Social Science Review

 

Exploring Menstrual Health of Adolescent Girls in Old Dhaka: A Sociological Perspective   Sidratul Muntaha1, Ayesha Siddequa Daize2,[*]   1M.S.S student, Department of Sociology, Jagannath University, Dhaka-1000, Bangladesh 2Professor, Department of Sociology, Jagannath University, Dhaka-1000, Bangladesh

 

Keywords		Abstract
Menstruation, Menstrual hygiene, Adolescence, Old Dhaka		The focus of the study is to find out various menstrual problems among adolescent girls including physical and psychological issue. As girls attain puberty at adolescence, they face various problems associated with menstruation. Menstruation is a natural phenomenon and an important indicator of women's health reflecting their reproductive function. In this study, the researcher has chosen both quantitative and qualitative method for comprehensive understanding about menstrual problems and enhances the validity or authenticity and the researcher has conducted a stratified sampling procedure with a sample size of 103 respondents. The study shows that religion, socio-economic background, education, family and also the environment of old Dhaka have a significant impact on adolescent girls’ menstrual hygiene. So, menstrual health is a significant issue for all adolescent girls but in old Dhaka where cultural taboos, inadequate access to sanitary producers and lack of education on menstrual hygiene health are found. These challenges contribute not only to compromised hygiene practices but also to feelings of embarrassment and school absenteeism during menstrual periods. Findings from this study emphasize the need for culturally sensitive health education, improved access to menstrual supplies and facilities, and community-based interventions that address both the material and social dimensions of menstrual health among adolescent girls in old Dhaka.

 

Introduction

Menstrual health is an integral aspect of adolescent girls’ overall well-being and reproductive health, yet it remains under-explored and inadequately addressed in many developing country contexts, including Bangladesh. Menstruation is a natural biological process that typically begins during puberty and continues throughout the reproductive years. Despite its universality, it is frequently surrounded by social taboos, misinformation, and cultural restrictions that affect how girls understand and manage their menstrual cycles (Hasan et al 2021). Adolescence is the transitional phase between childhood and adulthood marked by significant physical, psychological, and social development. The World Health Organization (WHO) defines adolescence as the period from 10 to 19 years of age. Menstruation (period) is a normal biological process in females where blood and tissue from the uterine lining are shed through the vagina, typically on a monthly basis — part of the reproductive cycle. Menarche is the term for the first menstrual period, which typically occurs during adolescence (often between about 9 to 16 years, commonly around 12–13 years) (Cleveland Clinic, 2022). In urban areas such as Dhaka, socio-environmental constraints further complicate menstrual hygiene management. Studies conducted in city slums and urban settings highlight issues such as lack of access to affordable menstrual products, inadequate sanitation facilities, and reliance on informal sources (e.g., family or peers) for menstrual information—all of which contribute to suboptimal menstrual management and its negative consequences (Afiaz, and Biswas, 2019).  These challenges are not only practical but also deeply social: girls often confront stigma and restrictive norms that hinder open discussion about menstruation and inhibit help-seeking behaviors (Hasan et al, 2021). From a sociological perspective, menstrual health cannot be understood solely as a matter of individual knowledge or hygiene practice; it is embedded within broader cultural, economic, and institutional structures that shape everyday life. Sociological inquiry into menstrual health explores how gender norms, family dynamics, educational environments, and community beliefs influence girls’ experiences and agency around menstruation. In urban Bangladesh, where rapid population growth, socioeconomic disparities, and dense living conditions intensify everyday challenges, understanding the social dimensions of menstrual health is especially important for informing effective interventions (UNFPA, 2023). Research from various parts of Bangladesh indicates that a significant number of adolescent girls have limited knowledge about menstruation before they experience menarche, which can result in confusion, anxiety, and poor hygiene practices (Hasan et al, 2021). In the densely, resource-constrained neighborhoods of Old Dhaka, these dynamics are intensified, making it imperative to explore how social structures, family relations, educational settings, and community norms collectively influence adolescent girls’ menstrual knowledge, attitudes, and practices. By situating menstrual health within its broader socio-cultural and structural context, this study seeks to illuminate the lived experiences of adolescent girls in Old Dhaka, identify the social determinants that shape their menstrual health outcomes, and contribute to a deeper understanding of gendered health disparities in urban Bangladesh. Such an inquiry not only addresses a critical public health concern but also contributes to ongoing efforts to promote gender equity, educational inclusion, and reproductive rights for young women in marginalized urban settings.              

 

Background of the Study 

Menstrual health is a fundamental component of adolescent girls’ overall well-being and reproductive health, yet it remains inadequately understood and largely neglected in many low-income countries, including Bangladesh. Menstruation is a natural physiological process marking the onset of reproductive capability; however, inadequate menstrual hygiene management (MHM) can lead to adverse health outcomes, social stigma, and compromised educational participation among young girls. Studies in Bangladesh consistently show that many adolescent girls have poor menstrual hygiene practices, often due to limited knowledge, lack of appropriate facilities, and socio-cultural barriers. For instance, research has found that a majority of girls use cloth or unhygienic materials rather than medical absorbents, and schools often lack proper sanitation and privacy for menstrual management, thereby hindering girls’ ability to manage menstruation safely (Alam et al., 2017; Ahmed et al., 2025)  Bangladesh’s socio-cultural context plays a significant role in shaping menstrual health experiences. Deep-rooted norms often frame menstruation as taboo and shameful, discouraging open discussion and contributing to misinformation among adolescents. This cultural silence significantly restricts girls’ access to accurate information before menarche and limits dialogue within families and schools, resulting in widespread hesitation and negative attitudes toward menstrual hygiene practices (Hasan et al, 2021).  Urban environments such as old Dhaka present complex challenges for menstrual health due to high population density, economic inequality, and inadequate water, sanitation, and hygiene (WASH) infrastructure. Evidence from slum areas of Dhaka shows that adolescent girls often lack access to private, adequately equipped sanitation facilities and face barriers to obtaining hygienic menstrual products, which can have consequences for both their health and educational engagement ((Hossain et al., 2024; Afiaz et al., 2021). Adopting a sociological perspective enables a deeper understanding of how social structures, cultural norms, gender roles, and institutional conditions influence menstrual health outcomes. A sociological approach emphasizes that menstrual experiences are shaped not just by biological processes but by social meanings, power dynamics, and every day practices embedded in community life. It also highlights how stigma and structural inequalities constrain girls’ agency, potentially affecting their physical and emotional well-being, educational attainment, and future life opportunities (Hasan et al, 2021). Therefore, examining menstrual health among adolescent girls in old Dhaka through a sociological point of view is very vital thing for exposure the social determinants of menstrual health disparities, informing culturally sensitive interventions, and supporting policies designed at improving both gender equity and health outcomes in old Dhaka as well as urban Bangladesh.

 

Objectives of the study

Main objective:

To explore the experiences of adolescent girls in old Dhaka regarding menstrual health from a sociological perspective.

Specific objective

• to observe the level of knowledge and information sources of adolescent girls on the topic of menstruation and menstrual hygiene.
• to identify the practices leading to poor menstrual hygiene, and the physical, psychological and social effects inflicted on adolescent girls..
• to find out the roles played by family and educational institutions in guiding adolescent girls through knowledge and support required during menstruation and assisting in hygiene practices.
• to examine the factors such as social taboos, myths, and cultural prohibitions, affecting adolescent girls regarding menstruation on their daily lives, health, and education.
•  to raise awareness about the importance of addressing menstrual problem as public health concern and to improve menstrual health management for adolescent girls in Old Dhaka.

 

Literature review 

According to Kumar & Srivastava (2011) in their work Cultural and social practices regarding menstruation among adolescent girls was focusing on the existing social and cultural practices regarding menstruation, awareness levels and the behavioral changes of adolescent girls during menstruation. The researchers used community based cross-sectional study method in this work with the sample size of 117 adolescent girls and 41 mothers from various communities. In this paper, a pretested, pre-coded methodology with closed and open-ended questions and both quantitative and qualitative data were collected. The findings of this work showed that religion, socio-economic status, education and family background have a significant impact on the menstrual practices of the adolescent girls. They came to the result that, about 47% of the participants reported that they attain menarche between 11 to 12 years ages, 45% on 13 to 14 years and 66.7% on 15 to 16 years. Of the participants, 58.8% of the adolescent girls in urban residential areas and 54.5% of the girls in the slum areas were unaware of the phenomena of menstruation and its mechanics before its onset. The limitation or research gap of this work was that the study highlights and concludes the only cultural and social practices regarding menstruation. It can also be elevated with other factors associated with menstruation. 

