Acceso y prácticas de higiene menstrual en América Latina: revisión de alcance

revisión de alcance de la literatura con protocolo de investigación registrado en el Open Science Framework, realizada en las bases de datos bibliográficas: PubMed, Scopus, Web of Science y Portal Regional da Biblioteca Virtual em Saúde. Los datos fueron analizados mediante estadística descriptiva simple y análisis temático.

Resultados:

se incluyeron 15 publicaciones, la mayoría de las cuales trataban sobre adolescentes en Brasil: 12 artículos, dos informes técnicos y una monografía de trabajo de conclusión de curso. Como temas recurrentes en las publicaciones se destacan: acceso a condiciones dignas para el manejo de la higiene menstrual; necesidad de acceso a información sobre el manejo de la higiene menstrual; y prácticas para el manejo de la higiene menstrual.

Conclusión:

adolescentes informan dificultades para acceder a baños, agua y materiales absorbentes, y falta de información sobre la salud menstrual, incluso en las escuelas, lo que lleva al ausentismo escolar. De esta manera, las lagunas en la literatura científica latinoamericana revelan desigualdades y diversidad en las experiencias menstruales interseccionadas por categorías como género, clase social y etnia.

Descriptores:
Conocimientos; Actitudes y Práctica en Salud; Productos para la Higiene Menstrual; Menstruación; Enfermería en Salud Pública; Salud Reproductiva; Revisión

Destacados:

(1) Falta de acceso a productos de higiene, baños y agua para la higiene corporal.

(2) Invisibilidad del problema de la pobreza menstrual en América Latina.

(3) Falta de estructura física en las escuelas agrava y conduce al ausentismo escolar.

(4) Letramiento en salud menstrual fue insuficiente para las demandas de las adolescentes.

(5) Estudios primarios sobre higiene menstrual en Latinoamérica son escasos.

