Awareness about menstruation and period pain lacking in India

Health Care, Heart Care Foundation of India, Medicine Comments Off

Girls in rural areas, in particular, miss school during the period days and subjected to stigma

New Delhi, 9th January 2019: Recent research indicates that about 71% of girls in India do not know anything about menstruation before their first period. The lack of awareness around her first period can put a young girl, sometimes as young as 10, through mental trauma and fear over what is happening to her. This when combined with a sense of shame that is instilled by the age-old stigma around a menstruating woman, can prove debilitating.

Approximately 80% of girls in rural India miss school for three to four days a month, coinciding with the start of menstruation. This is given the lack of awareness about usage of sanitary pads. A cloth is prone to leakage and staining and does not keep a girl comfortable or safe from infection during those days. The reasons for lack of sanitary napkins are many, affordability just being one of them.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI and Dr Anita Kant Sr Gynaecologist Faridabad said, “The myths and associated stigma surrounding menstruation are one of the many issues that girls and women face in India. In the rural areas, women and girls are still not allowed to discuss pain or other issues related to menstruation openly. They thus tend to suffer in isolation and skip school, college, and work. Menstrual hygiene must be inculcated in them as early as possible. Lack of hygienic methods can lead to infections and even cervical cancer going forward. Apart from this, it is imperative to normalize periods as something as regular and common as any other bodily process.”

Studies indicate that even mothers (about 70% of them!) consider menstruation as ‘dirty’ and ‘polluting’. They do not speak to their daughters about the subject or address their concerns.

Adding further, Dr Maj Prachi Garg Secretary IMA New Delhi Branch said, “The subject of menstruation, hygiene, etc. should not just be restricted to the female members of a household. There is a need to create awareness among the men in the family as well. It is also imperative to create an enabling environment in schools to educate girls and boys alike on this topic, especially in the rural areas.”

Some basic menstrual hygiene tips from HCFI

  • · Be it sanitary napkins, tampons, or menstrual cups, choose what you are comfortable in. Stick to one brand for one type of protection and understand if it suits you. Frequently switching brands can make you uncomfortable particularly because they address different kinds of flow and frequency.
  • · It is imperative to change the sanitary pad every 3 to 4 hours at least in the first two days. When blood stays for a long time in contact with air, it produces an unpleasant odour. Apart from this, it can also harbour microorganisms and cause infections of the urinary tract and vagina, apart from skin rashes.
  • · Avoid leaving tampons on for a long time as they can lead to what is called the toxic shock syndrome (TSS). It is a condition where bacteria infiltrate the body and cause severe infection that can send the body into shock.
  • · Clean yourself to keep away from infections and avoid bad odor. It is important to wash the vagina and labia well before you change into a new pad. If you cannot wash yourself before you change make sure to wipe off the areas using toilet paper or tissue.
  • · Do not use soaps or vaginal hygiene products. Soap can kill the good bacteria and make way for infections.
  • · Discard the used sanitary product properly. Used products can spread infections and can smell foul.

Rakesh Roshan diagnosed with early stage squamous cell throat carcinoma

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Yet another noted film personality has been diagnosed with cancer. After Irrfan Khan, Sonali Bendre, Nafisa Ali, now actor and filmmaker Rakesh Roshan has been diagnosed with early stage squamous cell carcinoma of throat and he will have undergone surgery for the same yesterday, as reported in TOI. The diagnosis was shared by his son, Hrithik Roshan, on social media.

What is squamous cell throat carcinoma? Let’s take a quick recap here:

  • Most throat cancers are squamous cell carcinomas (90-95%).
  • They can be categorized as well differentiated (>75% keratinization), moderately differentiated (25-75% keratinization) and poorly differentiated (< 25% keratinization) tumors.
  • Verrucous carcinoma (a variant of squamous cell carcinoma), adenocarcinoma, adenoid cystic carcinoma and mucoepidermoid carcinomas are other less common histologies.
  • Tobacco (smoked and smokeless) is the most important known risk factor for the development of the cancer.
  • Tobacco and alcohol consumption have a synergistic effect. The repeated exposure of the mucosa of the upper aerodigestive tract to tobacco, alcohol, or both appears to cause multiple primary and secondary tumors in this “condemned mucosa,” a phenomenon described as “field cancerization.”
  • Human papillomavirus (HPV) infection, a sexually transmitted virus, is also a causative agent. HPV-associated oropharyngeal cancer typically presents in younger patients without a history of excessive exposure to alcohol and tobacco. It has a better prognosis and response to therapy than HPV-negative disease.
  • Other risk factors include betel nut chewing, radiation exposure, vitamin deficiencies, periodontal disease, immunosuppression and other environmental and occupational exposures.
  • Squamous cell carcinoma often develops from premalignant lesions due to carcinogen exposure. Clinical signs are leukoplakia and erythroplakia. Histopathologically, dysplasia is associated with progression to invasive cancer in 15-30% of cases.

o   Leukoplakia is characterized by hyperparakeratosis and is usually associated with underlying epithelial hyperplasia. The chances of malignant transformation is <5%, if there are no underlying dysplastic changes.

o   Erythroplakia is characterized by red superficial patches adjacent to normal mucosa. It is commonly associated with epithelial dysplasia and is associated with carcinoma in situ or invasive tumor in up to 40% of cases

  • HPV tumor status should be determined for all cases of newly diagnosed oropharyngeal squamous cell carcinoma but not for the routine evaluation of nonsquamous carcinoma of the oropharynx or nonoropharyngeal squamous cell carcinoma of the head and neck. It may be useful in select cases of oropharyngeal cancer with uncertain histology.
  • Symptoms include hoarseness of voice, difficulty swallowing or feeling that something is caught in the throat, persistent sore throat, cough, unexplained weight loss, ear pain.
  • Diagnostic methods are biopsy of the lesion, imaging tests (CT, MRI, PET), barium swallow
  • Treatment: Surgery (minimally invasive or endoscopic, transoral laser microsurgery), chemotherapy and/or radiation therapy

(Source: Uptodate, MD Anderson Cancer Center)

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA