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Menstrual Memo 
Sent with <3 from the Menstrual Health Hub (7 min. read)
Standing (and bleeding) together,
separately


It’s been an unprecedented month as nations across the globe enact new measures to curb the COVID-19 pandemic. Through all of this, it has been astounding to see the MHH community work harder than ever to make menstruation matter.
 Working on menstrual health and hygiene (MHH) is of paramount importance during this pandemic because everyone who menstruates must be remembered and supported. In this Memo, we're bringing you some amazing examples of how the MHH community is stepping up to support medical professionals and citizens across the globe.

But first, Let's 'take a Eurotrip with the Tampon Tax'!


big, BIG virtual hugs, 

P.s. Click here to view this complete Menstrual Memo as it does get cut off in your inbox (and it's full of good stuff!)
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TODAY: Webinar on Understanding Unique Menstrual Health and Management Challenges for Girls

Wednesday, April 15, 2020
9:00 - 10:30AM ET
2:00 - 3:30 PM GMT
4:00 – 5:30PM East African Time (EAT)

 

Together with UNICEF, Water Aid, Girls Not Brides, and African Coalition for Menstrual Health Management, the Uganda Ministry of Education & Sports and the Uganda CSO Coalition on MHM is hosting a webinar on 'Understanding Unique Menstrual Health and Management Needs and Challenges for Girls and Efforts to Address Them'.

Details for joining the webinar:

Dial-in number (KE): 020 529 3326
Access code: 458991#
International dial-in numbers
Online meeting ID: uyahfchanel
RSVP Here

Online Cycle Power Summit
To Help Women Experiencing Fertility Issues During COVID-19


April 16th - 20th, 2020
RSVP Here

Period Talk: What do we need to consider during COVID-19?

April 21, 2020, 8AM ET / 1PM GMT / 3PM EAT 

Topics to be discussed: Menstrual materials for healthcare workers, MHM & COVID-19 in humanitarian contexts, MHM in quarantine (+ examples from India & Uganda), MHM & product affordability (+ examples from US & UK)
RSVP Here

What's next for health tech? 

Thursday, April 23, 2020, 2:30PM ET / 6:30PM GMT / 8:30PM EAT 

Some of the topics covered: 1) what it’s like to start a business in an industry that is still a taboo, i.e,. sex tech; 2) how to launch a product in a highly-regulated environment; 3) how to build a brand that can potentially have a social impact; 4) why Femtech is the next big thing in healthcare; 5) the importance of medical research for female health and why lack of medical data in this space is actually an opportunity for Femtech businesses to build next generation of products and services for women.
RSVP Here
Image: Marta Pucci, Clue

Your menstrual cycle under quarantine

 EDUCATION

 

Have you noticed a change in your menstrual cycle this month? 
Not uncommon. Period tracker app and Clue notes that "excess release of cortisol can suppress normal levels of reproductive hormones, potentially leading to abnormal ovulation, which can disrupt your cycle." Stress can cause irregularities, pain, and can even stop periods altogether, which is why this pandemic may be affecting periods. Here's more information about your menstrual cycle under quarantine.

Tampons spaced out against a blue backdrop. Image: Lola
 
US Government Acknowledges Period Products are
Necessities in COVID-19 Stimulus Bill

 
 POLICY

 

The United States recently passed the Coronavirus Aid, Relief, and Economic Securities (CARES) Act, or the $2 trillion stimulus package to provide relief from the economic fallout caused by COVID-19. The stimulus package is the largest emergency aid package the U.S. has seen. In section 4402 entitled "Inclusion of certain over-the-counter medical products as qualified medical expenses", it includes an unexpected provision to allow US citizens to purchase menstrual products with pre-tax dollars, using their health savings accounts (HSAs) or flexible spending accounts (FSAs). 
A massive victory for menstrual equity advocates like Period Equity (which have been fighting for this type of legislation for years), this inclusion is a crucial acknowledgment by the US government that menstrual products are necessary expenses for essential care.
 

