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Sitting by the half-open doors of the ‘menstrual hut’, Chantin, a 15-year-old girl in the Gajra village of Nepal’s Achham district kindles a fire to keep her warm. As the night passes, she falls asleep – never to wake up again.

The girl breathed her last in the dingy hut with poor sanitation and ventilation. She was among the many women who have died in these huts due to lack of medical care, animal attacks or smoke inhalation.

Menstruating women live in a small hut as part of Nepal’s century-old practice called Chhaupadi. They are separated from the community as they are considered ‘unclean.’

Although we are living in the 21st century, certain issues continue to remain taboo and are barely discussed in public or even with the family members. Menstrual health is one of them.

Neglect in this regard can cause serious physical and mental repercussions, especially in adolescent girls.

Every year, due to lack of proper health care, menstruation becomes the cause of death among women all over the world.

 Understanding menstrual health

In biological terms, the menstrual cycle involves a regular monthly discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. It is a biological process that marks the onset of pubertal growth in women, beginning at the age of 12 or 15. When fertility in women begins to decline, typically between the ages of 45 to 55, menstruation becomes less regular and eventually stops. The medical term of the end of fertility period in a woman is called menopause.

While some women breeze through their menstruation without any pain or discomfort, some experience severe cramps (known as dysmenorrhea) and heavy bleeding during the first and the second day of their menstruation. Excessive discharge of menstrual fluid can lead to iron deficiency causing anaemia and can also lay the grounds for gastrointestinal diseases.

Apart from these physical discomforts, some women also experience emotional disturbances such as extreme mood swings, crying spells and other mood disorders during their menstruation.

In certain cases, the mood symptoms can hamper concentration and memory, cause abnormal behaviour and even lead to anxiety and depression.  This is part of the Premenstrual syndrome (PMS) and is estimated to occur in 30 to 40% of women.

However, when the symptoms of depression get severe, they can cause Premenstrual Dysphoric Disorder or PMDD, which is characterised by aggression, feeling of hopelessness, either oversleeping or insomnia and suicidal thoughts.

Thus, paying a visit to a gynaecologist on a periodical (if not regular) basis is extremely essential for women to maintain their overall health. However, women tend to take their reproductive health for granted unless they are expecting a child. It is understandable that one gets nervous, especially if it is your first visit to the gynaecologist, but remember that the doctor has probably already heard all the issues imaginable.

 A day off for menstrual health – legit or sexist?

A working woman in Zambia, enjoys a legal freedom that many of her female counterparts don’t across the world. A ‘Mother’s Day’ leave!

There is a provision in the labour laws of the Republic of Zambia in Africa that allows its female employees to take a day off in a month for ‘Mother’s Day’, even though it applies to all the women irrespective of whether they have children or not.  Any employer who denies this entitlement to its female employees can face prosecution.

Though widely regarded as a menstrual leave, the legal definition of the provision is not precise. Therefore, a woman can take a day off, without giving any medical justification.

This ambiguity in the definition of the law is the reason why it has found itself surrounded in controversies and criticism.

Many term it as a sexist law, raising the question that why did people not object the law as it was a violation of the law of “equality at work”, while others view it as a denunciation of efficiency of women at work.

 Menstrual leave- not a new concept

Japan introduced the concept of menstrual leave for the first time in the early 20th century. Indonesia, South Korea and Taiwan followed suit and laid similar provisions in their labour laws. The idea was also proposed in Russia in 2013; however, it failed to become a law.

 The need to talk about menstrual health

It is essential and liberating to be informed about your reproductive health to spot problems whenever they arise. Invest time and effort to engage in conversations about the issue to create sensitivity and understanding towards a natural process that affects half of mankind.

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