Knowledge and Practice Regarding Menstrual Hygiene among School Going Adolescents of Sulaimani city
Keywords:
Cross-Sectional Studies, Health Education, MenarcheAbstract
Background and Objectives: Menstrual hygiene (MH) is a crucial aspect of adolescent health, impacting both physical and mental well-being. This study aimed to evaluate MH knowledge and practices among school-aged adolescents in Sulaimani City, Iraq.
Methods: A cross-sectional study was conducted between January and March 2025, involving 195 female students aged 12–16 years from three randomly selected private schools. Participants were chosen through a two-stage random sampling process. Data were collected using a structured, pre-tested questionnaire covering sociodemographic information, menstrual history, knowledge about menstruation, and hygiene practices.
Results: Among 195 adolescent girls (mean age: 13.78 ± 0.911 years), 61% (n=119) began menstruation at 12–13 years. Prior menstrual knowledge was reported by 59% (n=115), with mothers as the primary source (52.8%, n=103). Initial reactions included fear (31.3%, n=61) and embarrassment (39%, n=76). Hygiene practices: 66.7% (n=130) knew to change pads every 4 hours, and 90.3% (n=176) emphasized handwashing. Menstrual discomfort affected 72.3% (n=141) in class, with 63.6% (n=124) reporting academic impacts. Age, maternal education, employment, and household economics influenced hygiene practices.
Conclusion: The knowledge and understanding of various menstrual aspects among the girls were moderate, with nearly 50% demonstrating adequate understanding of menstruation. Their practices and behaviors related to MH were generally satisfactory. Menstruation and its associated processes negatively impacted the comfort and participation of many adolescents in school and educational activities.
Downloads
Metrics
References
Boruah B, Hakmaosa A,Hajong S, A study on the knowledge and practices of menstrual hygiene among the adolescent girls of Nagaon, Barpeta District, Assam. J Family Med Prim Care. 2022;11(10):5918-5923. https://doi.org/10.4103/jfmpc.jfmpc_146_22.
Odey GO, Adegbite MA, Razaqi N, Faizi G, Afzali H, Ahmadi M, et al., Knowledge and practice of menstrual hygiene among adolescent girls in secondary schools of Herat, Afghanistan. Razi International Medical Journal. 2022;2(1):12-22. https://doi.org/10.56101/rimj.v2i1.20.
Vijayakumar N, Pfeifer JH, Flournoy JC, Hernandez LM,Dapretto M, Affective reactivity during adolescence: Associations with age, puberty and testosterone. Cortex. 2019;117:336-350. https://doi.org/10.1016/j.cortex.2019.04.024.
Belayneh Z,Mekuriaw B, Knowledge and menstrual hygiene practice among adolescent school girls in southern Ethiopia: a cross-sectional study. BMC Public Health. 2019;19(1):1595. https://doi.org/10.1186/s12889-019-7973-9.
Betsu BD, Medhanyie AA, Gebrehiwet TG,Wall LL, "Menstruation is a Fearful Thing": A Qualitative Exploration of Menstrual Experiences and Sources of Information About Menstruation Among Adolescent Schoolgirls. Int J Womens Health. 2023;15:881-892. https://doi.org/10.2147/IJWH.S407455.
Ahmad A, Garg SG, Gupta S,Alvi R, Knowledge and practices related to menstruation among Lucknow College students in North India: Results from cross-sectional survey. Medrxiv. 2021:2021.02. 10.21251460. https://doi.org/10.1101/2021.02.10.21251460.
Moore Heslin A,McNulty B, Adolescent nutrition and health: characteristics, risk factors and opportunities of an overlooked life stage. Proceedings of the Nutrition Society. 2023;82(2):142-156. https://doi.org/10.1017/S0029665123002689.
Anthon C, Steinmann M, Vidal A,Dhakal C, Menstrual Disorders in Adolescence: Diagnostic and Therapeutic Challenges. Journal of Clinical Medicine. 2024;13(24):7668.
Mosavi Z, Parsa P, Cheraghi F,Farhadian M, Investigating the Effective Demographic Factors on Menstrual Health Knowledge and Practices among High School Girls in Hamadan, in 2014. Avicenna Journal of Nursing and Midwifery Care. 2018;26(1):26-32. https://doi.org/10.30699/sjhnmf.26.1.26.
Qaralleh H, Knowledge and Self-Care Behaviors During Menstruation Among Adolescent Females. Journal of Comprehensive Pediatrics. 2024;15(4):1-11.
Ali AM, Bashier SA, Ahmed S, Subeh HHE, Taha RM, Ibrahim SA, et al., Factors associated with age at menarche, menstrual knowledge, and hygiene practices among schoolgirls in Sharjah, UAE. International Journal of Adolescence and Youth. 2024;29(1):2367117.
