Bloody Hell – It’s Menstrual Hygiene Day 2022!!

It’s that period of the year again – pun intended.

May 28th, we celebrate Menstrual Hygiene Day just like we do every year. This day was created to bring different actions and voices together and to put good menstrual health and hygiene in the spotlight. There is still far too little knowledge about this subject. For example, a study in the United States showed that only 21% of young people in elementary school had learned about puberty and the biological ‘changes’. As a consequence, most girls didn’t really know anything about menstruation when they first got their period?! In any case, I would get a good scare and immediately think that something is seriously wrong!

Bringing menstrual health into the spotlight is a complex story that cannot be addressed unilaterally. For example, it encompasses various factors such as health, education, gender equality, availability of clean water, etc. all of which need to be taken into account.Menstruele gezondheid in de spotlight zetten is een complex verhaal dat niet eenzijdig aangepakt kan worden. Zo omvat het diverse factoren zoals gezondheid, onderwijs, gendergelijkheid, beschikbaarheid van schoon water, enz. waar allemaal rekening mee gehouden moet worden.

With Isala, we would like to contribute a little to highlighting this natural process and its necessities. We previously told you about the global problem of menstrual poverty (or period poverty), the lack of women-friendly alternatives to menstrual pain and the impact of menstruation on your mental health. So it’s something we care about strongly at Isala! For example, our research also looks at the influence of menstrual care products on your vaginal microbiome and health. But also making menstrual health and hygiene a topic of discussion is very close to our hearts.

Period Poverty

What? The lack of access to the safe and hygienic use of menstrual care products such as; pads, a menstrual cup, tampons, (reusable) panty liners and menstruation underwear. But also access to clean water, laundry facilities and waste disposal.

How? This is facilitated by financial shortages, but also a taboo surrounding the subject, lack of education and a general lack of good resources.

Consequence? Women sometimes have to choose between buying food or menstrual care products. Many use unhygienic and dangerous alternatives instead such as; toilet paper, socks, newspapers, sheets, leaves, plastic bags, etc. Many girls skip school during their periods.

Al heel wat analyses werden uitgevoerd op de verkregen microbioom data en verder gelinkt aan de antwoorden uit de uitvoerige vragenlijsten dat door de Many analyses were already performed on the microbiome maps and linked to the answers from the extensive questionnaires that were filled out by the participants – you!. Like this, we saw that the vaginal microbiome was linked to the moment in the menstrual cycle. We found more Lactobacillus crispatus in the luteal phase, while we found less in the follicular phase (see figure below). In the latter we also found more different types of bacteria in the microbiome, which means a greater diversity. This was also described in scientific literature and could be explained by a temporary ‘disturbance’ of the balance in your microbiome due to the bleeding. PS: Lactobacillus crispatus is one of those lactobacilli/lactic acid bacteria that often dominates your vaginal microbiome and has been linked to a healthy microbiome. Be sure to read our results page if you want to refresh your memory!

Furthermore, we also saw in the Isala data that the menstrual cup caused an increase in the occurrence of Lactobacillus crispatus, in contrast to menstrual pads, where we saw more different and less beneficial bacterial species. Would you like to know more about our scientific results? Then be sure to check out our preprint of the very first major Isala paper. A ‘preprint’ is an article that still needs to be reviewed by scientific experts before it is ‘really’ published in a scientific journal. At the moment, our article is under review at the prestigious journal Nature Microbiology.

A refresher on the menstrual cycle

o Your cycle starts the first day of your bleeding – or menstruation – and ends when you bleed next. On average, this is between 24 and 38 days but of course there are several exceptions.
o Your hormones send signals back and forth between your brain and ovaries and fluctuate throughout your cycle.
o Follicular phase: Between the start of menstruation and ovulation, this is where an egg is prepared.
o Menstruation: When the egg from the previous cycle is not fertilized by a sperm cell during ovulation, the thickening of the uterine wall comes off. This results in bleeding.
o Ovulation: An egg is released, at this moment you are fertile.
o Proliferation phase: The uterine wall thickens in preparation of receiving a fertilized egg.
o Luteal phase/Secretory phase: After ovulation and before the next menstrual period, the body continues to prepare for a possible pregnancy. The uterine wall, due to hormonal signals from a fertilized egg, is completely ready to receive OR is just being prepared to abort.

Want to know more? Be sure to read this article

External factors such as menstrual care products can have a significant impact. But you can suspect where we are going… Unfortunately, not much research has been done on this subject. Of course, it’s not easy to research, because there are many factors to consider. But for Isala, the challenge is accepted!

At Isala, however, research never stops and since the start several projects have emerged that focus more on these external influences. Did you know that in my PhD I will be investigating the influence of underwear fabric on the vaginal microbiome? After all, underwear fabric has a very intimate contact with our vaginal microbiome, not surprising that this can have an influence, right? Only this has not been well studied yet. Some ‘association studies’ (i.e. no cause-and-effect) have been conducted but even here the conclusions are not unambiguous. And this is exactly what I want to investigate as a new team member of Isala. The same applies to menstrual care products such as panty liners and menstrual pads. There is little research on them and often they contradict each other or we don’t have enough evidence. Another reason to put menstrual hygiene in the spotlight I guess!

Period. To end our story, you too can do your part today on May 28th. A simple contribution from all of us is to make menstrual health and hygiene a topic of discussion in our immediate environment (with big and small people). WASH-united (WAter – Sanitation – Hygiene) is a global non-profit organization that created this Menstrual Hygiene Day. It brings together non-profits, governments, individuals, industry and media to highlight good menstrual health and hygiene for all women and girls. For example, they created a free education guide that teaches young children around the world about menstrual hygiene. And every year they organize an online campaign that encourages people to put this topic in the spotlight with free promotional material. So we are #WeAreCommitted, are you too?