 

Lee et al. (2006) conducted a landmark cross-sectional descriptive study to investigate menstrual characteristics and associated factors among adolescent girls in Negeri Sembilan, Malaysia. The researchers used a cross-sectional descriptive study method in this work. They collected data from secondary school adolescent females in Negeri Sembilan, Malaysia with 2411 samples. The data were collected using a self-administered structured questionnaire. The study found about 74.6% of the respondents experienced premenstrual syndrome and 69.4% had dysmenorrheal . The findings of the study showed that menstrual disorders were more common in female adolescents who smoke and have suicidal behaviors and the adolescent females are influenced by certain modifiable factors. One of the limitations of this paper is that the results were based on adolescents’ self-reports of their behavior which can be reported by their peer groups. Another limitation is that the data were collected only from schools where the school-age dropped out female adolescents could not be reached and the results cannot be generalized nationwide for this reason. 

 

In their study titled “Menstrual Problems Among Adolescent Girls in Thiruvananthapuram District”, Beevi et al. (2017) examined the prevalence of menstrual problems among adolescent school students in a district in India. A school based cross-sectional study method is used in this work. A pretested semi-structured questionnaire was used with 510 sample size that was randomly selected from some high schools in a period of 15th June, 2016 to 30th June, 2016. In this paper, SPSS version 16 was used for data analysis. For testing the association between qualitative variables, chi square test was used and the quantitative variables were expressed in frequency and percentages. The findings of the study showed that 84.8% has one or more menstrual problems and 33% of girls suffer from dysmenorrhea and 69.1% have normal menstrual cycles and 31% have menorrhagia. The limitation of this study is that the paper studied about only the problems associated with menstruation. It can also be focused on the impact of those problems in academic performance or others of the adolescent girls. 

 

In the study titled “Menstrual problems and health-seeking behaviour in Hong Kong Chinese girls”, Chan et al. (2009) investigated the prevalence of menstrual problems and associated health-seeking behaviours among adolescent girls in Hong Kong. In this paper, a self-administered, structured method of study was used and secondary schools in the catchment area of a tertiary teaching hospital in Hong Kong were invited to join the study. In this paper, descriptive statistics were used to characterize the study population and chi square test was used for analyzing the difference in proportions. A total of 5609 girls from 10 secondary schools were participated in this study. The results of the study showed that the response rate is 96.5 percent where 9.8 percent reported to pre-menarche, 89.2 percent were post-menarche and 0.8 percent did not know their menarche status. The limitation of the study is that the findings were confirmed a significant proportion had poor understanding of the normal menstrual cycle length. It can be specifically testing the girl’s knowledge on menstruation. 

 

Theoretical Framework

Social Learning Theory

Social Learning Theory was introduced by psychologist Albert Bandura in 1977. According to Albert Bandura, this theory proposed that individuals learn from observation, imitation and modeling the behaviors, attitudes and emotional reactions of others. This theory considers how both environmental and cognitive factors interact to influence human learning and behaviors. This theory also suggests that learning occurs because people observe the consequence of other people’s behavior. For Bandura, learning occurs through cognitive factors include classical conditioning and operant conditioning which considers psychological influences such as attention and memory. According to Bandura, people observe behavior either directly through social interactions with others or indirectly by observing behaviors through media. According to Bandura, the learning process is divided into four stages and each of them plays an important role in the learning process. These are: 1. Attention 2.Retention 3.Reproduction 4.Motivation. Bandura also theorized that there are two types of social learning: 1. Reinforcement learning: Reinforcement learning is when someone learns from the repercussions of their behaviors or actions. 2. Vicarious learning: Vicarious learning is where learning occurs from watching people and replicating their behaviors. In the context of this study of menstrual problem among adolescent school going girls in Old Dhaka, this theory can be applied to understand how adolescent girls in Old Dhaka learn about and cope with menstrual issues by directly observing the behaviors of their peers, family members and community. Or, they may indirectly learn the behaviors related to menstrual issues through observing the behaviors from the interaction with media. Those direct or indirect interaction which influence menstrual issues between people and the adolescent girls in Old Dhaka are responsible for occurring different menstrual problem among those adolescent girls.