Jarrahi R, Golmakani N, Mazloom SR,Forouzanfar H, The Effect of Menstrual Health Education Adopting the Peer Education Method with the Participation of Mothers on Adolescents' Menstrual Health Behaviors: a Clinical Trial. Journal of Midwifery and Reproductive Health. 2021;9(1):2582-2589. https://doi.org/10.22038/jmrh.2020.42482.1489.
Saei Ghare Naz M, Farahmand M, Dashti S,Ramezani Tehrani F, Factors Affecting Menstrual Cycle Developmental Trajectory in Adolescents: A Narrative Review. Int J Endocrinol Metab. 2022;20(1):e120438. https://doi.org/10.5812/ijem.120438.
Okagbue HI, Samuel OW, Nzeribe EC, Nto SE, Dahunsi OE, Isa MB, et al., Assessment of the differences in Mean Age at Menarche (MAM) among adolescent girls in rural and urban Nigeria: a systematic review. BMC Public Health. 2024;24(1):3468. https://doi.org/10.1186/s12889-024-21054-y.
Maulingin-Gumbaketi E, Larkins S, Whittaker M, Rembeck G, Gunnarsson R,Redman-MacLaren M, Socio-cultural implications for women’s menstrual health in the Pacific Island Countries and Territories (PICTs): a scoping review. Reproductive health. 2022;19(1):128.
Secor-Turner M, Huseth-Zosel A,Ostlund R, Menstruation experiences of middle and high school students in the Midwest: a pilot study. The Journal of School Nursing. 2022;38(6):504-510.
Uzoechi CA, Parsa AD, Mahmud I, Alasqah I,Kabir R, Menstruation among In-School Adolescent Girls and Its Literacy and Practices in Nigeria: A Systematic Review. Medicina (Kaunas). 2023;59(12):1-11. https://doi.org/10.3390/medicina59122073.
Balat MS, Sahu SK,Patel M, Assessment of knowledge and practice of menstrual hygiene management among adolescent school girls in Ahmedabad City. Education. 2019;16(10):2.32.
Al-Mafraq J, Knowledge and Practices of Menstrual Hygiene among Adolescent Schoolgirls in Jordanian Badia Region: A Field Study. Jordan Journal of Nursing Research. 2023;2(3):1-11.
Rathoria R, Rathoria E, Singh V, Agrawal P,Bansal U, Knowledge, attitude and practices regarding menstrual hygiene among adolescent school girls. Sudan J Paediatr. 2024;24(2):103-113. https://doi.org/10.24911/sjp.106-1683123185.
Sadiq MA,Salih A, Knowledge and practice of adolescent females about menstruation in Baghdad. J Gen Pract. 2013;2(1):1-4.
Yadav RN, Joshi S,Park JS, Awareness of Menstrual Hygiene Management Rights and Perception of Risks, Self-Efficacy, and Behavior. J Nepal Health Res Counc. 2024;22(1):66-72. https://doi.org/10.33314/jnhrc.v22i01.5095.
Oshineye A, Olayanju O, Adeami T, Azi K, James A, Onifade P, et al., The Assessment of Adolescent Girls' Menstrual Hygiene Knowledge and Practice in Ede South Local Government Secondary Schools, Ede, Osun State. Fountain Journal of Natural and Applied Sciences. 2023;12(2):1-11.
Gebre W, Kidane EM, Negussie YM, Getahun MS, Bekele NT,Gurara AM, Assessment of menstrual hygiene management knowledge, practice, and associated factors among girls in Boset District, Ethiopia: a school-based cross-sectional study. Contraception and Reproductive Medicine. 2023;8(1):34. https://doi.org/10.1186/s40834-023-00233-z.
Swe ZY, Mon NO, Than KK, Azzopardi PS, Kennedy EC, Davis J, et al., Adolescent girls' experiences of menstruation and schooling in monastic schools in Magway Region, Myanmar: A mixed-methods exploration. Front Reprod Health. 2022;4:893266. https://doi.org/10.3389/frph.2022.893266.
Brown N, Forrest LJ, Williams R, Piasecki J,Bruinvels G, ‘Everyone needs to be educated’: pupils’ voices on menstrual education. Reproductive Health. 2024;21(1):121. https://doi.org/10.1186/s12978-024-01862-6.
M Y, Trivedi NS, Damor R, Patel M, Ladani H, Ramachandran A, et al., Assessment of Knowledge, Attitudes, and Practices Regarding Menstrual Hygiene Management Among Adolescent Schoolgirls (10-19 Years) in the Saurashtra Region, Gujarat. Cureus. 2023;15(12):e50950. https://doi.org/10.7759/cureus.50950
Downloads
Published
How to Cite
Issue
Section
License

This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.