Menstruation, Hygiene Practice and Menstrual Distress in Female Undergraduate Students

Main Article Content

Kumiko Kido
Ayana Hirai
Yuka Kasai
Yuko Uemura


Background: Currently, there is no up-to-date survey on actual menstruation, including recent changes in the amount of menstrual blood loss in women as the age of the first menstruation decreases in Japan. Also, few study has examined whether temperature in clothing reflecting with basal body temperature and other factors are related to menstruation-associated symptoms.

Purpose: The study aimed to determine the actual menstruation, the change in the number of sanitary napkins and menstrual distress during one menstrual cycle, and the predictive factors of menstrual distress.

Methods: The samples were eight university students over the age of 20. This study was conducted from the end of June to the end of September 2020. They were asked to undertake the following: menstrual cycle, length of menstruation; the amount of menstrual blood loss; changing sanitary napkins; the Japanese version of the Menstrual Distress Questionnaire (J-MDQ). The J-MDQ consists of 47 questions answered on a scale of 0 to 3, with a higher score indicating more severe menstruation-related symptoms, within a week before, during and a week after menstruation. Multiple liner regression and Friedman test were conducted as statistical analysis.

Results: The volume of menstrual blood loss increased drastically on the second day of the menstruation, and rapidly decreased from the third day. Napkin changing was also most frequent on the second day, however there is no correlation between the volume of menstrual blood and the number of times changing sanitary napkins after the second day of menstruation. The total J-MDQ during menstruation was significantly higher than pre and after menstruation (P<0.05). The duration of blood flow were associated with J-MDQ.

Conclusions: Appropriate changing sanitary napkins needs to be recommended to improve for vulvar hygiene. The menstrual distress was highest during menstruation.

Article Details

How to Cite
Kido, K., Hirai, A. ., Kasai, Y. ., & Uemura, Y. . (2022). Menstruation, Hygiene Practice and Menstrual Distress in Female Undergraduate Students. Women, Midwives and Midwifery, 2(1), 29-39.


Akiyama A, K. K. (1979). Students on the influence of the menstrual cycle upon the physical and mental condition by means of MDT. Journal of Japan Society of Nursing Research, 2(2), 2_61-2_66.

Anikwe, Mamah, Okorochukwu, Nnadozie, Obarezi, & Ekwedigwe. (2020). Age at menarche, menstrual characteristics, and its associated morbidities among secondary school students in Abakaliki, southeast Nigeria. Heliyon, 6(5), 40–18.

Asgari, S., Alimoardi, Z., Soleimani, M. A., Allen, K.-A., & Bahrami, N. (2020). The effect of psychoeducational intervention, based on a self-regulation model on menstrual distress in adolescents: a protocol of a randomized controlled trial. Trials, 21(1), 747.

Ball, M., Weaver, C., & ... (2016). Healthcare Information Management Systems. In Journal of Information Systems Education (Vol. 14, Issue 4).

Bernardi, M., Lazzeri, L., Perelli, F., Reis, F. M., & Petraglia, F. (2017). Dysmenorrhea and related disorders. F1000Research, 6, 1645.

Chang, Koo, & Choi. (2018). The Effect of Pilates Stabilization Exercise and Kinesio taping on the Dysmenorrhea and Prostaglandin F2? of Female University Students. Journal of International Academy of Physical Therapy Research, 9(3), 1558–1563.

Das, Baker, Dutta, Swain, Sahoo, Das, Panda, Nayak, Bara, Bilung, Mishra, & Panigrahi. (2015). Menstrual Hygiene Practices, WASH Access and the Risk of Urogenital Infection in Women from Odisha, India. PLOS ONE, 10(6), 13–77.

Durand, H., Monahan, K., & McGuire, B. E. (2021). Prevalence and Impact of Dysmenorrhea Among University Students in Ireland. Pain Medicine.

Ferin, M. (1999). Stress and the Reproductive Cycle. The Journal of Clinical Endocrinology & Metabolism, 84(6), 1768–1774.

Gebeyehu, M. B., Mekuria, A. B., Tefera, Y. G., Andarge, D. A., Debay, Y. B., Bejiga, G. S., & Gebresillassie, B. M. (2017). Prevalence, Impact, and Management Practice of Dysmenorrhea among University of Gondar Students, Northwestern Ethiopia: A Cross-Sectional Study. International Journal of Reproductive Medicine, 2017, 1–8.

Geethanjali, S., Venugopal, V., Poonguzhali, S., & Maheshkumar, K. (2020a). Effect of clary sage oil as an aromatherapy on cardiac autonomic function among patients with premenstrual syndrome – A randomized controlled study. Obesity Medicine, 18, 100193.

Geethanjali, Venugopal, Poonguzhali, & Maheshkumar. (2020b). Effect of clary sage oil as an aromatherapy on cardiac autonomic function among patients with premenstrual syndrome – A randomized controlled study. Obesity Medicine, 18(1), 100193.

Goldfeld, S. R., & Hayes, L. (2012). Factors influencing child mental health: A state-wide survey of Victorian children. Journal of Paediatrics and Child Health. 48(12), 1065–1070.

Hervé, F., Katty, A., Isabelle, Q., & Céline, S. (2018). Impact of uterine fibroids on quality of life: a national cross-sectional survey. European Journal of Obstetrics & Gynecology and Reproductive Biology, 229, 32–37.