País/Año de Publicación	Diseño del estudio	Participantes	Grupo de edad	Principales hallazgos
México/2012 ⁽ ²⁶26. Marván ML, Molina-Abolnik M. Mexican adolescents’ experience of menarche and attitudes toward menstruation: role of communication between mothers and daughters. J Pediatr Adolesc Gynecol. 2012;25:358-63. https://doi.org/10.1016/j.jpag.2012.05.003 https://doi.org/10.1016/j.jpag.2012.05.0... ⁾	Transversal	405 adolescentes	12 a 15 años	Acceso a la información
Bolivia y Argentina/2013 ⁽ ¹⁴14. Sommer M, Kjellén M, Pensulo C. Girls’ and women’s unmet needs for menstrual hygiene management (MHM): the interactions between MHM and sanitation systems in low-income countries. J Water Sanitat Hyg Dev. 2013;3:283-97. https://doi.org/10.2166/washdev.2013.101 https://doi.org/10.2166/washdev.2013.101... ⁾	Mixto (revisión sistemática/transversal)	21 gestores de Saneamiento Básico	SI‡ Acceso al MHM*
Brasil/2013 ⁽ ²⁷27. Bardin MG, Giraldo PC, Pinto CLB, Piassaroli VP, Amaral RLG, Polpeta N. Association of sanitary pads and clothing with vulvovaginitis. Braz J Sexually Transm Dis [Internet]. 2013 [cited 2022 Nov 10];25(3):123-7. Available from: https://bjstd.org/revista/article/view/350 https://bjstd.org/revista/article/view/3... ⁾	Cohorte	307 mujeres	18 a 45 años	Prácticas de higiene menstrual
Bolivia/2013 ⁽ ²⁸28. Long JL, Caruso BA, Lopez D, Vancraeynest K, Sahin M, Andes KL, et al. WASH in schools empowers girls’ education in rural Cochabamba, Bolivia: an assessment of menstrual hygiene management in schools [Internet]. New York, NY: United Nations Children’s Fund; 2013 [cited 2022 Nov 7]. Available from: https://resourcecentre.savethechildren.net/document/wash-schools-empowers-girls-education-rural-cochabamba-bolivia-assessment-menstrual-hygiene/ https://resourcecentre.savethechildren.n... ⁾	Cualitativo	157 personas (adolescentes, madres, profesores)	SI‡ Acceso a la información y al MHM*
México/2014 ⁽ ²⁹29. Marván ML, Alcalá-Herrera V. Age at menarche, reactions to menarche and attitudes towards menstruation among mexican adolescent girls. J Pediatr Adolesc Gynecol. 2014;27:61-6. https://doi.org/10.1016/j.jpag.2013.06.021 https://doi.org/10.1016/j.jpag.2013.06.0... ⁾	Transversal	602 niñas adolescentes	11 a 16 años	Acceso a la información y al MHM*
Colombia/2017 ⁽ ³⁰30. Ariza-Ruiz LK, Espinoza-Menéndez MJ, Rodriguez-Hernández JM. Challenges of menstruation in girls and adolescents from rural communities of the Colombian Pacific. Rev Salud Pública. 2017;19:833-41. https://doi.org/10.15446/rsap.v19n6.71741 https://doi.org/10.15446/rsap.v19n6.7174... ⁾	Mixto (transversal/cualitativo)	246 niñas adolescentes	14 a 15 años	Acceso a la información y al MHM*
Haití/2017 ⁽ ³¹31. Coker-Bolt P, Jansson A, Bigg S, Hammond E, Hudson H, Hunkler S, et al. Menstrual education and personal hygiene supplies to empower young women in Haiti. OTJR. 2017;37:210-7. https://doi.org/10.1177/1539449217719866 https://doi.org/10.1177/1539449217719866... ⁾	Cohorte	101 mujeres y 49 universitarias	18 a 24 años (Universitarias)	Acceso y prácticas de MHM*
Belice/2017 ⁽ ³²32. Khan SM, Bain RES, Lunze K, Unalan T, Beshanski-Pedersen B, Slaymaker T, et al. Optimizing household survey methods to monitor the Sustainable Development Goals targets 6.1 and 6.2 on drinking water, sanitation and hygiene: A mixed-methods field-test in Belize. PLoS One. 2017;12:e0189089. https://doi.org/10.1371/journal.pone.0189089 https://doi.org/10.1371/journal.pone.018... ⁾	Mixto (transversal/cualitativo)	429 familias y 246 mujeres	15 a 49 años	Acceso al MHM*
