周岁最多,其中以14、15、16岁更为集中,分别占24.3%、25.7%和23.4%。平均月经初潮时间是14.87岁。在12 973人中,月经周期正常12 112人,占93.36%;月经周期异常(包括不规律和从未来月经的)861人,占6.64%。在调查的人群中,产后3个月内恢复月经的比例为35%,6个月内就达到了64%,只有27%在产后的半年后恢复月经。结论:日照市女性月经初潮年龄逐渐提前,经过20年提前了1年左右。月经周规天数为28、29、30天的分别占27.28%、8.92%、46.26%,合计达82.46%,具有高度的集中特征。产后3个月内恢复月经的比例为35%,半年内达64%(近2/3),必须及时采用避孕节育措施。     

Attitudes toward menstruation, menstrual-related symptoms, and premenstrual syndrome among adolescent girls: a rural school-based survey

Folk culture surrounding menstrual-related matters has considerable implications for symptom expression and treatment-seeking behavior. A cross-sectional survey of 1,295 rural adolescent girls aged 13 to 19 years was conducted between February 4 and April 16, 2009 to examine these associations. With a higher score indicating a more positive attitude toward menstruation, the mean attitude score was 3.84 (SD ± 1.62) out of a maximum of six. No significant association was observed between the severity of menstrual symptoms and attitudes. Most (63.1%) of the participants identified themselves as having premenstrual symptoms, and 61.1% viewed premenstrual symptoms as a normal part of menstrual cycle. Participants with a higher severity of symptoms in the premenstrual (OR 1.05, 95% CI 1.01-1.10) and menstrual phase (OR 1.04, 95% CI 1.01-1.07), were more likely to consult a physician for premenstrual symptoms, and having a divorced/separated parents was associated with a reduced odds of consulting a physician compared to those having parents that were married (OR 0.19, 95% CI 0.05-0.83). The findings imply the need for education to help adolescent girls manage menstrual symptoms and increase awareness of the benefit of treating them. Given that menstrual-related information was widely available from mothers, family, and social culture are potentially important in shaping good menstrual attitudes.     

"Nobody told me nothin": communication about menstruation among low-income African-American women

The purpose of this study was to explore communication about menstruation among low-income African American women and the impact of this communication on their understanding of and attitudes toward the menstrual events that will occur throughout their lives. This is of particular importance since minority women disproportionately face greater menstrual problems than those experienced by majority women in the United States. A grounded theory design was used for this study. Seventeen African American women from a public housing project were interviewed. The core theme that emerged from the qualitative data was the avoidance or negative discussion of menstrual events throughout the women's lives. The women had few sources of and very limited menstrual learning from school, their mothers, and other women. This led to confusion and inaccurate beliefs about and negative attitudes toward menstruation, menopause, and menstrual-related health conditions. While these women desired to have better communication, their history of avoidance of and negative discussions surrounding menstruation will likely continue to make it difficult for them to have positive and informative discussions with others in the future unless some type of educational intervention occurs.     

Cultural and social practices regarding menstruation among adolescent girls

The study attempts to find out the existing social and cultural practices regarding menstruation, awareness levels, and the behavioral changes that come about in adolescent girls during menstruation, their perception about menarche, how do they treat it, and the various taboos, norms, and cultural practices associated with menarche. The study was conducted on 117 adolescent girls (age 11-20 years) and 41 mothers from various communities and classes in Ranchi comprising residential colonies and urban slums. The findings unfolds many practices: cultural and social restrictions associated with menstruation, myth, and misconception; the adaptability of the adolescent girls toward it; their reaction, reaction of the family; realization of the importance of menstruation; and the changes that have come in their life after menarche and their resistance to such changes. The article also suggests the strategies to improve menstrual health and hygiene among adolescent girls. The study concludes that cultural and social practices regarding menstruation depend on girls' education, attitude, family environment, culture, and belief.     

