FAQs

A. MENSTRUATION & MENSTRUAL CYCLE

 

1.   What is menstruation?

Menstruation is a natural bodily function for the reproductive health of women and adolescent girls. It results in bleeding from the womb (uterus) being lost through the vagina. Menstruation is normal and healthy for girls.

Sources: (House, Mahon, & Cavill, 2012)

 

2.   Is menstruation normal?

Yes! Menstruation is a natural process linked to the reproductive cycle of women and girls. It is a sign of good health and growing up. It is not a sickness.

Sources: (House, Mahon, & Cavill, 2012)

 

3.   How long is a menstrual cycle?

The menstrual cycle is usually around 28 days but can vary from 21 to 35 days.

Sources: (House, Mahon, & Cavill, 2012)

 

4.   What is a menstrual cycle?

Each month, a girl’s menstrual cycle begins with menstruation, which typically lasts between 2 and 7 days, with some lighter flow and some heavier flow days. Following menstruation, tissue and blood start to line the walls of the uterus to prepare the uterus for receiving a fertilised egg. Around day 14 of each cycle an egg is released from one of the ovaries (ovulation) and moves into the uterus through the fallopian tubes. If the egg is not fertilised, the lining of the uterus then detaches and is shed through the vagina along with blood. The cycle is often irregular for the first year or two after menstruation begins.

Sources: (House, Mahon, & Cavill, 2012)

 

5.   What age do girls menstruate? When does menstruation start and end?

Girls typically start to menstruate during puberty or adolescence, usually between the ages of ten and 19. At this time, they experience physical changes (eg growing breasts, wider hips and body hair) and emotional changes due to hormones. Menstruation continues until they reach menopause, when menstruation ends, usually between their late 40s and 50s.

Sources: (House, Mahon, & Cavill, 2012)

 

6.   What is menarche?

Menarche is the term for a girl’s very first period. Girls typically reach menarche during puberty or adolescence, usually between the ages of 10 and 19.

 

7.   How long does menstruation last?

Menstruation usually occurs monthly for two to seven days.

Sources: (House, Mahon, & Cavill, 2012)

 

8.   Can someone tell if I have my period?

No, not unless you tell the person! But when you have your period, tell your mother, sister or another adult you can trust. That way there will be somebody to answer any questions you have.

Sources: (House, Mahon, & Cavill, 2012)

 

9.   Why do girls menstruate?

Menstruation is natural bodily function for the reproductive health of women and adolescent girls. Each month, a girl’s menstrual cycle begins with menstruation, which typically lasts between 2 and 7 days, with some lighter flow and some heavier flow days. Following menstruation, tissue and blood start to line the walls of the uterus to prepare the uterus for receiving a fertilised egg. Around day 14 of each cycle an egg is released from one of the ovaries (ovulation) and moves into the uterus through the fallopian tubes. If the egg is not fertilised, the lining of the uterus then detaches and is shed through the vagina along with blood. The cycle is often irregular for the first year or two after menstruation begins.

Sources: (House, Mahon, & Cavill, 2012)

 

10. How much blood do girls lose during their period?

The average amount of blood lost during a menstrual period is about two tablespoons (30-40 ml). Women and girls generally experience some lighter flow and some heavier flow days during their menstrual period.

Sources: (House, Mahon, & Cavill, 2012)

 

11. What is menstrual blood made of?

Menstrual ‘blood’ is made up of various bodily fluids; about half of menstrual fluid is blood. In addition to blood, the fluid consists of the uterine lining as well as cervical mucus and vaginal secretions.

 

 

B. PUBERTY

 

12. When does puberty start?

Changes take place in girls and boys at different times. Generally, changes start later for boys than girls. Some people start puberty before the age of 10, sometimes as young as 8, while others start after 17. For some, changes may take place in a year or less. For others, they can take as long as 6 years.

Sources: (House, Mahon, & Cavill, 2012)

 

13. What is puberty? What happens to girls during puberty?

Puberty starts when extra amounts of hormones begin to be produced in the body. These hormones lead to changes in the body. Apart from causing physical changes, they cause emotional changes too. So a growing girl may feel happy one moment, and angry, sad or confused the next moment.

