Prevalence and determinants of menstrual disorders and napkin usage among women in India using DLHS-4 data

Introduction: Menstrual disorders and hygiene practices during the menstruation significantly affect the health of reproductive age-group women. Methods: The data from nationally representative survey, DLHS-4, was used. The outcome assessed were menstrual disorders and napkin usage. The predictor variables were socio-demographic characteristics such as age group, caste, religion, marital status, and education status; reproductive characteristics such as outcome of pregnancy, condom use, IUCD usage, and vaginal discharge. The descriptive analysis and logistic regression analysis were done on 1,70,632 women. Results: The most common problems experienced by women were pain (5.4%), irregular periods (4.2%), followed by frequent period, prolonged bleeding, no period, scanty bleeding, excessive bleeding, and intermenstrual bleeding. A large proportion (37%) women were using cloth during menstruation. The factors significantly associated with menstrual problems were age, 36-40 years (OR 1.26, P value < 0.001), marriage before 18 years (OR 1.16, P value < 0.001), no education (OR 1.24 P value < 0.001), BPL card holders (OR 1.14, P value < 0.001), non-users of sanitary napkin (OR 1.09, P value < 0.001). The socio-demographic factors significantly associated with napkin usage were women with secondary education and higher (OR 3.52, P value < 0.001), toilet use - using flush toilet (OR 1.97, P value < 0.001), not possessing BPL card (OR 1.42, P value < 0.001), marriage after the age of 18 years (OR 1.35, P value < 0.001). The reproductive characteristics significantly associated with menstrual problems were history of spontaneous abortion (OR 1.79, P value < 0.001), history of induced abortion (OR 2.29, P value < 0.001), women never used condoms (OR 1.09, P value < 0.001), ever used IUCD (OR 1.11, P value < 0.001), history of abnormal vaginal discharge during last three months (OR 5.32, P value < 0.001). Conclusion: The use of sanitary napkin should be promoted as it promotes dignity, and equality of women, apart from the public health aspect.