 

The Health Belief Model (HBM) 

The Health Belief Model (HBM) also associated with this study. This model was developed by social psychologists Hochbaum, Rosenstock and others in 1950. The Health Belief Model (HBM) is a social psychological health behavior change model developed to explain and predict health-related behaviors, particularly in regard to the uptake of health services. These models propose that individuals are most likely to take preventative action if they perceive the threat of a health risk to be serious, if they feel they are personally susceptible. They are perceived severity, perceived susceptibility, perceived benefits, perceived barriers and self-efficacy. This model predicts that a specific health behavior is more or less likely based on individuals’ perception about any disease with perceived benefits and barriers to that behavior. Interventions focusing on this model may involve risk calculation and prediction, as well as personalized advice and education. For an individual to adopt a specific behavior, the perception of the threat of disease and the benefits of the health behavior must outweigh the perceived barriers. Personal factors, sense of self-efficacy, and cues to action are also frequently included in the model. The Health Belief Model is most applicable to behavior change interventions for people. There are four key constructs of this theory are included: 1.Perceived susceptibility2.Perceived severity3.Perceived benefits 4.Perceived barriers. More recent adaptations have added the concepts “cue to action,” a stimulus to undertake behavior; and self-efficacy, or confidence in one's ability to perform an action. This model can be applied to this study to understand the factors influencing adolescent girls’ attitudes and behaviors related to menstruation, menstrual hygiene, and seeking help for menstrual problems. By applying this model to the study, the researcher can illuminate how the adolescent girls maintain hygiene during menstruation and the role of their families and surrounding’s for maintaining menstrual hygiene and the menstrual attitudes and behaviors.

 

Methodology of the study

Both quantitative and qualitative method research design was conducted by the researcher including quantitative and qualitative data analysis in this study. For conducting this study, stratified random sampling technique was employed to ensure representation across four Thanas of Old Dhaka.  Besides, this study had conducted in Old Dhaka with a sample size of 103 respondents. Four Thanas of Old Dhaka were included in the study area including 28 respondents from Kotwali Thana, 25 respondents from Sutrapur Thana, 25 respondents from Gandaria Thana and 25 respondents from Narinda Thana. Primary sources of data were collected in this study. For quantitative data collection, the researcher was taking survey with face to face interview by semi-structured questionnaire and for qualitative data collection; the researcher conducted Focus Group Discussion (FGD) with an open-ended questionnaire. The researcher was interviewed 5 respondents for pre-testing. Based on pre-testing findings, the researcher prepared final interview schedule and another questionnaire including open-ended questions. Data analysis was processed by using SPSS Software to take valid statistical data. Quantitative data were analyzed using SPSS software to generate valid statistical results, while qualitative data from the FGDs were processed through thematic interpretation to explore deeper social insights. This mixed approach enabled the researcher to combine measurable data with rich narrative accounts to better understand the social dimensions of menstrual health.

 

Analysis

Quantitative analysis

The researcher used SPSS software to code the numerical data for quantitative analysis because this software is generally better for performing complex calculations, exploring possible outcomes and producing high quality charts.

 

Socio-demographic aspects of the respondents

The data of the following table describe the socio-demographic information of the participants. Here, the socio-demographic information included age, class and religion.

 

Table-1.1: The socio-demographic information included age, class and religion

Information about respondents	Categories	Number of respondents	Percentage
Age	10-13 14-16 17-19	39 35 29	37.86 33.98 28.16
Class:	Six Seven Eight Nine Ten Not Study	14 17 27 26 12 7	13.59 16.50 26.21 25.24 11.66 6.80
Religion	Muslim Hindu Christian	52 40 11	50.49 38.83 10.68

Source:  Fieldwork -2024

 

The mentioned data in table-1.1 shows that maximum respondents took part in the interview were between 10-13 years. They were 37.86 percent (39) and from 14-16 years were 33.98 percent (35). Beside those, minimum respondents from 17-19 years were 28.26 percent (29). The researcher interviewed the respondents also on the basis on the class they studied. Maximum respondents took part on the interview were read in class eight which is 26.21percent (27). Besides, at about 26 respondents in class nine took part on this interview which percentage is 25.24 percent which is second maximum rate.  Also, at about 14 and 17 respondents took part in the interview read in class six and seven which are 13.59 percent and 16.50 percent. At about 7 of total respondents was not study which is 6.80 percent at the total of 100 percent. In this face-to-face interview, the researcher interviewed the respondents also on the basis on religion in which they belong because, in this study, religion played a significant role for getting authentic information. In the table, the Muslim respondents are 52 who took part in the interview which is 50.49 percent. Besides, there are 40 respondents from Hindu religion which is 38.83percent and 11 respondents from Christian religion which is 10.68 percent at the total of 100 percent with 103 respondents.

 

Primary information about menstrual hygiene of adolescent girls

The menstruation process of females starts at different age at between 10-19 years. The researcher had tried to identify at which age menstruation usually starts by the following table. 

Table-2.1: The age of starting menstruation of the respondents.

