Psychological and emotional aspects of menstrual health and hygiene management: Experiences of adolescent girls from rural Assam, India

The onset of menstruation is a landmark event in women’s life which is known to bring many psychological and emotional changes along with physical changes. In many countries, particularly in developing and emerging countries, such as India, it also brings various challenges for women to manage menstruation hygienically. Studies have often highlighted several well-known practical and physical barriers to Menstrual Health and Hygiene Management (MHHM); e.g., lack of WASH (Water, Sanitation and Hygiene) facilities, lack of affordable menstrual absorbents, and so on. However, there are also some psychological and emotional barriers; such as, trauma of menarche, feelings of embarrassment, stress, anxiety, and shame. These psychological and emotional barriers are known to create tremendous psychological burden for millions of girls while managing their menstruation. However, these challenges and their impact on women’s psychological well-being are relatively less acknowledged and ill-understood. The study was conducted in Assam, India, with a sample of 185 adolescent girls (10-19 years) who participated in 21 Focused Group Discussions (FGDs). Findings show that mostly girls were unaware about menstruation before menarche; their first encounter with menarche was traumatic. Lack of adequate guidance and counselling even after menarche result in significant mental pressure among girls. Several cultural and religious restrictions, feelings of shame and embarrassment, myths and misconceptions associated with menstruation were mentioned. The study concludes that the emotional and psychological barriers of MHHM are preventable by improving the channels of proper guidance and counselling about menstruation in a supportive environment. The study suggests some interventions for the same.