A Study to Assess the Knowledge of Adolescent Girls Regarding the Usage of Menstrual Cup in Menstrual Hygiene in Selected Nursing Schools at Bangalore with A View to Develop an Informative Booklet

 

Risha P S, J. Vijayalakshmi

Professor, Department of OBG Nursing, Sarvodaya College of Nursing, Bangalore 560079, Karnataka, India.

*Corresponding Author E-mail: rishaarun88@gmail.com

 

ABSTRACT:

Introduction: Menstrual health and hygiene, often known as menstrual hygiene management, includes evaluating menstrual hygiene products to collect blood flow during menstruation, providing a facility for disposing of menstrual management materials, and providing privacy for changing the materials. The systemic elements that connect a woman's menstruation to her health and well-being may also be included. A product used for menstrual hygiene that is placed into the vagina during the menstrual cycle is called a menstrual cup. The menstrual cup is a bell shaped one which is placed around the vagina The menstrual cup collects blood flow rather than absorbing it as with pad and tampons. Objectives: To assess the knowledge of adolescent girls regarding usage of menstrual cup in menstrual hygiene. To find out the association between level of knowledge on usage of menstrual cup in menstrual hygiene among adolescent girls with their selected demographic variables. To develop an information booklet. Methodology: The research approach chosen for the study is descriptive survey approach, the research design selected for the study is non-experimental descriptive research design. A sample of 100 adolescent girls were selected from the target population for the study and convenient sampling technique was adopted to draw samples for the study. Result: the study shows that out of 100 adolescent girls around 68% adolescent girls has moderate knowledge, 31% has inadequate knowledge and 0.1% have adequate knowledge in usage of menstrual cup in menstrual hygiene and there was no significant association between the level of knowledge and selected demographic variable.

 

KEYWORDS: Knowledge, Adolescent girls, Menstrual cup, Menstrual hygiene, Information booklet.

 

 

 

INTRODUCTION:

Adolescence is a physiological stage between puberty and end of body growth. It has been recognised as a unique period of human development. Menarche represents an important step in development puberty of young girls1. girls. The taboos around menstruation that are prevalent in many Indian societies have a significant effect on the emotional state, mind-set, lifestyle, and health of girls and women. When fighting these problems, an effective strategy is required. Menstruation-related taboos keep women and girls out of many areas of social and cultural life.2

 

For women and adolescent girls in developing nations, where access to clean water and sanitary facilities is frequently limited, managing menstruation hygiene can be especially difficult3. Being clean and hygienic during one's period is strongly linked to one's general health and should be taken very seriously by women. During menstruation, it is crucial for individuals to follow certain fundamental hygiene measures. Maintaining one's cleanliness during the monthly cycle requires specific practices. The unhygienic and poor practices can have a significant impact on the overall health of a woman.4

 

A report released by Water Aid claims that illnesses linked to inadequate access to water, basic sanitation, and hygiene killed nearly 800,000 women worldwide in a single year, ranking it as the fifth leading cause of death for women, after heart disease, stroke, lower respiratory tract infections, and chronic obstructive pulmonary disease.5

 

Young women's and girls' menstrual health outcomes are significantly influenced by their geographic location, economic standing, and educational attainment. The latest India 2019–2021 Health and Family Welfare Survey found that women utilise unsanitary menstruation methods of protection nearly three times as frequently as their urban counterparts.6

 

Menstrual cups are flexible, reusable device shaped like a bell that are used during menstruation. They are inserted into the vaginal canal to gather menstrual discharge effectively. Menstrual cups are usually made of flexible medical grade silicone, latex, or thermoplastic isomers.7

 

The Economic Times of India published a study on menstruation cups and global menstrual hygiene on May 28, 2019. The average woman's menstrual cycle lasts three to seven days. This indicates that a woman's life spans 6.25 years. During her menstrual cycle, a woman in India nowadays usually discards more than one lakh tampons or pads. A greater worry is the issue of sanitary waste disposal. Most disposal menstrual products such as pads and tampons contains up to 90% of plastic or non-degradable materials. The menstrual cups are being considered as a suitable and cost-effective option.8

 

Globally inadequate menstrual hygiene can hinder girl’s education and women’s workforce participation while also elevating the risk of urogenital infections and certain cancers when low quality sanitary products are used. The menstrual cup captures blood flow rather than absorbing it as with pad and tampons. Like tampons they are inserted into vagina, being emptied every 4-12 hours. There are currently two types of menstrual cups they are vaginal cup and cervical cup. The cervical cup, which is positioned around the cervix high in the vagina, resembles a diaphragm, while the vaginal cup is a bell-shaped one that is placed around the vagina.9

Proper menstrual hygiene involves using high-quality sanitary products and thoroughly cleaning the genital area, which is essential during menstruation. Women and girls of reproductive age need asses to water source and comfortable quality sanitary material which can protect their health; with this background the present study was conducted to evaluate the level of awareness and the source of menstrual cups among adolescent girls.10

 

OBJECTIVES:

1.     To assess the knowledge of adolescent girls regarding usage of menstrual cup in menstrual hygiene.

2.     To find the association between level of knowledge about usage of menstrual cup in menstrual hygiene among adolescent girls with their selected demographic variables.

