Menstrual Hygiene Practices and Their Physical, Social, and Environmental Impact in Women's Lives: A Study of 2,000 Women Reporting to a Tertiary Care Hospital in Pakistan

Abstract

Objective: To evaluate menstrual hygiene practices and their association with physical, social, and environmental outcomes among women attending a tertiary care hospital in Pakistan.

Methodology: This cross-sectional study was conducted at a tertiary care hospital in Islamabad, Pakistan, from July to December 2025. A total of 2,000 women aged 15–50 years were selected through stratified random sampling. Data on menstrual hygiene practices, physical health outcomes, social consequences, and menstrual waste disposal were collected using a structured questionnaire. Associations were assessed using chi-square tests, while multivariable logistic regression identified independent predictors of adverse outcomes. A p-value <0.05 was considered statistically significant.

Results: Of the 2,000 participants, 68% used sanitary pads, 25% used cloth, and 7% used other absorbents. One-quarter reported irregular absorbent changing, and 30% bathed less than once daily during menstruation. Cloth use and irregular absorbent changing were significantly associated with higher frequencies of reproductive tract infections, urinary tract infections, skin irritation, stigma, absenteeism, and unsafe menstrual waste disposal (p<0.05). Multivariable analysis showed that cloth use independently increased the odds of reproductive tract infections (AOR=2.12, 95% CI:1.62–2.78), urinary tract infections (AOR=1.76, 95% CI:1.28–2.42), and absenteeism (AOR=1.92, 95% CI:1.38–2.70). Low socioeconomic status independently predicted stigma (AOR=2.33, 95% CI:1.65–3.40) and unsafe disposal practices (AOR=2.74, 95% CI:1.90–3.98).

Conclusion: Poor menstrual hygiene practices, particularly cloth use and infrequent absorbent changing, are significantly associated with adverse physical, social, and environmental outcomes. Improving access to affordable menstrual hygiene products, health education, and safe waste disposal systems may reduce these risks and improve women's reproductive health and well-being.