Menstrual awareness, hygiene, practices and perceptions among the adolescent girls of Nahan, Himachal Pradesh, India

Maninder Kaur, Tanya Vats


Background: Onset of first menstrual cycle also termed as “menarche” signifies the initiation of sexual maturation of girls. The present study aims to represent an amalgam of menstrual awareness, perceptions and hygiene in light of the associated menstrual practices prevalent in the adolescence girls of Nahan.

Methods: A cross-sectional data of 189 girls aged between 10 to 16 years were collected from Nahan, district Sirmaur in Himachal Pradesh. Data regarding perceptions, awareness and hygienic conditions during menstruation were also gathered through an interview based schedule.

Results: Menarche was known to be a normal physiological process by only 53.43% girls, while the rest of the participants didn’t know the reason for its occurrence. For 81.2% girls the informant was their mother and a very little role was played by sisters (5.36%), books (0.67%), friends (6.04%) and relatives (5.36%). Most of the girls (95.28%) used sanitary napkin as absorbent for menstrual flow, but the use of single sanitary napkin for 7 to 8 hours by 48% participants was of alarming concern. Stomachache was the most common problem associated with menarche, whereas breast heaviness (16.98%), body ache (16.03%) and backache (26.41%) were witnessed in considerable proportion of girls. A significant number of girls (78.3%) were prohibited from entering in the holy places/temples during this period.

Conclusions: Although menarcheal health is acquiring greater significance across the globe, but the age old social restrictive practices associated with menstruation are still common and prevalent in this societies.


Adolescence, Menarche, Menstrual hygiene, Reproductive health

Full Text:



Popat VB, Prodanov T, Calis KA, Nelson LM. The menstrual cycle a biological marker of general health in adolescents. Ann New York Acad Sci. 2008;1135:43.

Hawkins SM, Matzuk MM. Menstrual cycle: basic biology. Ann New York Acad Sci. 2008;1135:10.

Kendler KS, Silberg JL, Neale MC, Kessler RC, Heath AC, Eaves LJ. Genetic and environmental factors in the aetiology of menstrual, premenstrual and neurotic symptoms: a population-based twin study. Psychol Medi. 1992 Feb;22(1):85-100.

Treloar SA, Martin NG. Age at menarche as a fitness trait: nonadditive genetic variance detected in a large twin sample. Am J Human Genet. 1990 Jul;47(1):137.

Chawla J. Mythic origins of menstrual taboo in Rig Veda. Econ Polit Weekly. 1994 Oct 22:2817-27.

Bhandaree R, Pandey B, Rajak M, Pantha P. Chhaupadi: victimizing women of Nepal. Paper presented at: Second International Conference of the South Asian Society of Criminol Victimol. 2013.

New Statesmen Article, 2014. What is life like when your period means you are shunned by society?’ Available at: -your-period-means-you-are-shunned-society. Accessed 11 March 2014.

WaterAid. 2009. Is Menstrual Hygiene And Management An Issue For Adolescent School Girls? A Comparative Study of Four Schools in Different Settings of Nepal. Kathmandu, Nepal: WaterAid. Available at: Accessed on 3 March 2009.

Sommer M. Ideologies of sexuality, menstruation and risk: girls' experiences of puberty and schooling in northern Tanzania. Culture, Health Sexuality. 2009 May 1;11(4):383-98.

Mohamed Y, Durrant K, Huggett C, Davis J, Macintyre A, Menu S, et al. A qualitative exploration of menstruation-related restrictive practices in Fiji, Solomon Islands and Papua New Guinea. PloS One. 2018;13(12).

UNICEF, Bangladesh; Tackling menstrual hygiene taboos; Sanitation and hygiene case study no 10, 2008. Available at: spanish/wash/files/10_casestudy/Bangladesh_ 4web.pdf. Accessed on 3 January 2019.

Ahmed R, Yesmin K. Menstrual hygiene: breaking the silence. Beyond construction: Use by all. A collection of case studies from sanitation and hygiene promotion practitioners in South Asia. London: WaterAid. 2008: 283-287.

Khanna A, Goyal RS, Bhawsar R. Menstrual practices and reproductive problems: a study of adolescent girls in Rajasthan. J Health Manag. 2005;7(1):91-107.

Dasgupta A, Sarkar M. Menstrual hygiene: how hygienic is the adolescent girl?. Ind J Comm Medi: Official Publication Ind Assoc Prevent Social Medi. 2008;33(2):77.