3.     To develop an information booklet.

 

HYPOTHESIS:

H01-There is no significant association between the level of knowledge on usage of menstrual cup in menstrual hygiene with their selected demographic variables.

 

RESULT:

The research approach is Descriptive survey approach; the research design is Quantitative descriptive research design was used to the knowledge of adolescent girls regarding the usage of menstrual cup in menstrual hygiene in selected nursing institutions at Bangalore with the objective of develop an informative booklet. 100 adolescent girls aged between 18 and 19 years studying in selected nursing school were selected by convenient sampling technique. Self-administered questionnaire was employed collect the required data. The investigator used a structured questionnaire to elicit the knowledge of adolescent girls regarding the usage of menstrual cup in menstrual hygiene. Collected data was analyzed by using descriptive and inferential statistics.

 

The Present study reveals that out of 100 adolescent girls’ majority 68 (68.0%) of the adolescent girls had moderate level of knowledge,31 (31.0%) had inadequate knowledge and only 1 (0.01%) demonstrate adequate knowledge. The study reveals that the mean level of knowledge in menstruation was 6.37 with SD 14.3 with mean percentage 63.7 and SD percentage 14.3. Mean level of knowledge in menstrual hygiene was 6.24 with SD 1.40 with mean percentage 62.4 and SD percentage 14.0. Mean knowledge level of menstrual cup was 5.49 with SD 1.76, with mean percentage 45.8 and SD percentage 14.7. This study indicate adolescent girls require education on use of menstrual cup for effective menstrual hygiene management.

 

The analysis of the data is organized and presented under the following headings:

Section A: Frequency and percentage distribution of socio-demographic variables.

Section B: Level of knowledge on usage of menstrual cup in menstrual hygiene

Section C: Aspect wise level of knowledge of adolescent girls regarding usage of menstrual cup

Section D: Association between level of knowledge on usage of menstrual cup with selected demographic variables

 

Section A: Frequency and percentage distribution of socio-demographic variables.

Among 100 participant’s majority 65 participants (65 %) were falling in the age group of 18 years and 35 (35 %) in the age group of 19 years. Among them 55 (55 %) had attained their menarche in the age of 13 years, 28 (28 %) attained their menarche on 14 years, 13 participants (13 %) attained above 14 years and 4 participants (04.0 %) attained their menarche below 12 years of age. With regards to religion majority 63 participants (63%) were Hindus,25 participants (25 %) were Muslims and remaining 12 participants (12 %) were belonging to Christians. In place of living majority 48 (48 %) were living in rural area,39 (39 %) were from urban area,7 (07.0 %) belongs to tribal community and 6 (06.0 %) belongs to semi urban area. Out of 100 adolescent girls 57 (57 %) were from nuclear family, 42 participants (42%) were from joint family and one person (01.0 %) was from single parent family. With regards to number of females in the family 40 participants (40 %) were from family were number of females were two,32 participants (32 %) were from family with one female,15 participants (15 %) where from family with three females and 13 (13 %) had more than three females in their family. Regarding income 49 participants (49%) were having a monthly income between Rs11000 - 15000, 26 participants (26 %) with monthly income Rs 5000-10000, 23 participants (23%) with monthly income of Rs 16000-20000 and 2 participants (0.2 %) with monthly income above 21000.

 

Regard to the menstrual irregularities, majority of the participants 56 (56 %) were having menstrual irregularities and 44 (44 %) were not having menstrual irregularities. Among 100 adolescent girls 51 (51 %) were having duration of menstrual flow for 4-5 days, 23 (23 %) were having menstrual flow for 6-7 days, 23 with more than 7 days of flow and 3 participants (03.0 %) with 2-3 days of flow. With regards to method of disposal of sanitary napkin the majority participants 77 (77 %) dumped the used sanitary napkin, 22 (22 %) throw outside and one participant directly burned the used sanitary napkins. Out of 100 participants 58 (58 %) got prior information regarding menstrual cup and 42 (42 %) doesn’t have any information. Out of 100 participants 42 participants (42.0 %) does not receive any previous information,31 (31 %) got information from mass media and 27 (27%) received information from friends and relatives.

 

Section B: Level of knowledge on usage of menstrual cup in menstrual hygiene:

 

Figure 1: Bar diagram representing the knowledge score of participants.