 

Read more about period product provisions in the CARES Act
Aisle's new menstrual cup set against a blue and turquoise background. Image: Aisle.

Lunapads is now Aisle

INNOVATION
 

Lunapads (which has been around since 1993!) has recently rebranded as Aisle. This rebranding came about due the brand’s key principles of environmental and social sustainability, inclusion, and intersectionality. The rebranding to Aisle is to ensure the inclusion of everyone in their diverse community and to help their customers have a positive relationship with their bodies and their periods. The new design and branding is extremely inclusive, representing trans & non-binary people, and includes a variety of body types in their marketing, demonstrating an understanding that there is no specific body that has a period. Aisle has also launched their first period cup, manufactured in Canada.
In light of COVID-19, Aisle is mobilizing Vancouver's local manufacturing partners to make washable, reusable fabric masks a coordinated effort to help prevent the spread of the virus in Vancouver's lowest-income and most vulnerable neighbourhood, the Downtown East Side (DTES).

Help provide masks for frontline workers in Vancouver
Image: Medium

Menstrual Health + COVID-19 Resources all in one place

EDUCATION
 

The Menstrual Health & Hygiene (MHH) community knows that periods don’t pause for pandemics, and to support the MHH community during COVID-19, the Menstrual Hygiene Day Secretariat has created a webpage collecting news articles, blog posts and information related to MHH and Coronavirus Sars-CoV-2 / COVID-19. Thank you, MH Day (28 May) for this useful, live resource about how COVID-19 intersects with MHH.

Show me the MH + COVID-19 resources
Women sewing cloth masks when they normally sew reusable pads.
Image: Arnaud Ndayiragije, Communications Officer for SaCoDé, Burundi

Menstrual companies stepping up in COVID-19 response

INNOVATION
 

A few companies and NGOs producing reusable period products have begun pivoting operations to produce fabric face masks. Research that has shown that the filtration provided by cloth masks is not nearly as effective as compared to surgical masks, however, there are very few studies on the effectiveness of fabric masks in general. The authors of this research recently published an additional note to this study saying that their research "does not condone health workers working unprotected [and] recommends that health workers should not work during the COVID-19 pandemic without respiratory protection as a matter of work health and safety." In countries like Austria and the USA, there have been recommendations to wear masks, as masks can still be a useful aid to remind people not to touch their face. It is great to see the MHH community come together to support this pandemic response, including these helpful instructions on how to use a facemask, courtesy of Aisle.


Here are a couple more menstrual companies to learn more about and support their valiant efforts:

SaCoDé's Mask & Gown Efforts in Burundi
Days for Girls Mask Efforts
Image: Ruby Cup

Ruby Cup offers free cup to health workers on the front line
 
Ruby Cup is supporting nurses, doctors & healthcare workers by them giving free Ruby Cups to allow them to have fuss-free periods while on-the-job. They are looking for contacts at hospitals in Europe and Kenya that can distribute the cups to those who are helping fight COVID-19. If you know anyone who could help, please email hello@rubycup.com.
Email Ruby Cup

