Fundació Institut Universitari Per a La Recerca a L'Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Gran Via de Les Corts Catalanes 587 Attic, 08007, Barcelona, Spain.
Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.
Int J Equity Health. 2023 May 17;22(1):92. doi: 10.1186/s12939-023-01904-8.
Available research suggests that menstrual inequity has an impact on (menstrual) health outcomes and emotional wellbeing. It is also a significant barrier to achieve social and gender equity and compromises human rights and social justice. The aim of this study was to describe menstrual inequities and their associations with sociodemographic factors, among women and people who menstruate (PWM) aged 18-55 in Spain.
A cross-sectional survey-based study was conducted in Spain between March and July 2021. Descriptive statistical analyses and multivariate logistic regression models were performed.
A total of 22,823 women and PWM were included in the analyses (Mean age = 33.2, SD = 8.7). Over half of the participants had accessed healthcare services for menstruation (61.9%). The odds for accessing menstrual-related services were significantly higher among participants with university education (aOR: 1.48, 95% CI, 1.13-1.95). Also, 57.8% reported having had partial or no menstrual education pre-menarche, with odds being higher among participants born in non-European or Latin American countries (aOR: 0.58, 95% CI, 0.36-0.93). Lifetime self-reported menstrual poverty was between 22.2-39.9%. Main risk factors for menstrual poverty were identifying as non-binary (aOR: 1.67, 95% CI, 1.32-2.11), being born in non-European or Latin American countries (aOR: 2.74, 95% CI, 1.77-4.24), and not having a permit to reside in Spain (aOR: 4.27, 95% CI, 1.94-9.38). Completed university education (aOR: 0.61, 95% CI, 0.44-0.84) and no financial hardship < 12 months (aOR: 0.06, 95% CI, 0.06-0.07) were protective factors for menstrual poverty. Besides, 75.2% reported having overused menstrual products due to lack of access to adequate menstrual management facilities. Menstrual-related discrimination was reported by 44.5% of the participants. Non-binary participants (aOR: 1.88, 95% CI, 1.52-2.33) and those who did not have a permit to reside in Spain (aOR: 2.11, 95% CI, 1.10-4.03) had higher odds of reporting menstrual-related discrimination. Work and education absenteeism were reported by 20.3% and 62.7% of the participants, respectively.
Our study suggests that menstrual inequities affect a high number of women and PWM in Spain, especially those more socioeconomically deprived, vulnerabilised migrant populations and non-binary and trans menstruators. Findings from this study can be valuable to inform future research and menstrual inequity policies.
现有研究表明，月经不平等会影响（月经）健康结果和情绪健康。它也是实现社会和性别平等的重大障碍，损害了人权和社会正义。本研究的目的是描述西班牙 18-55 岁女性和月经人群（PWM）中的月经不平等及其与社会人口因素的关联。
这是一项 2021 年 3 月至 7 月在西班牙进行的基于横断面调查的研究。进行了描述性统计分析和多变量逻辑回归模型分析。
共纳入 22823 名女性和 PWM（平均年龄 33.2，标准差 8.7）。超过一半的参与者曾因月经问题寻求过医疗服务（61.9%）。与没有接受过大学教育的参与者相比，接受过月经相关服务的参与者具有更高的获得服务的几率（优势比：1.48，95%置信区间，1.13-1.95）。此外，57.8%的参与者报告在初潮前接受过部分或完全没有月经教育，出生在非欧洲或拉丁美洲国家的参与者接受过该教育的几率更高（优势比：0.58，95%置信区间，0.36-0.93）。终生自我报告的月经贫困率在 22.2%-39.9%之间。月经贫困的主要风险因素是非二元性别认同（优势比：1.67，95%置信区间，1.32-2.11）、出生在非欧洲或拉丁美洲国家（优势比：2.74，95%置信区间，1.77-4.24）和没有在西班牙的居住许可证（优势比：4.27，95%置信区间，1.94-9.38）。完成大学教育（优势比：0.61，95%置信区间，0.44-0.84）和没有 12 个月以下的财务困难（优势比：0.06，95%置信区间，0.06-0.07）是月经贫困的保护因素。此外，75.2%的参与者因缺乏适当的月经管理设施而过度使用月经产品。44.5%的参与者报告了月经相关歧视。非二元性别认同的参与者（优势比：1.88，95%置信区间，1.52-2.33）和没有在西班牙居住许可证的参与者（优势比：2.11，95%置信区间，1.10-4.03）报告月经相关歧视的几率更高。20.3%和 62.7%的参与者分别报告了工作和教育缺勤。
本研究表明，月经不平等现象在西班牙影响了大量的女性和 PWM，尤其是那些社会经济地位较低、弱势移民群体以及非二元性别和跨性别月经人群。本研究的结果可为未来的研究和月经不平等政策提供参考。
