Age of menarche and menstrual hygiene of pubertal female students in Bhutan: a cross-sectional survey, 2017

Abstract

Introduction: In Bhutan, pubertal and adolescent female students (10-19 years) make up 8.5% of the population. The need for menstrual hygiene management (MHM) is more urgent in post-menarcheal female students and in resource-poor settings. However, until recent time, there were strong socio-cultural barriers to discourses on menarche and MHM. This study was conducted to determine the age of menarche among Bhutanese female students to identify when to offer MHM support, their knowledge on menstruation and practices related to menstrual hygiene. Methods: This was a cross-sectional survey of female students studying in Grade 10 in Thimphu, Bhutan. A multistage clustered sampling was used. Data was collected using a self-administered questionnaire developed for the purpose of this study. Results: A total of 439 post-menarcheal female students were interviewed. The mean age of menarche was 12.8±1.1 years, and fear (38.3%) and confusion (25.1%) were the commonest responses. The mean score on knowledge on menstruation and MHM was 5.9±1.5 out of 9. The proportion of students with good knowledge was 36.7%. The common sources of information were the mother, teacher, and sister. The majority used commercial pads (92.5%) while some used clean cloths (5.7%) and tampons (1.6%). The proportion who stayed absent from school during menstruation in the month prior to data collection was 9.8%. Visiting religious places (67.6%) and participating in sports (4.3%) were common restrictions during menstruation. Conclusions: Female students experience difficulties in menstrual hygiene management in schools. Menstruation could lead to missing schools and other activities. Keywords: Developing country; Health behaviour; Menstrual hygiene product; Standard of living.