Brasil/2018 ⁽ ³²32. Khan SM, Bain RES, Lunze K, Unalan T, Beshanski-Pedersen B, Slaymaker T, et al. Optimizing household survey methods to monitor the Sustainable Development Goals targets 6.1 and 6.2 on drinking water, sanitation and hygiene: A mixed-methods field-test in Belize. PLoS One. 2017;12:e0189089. https://doi.org/10.1371/journal.pone.0189089 https://doi.org/10.1371/journal.pone.018... ⁾	Cualitativo	39 adolescentes	12 a 17 años	Acceso al MHM*
Brasil/2018 ⁽ ³⁴34. Ernandes CC, Cruz RC, Weber MAA. A quebra de tabus sobre menstruação e práticas sustentáveis [Trabalho de Conclusão de Curso]. São Gabriel: Universidade Federal do Pampa; 2018 [cited 2022 Nov 10]. Available from: https://dspace.unipampa.edu.br/handle/riu/4529 https://dspace.unipampa.edu.br/handle/ri... ⁾	Transversal	66 mujeres	17 a 43 años	Prácticas de higiene menstrual
Brasil/2020 ⁽ ³⁵35. Araujo MP, Brigido BP, Chimello L, Sartori MG, Ejnisman B, Pochini AC. Evaluation of the safety and comfort of menstrual cup during physical exercise: a prospective cohort study. Femina [Internet]. 2020 [cited 2022 Nov 10];48(11):680-4. Available from: https://docs.bvsalud.org/biblioref/2020/12/1140184/femina-2020-4811-680-684.pdf#:~:text=A%20inser%C3%A7%C3%A3o%20e%20a%20remo%C3%A7%C3%A3o,p%20%3E%200%2C05 https://docs.bvsalud.org/biblioref/2020/... ⁾	Cohorte	49 jóvenes universitarias	19 a 30 años	Prácticas de higiene menstrual
Brasil/2021 ⁽ ³⁶36. Santos CCM. Pobreza menstrual no Brasil: desigualdade e violações de direito [Internet]. Brasília: Fundo de População das Nações Unidas; Fundo das Nações Unidas para a Infância; 2021 [cited 2022 Nov 7]. Available from: https://www.unicef.org/brazil/relatorios/pobreza-menstrual-no-brasil-desigualdade-e-violacoes-de-direitos https://www.unicef.org/brazil/relatorios... ⁾	Cuantitativo	118,628 adolescentes	13 a 18 años	Acceso al MHM*
Brasil/2021 ⁽ ³⁷37. Soeiro RE, Rocha L, Surita FG, Bahamondes L, Costa ML. Period poverty: menstrual health hygiene issues among adolescent and young Venezuelan migrant women at the northwestern border of Brazil. Reprod Health. 2021;18:238. https://doi.org/10.1186/s12978-021-01285-7 https://doi.org/10.1186/s12978-021-01285... ⁾	Transversal	167 niñas adolescentes	12 a 24 años	Acceso al MHM*
México/2022 ⁽ ³⁸38. Long JL, Haver J, Mendoza P, Kotasek SMV. The more you know, the less you stress: menstrual health literacy in schools reduces menstruation-related stress and increases self-efficacy for very young adolescent girls in Mexico. Front Glob Womens Health. 2022;3:859797. https://doi.org/10.3389/fgwh.2022.859797 https://doi.org/10.3389/fgwh.2022.859797... ⁾	Cohorte	193 niñas adolescentes	5to y 6to grado†	Acceso a la información
Brasil/2022 ⁽ ³⁹39. Rocha L, Soeiro R, Gomez N, Costa ML, Surita FG, Bahamondes L. Assessment of sexual and reproductive access and use of menstrual products among Venezuelan migrant adult women at the Brazilian-Venezuelan border. J Migration Health. 2022;5:100097. https://doi.org/10.1016/j.jmh.2022.100097 https://doi.org/10.1016/j.jmh.2022.10009... ⁾	Transversal	177 mujeres	18 a 49 años	Acceso al MHM*

