Reproductive Tract Infections (RTI)
It is assumed that the risk of infection (including sexually transmitted infection) is higher than normal during menstruation because the blood coming out of the body creates a pathway for bacteria to travel back into the uterus. Certain practices are more likely to increase the risk of infection (see figure below). Using unclean rags for example, especially if they are inserted into the vagina, can introduce or support the growth of unwanted bacteria that could lead to infection.
The burden of RTIs is a major public health concern worldwide and RTI are particularly widespread in low income settings. The proportion of this burden that can be attributed to poor menstrual hygiene management (MHM), as opposed to sexually transmitted infections; iatrogenic infections; or endogenous infections caused by agents other than those introduced through poor menstrual management is unknown. Confusing any attempt to investigate if the fact that concurrent infection from multiple sources is possible.
Female Genital Mutilation (FGM)
In communities where FGM is practiced, multiple health risks exist. Where the vaginal aperture is inadequate for menstrual flow, a blockage and build-up of blood clots is created behind the infibulated area. This can be a cause for protracted and painful period, increased odour, discomfort and the potential for additional infections (KIRK & SOMMER 2006).
Multiple studies in Subsaharan Africa indicated that young school girls engaged in transactional sex in order to obtain money for sanitary pads so they could attend school (Mason et al., 2013 and Malusu and Zani, 2014). Engaging in transactional sex exposes girls for numerous health risks including sexually transmitted infections and violence.