 

The data in the figure (1) reveals that out of 100 adolescent girls’ majority 68 (68.0%) of the adolescent girls had moderate knowledge, 31 (31.0%) had inadequate knowledge and 1 (0.01%) have adequate knowledge.

 

Section C: Aspect wise level of knowledge of adolescent girls regarding usage of menstrual cup:

The table-1 reveals that mean level of knowledge in menstruation was 6.37 with SD 14.3 with mean percentage 63.7 and SD percentage 14.3. Mean level of knowledge in menstrual hygiene was 6.24 with SD 1.40 with mean percentage 62.4 and SD percentage 14.0. Mean knowledge level of menstrual cup was 5.49 with SD 1.76, with mean percentage 45.8 and SD percentage 14.7. The high mean score of knowledge is in the aspect of general information on menstruation compared to menstrual hygiene and usage menstrual cup

 

Table-1:

Knowledge aspects

Statements

Max Score

Knowledge score

Mean

SD

Mean (%)

SD (%)

General information on menstruation

10

10

6.37

1.43

63.7

14.3

Menstrual hygiene

10

10

6.24

1.40

62.4

14.0

Usage of Menstrual Cup

12

12

5.49

1.76

45.8

14.7

Combined

32

32

18.10

2.90

56.6

9.1

Section D: The association between level of knowledge on usage of menstrual cup in menstrual hygiene among adolescent girls with their selected demographic variables.

 

Table-2:

Demogaphic Variables

Category

Sample

Knowledge level

X2 Value

P Value

Inadequate

Adequate

N

%

N

%

Age

18

65

17

54.8

48

69.6

2.039

0.153(NS)

19

35

14

45.2

21

30.4

Age Menarche

<12 Yrs

04

02

6.5

02

2.9

1.388

0.708(NS)

13 Yrs

55

15

48.4

40

58.0

14 Yrs

28

09

29.0

19

27.5

>14 Yrs

13

05

16.1

08

11.6

Religion

Hindu

63

17

54.8

46

66.7

1.452

0.484(NS)

Muslim

25

10

32.3

15

21.7

Christian

12

04

12.9

08

11.6

Place of Living

Rural

48

19

61.3

29

42.0

5.406

0.144(NS)

Urban

39

11

35.5

28

40.6

Tribal

07

01

3.2

06

08.7

Semi Urban

06

00

0.00

06

08.7

Type of family

Joint

42

12

38.7

30

43.5

0.710

0.701(NS)

Nuclear

57

19

61.3

38

55.1

Extended

01

0

0.00

01

1.4

Number of females in family

1

32

10

32.3

22

31.9

2.108

0.550(NS)

2

40

10

32.3

30

43.5

3

15

05

16.1

10

14.5

>3

13

06

19.4

07

10.1

Income

Rs5000-Rs10000

26

08

25.8

18

26.1

1.573

0.666(NS)

Rs10001-Rs15000

49

17

54.8

32

46.4

 

 

Rs15001-Rs. 20000

23

05

16.1

18

26.1

 

 

Above Rs.2000

02

01

3.2

1

1.4

 

 

Irregular Menstrual

Yes

56

15

48.4

41

59.4

1.057

0.304

No

44

16

51.6

28

40.6

 

 

Duration of Menstrual flow

2-3 days

03

01

3.2

02

2.9

4.561

0.207(NS)

4-5 days

51

19

61.3

32

46.4

 

 

6-7 days

23

8

25.8

15

21.7

 

 

More than 7 days

23

3

9.7

20

29.0

 

 

Method of disposal of sanitary Napkin

Directly burnt

01

0

0.0

1

1.4

0.670

0.715(N)

Throw outside

22

06

19.4

16

23.2

 

 

Dumped

77

25

80.6

52

75.4

 

 

Information about Menstrual Hygiene

Yes

58

18

58.1

40

58.0

0.0001

0.993(NS)

No

42

13

41.9

29

42.0

 

 

Note: S- significant p (p<0.05); NS- Not Significant (P>0.05).

Above table Shows that majority of the demographic variables are non-significant

 

DISCUSSION:

The data in the study reveals that out of 100 adolescent girl’s majority 68 (68.0%) of the adolescent girls had moderate knowledge,31 (31.0%) had inadequate knowledge and 1 (0.01%) have adequate knowledge. The chi-square analysis was carried out to determine the association between level of knowledge on usage of menstrual cup in menstrual hygiene among adolescent girls with their selected demographic variables and it is found to be associated with one variable that is menstrual irregularities whereas other variables like  age, age of menarche, religion, place of living, type of family, number of females in family, monthly income,  duration of menstrual flow, method of disposal of sanitary napkin and information about menstrual hygiene were not statistically significant. The result of chi-square analysis indicated that since there is one variable which is significant so there is significant association of knowledge with their selected variables. Hence the null hypothesis (H01) was rejected.