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Autor de correspondencia:
Mariana Santos Felisbino-Mendes E-mail: marianafelisbino@yahoo.com.br https://orcid.org/0000-0001-5321-5708

Temas de los estudios sobre higiene menstrual en América Latina y el Caribe
Acceso a la información para el manejo de higiene menstrual
Falta de información sobre formas de manejo de la menstruación ⁽ ²⁹29. Marván ML, Alcalá-Herrera V. Age at menarche, reactions to menarche and attitudes towards menstruation among mexican adolescent girls. J Pediatr Adolesc Gynecol. 2014;27:61-6. https://doi.org/10.1016/j.jpag.2013.06.021 https://doi.org/10.1016/j.jpag.2013.06.0... ^- ³⁰30. Ariza-Ruiz LK, Espinoza-Menéndez MJ, Rodriguez-Hernández JM. Challenges of menstruation in girls and adolescents from rural communities of the Colombian Pacific. Rev Salud Pública. 2017;19:833-41. https://doi.org/10.15446/rsap.v19n6.71741 https://doi.org/10.15446/rsap.v19n6.7174... ⁾; diálogo entre adolescentes y las madres proporciona actitudes positivas con relación al MHM ⁽ ²⁶26. Marván ML, Molina-Abolnik M. Mexican adolescents’ experience of menarche and attitudes toward menstruation: role of communication between mothers and daughters. J Pediatr Adolesc Gynecol. 2012;25:358-63. https://doi.org/10.1016/j.jpag.2012.05.003 https://doi.org/10.1016/j.jpag.2012.05.0... ⁾; intervenciones dirigidas a aumentar el conocimiento sobre MHM ⁽ ³⁸38. Long JL, Haver J, Mendoza P, Kotasek SMV. The more you know, the less you stress: menstrual health literacy in schools reduces menstruation-related stress and increases self-efficacy for very young adolescent girls in Mexico. Front Glob Womens Health. 2022;3:859797. https://doi.org/10.3389/fgwh.2022.859797 https://doi.org/10.3389/fgwh.2022.859797... ⁾; incomodidad en la búsqueda de información y orientación sobre MHM ⁽ ²⁸28. Long JL, Caruso BA, Lopez D, Vancraeynest K, Sahin M, Andes KL, et al. WASH in schools empowers girls’ education in rural Cochabamba, Bolivia: an assessment of menstrual hygiene management in schools [Internet]. New York, NY: United Nations Children’s Fund; 2013 [cited 2022 Nov 7]. Available from: https://resourcecentre.savethechildren.net/document/wash-schools-empowers-girls-education-rural-cochabamba-bolivia-assessment-menstrual-hygiene/ https://resourcecentre.savethechildren.n... ⁾.
Acceso a condiciones dignas para el manejo de la higiene menstrual
Dificultad para acceder a baños, privacidad, agua limpia y materiales absorbentes ⁽ ¹⁴14. Sommer M, Kjellén M, Pensulo C. Girls’ and women’s unmet needs for menstrual hygiene management (MHM): the interactions between MHM and sanitation systems in low-income countries. J Water Sanitat Hyg Dev. 2013;3:283-97. https://doi.org/10.2166/washdev.2013.101 https://doi.org/10.2166/washdev.2013.101... ^, ³⁷37. Soeiro RE, Rocha L, Surita FG, Bahamondes L, Costa ML. Period poverty: menstrual health hygiene issues among adolescent and young Venezuelan migrant women at the northwestern border of Brazil. Reprod Health. 2021;18:238. https://doi.org/10.1186/s12978-021-01285-7 https://doi.org/10.1186/s12978-021-01285... ^, ³⁹39. Rocha L, Soeiro R, Gomez N, Costa ML, Surita FG, Bahamondes L. Assessment of sexual and reproductive access and use of menstrual products among Venezuelan migrant adult women at the Brazilian-Venezuelan border. J Migration Health. 2022;5:100097. https://doi.org/10.1016/j.jmh.2022.100097 https://doi.org/10.1016/j.jmh.2022.10009... ⁾, incluso en la escuela ⁽ ³⁰30. Ariza-Ruiz LK, Espinoza-Menéndez MJ, Rodriguez-Hernández JM. Challenges of menstruation in girls and adolescents from rural communities of the Colombian Pacific. Rev Salud Pública. 2017;19:833-41. https://doi.org/10.15446/rsap.v19n6.71741 https://doi.org/10.15446/rsap.v19n6.7174... ^, ³³33. Coswosk ÉD, Neves-Silva P, Modena CM, Heller L. Having a toilet is not enough: the limitations in fulfilling the human rights to water and sanitation in a municipal school in Bahia, Brazil. BMC Public Health. 2019;19:137. https://doi.org/10.1186/s12889-019-6469-y https://doi.org/10.1186/s12889-019-6469-... ^, ³⁶36. Santos CCM. Pobreza menstrual no Brasil: desigualdade e violações de direito [Internet]. Brasília: Fundo de População das Nações Unidas; Fundo das Nações Unidas para a Infância; 2021 [cited 2022 Nov 7]. Available from: https://www.unicef.org/brazil/relatorios/pobreza-menstrual-no-brasil-desigualdade-e-violacoes-de-direitos https://www.unicef.org/brazil/relatorios... ⁾; experiencia de pesar y vergüenza durante el período menstrual relacionada con la dificultad para el MHM ⁽ ²⁹29. Marván ML, Alcalá-Herrera V. Age at menarche, reactions to menarche and attitudes towards menstruation among mexican adolescent girls. J Pediatr Adolesc Gynecol. 