Hinobayashi, Shimizu, Onishi, Kanazawa, Akai, & Minami. (2013a). Menarcheal age among Japanese schoolgirls in 2011. The Proceedings of the Annual Convention of the Japanese Psychological Association, 77(1), 2PM-068-2PM – 068.

Hinobayashi, T., Shimizu, M., Onishi, K., Kanazawa, T., Akai, S., & Minami, T. (2013b). Menarcheal age among Japanese schoolgirls in 2011. The Proceedings of the Annual Convention of the Japanese Psychological Association, 77, 2PM-068-2PM – 068.

Hirabayashi, T. (2020). Two Cases of Successful Treatment With Hachimijiogan for Irregular Menstruation. Frontiers in Nutrition, 7.

Kanda, Y. (2013). Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplantation, 48(3), 452–458.

Kato S, Higashino T, N. M. (2020). Consideration of the relationship between menstrual pain, menstruation accompanying symptoms and personality. Journal of the Japan society Acupuncture and Moxibution. Journal of the Japan Society Acupuncture and Moxibution, 70(2), 101–111.

Katsuno, C., Gregorio, E. R., Lomboy, M. F. T. C., Nonaka, D., Hernandez, P. M. R., Estrada, C. A. M., Pimentel, J. M. T., Bernadas, R. M. G. C., & Kobayashi, J. (2019). Quality of public school toilets and the frequency of changing sanitary napkins among students in public secondary schools in the City of Manila, Philippines. Tropical Medicine and Health, 47(1), 5.

Kayashima K, Maehara S, A. A. (1989). Studies on menstrual volume (Part 1) The relationship between menstrual blood volume and physical and mental condition(Gekkeiryo ni kansuru kenkyu daiipou gekkeiketsuryo oyobi sono shinshinno jyotai tono kanren nitsuite). Japanese Journal of Maternal Health, 30(2), 240–251.

Kondo N, Fujishima Y, Totani M, O. M. (2019). Relationship between the Menstrual Cycle and Quality of Life and Mental Health of Female Undergraduates. Bulletin of the Graduate School of Human Life Sciences, Showa Women’s University, 28, 1–14.

Kulkarni, A., & Deb, S. (2019). Dysmenorrhoea. Obstetrics, Gynaecology & Reproductive Medicine, 29(10), 286–291.

Leung, & Lin. (2019). Adolescent Sexual Risk Behavior in Hong Kong: Prevalence, Protective Factors, and Sex Education Programs. Journal of Adolescent Health, 64(6), 52–58.

Mesaki NSigemitsu SInaba J. (1986). Present Status of Menstrual Characteristics in College Student. Acta Obstetrica et Gynaecologica Japonica, 38(10), 1799–1802.

Miyazaki, & Tsukamoto. (2019). Relationship between the degree of symptoms of menstruation and coping behaviours of female college students. Bulletin of Shizuoka Sangyo University, 227–235.

Momoko, K. H. (2018). Relationship between sensitivity to cold, the menstruation-associated symptoms and autonomic nervous activities and in female college students. Health Sciences Bulletin Akita University, 26(2), 1–11.

Momoko, K. H. (2020). The effect of moxibustion in Sp6 on menstruation-associated symptoms,temperature, and autonomic nervous activity in female college students. Health Sciences Bulletin Akita University, 28(2), 21–29.

Nito. (2019). Companionship support for female junior and senior high school students who have been victims of sexual exploitation and sexual violence (Seitekisakushu ya seibouryokuhigai niatta joshichugakusei/kosei no bansoshien). NWEC Jiseen Kenkyu, 9(1), 129–147.

Omidvar, Amiri, Bakhtiari, & Begum. (2018). A study on menstruation of Indian adolescent girls in an urban area of South India. Journal of Family Medicine and Primary Care, 7(4), 689.

Rad, Sabzevary, & Dehnavi. (2018). Factors associated with premenstrual syndrome in female high school students. Journal of Education and Health Promotion, 7(1).

Rubinsky, Gunning, & Cooke-Jackson. (2020). “I Thought I Was Dying:” (Un)Supportive Communication Surrounding Early Menstruation Experiences. Health Communication, 35(2), 242–252.

Salam, R. ., Hooda, M., Das, J. ., Arshad, A., Lassi, Z. ., Middleton, P., & Bhutta, Z. . (2016). Interventions to Improve Adolescent Nutrition: A Systematic Review and Meta-Analysis. 59(5). doi:

Sato. (2010). An Investigation into the Actual Conditions of Female Students’ Menstruation ?Focus on a View of Menstruation. Studies in Teaching Strategies, Ibaraki University, 29, 213–222.

Sato M, Kojima M, Toyoshima Y, S. N. (2006). A study on the comfort sanitary napkins during the menstruation period by analysing the microclimate in wearing condition. Journal of Home Economics of Japan, 57(7), 477–485.

Suzuki E, Tamaki M, H. N. (2018). Factors that affect the menstrual symptoms in female university students. Journal of Health Sciences of Mind and Body, 14(1), 26–33.

Tabuchi Y, Yoshidome A, Ban N, K. T. (2014). Research on the amount of menstrual blood loss and menstrual symptoms. Nursing Research, 47(3), 248–255.

Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z., Xiang, J., Wang, Y., Song, B., Gu, X., Guan, L., Wei, Y., Li, H., Wu, X., Xu, J., Tu, S., Zhang, Y., Chen, H., & Cao, B. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet, 395(10229), 1054–1062.