Infertility: When menstrual hygiene becomes a concern

Biologically, menstruation is a particular time of the month women of child-bearing age always look forward to as it is a sign of fertility. However, over the years, menstrual hygiene has attracted the attention of health experts as many women have brought infections and fertility concerns upon themselves majorly for neglecting their menstrual health. PAUL OKAH reports.

Menstruation or menstrual flow is an ‘inconvenience’ every woman of reproductive age has to endure for three to five days every month. It is a normal vaginal flow that occurs as part of a woman’s monthly cycle, as a woman’s body prepares for pregnancy between the ages of 12 and 45 or 55 years. The menstrual blood is partly blood and partly tissue from inside the uterus which passes out of the body through the vagina. However, if no pregnancy occurs, the uterus or womb sheds its lining.

Therefore, it is regarded as abnormal for any woman within a reproductive age not to experience menstruation. In such a situation, parents of the girl-child usually visit the hospital for a proper medical assessment and treatment, as the situation is usually seen as a sign of infertility.

However, health experts have lamented the use of strange objects by menstruating girls and women, including infected pieces of cloths, tissue papers, among others, in place of sanitary pads; thereby blocking their fallopian tubes and causing all manner of infections that often require a lifetime to cure or even leading to permanent infertility.

NGO’ initiatives

On May 28, in celebration of the Menstrual Hygiene Day, a non-governmental organisation, AIDS Health Foundation (AHF) Nigeria, in collaboration with the Strong Enough Girls Empowerment Initiative (SEGEI) and health experts, held a sensitisation campaign for secondary school students in the Federal Capital Territory (FCT).

Addressing participants at the event, Advocacy and Marketing manager of AHF, Mr. Steve Aborisade, lamented that girls avoid attending schools as a result of lacking access to water or even safe places to change sanitary pads.

He said, “The majority of our young girls lack access to sanitary pads, which is necessary for optimal health, especially for girls in school. They have to go to school and they have to have that confidence. When they don’t have access to sanitary pads, a lot of things come into play.

“Some of them skip school because of the fact that they don’t have pads. Even in some schools, there are no water facilities or safe space to change your pad or even to dispose of a used pad. We at AHF feel that for a commodity as necessary as a sanitary pad, we must ensure that we provide it. We must ensure that we advocate to other stakeholders to see the need to make the pad available to our young girls.

“We want people to understand that menstruation is necessary for young girls and for a better part of a woman’s life. It has been calculated that the average woman uses almost seven years of her life to menstruate. That’s huge. Therefore, there is a need for constant attention. We want the government and other stakeholders to begin to look inward to see that it is an area of intervention. We want schools to have a corner where the girls can go and have a change of pads.

“We want a menstrual sanitation bank where we will have enough sanitation pad available for young girls to access. AHF is providing five million pads globally for this event, while over 40,000 sanitary pads were distributed to different states we cover in Nigeria. For the sanitary bank idea, we have given the Ministry of Health pads to distribute to women.

“We have also given to our partners in the centres where we operate, including Benue, Kogi, Nasarawa, Anambra, Cross River, Akwa Ibom and FCT for people to have access. Some women use different objects for their menstruation as a result of inability to afford sanitary pads and not knowing any better. Therefore, we provide menstrual education to bridge the knowledge gap.”

On her part, the programme officer of Strong Enough Girls Empowerment Initiative (SEGEI), Linda Raji, said menstrual hygiene and knowledge should be the concern of everyone and not limited to women alone as men can also help girls and women with information on menstruation whenever the need arises, even as she provided tips for girls on menstrual hygiene and disposal of used sanitary pads.

She said: “Sometimes, your menstruation can skip as a result of hormonal imbalance and stress and not necessarily as a result of pregnancy. It is good to take your bath regularly, especially while on your period. That will make you smell nice and not nasty because of your period. Everybody should know something to talk about menstruation, it is not gender based. Men should also know about it so that they can help with information when they can.

“It is advisable that you tie a used pad very well and dispose of it properly. You should not flush it down your WC, because it will block it with time. If you burn it, it will pollute the environment. Also, you should use a pad for a maximum of six hours. You can change every three or four hours, but let it not exceed six hours. Furthermore, be careful of the medicine you use as a painkiller when you have menstrual cramps.”

Health ministry, women affairs react

In an interview with Blueprint Weekend, Nursing Officer 1, Gender, Adolescent School Health and Elderly Care (GASHE) Department of Family Health in the Ministry of Health, Mrs. Stella Adaeze Ike, said misconception and ignorance are some of the challenges associated with menstrual health in Nigeria.

“Menstrual hygiene is a normal process. It starts as an adolescent girl and stops at menopause. We have the fallopian tube and female reproductive organs, including two ovaries, with different stages. One is the pre-parative stage, an increase in the ovary. As these stages are coming up, the womb is preparing for fertilisation. But if there is no fertilisation, it starts to shrink. That shrinkage is the ovary that was not fertilised and that is the lump you see. Then the mucus from the linen in the womb is the things that come up.

“There are people that use cloth and don’t wash it. They leave it for a long time without washing and infection sets in. The infection then affects the womb, the pelvic organ and other female reproductive organs, leading to infertility.

“Sanitary pad is not bad, but it depends on the type you are using. If you notice you have any reaction, change to another pad and then should be consistent with the one that is good for you to avert any effect that comes up.

“You are damaging yourself if you take alcohol without eating in the morning because of menstruation. That is also how ulcers start. You can have 5 or more symptoms of pre-menstrual syndrome. Children should not depend on information from their friends on menstruation. Rather, reach out to health experts and organisations.

“Use of sugar doesn’t stop menstrual pain. It has no link with menstruation, except misconception. As a woman, you don’t have to be shy about menstruation. In fact, you’re free to ask questions whenever you need help with regards to menstrual hygiene. It is also advisable to dispose of your used pads properly. There is no point removing the outer layer before disposal, as many claim the blood will be used for ritual purposes,” she said.

Also speaking with Blueprint Weekend, a principal community development officer, health desk, Ministry of Women Affairs, Mrs. Chioma Ukachi, said the ministry now has a menstrual pad bank for women.

She said, “Right now, there is a virtual meeting going on with the minister, Pauline Tallen. We collaborate with NGOs to make sure that there is awareness on menstrual health and menstrual hygiene management. In fact, one of the activities taking place in our ministry today is the unveiling of the menstrual pad bank, so that during emergency, especially if your menses start suddenly, any woman can access menstrual facilities, not only pad, but other things, including hand sanitiser, soap.

“We invited school children, PLWDs, among others to distribute pads and other items to them. We want the menstrual pad bank to be replicated in markets, schools, offices, etc. The ministry is so passionate about the health of women that it created the health desk to take care of girls and women.”