Days for Girls provides educational resources
 
Menstrual health infographics, poster and PSAs all about COVID-19 Resources in English, Spanish and French, because periods don't pause for pandemics.
Days for Girls' COVID-19 MH Resources
1. Blog from Dr. Amita Bhakta: It’s time for the water, sanitation and hygiene sector to hear about the perimenopause. Dr. Amita Bhakta recently complete her PhD with Julie Fisher and Brian Reed at Loughborough University, on the WASH needs of perimenopausal women in Ghana who are making the transition to menopause. The PhD found  that the menstrual hygiene needs of women at this stage (aged mid 40s-50s) are incredibly different to the needs of adolescent girls, where the focus of much of the WASH sector is. At the perimenopause stage, women are trying to manage very heavy, erratic and irregular bleeding, and so their hygiene needs change, because MHM needs to be adapted to absorb more blood. This is a neglected area in WASH and MHH.
2. Goddard & Sommer., 2020:
Menstrual Health and Hygiene Management and WASH in Urban Menstrual Health and Hygiene Management and WASH in Urban Slums: Gaps in the Evidence and Recommendations. A review was done to highlight interlinkages between urbanisation, WASH, and MHM identified two important intersection influencing the experiences of menstruators in varying contexts: (1) The Intersection of Governance, Urban Slums and menstrual health and hygiene management (MHM), and (2) The Intersection of Urban Sanitation Systems, Gender, and Menstruation. Three recommendations emerged from this review on the intersection of menstruation and WASH systems in low-income urban contexts: (1) Building the evidence on menstruators’ lived experiences of MHM in urban contexts, including issues of privacy, dignity, and access to WASH systems; (2) Building the evidence on what works and what is acceptable in terms of addressing MHM products disposal in diverse cultural urban contexts with varying systems of governance; and (3) Inclusion of more specific targets and indicators related to MHM in global development frameworks.
 

3. Seydou et al., 2020: Menstrual Hygiene Management in School Setting in Two Secondary Schools in the Bamako District, Case of the School “La Chaine Grise” and the School Cheick Modibo Diarra. A cross-sectional, descriptive study was conducted in two schools among 100 girls ages 16-18 in the Bakamo District of Mali in 2019 to understand girls’ knowledge about menstruation, what product they use, and school attendance during their period. 50% of participants reported having poor knowledge on menstruation and not learning about menstruation until menarche. Mothers are the most common teachers on the subject (64%) and the source of finances to purchase menstruation products (90%). The most common product used during this time is cotton (90%). 1 out of 10 participants reported staying home during their period. Reasons for missing school include dysmenorrhea, fear of leaking on clothes, and inadequate sanitary facilities. The schools do not have proper facilities to change materials. This study found that 96% of girls find the toilets inadequate and 100% report lack of toilet paper, soap, and a container for water a difficulty. Additionally, 83% of the girls mentioned lack of privacy in the toilets.

4. Diamond-Smith et al., 2020: Knowledge of menstruation and fertility among adults in rural Western Kenya: Gaps and opportunities for support. In 2014, the Demographic and Health Survey of Kenya found only 26% of women knew the correct fertile window during their menstrual cycle, which displays no change from the survey sent out six years prior. Therefore, a qualitative study was done in Bondo, western Kenya, among 45 parent participants (female age: 15-49, male age: >20) of a living pre-term child under the age of 5 to inform the development of an intervention about the knowledge of menstruation, the link with fertility, and the support and approaches for tracking menstruation. Results: All 45 participants answered similarly about where they gained their knowledge of menstruation. Information comes mainly from friends and family, or wives in the case of the male participants, rather than health professionals. Participants indicate low levels of knowledge about the relationship between women’s menstrual cycle and pregnancy. Many participants rely on calendars or even on their partners to help them keep track of their cycle. This also aids in avoiding “visits” for unmarried adolescents during the fertile window. However, there was a general misunderstanding of the timing of the fertile window by participants. When asked about methods of tracking periods, privacy was the most important aspect of tracking. There is a larger interest in tracking on paper rather than on a digital tool.

