Menstrual Health and Hygiene Challenges Among Adult Women in the Workplace Across the Life Course: A Narrative Review

Abstract:

Menstruation, a biological phenomenon experienced by all women, significantly impacts health, education, gender equity, and economic engagement. Although Menstrual Health and Hygiene (MHH) has garnered increased global attention in recent years, the majority of research and interventions have concentrated on adolescent girls within educational settings. As a result, adult women, especially those employed in formal and informal labor markets, are underrepresented in the existing literature. This narrative review aims to consolidate evidence concerning MHH throughout the lifespan, specifically focusing on adult women and the challenges they face in the workplace, to pinpoint critical gaps and inform policy recommendations. The narrative review methodology was chosen because of the diverse study designs and academic disciplines that contribute to MHH research. A preliminary selection of 205 studies, published between 2015 and 2024, was initially identified and then expanded through systematic database searches conducted until January 2025; ultimately, 35 studies were included in the thematic analysis. The studies that were included focused on menstruating women aged 20 and older, along with adolescent research related to adult developmental patterns, and used cross-sectional, qualitative, mixed-methods, intervention, and review methodologies. Thematic synthesis of the findings was performed across seven key domains: knowledge, practices, determinants, psychosocial dimensions, Water, Sanitation and Hygiene (WASH) infrastructure, interventions, and workplace factors. Across various settings, consistent reports highlighted persistent knowledge gaps, societal stigma, financial difficulties, and inadequate WASH infrastructure. Workplace studies showed that menstruating individuals missed an average of one to two days of work each month, primarily due to stigma and insufficient disposal options. The review underscores the pressing requirement for collaborative policy and research endeavors, emphasizing the importance of sustainable, economically viable interventions and rigorous longitudinal assessments of workplace and community programs. Furthermore, it calls for the systematic incorporation of menstrual health considerations into WASH, labor, and occupational health policies, underpinned by explicit, quantifiable indicators pertaining to access, absenteeism, and overall well-being.