 

The above finding was supported by the following study:

A cross-sectional study was conducted in Urban area of south Kerala in 2021 among females of reproductive age group to assess the knowledge, attitude and practices regarding menstrual cups use and the relation with associated factors. The results shown that among study participants 22.6% had lack of knowledge and 56.2% had fear of insertion were the major reason for not trying a menstrual cup. The study concluded that two third of the participants had good knowledge regarding menstrual cup, but only 15.1% had tried to use menstrual cup due to fear of insertion and lack of knowledge for trying a menstrual cup. Younger age and higher educational qualification were found to be inadequately associated with knowledge level regarding menstrual cup.

NURSING IMPLICATIONS OF THE STUDY:

Nursing Education:

The study had showed that there is a need to improve the knowledge regarding the usage of menstrual cup in menstrual hygiene, to impact his knowledge and skill the nursing personnel need be equipped with adequate knowledge and skill regarding usage of menstrual cup in menstrual hygiene.

 

Nursing Practice:

Nurses are the key personnel of a health team, who play a major role in the promotion and maintenance of health. The nurse need to have thorough knowledge regarding the use of menstrual cup in menstrual hygiene so that she can conduct health education sessions in the hospitals and community areas.

 

Nursing Administration:

The nurse administrator should encourage the nursing staff to use their knowledge and skills in bringing out adolescent girls with adequate knowledge regarding the usage of menstrual cup in menstrual hygiene. Nurse administrators can be able to take the initiative in imparting information through different method.

 

Recommendations for the Further Study:

A similar type of study can be conducted in a larger population.

 

A similar study can be conducted in different settings.

 

A similar study can be conducted by selecting a different sample.

 

A similar study can be conducted in rural or urban areas.

 

A comparative study can be conducted between the effect of nursing interventional package versus structured teaching program.

 

DELIMITATIONS:

The study is delimited for four weeks only

 

The study is delimited to adolescent girls aged 18 and 19 years.

 

The study is delimited to adolescent girls who are studying in selected nursing school.

 

The study is delimited to 100 samples.

 

CONCLUSION:

A menstrual cup is a modern device mainly used for menstrual hygiene practices. The incidence of usage of menstrual cup among adolescent girls is very less due to inadequate knowledge about it. The study reveals that the majority 68 (68.0%) of the adolescent girls had moderate knowledge, 31 (31.0%) had inadequate knowledge This shows that adolescent girls are in need of education on the usage of menstrual cup in menstrual hygiene.

 

CONFLICT OF INTEREST:

None.

 

ACKNOWLEDGMENT:

I express my sincere appreciation and gratitude to Principal, Department HOD Cum Guide Prof. J. Vijayalakshmi, Co-faculties and all those who helped us to complete this study peacefully.

 

REFERENCES:

1.        Adele Pillitteri, Maternal and Child Health Nursing, 4th edition, 2003. Page no: 905.

2.        Nandini Sahay, Myths and Misconceptions about menstruation. Journal of Family Medicine and Family Care. 2020, Available from: https://WWW.researchgate.

3.        Dasgupta. A, Sankar.M. Menstrual hygiene: How hygienic is the adolescent girls. Indian J Community Med [serial online] 2008 [cited 2021 Jun 25]; Available from URL: https;//www.ijcm.org.in/text.2008/33/2/77/40872.

4.        Sanghamitra Singh. Menstrual hygiene day 2022: Normalizing menstruation in India; June 10 2022. Available from URL: https://www.google.com.

5.        Priyanka Tanwr, Kalpana Apte. No access to menstrual hygiene is fifth biggest killer of women in the world. India Today. June 20 2019; Available from URL: https://www.indiatoday.in.

6.        Ellen Mc Cammon, Suchi Bansal Luciana E. Hebert, et al. Exploring young women’s menstruation related challenges. Articles from Sexual and Reproductive Health Matters (a newspaper article from times of India in May 28 2022).

7.        Menstrual cup. Available from URL: https://www.wikipedia.org.

8.        Tanushree Banerjee. World menstrual hygiene and menstrual cup. The Economic Times; 2019.Available from URL: https://economictimes.indiatimes.com.

9.        Anna Maria Van, Linda Mason, Muthusamy Sivakami et al. Menstrual cup use, leakage, acceptability. The Lancet Public Health; July 16 2019. Available from URL: http://www.eurekalert.org.

10.      Menstrual Hygiene Management Enables women and girls to reach their full potential. Washington (DC): World Bank; 2018 May 25.

 

 

 

 

Received on 03.07.2025         Revised on 09.08.2025

Accepted on 12.09.2025         Published on 03.11.2025

Available online from November 12, 2025

A and V Pub J. of Nursing and Medical Res. 2025;4(4):125-129.

DOI: 10.52711/jnmr.2025.28

©A and V Publications All right reserved

 

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.