Source:  Fieldwork -2024

 

The data mentioned in the table-2.1 shows the age of the respondents at which the menstruation usually starts. The table describes that maximum respondent’s menstruation usually start at the age of 13 which is 40.78 percent (42) and the minimum number of respondent’s menstruation start at the ages of up to 10, and 16  and above which is 0.97 percent (1) and also 2 respondents from 11 years to start menstruation is 1.94 percent.  Further, there are about 18 respondents whose menstruation starts at the age of 12 which is 17.48 percent and at about 35 respondents whose menstruation start at the age of 14 which is 17 percent. Besides at about 4 respondents whose menstruation starts at the age of 15 which is 3.88 percent at the total of 100 percent with 103 respondents. After that, the researcher asked the knowledge about menstruation to the respondents. One of the respondent’s name Umme Habiba, 13-year-old, and reads in class seven said,

I still remember the day when started my first ministration. I was then 11 years old girl, and one early in the morning I felt a little pain in my lower abdomen, like gentle cramps. I wasn’t sure what it was at first, but it felt different from anything I had felt before. Later on when I went to the bathroom, I saw some blood in my underwear, and then I realized my period had started. It made me feel shocked and a little bit nervous at first, but I also felt a little proud because I knew this was something every girl goes through as her body grows up.

Figure-2.1: Knowing about menstruation

Source:  Fieldwork -2024

 

The data mentioned in Figure-2.1 shows the different source by which respondents got knowledge about menstruation. The figure describes that most of the respondent got idea from family which is 36 percent (37) and the undermost of the total respondents got idea from media which is 7 percent (7). Besides, at about 28 percent (29) of the total respondents got idea from friends with whom they interact. Also, at about 14 respondents from both textbooks and 16 respondents from teachers which are 14 percent and 15 percent from the total of 100 percent with 103 respondents got idea. 

 

Causes, effects and consequences

The data mentioned in the figure -3.1 shows different causes of menstruation. The figure describes that maximum respondent which is 75.73 percent (78) from the total of 103, gave the opinion to the researcher that hormone is the cause of menstruation and minimum level of respondents which is 8.74 percent (9) said that they didn’t know the cause of menstruation and at about 15.53 percent (16) students had the opinion that it’s a disease. 

Figure -3.1: Causes of menstruation.

Source:  Fieldwork -2024

 

After that, the researcher asked about the experience of the respondent’s first menstruation. They had somewhat similar and somewhat dissimilar experiences. One of them, named Puja Biswas, a 16 years old adolescent girl, reads in class 9, shared her experience 

My first menstruation occurred when I was 13 years old. I already had knowledge about menstruation, so I was not afraid when it happened. I understood that it is a natural and healthy biological process that most girls experience during puberty, which helped me feel calm and prepared. However, when I noticed various physical and psychological changes in my body and mind, I initially felt somewhat afraid. With the support and guidance of my family and friends, I gradually adapted to these changes.

From the question, ‘being afraid of respondents physical and mental changes for menstruation’ the researcher had tried to identify the attitudes towards being afraid of those changes. It describes that 59.22 percent (61) of the total respondents weren’t being afraid of their physical and mental changes and 40.78 percent (42) of the total respondents were being afraid of their physical and mental changes occurred for menstruation.  The data mentioned in the table-3.2 describes various physical problems which the adolescent school-aged girls faced at the time of menstruation by which their daily works may hamper as well.

 

Table-3.2: Kind of physical problem the respondents face at the time of menstruation.

Facing physical problem during menstruation	Frequency	Percentage
Breast pain	9	8.74
Excessive Bleeding	48	46.60
Abdominal pain	35	33.98
All of them	7	6.80
None of the above	4	3.88
Total	103	100

             Source:  Fieldwork -2024

The table describes that maximum girl in Old Dhaka faced the physical problem of excessive bleeding which is 46.60percent (48). At about 9 respondents faced breast pain during menstruation which is 8.74percent and at about 9 respondents faced abdominal pain during menstruation which is 30 percent of the total respondents. Besides, 2 of them faced those entire physical problem and 2 of them had not yet faced any physical problem during menstruation which are 13 percent and 7 percent of the total respondents.  With the question, ‘about the kind of mental problem the respondents face at the time of menstruation’ the researcher had tried to present a clear idea about those mental problem which may hamper their regular activities. It showed that maximum girl in Old Dhaka faced the mental problem of irritable temper which is 54.37 percent (56). At about 28 respondents faced repeated mood swing during menstruation which is 27.18 percent of the total respondents. Besides, 19 of them faced both of the mental problems and which is 18.44 percent of the total respondents.