5. Singer et al., 2020: Pediatricians’ knowledge, attitudes and practices surrounding menstruation and feminine products. A 53 item online questionnaire was emailed to 2,500 AAP members across the United States to find if primary care pediatricians are knowledgeable about menstruation in general, routinely evaluating patients’ menstrual cycles, and educating patients about menstruation and menstrual health products. Of the pediatricians invited, 20.7% responded, 78.8% of these female. Results: 75.3% of pediatrics report that they provide guidance to pre-menarchal patients and 62.1% provide patients’ caregivers information about menstruation to “most” or “almost all” about what to expect of menarche. Despite 70.8% of pediatricians felt this guidance was “very” or “extremely” important, only 50.2% were familiar with the AAP guidelines on the subject. Similarly, 66.9% of pediatricians reported they discuss menstruation with post-menarchal patients “most” or “almost all” of the time and 78.6% believe it was “very” or “extremely” important to do so. Most pediatricians responded that they “very often” or “almost always” ask about the pattern of menses (94.4%) and the date of their LMP (71.6%). Pediatricians rated themselves as “very” or “extremely” knowledgeable about menstruation (60.4%). Male pediatricians were less likely to talk to their patients, pre/post menarchal, and/or caregivers on all accounts and only 32% self-evaluated themselves “very” or “extremely” knowledgeable about menstruation. Many pediatricians indicated there was a “very low” or “low” likelihood of discussing menstrual health products, and male pediatricians less likely than female pediatricians.

6. Belay et al., 2020: Girls’ attendance at school after a menstrual hygiene intervention in northern Ethiopia. A prospective study was conducted in 15 schools in northern Ethiopia among 8839 male and female students in grades 7–12 during the 2015–2016 academic year to evaluate the effect on school attendance of a menstrual hygiene intervention that distributes educational booklets to both male and female school children and menstrual hygiene kits to schoolgirls. Results: over 12 211 educational booklets were distributed to students and 5991 menstrual hygiene kits were distributed to schoolgirls. After the intervention, girls had 24% fewer school absences than boys.

7. Wea et al., 2020: The experiences of visually impaired teenage girls on menstrual hygiene management: a qualitative study. A qualitative study was done to collect the information from 6 visually impaired children related to their menstrual hygiene. Results: The majority of the participants acquired the knowledge on menstruation and how to clean the menstrual pad from the teacher. The emotional responses stated such as dependence on feeling when doing menstrual self-hygiene. This study also indicates the negative thoughts such as fear as well as myth faced by the visually impaired children.

8. Smith, Muli, Scwab and Hennegan, 2020. National Monitoring for Menstrual Health and Hygiene: Is the Type of Menstrual Material Used Indicative of Needs Across 10 Countries? This study investigated whether survey data provides a useful indication of women’s menstrual material needs being met. Using data from 12 national or state representative surveys from the Performance Monitoring and Accountability 2020 program, authors compared self-reported menstrual material use against respondents’ reported menstrual material needs (including needing clean materials, money, or access to a vendor). Findings suggest that caution is needed when using menstrual material use as an indicator for menstrual health.

9. FSG, 2020, Advancing Gender Equity by Improving Menstrual Health. This report captures key changes in the menstrual health and hygiene (MHH) space that have happened since the publication of 'An Opportunity to Address Menstrual Health and Gender Equity' in 2016, paying particular attention to the remaining gaps and highlight opportunities for further action and investment.

Opportunities in Menstrual & Female Health
Image: Orikalankini
Apply here by April 30, 2020
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*We use the word female to denote the sex that can bear offspring or produce eggs, distinguished biologically by the production of gametes (ova). At the MH Hub, the term 'female health' is used to capture the experiences related to the presence of the menstrual cycle and the specific health issues an individual may face over their life cycle as a result.  We recognize that not all women menstruate, and not all who menstruate identify with being a woman, and strongly advocate for the inclusion of diverse voices, identities and bodies in discussions around female and menstrual health.


Copyright © *|2020|* *|Menstrual Health Hub (MH Hub)|*, All rights reserved.


The Menstrual Health Hub (MH Hub) is a female health impact organization focused on ecosystem-building, knowledge sharing and high-level advocacy around menstrual health worldwide. Menstrual Health Hub gUG (haftungsbeschränkt) is a German nonprofit-enterprise company (limited liability)  

MH Hug UG is a strategic consulting agency specializing in gender and female health.
 MH Hub UG (haftungsbeschränkt) is an German enterprise company (limited liability). Both companies are registered at Factory Berlin, 76/77 Rheinsbergerstraße, 10115 Berlin, Germany. 

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