2014;27:61-6. https://doi.org/10.1016/j.jpag.2013.06.021 https://doi.org/10.1016/j.jpag.2013.06.0... ^, ³⁷37. Soeiro RE, Rocha L, Surita FG, Bahamondes L, Costa ML. Period poverty: menstrual health hygiene issues among adolescent and young Venezuelan migrant women at the northwestern border of Brazil. Reprod Health. 2021;18:238. https://doi.org/10.1186/s12978-021-01285-7 https://doi.org/10.1186/s12978-021-01285... 38. Long JL, Haver J, Mendoza P, Kotasek SMV. The more you know, the less you stress: menstrual health literacy in schools reduces menstruation-related stress and increases self-efficacy for very young adolescent girls in Mexico. Front Glob Womens Health. 2022;3:859797. https://doi.org/10.3389/fgwh.2022.859797 https://doi.org/10.3389/fgwh.2022.859797... ^- ³⁹39. Rocha L, Soeiro R, Gomez N, Costa ML, Surita FG, Bahamondes L. Assessment of sexual and reproductive access and use of menstrual products among Venezuelan migrant adult women at the Brazilian-Venezuelan border. J Migration Health. 2022;5:100097. https://doi.org/10.1016/j.jmh.2022.100097 https://doi.org/10.1016/j.jmh.2022.10009... ⁾ y al ausentismo escolar ⁽ ²⁸28. Long JL, Caruso BA, Lopez D, Vancraeynest K, Sahin M, Andes KL, et al. WASH in schools empowers girls’ education in rural Cochabamba, Bolivia: an assessment of menstrual hygiene management in schools [Internet]. New York, NY: United Nations Children’s Fund; 2013 [cited 2022 Nov 7]. Available from: https://resourcecentre.savethechildren.net/document/wash-schools-empowers-girls-education-rural-cochabamba-bolivia-assessment-menstrual-hygiene/ https://resourcecentre.savethechildren.n... ^, ³⁰30. Ariza-Ruiz LK, Espinoza-Menéndez MJ, Rodriguez-Hernández JM. Challenges of menstruation in girls and adolescents from rural communities of the Colombian Pacific. Rev Salud Pública. 2017;19:833-41. https://doi.org/10.15446/rsap.v19n6.71741 https://doi.org/10.15446/rsap.v19n6.7174... ^, ³⁶36. Santos CCM. Pobreza menstrual no Brasil: desigualdade e violações de direito [Internet]. Brasília: Fundo de População das Nações Unidas; Fundo das Nações Unidas para a Infância; 2021 [cited 2022 Nov 7]. Available from: https://www.unicef.org/brazil/relatorios/pobreza-menstrual-no-brasil-desigualdade-e-violacoes-de-direitos https://www.unicef.org/brazil/relatorios... ⁾; necesidad de políticas públicas para garantizar la dignidad para el MHM ⁽ ³¹31. Coker-Bolt P, Jansson A, Bigg S, Hammond E, Hudson H, Hunkler S, et al. Menstrual education and personal hygiene supplies to empower young women in Haiti. OTJR. 2017;37:210-7. https://doi.org/10.1177/1539449217719866 https://doi.org/10.1177/1539449217719866... ⁾; condición suficiente para el MHM ⁽ ³²32. Khan SM, Bain RES, Lunze K, Unalan T, Beshanski-Pedersen B, Slaymaker T, et al. Optimizing household survey methods to monitor the Sustainable Development Goals targets 6.1 and 6.2 on drinking water, sanitation and hygiene: A mixed-methods field-test in Belize. PLoS One. 2017;12:e0189089. https://doi.org/10.1371/journal.pone.0189089 https://doi.org/10.1371/journal.pone.018... ⁾.
Prácticas de higiene menstrual
Segregación de mujeres durante el período menstrual ⁽ ³¹31. Coker-Bolt P, Jansson A, Bigg S, Hammond E, Hudson H, Hunkler S, et al. Menstrual education and personal hygiene supplies to empower young women in Haiti. OTJR. 2017;37:210-7. https://doi.org/10.1177/1539449217719866 https://doi.org/10.1177/1539449217719866... ⁾, uso de toallas desechables para el MHM ⁽ ³⁴34. Ernandes CC, Cruz RC, Weber MAA. A quebra de tabus sobre menstruação e práticas sustentáveis [Trabalho de Conclusão de Curso]. São Gabriel: Universidade Federal do Pampa; 2018 [cited 2022 Nov 10]. Available from: https://dspace.unipampa.edu.br/handle/riu/4529 https://dspace.unipampa.edu.br/handle/ri... ⁾, no asociación entre el uso de toallas higiénicas y la presencia de vaginosis o candidiasis ⁽ ²⁷27. Bardin MG, Giraldo PC, Pinto CLB, Piassaroli VP, Amaral RLG, Polpeta N. Association of sanitary pads and clothing with vulvovaginitis. Braz J Sexually Transm Dis [Internet]. 2013 [cited 2022 Nov 10];25(3):123-7. Available from: https://bjstd.org/revista/article/view/350 https://bjstd.org/revista/article/view/3... ⁾, uso de copa menstrual para MHM ⁽ ³⁴34. Ernandes CC, Cruz RC, Weber MAA. A quebra de tabus sobre menstruação e práticas sustentáveis [Trabalho de Conclusão de Curso]. São Gabriel: Universidade Federal do Pampa; 2018 [cited 2022 Nov 10]. Available from: https://dspace.unipampa.edu.br/handle/riu/4529 https://dspace.unipampa.edu.br/handle/ri... ^- ³⁵35. Araujo MP, Brigido BP, Chimello L, Sartori MG, Ejnisman B, Pochini AC. Evaluation of the safety and comfort of menstrual cup during physical exercise: a prospective cohort study. Femina [Internet]. 2020 [cited 2022 Nov 10];48(11):680-4. Available from: https://docs.bvsalud.org/biblioref/2020/12/1140184/femina-2020-4811-680-684.pdf#:~:text=A%20inser%C3%A7%C3%A3o%20e%20a%20remo%C3%A7%C3%A3o,p%20%3E%200%2C05 https://docs.bvsalud.org/biblioref/2020/... ⁾.