 

Role of family and educational institution

With the question, ‘about getting support from family during menstruation’, the researcher had tried to present a clear idea about that which have a significant role in this study. The analysis described that 13.59 percent (14) of the total respondents weren’t getting notable support from family and 86.41 percent (89) of the total respondents were positively respond that they get support from family during menstruation. With the question about ‘kind of support given by family during menstruation’, the researcher had tried to present a clear idea about that which plays a significant role in maintaining mental and physical hygiene healthy. The data analysis described that at about 10.67 percent (11) respondents said that their family maintains healthy food habit during menstruation for maintain their menstrual hygiene. Besides, at about 7 respondents from both of the option ‘Keep the house clean’ and ‘mental support’ which are 7.77 percent and the maximum respondent at about 73.79 percent (76) from the total respondent gave the opinion to the researcher that all of the above support given from their family during menstruation.

 

Figure 4.1: Getting support from school during menstruation.

Source: Field study, 2024

The data mentioned in the Figure-4 shows the percentage distribution of getting support from school during menstruation. The figure describes that 55.34 percent (57) of the total respondents weren’t getting notable support from school and 44.66 percent (46) of the total respondents were positively respond that they get support from school during menstruation. After that, the researcher asked about the supports given from school during menstruation to all the participants and a small number of people who could able to describe that. A respondent from St. Francis Xavier School & College talked about the supports given from her school,

One of the best things about my school is that they actually talk about menstrual hygiene. Our teachers and school authority organize awareness campaigns to teach us how to maintain proper hygiene during menstruation. They also understand our needs — if anyone feels unwell, we are allowed to take leave without hesitation. Sometimes the school even provides sanitary napkins to those who need them. It really makes us feel supported and comfortable to manage our period at school.

 

Safeguards of menstrual hygiene

Concerning about maintaining menstrual hygiene, with the question, ‘what do they use during menstruation’ the researcher tried to understand adolescent girls’ menstrual hygiene. The data analysis described that maximum respondents use sanitary napkin at the time of menstruation which is 69.90 percent (72) and only 30.10 percent (28) of the total respondents use piece of cloth which may not healthy for menstrual hygiene. With this question about ‘facing economic difficulties for buying sanitary napkin’, the researcher tried to find out the people who had not the ability to buy sanitary napkin and use piece of cloth or other material. The analysis described that a small number of respondents who always face economic difficulties for buying sanitary napkin which is 12.62 (13) and those who sometimes face economic difficulty is about 31.07 percent (32) from the total population. And maximum respondents who didn’t face any economic difficulties were about 56.71 percent (58) from the total population.

 

Table: 5.1. Safeguards of menstrual hygiene of adolescent girls

Category	Frequency	Percentage (%)
Use of Menstrual Material Sanitary napkin   Piece of cloth  or unhealthy option	72 28	69.90 30.10
Economic Difficulty in Buying Sanitary Napkin       Always face economic difficulty       Sometimes face economic difficulty       Don’t face economic difficulty	13 32 58	12.62 31.07 56.71
Sources of information Peer group       Family members       School       Others	52 33 13 5	50.49 32.04 12.62 4.85

Source: Field study, 2024

 

With the question about ‘the source from which the respondents knew about using sanitary napkin, the researcher tried to find out different kind of sources from which the respondents knew about using sanitary napkin. The table 5.1 also described that maximum respondents got the idea from their peer group with whom they interact which is 50.49 percent (52) and the minimum number of respondents got the idea from others instead of family, peer group or school which is 4.85 percent (5). Besides, 32.04 percent (33) of the total respondents got the knowledge from family and about 12.62 percent (13) of the respondents got the idea from school from the total respondents which is 103. With this question about, ‘the opinion of the respondents about the cleanliness of Old Dhaka’s environment for adolescent girls, the researcher tried to understand the attitudes about the environment of this area of all adolescent girls. The analysis described that, from the total of 103 respondents, maximum respondent had the opinion that the environment of Old Dhaka is unhealthy for adolescent girls’ menstrual hygiene which is 71.84 percent (74) and no one had the opinion of the area’s healthy environment which is 0 percent. Besides, at about 14.56 percent (15) of total respondents gave the opinion that the area’s environment is somewhat unhealthy and 4.85 percent (5) of the total respondents said that the area is somewhat healthy. Also, at about 8.74 percent (9) respondent had not any idea about the cleanliness of Old Dhaka which had a great impact on their menstrual hygiene.