Relationships Between Menstrual and Menopausal Attitudes and Associated Demographic and Health Characteristics: The Hilo Women's Health Study

The objective of this study was to examine the relation of menstrual attitudes to menopausal attitudes and the demographic and health characteristics associated with each. This cross-sectional study consisted of a randomly selected sample of 1,824 respondents aged 16 to 100 years in multi-ethnic Hilo, Hawai'i. Women completed questionnaires for demographic and health information, such as age, ethnicity, education, residency in Hawai'i, menopausal status, exercise, and attitudes toward menstruation and menopause. Women more often chose positive terms, such as “natural,” to describe menstruation (60.8%) and menopause (59.4%). In bivariate analyses, post-menopausal women were significantly more likely to have positive menstrual and menopausal attitudes than pre-menopausal women. Factor analyses were used to cluster attitudes followed by linear regression to identify demographic characteristics associated with factor scores. Asian-American ethnicity, higher education, reporting more exercise, and growing up outside of Hawai'i were associated with positive menstrual attitudes. Higher education, older age, post-menopausal status, growing up outside of Hawai'i and having hot flashes were associated with positive menopausal attitudes. Bivariate correlation analyses suggested significant associations between factor scores for menstrual and menopausal attitudes. Both negative and positive menstrual attitudes were positively correlated with the anticipation of menopause, although negative attitudes toward menstruation were negatively correlated with menopause as a positive, natural life event. Demographic variables, specifically education and where one grows up, influenced women's attitudes toward menstruation and menopause and should be considered for inclusion in subsequent multi-ethnic studies. Further research is also warranted in assessing the relationship between menstrual and menopausal attitudes.     

Sociocultural aspects of menstrual attitudes and premenstrual experiences in India

Menstrual attitudes were studied in a group of 48 Indian women using the Menstrual Attitude Questionnaire, modified and adapted for Indian background. Attitudinal factors of menstruation being a natural, bothersome and debilitating event were studied, as also denial of the event and healthy/unhealthy attitudes. High rating was seen in menstruation being perceived as a natural event and least as a debilitating one. Older women considered menstruation as a natural event. Relating premenstrual experiences to attitudes, it was observed that distressful symptoms correlated significantly with debilitating and unhealthy attitudes. Similarly, premenstrual well-being correlated highly with naturalness attitudes, thereby suggesting that the personal experiences are likely to influence the menstrual attitudes.     

某大学女生月经及痛经情况调查

目的:了解大学女生月经及痛经的情况,做好青春期卫生保健防病指导工作。方法:采用自制调查表,对不同专业、不同年级的女生进行问卷调查,回收答卷后进行统计分析。结果:共发放问卷1 000份,收回973份。女大学生的初潮年龄在12～15岁,占调查总人数的86.20%,平均初潮年龄为(13.28±1.36)岁;493例有痛经,占总人数的50.67%;经期伴随症状发生率较高;不同年级对痛经发生率有一定影响。结论:发放月经生理常识手册,加强自我保健知识的健康教育,普及正确预防与治疗月经异常和痛经的知识有利于提高青春期保健水平。     

卵巢癌危险因素的病例对照研究

目的探索卵巢癌发病的危险因素和保护因素,为预防卵巢癌发病提供依据。方法采用病例对照研究方法,病例选自2000年7月~2005年4月某省级医院被确诊为卵巢癌的住院患者229名,366名对照来自同一医院确诊的外伤患者。用卵巢癌危险因素流行病学调查问卷,对病例与对照的病历进行查询。对所得资料进行单因素和多因素非条件logistic回归分析。结果单因素分析显示,子宫肌瘤、痛经、一级亲属肿瘤史、初潮年龄、行经期、月经周期、肿瘤史和累计结婚年数等是卵巢癌的危险因素,共妊娠数、自然流产数、人工流产数等是卵巢癌的保护因素。多因素分析显示,与卵巢癌发生关联显著的因素是共妊娠数、人工流产数、初潮年龄、行经期和月经周期。结论卵巢癌的发病是多因素共同参与的结果。