Indian Journal of Community Medicine Vol. 30, No. 1, January-March, 2005
Perceptions and Practices Regarding Menstruation: A Comparative Study in Urban and Rural Adolescent Girls. D.S. Deo, C.H. Ghattargi Introduction Adolescence in girls is a turbulent period, which includes stressful events like menarche, considered as a landmark of female puberty1. One might expect that menarche will be positively received by young women; however negative responses such as shame, fear, anxiety and depression are more common. The manner in which a girl learns about menstruation and its associated changes may have an impact on her response to the event of menarche. Myth, mystery and superstition have long enveloped the facts about menstruation. In India even mere mention of the topic has been a taboo in the past and even to this date the cultural and social influences appear to be hurdle for advancement of the knowledge of the subject2. The social practices about menstruation make girl child feel subnormal and may hamper her development. Menarche may remain a traumatic event for her unless she is prepared for it. Adolescent girls constitute a vulnerable group, particularly in India where female child is neglected one. Most studies on female adolescence focus on the gynecological problems but problems of nutritional and psychological origin cannot be ignored1. Hence present study was undertaken to assess the 1) source of information regarding menstruation, 2) reaction to first and subsequent menstruation, 3) taboos and restrictions as result of menstruation and 4) hygiene practiced during menstruation. Material and Methods The present study was undertaken in adolescent school girls of urban and rural field practice area of Swami Ramanand Teerth Rural Medical College Ambajogi. The girls were selected according to the WHO criteria for adolescence that is 10-19 yrs3. The study was restricted to only secondary school girls. The rural and urban schools having teaching facility up to 10th standard were included. In rural area Jai Bhavani Vidyalaya Lokhandi Sawargaon was having school facility up to 10th standard only. Kholeshwara Vidyalaya Ambajogai was randomly selected as urban school. 94 girls from urban school and 74 from rural school who had attained menarche were included in the present study. This was a cross sectional study carried out in educational year 1999-2000. The data was collected after taking permission from school authority. Age of the girls was ascertained from school records and rounded of to nearest completed year. Pretested questionnaire regarding perceptions and practices about menstruation was provided which included questions related to awareness about menstruation, emotional reaction to first and subsequent menstruation, source of information Swami Ramanand Teerth Rural Medical College, Ambajogai, Dist: Beed (MS). E-mail :
[email protected]
regarding menstruation, taboos and restrictions as result of menstruation and hygiene practiced during menstruation. The queries of the respondents were answered by principal research worker during the study. Perceptions and practices about menstruation were compared among urban and rural girls. Results The age of menstruating girls ranged from 12-17 yrs with maximum number of girls between 13-15 yrs of age. 40 (42.5%) urban and 41 (55.4%) rural girls were aware about menstruation prior to attainment of menarche. In urban girls mother was the main source of information about menstruation (27.5%), while it was teacher in the rural counterparts (27.01%). Other sources of information were friends, relative and books. Table I : Distribution of Girls by Their Emotional Response to First and Subsequent Menstruation. a. Reaction to first
b. Reaction to subsequent menstruation menstruation Response Urban Rural Total ResponseUrban Rural Total (n=94) (n=74) (n=168) (n=92) (n=72) (n=164) % % % % % % Scared
44 (46.8) Indifferent 20 (21.7) Discomfort 21 (22.3) Disgusted 5 (5.3) Guilty 16 (17.02) Other 8 (8.5)
33 (44.6) 25 (33.9) 3 (4.05) 3 (4.05) 5 (6.7) 6 (8.1)
77 (44.8) 45 (26.8) 24 (14.3) 8 (4.8) 21 (12.5) 14 (8.3)
Scared
13 (14.1) Indifferent 48 (52.2) Accepted 44 (47.8) Disgusted 6 (6.5) Boredom 2 (2.2) -
6 (8.3) 51 (70.8) 46 (22.2) 1 (1.4) -
19 (11.6) 99 (60.4) 60 (36.6) 7 (4.3) 2 (1.2) -
The reaction to first menstruation were scare, indifference discomfort, disgust and guilt and other reactions like surprise, pleasure, depression, fear as shown in Table I. The number of girls not practicing any taboo was significantly more among rural girls (21.6%) as compared to urban girls (4.3%). (Z=3.6, P