Talwar I, Kaur M. Growth pattern and age at menarche in Bania girls of Mandi Gobindgarh. Anthropologist. 1999;1(3):175-8.

Ayele E, Berhan Y. Age at menarche among in-school adolescents in Sawla Town, South Ethiopia. Ethiop J Health Sci. 2013;23(3):189-200.

Lalys L, Pineau JC. Age at menarche in a group of F rench schoolgirls. Pediatr Int. 2014;56(4):601-4.

Petridou E, Syrigou E, Toupadaki N, Zavitsanos X, Willett W, Trichopoulos D. Determinants of age at menarche as early life predictors of breast cancer risk. Int J Cancer. 1996;68(2):193-8.

Walvoord EC. The timing of puberty: is it changing? Does it matter?. J Adolesc Health. 2010;47(5):433-9.

UNICEF. Report: The state of World’s children. 2011. Available at: sowc2011/fullreport.php. Accessed on 3 January 2019.

Chopra S, Sharma K. Psycho-social Characterization of Menstruation in the Light of Globalization and Local Cultural Ethos among semi-rural Adolescent Girls of Yamunanagar, Haryana 2014.

Tanner JM, Whitehouse RH, Takaishi M. Standards from birth to maturity for height, weight, height velocity, and weight velocity: British children, 1965. I. Arch Dis Child. 1966;41(219):454-613.

Tiwari H, Oza UN, Tiwari R. Knowledge, attitudes and beliefs about menarche of adolescent girls in anand district, Gujarat. East Mediterr Health J. 2006;12:428-33.

Drakshayani KD, Venkata PR. A study on menstrual hygiene among rural adolescent girls. Ind J Medi Scie. 1994;48(6):139-43.

Thakre SB, Thakre SS, Reddy M, Rathi N, Pathak K. Menstrual hygiene: knowledge and practice among adolescent schoolgirls of Saoner, Nagpur district. J Clin Diagn Res. 2011;5(5):1027-33.

Walia DK, Yadav RJ, Pandey A, Bakshi RK. Menstrual patterns among school going adolescent girls in chandigarh and rural areas of himachal pradesh, north India. Nat J Comm Medi. 2015;6:583-6.

Jahanfar S. Genetic and environmental determinants of menstrual characteristics. Ind J Human Genet. 2012;18(2):187.

World Health Organization. A prospective multicentre trial of the ovulation method of natural family planning. III. Characteristics of the menstrual cycle and of the fertile phase. Fertility Sterility. 1983;40(6):773-8.

Yasmin S, Manna N, Mallik S, Ahmed A, Paria B. Menstrual hygiene among adolescent school students: An in-depth cross-sectional study in an urban community of West Bengal, India. IOSR J Dent Med Sci. 2013;5(6):22-6.

Kansal S, Singh S, Kumar A. Menstrual hygiene practices in context of schooling: A community study among rural adolescent girls in Varanasi. Ind J Comm Medi: Official Public Ind Assoc Prevent Social Medi. 2016;41(1):39.

Shanbhag D, Shilpa R, D'Souza N, Josephine P, Singh J, Goud BR. Perceptions regarding menstruation and practices during menstrual cycles among high school going adolescent girls in resource limited settings around Bangalore city, Karnataka, India. Int J Collabor Res Int Medi Pub Health. 2012;4(7):1353.

Deo DS, Ghattargi CH. Perceptions and practices regarding menstruation: a comparative study in urban and rural adolescent girls. Ind J Comm Med. 2005;30(1):33-40.

Mahon T, Fernandes M. Menstrual hygiene in South Asia: a neglected issue for WASH (water, sanitation and hygiene) programmes. Gender Develop. 2010;18(1):99-113.

Santra S. Assessment of knowledge regarding menstruation and practices related to maintenance of menstrual hygiene among the women of reproductive age group in a slum of Kolkata, West Bengal, India. Int J Comm Med Public Health. 2017;4(3):708-12.

Bachloo T, Kumar R, Goyal A, Singh P, Yadav SS, Bhardwaj A, et al. A study on perception and practice of menstruation among school going adolescent girls in district Ambala Haryana, India. Int J Comm Med Pub Health. 2016;3(4):931-7.

Goel MK, Kundan M. Psycho-social behaviour of urban Indian adolescent girls during menstruation. Austr Med J. 2011;4(1):49.

Chandra-Mouli V, Patel SV. Mapping the knowledge and understanding of menarche, menstrual hygiene and menstrual health among adolescent girls in low-and middle-income countries. Reproduct Health. 2017;14(1):30.