After that, the researcher wanted some explanation from the respondents about the environment’s cleanliness. Most of the people had the argument that the area is smaller than the population of its. One of the respondents gave the opinion that most of the area filled up with waste, garbage and others which affected menstrual hygiene and also, most of the people are not concern about maintaining menstrual hygiene that’s why the problem had not yet solved.  As maintaining healthy food habit is essential for being healthy, the researcher thought to get the opinion about maintaining healthy food habit during menstruation. The analysis described that 40.78 percent (42) of the total respondents weren’t maintain healthy food habit and 59.22 percent (61) of the total respondents were positively respond that they maintain healthy food habit during menstruation because of maintaining menstrual hygiene.

 

Effects of taboo during menstruation

As there is different kind of taboo given to the female people at the time of menstruation and it affected greatly to them, the researcher tried to understand how many people face the taboo and what kind of taboo they face during menstruation. The analysis described that 21.36 percent (22) of the total respondents weren’t face any taboo and 78.64 percent (81) of the total respondents were face different kind of taboo during menstruation. Again, maximum number of respondents face religious taboo (The Muslim respondents are not allowed to prayer or touch the Quran and the Hindu respondent are not allowed to go the temple and treat them as impure) which is 84.47 percent (87) and 2.91 percent (3) face social taboo (not allowed to go outside from home, not able to do regular work). Besides, at about 12.62 percent (13) respondents face none of those taboos during menstruation.

 

Qualitative analysis

FGD method was conducted in this research in which a selected group of people (mothers of adolescent-girls) discussed the given topic in-depth, facilitated by the researcher. The researcher had done a focus group discussion to get insight into the experiences and perspectives about menstrual problems. In this discussion, the selected groups of people were mothers who had a core connection with their daughters. The researcher had given a number of questions as topics for discussion. The mother participated on this discussion who living in Old Dhaka’s different area named Dholaikhal, Jatrabari, Narinda and Lakshmibazar. In this discussion, at first, they discuss about maintaining menstrual hygiene. They all had a good understanding about menstrual hygiene. One of them had the opinion that, ‘for maintaining my daughter’s menstrual hygiene, I try to maintain cleanliness of my house and also gave nutritious food to my daughter’. Others were agreed with her. Then, they had the opinion about school attendance and performance during menstruation that sometimes their daughters had not able to attend school and study properly during menstruation. But most of the time they attend their classes and examination during menstruation. They shared their experience that at the time of starting menstruation that their daughters were very afraid about their physical changes but after sometime, they adopted with those changes. The researcher also asked about the impact of the environment of Old Dhaka to the menstrual hygiene of adolescent girls. Through their discussion, they came to the point that there was always an unhealthy environment in Old Dhaka that’s why their daughter doesn’t want to go outside during menstruation. One of them had the opinion that ‘My daughter doesn’t even go to the school during menstruation because of unhygienic roads of Puran Dhaka’. Besides, they also discussed about their financial difficulty for buying sanitary napkin that, though they sometimes face difficulties for buying sanitary napkin but they prefer to use it. After that, they also discussed that the information and education about menstruation not yet available in Old Dhaka and it should be increased and also raising awareness about menstrual problem come to an essential point for adolescent girls’ menstrual hygiene.  So, most of their opinion about menstrual problems among adolescent girls were similar to the respondents who participated on the face-to-face interview.

 

Discussion

To inquire different types of menstrual problems, this study represents that the maximum age of starting menstruation is 13 years old where the respondents who participated in the interview were between 10-19 years old who faced various physical and mental menstrual problems. For demographic information of the participants, the researcher also included class in which the respondents’ study and the religion in which they belong along with age. In this study, maximum respondents were studied in class seven and most of them belong from the religion of Muslim. In this study, the researcher conducted quantitative analysis with semi-structured questionnaire along with qualitative analysis where the researcher came into more or less authentic results because the respondent’s ages were approximated. Further, in understanding the adolescent girls’ adaptation to rapid physical, mental and sexual changes, the researcher had tried to identify the attitudes of being afraid of various physical, mental and sexual changes where she found that about 60 percent of the respondents were being afraid of their physical, mental and sexual changes occurred for menstruation where 40 percent of them weren’t. Again, the researcher tried to present a clear idea about the kind of their physical and mental changes and menstrual problem through this study and came to the point that maximum about 33 percent of the respondents faced excessive bleeding and 53 percent of them faced irritable temper during menstruation. To explore the perceptions, knowledge and attitudes about menstruation among adolescent school girls, in the quantitative analysis, the researcher found that 37 percent of the respondents got knowledge about menstruation from their family which was somehow conceivable and most of the respondents amnestied hormones as the cause of menstruation where 23 percent respondents had not any idea about the cause of menstruation.

