Menstrual Health Management
(MHM)

Definition of MHM

Women and adolescent girls use a clean material to absorb or collect menstrual blood, and this material can be changed in privacy as often as necessary for the duration of menstruation. MHM also includes using soap and water for washing the body as required, and having access to facilities to dispose of used menstrual management materials (WHO).

MHM involves the practices, culture, education, facilities and materials linked to menstruation. MHM influences adolescent girls and women in their ability to adequately manage their menstruation. 

MHM Strategies 

Globally women and girls have developed their own personal strategies to cope with menstruation. These vary greatly from country to country, and within countries, dependent on an individual’s personal preferences, available resources, economic status, local traditions and cultural beliefs and knowledge or education.

Women and girls in lower income settings face significant MHM challenges, particularly in rural, low socioeconomic settings.

Strategies to manage their menstruation are influenced by many things such as; personal preferences, available resources, economic status, local traditions, cultural beliefs and, knowledge and education.

Women will often have to use unhygienic, inconvenient and undignified methods such as unhygienic cloths, banana leaves and newspapers. 

A body of research has documented menstruating girls’ experiences of shame, fear, and confusion across numerous country contexts and the challenges girls face attempting to manage their menstruation with insufficient information, a lack of social support, ongoing social and hygiene taboos, and a shortage of suitable water, sanitation and waste disposal facilities in school environments.

Women and girls often lack water, soap, privacy, and space to change; adequate time to manage their menses comfortably, safely, and with dignity; and hygienic sanitary products and sometimes underwear.

Unsanitary Absorbents

The strategies that women use to manage their menstruation vary greatly. There is a widespread use of unsanitary absorbents.

Reusable absorbents are often inadequately washed and dried. The cleaning of the cloths and reusable pads is often done without soap, in unclear water. The drying of the cloths and reusable pads is often not done in the sunlight and open air but in a closed space indoors due to the social restrictions and taboos. This leads to the reuse of material that has not been adequately sanitized.

Social Restrictions

The  onset of menstruation is an important moment in a girl's life. Depending on the setting there are numerous social restrictions with long lasting impact that apply for women and adolescent girls. 

In some cultures girls are seen as marriageable and are moving into their role of child bearing. 

The disgust and sexual connotations surrounding the subject can make it hard for the mothers and girls to talk openly with each other. 

The lack of pre-menarche education and lack of communication during the start of menstruation contribute to feelings of fear and anxiousness. 

Following the menarche can come the exclusion of everyday tasks such as: touching water, cooking, cleaning, attending religious ceremonies, socializing, sleeping in one’s own bed or house. 

Absence and drop-out from school has been of particular interest of many International organizations since it has been reported that females staying longer in school is associated with many health outcomes.

MHM Interventions

To change this situation, a combination of facilities and information is needed to manage menstruation hygienically – i.e. information on hygienic behaviour, private toilets for women and menstrual products.

In addition girls and boys, men and women need information regarding what menstruation is and how it relates to sexuality and reproduction. It is essential the whole community has access to this information through comprehensive sexuality education.

Last but not least, cultural taboos need to be lifted, myths need to be broken and all menstruation-related restrictions to the full participation of women and girls in society – including school and the work force – need to be removed.