Further, the researcher also tried to examine the effects on education and school attendance during menstruation and had tried to present a clear idea about getting support from family and school during menstruation. Here, maximum respondents gave positive response about the support of family and said that their family support them by maintaining healthy food habit, keeping the house and cloths clean and also gave mental support which was 63 percent of the total respondents. But at about 67 percent of the respondents gave negative response about getting support from school. This was not at all fortunate because in Bangladesh, there is a little number of schools by whom students get support about their menstrual hygiene and people should be more aware about this. Significant information got the researcher through this study about the material the adolescent girls used in menstruation. The researcher came to the point that about 87 percent of the respondents’ use sanitary napkin though they sometimes faced economic difficulties for buying this. And 13 percent of the respondents including those who were not studying use piece of cloth because of their incapability. It's a very concerning issue for us to reduce the price of sanitary napkin so that every female can able to buy it. Besides, most of the respondents got the idea about using sanitary napkin from their peers which is 43 percent and the second maximum rate is 33 percent who got the idea from family in Old Dhaka. As people always had the assumption that there is an unclean environment in Old Dhaka, another concerning issue for the researcher was the cleanliness of Old Dhaka's environment which had a great impact on menstrual hygiene of adolescent girls. At about 57 percent of the respondents said that the environment was unhealthy for the menstrual hygiene. The researcher also took the information about maintaining healthy food habit during menstruation which is another essential point for this study. Here, about 53 percent of the respondents gave positive response that they maintain their food habit during menstruation by eating more and more nutritious food. The researcher was also concern about the taboo faced by the adolescent girls during menstruation. And the analysis said that, most of the people faced religious taboo which will not be changeable and the percentage was 83 percent who faced religious taboo. A minimum number of people about 13% faced none of taboo during menstruation. Lastly, the researcher took the information about physical and mental problems faced on the last menstruation where about 57 percent of the respondent faced abdominal pain during menstruation which is maximum rate and 43 percent of the respondent faced both irritable temper and repeated mood swing during last menstruation. 

In the qualitative analysis with FGD, the researcher got maximum opinions were similar with the responses of the respondents. Through this discussion, the researcher got clear idea that nowadays, people are more concern about maintaining menstrual hygiene but there are also a group of people who have not yet any idea about why and how to maintain menstrual health and they somehow incapable to do so. Through this study, the researcher had tried to raise awareness about the importance of addressing menstrual problem as public health concern and to improve menstruating health management for adolescent girls in Old Dhaka, the related agencies have to take essential steps by doing different campaign on menstrual problems because child birth and productiveness of women is a vital issue for maintain the stability of the world. Raising awareness is very important about menstrual problem because it’s a sensitive issue for all female people. Other study has also found those physical and mental problems as found from this study. But in this study, the researcher found various social, cultural taboos which most of previous studied didn’t address yet. Besides, most of the previous study somewhat ignored the adolescent girls who dropped out from school.  But, in this study, the researcher collected and analyzed data from both school-going and dropped out adolescent girls. The limitation of this study is that the sample size was somewhat small. The researcher suggests that those who sub sequentially will intend to escalate the sample size. 

 

 

 

Conclusion

In conclusion of ‘Menstrual health concerns among adolescent girls in Old Dhaka is a significant issue that needs to be addressed. The lack of access to proper sanitary facilities and education about menstrual health can lead to physical and psychological problems for these adolescent girls in Old Dhaka. Basically, Adolescence is the period of transition between childhood and adulthood. Children entering adolescence are going through many changes in their bodies and brains. These include physical, intellectual, psychological and social challenges, as well as development of their own moral compass. And menstruation is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. The menstruation is characterized by the rise and fall of hormones which has a core connection with women productiveness.  So, it is essential for the government and non-governmental organizations to take action to ensure that these girls have access to proper menstrual hygiene products, education, and support. By addressing these issues, we can help these girls lead healthier and more confident lives.

 

Recommendations

• Awareness programs should be conducted by health professionals and teachers through school health programs.
• Teachers should be trained for the effective implementation of health programs of adolescent health.
• The authority should be taken essential steps to ensure a healthy environment for maintaining menstrual hygiene.

 

 

References

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