·       Puberty is the time when girls begin to produce eggs and boys begin to produce sperm. It is the time when children develop into young women and men, and their bodies start maturing so that one day they can have children and start their own families. However, this does NOT mean that adolescent girls are ready to have children, because other changes will still be happening in their bodies, minds, and emotions! If a young woman’s body is not ready for childbirth, it can cause many health problems for her and her baby.

·       A girl’s breasts start to grow and her hips get rounder. Hair starts to grow under her arms and between her legs. She starts to menstruate (also known as a monthly period).

·       Hormone changes can also cause an increase in spots and pimples just before or during a girl’s monthly period.

Sources: (House, Mahon, & Cavill, 2012)

 

14. What is adolescence?

Adolescence is a life stage when a boy or girl is not a child anymore but not yet an adult. It generally spans the ages of 10 to 19 years old and it is associated with a period of emotional, physical and social growth. During adolescence, cognitively boys and girls start to think abstractly, developing morals and setting goals. Socially they might feel awkward, worry about being normal and struggle with sense of identity. Emotionally they might experience mood swings, insecurities, changes in personal image, fall in love or have interest in sex.

 

15. What is the difference between puberty and adolescence?

Puberty marks the beginning of adolescence. Puberty generally describes the physical and physiological changes in the body while adolescence describes a life-stage that everyone goes through.

 

16. What is PMS?

PMS is short for pre-menstrual syndrome. Not all girls get this, but many do for a few days before they start their period. This is because changes in the levels of hormones in a girl’s body can affect her moods. Some feel sad, while others feel irritable and get angry for no real reason. Some girls’ breasts feel swollen and sore. This is natural and should not be a worry.

Sources: (House, Mahon, & Cavill, 2012)

 

C. BOYS & MEN

 

17. Do boys menstruate? Why don’t boys menstruate?

No, boys do not get periods. This is because boys’ bodies are different inside to girls’, and they cannot become pregnant.

Sources: (House, Mahon, & Cavill, 2012)

 

18. What does menstruation have to do with boys?

Men and boys influence women’s and girls’ experiences of menstruation through their roles as husbands, fathers, brothers, students, peers, teachers, community leaders, entrepreneurs, employers, development and humanitarian practitioners, and policymakers.

Source: (Mahon, Tripathy, & Sahin, 2015)

 

19. How can boys help girls during their period?

Growing up and becoming a man means learning to support and respect those around you, including girls and women during their period. Boys should not tease or joke about menstruation or girls who have their period. Boys can educate themselves and their friends on puberty and changes, and talk to their mothers, sisters, and friends about their experiences and how they can support them.

 

D. HYGIENE

 

20. What is menstrual hygiene management? How can I stay clean and safe during menstruation?

When girls begin to menstruate, they need to take a few steps to deal with their menstrual flow and to maintain general hygiene. Here are some tips for managing your hygiene and health during your period:

·       Bathe every day (morning and evening if possible) wash your genitals with soap and water. Remember that your vagina has its own self-cleaning mechanism and an external cleaning agent like deodorant or soap should not be used inside it!

·       Use clean undergarments and change them regularly.

·       Change your pad, cloth, tampon, or cup as and when required, at least every 4 to 6 hrs.

·       Eating a balanced diet to provide the body essential nutrients.

·       Maintaining an active lifestyle while avoiding stress and tension.

Sources: (House, Mahon, & Cavill, 2012) (UNICEF, 2008)

 

21. Should I bathe when I have my period?

Yes! Bathe every day (morning and evening if possible) wash your genitals with soap and water.

Keep unused cloths and pads clean (wrapped in tissue or plastic bag) for further use.

Pat the area dry with a cloth, and put a fresh cloth, pad, cotton or tissue on your underwear.

Always wipe from front to back after defecation. Never douche (washing out the vagina with water) as this could make you more likely to get a pelvic infection.

Sources: (House, Mahon, & Cavill, 2012) (Sommer, 2009)

 

22. They say you should not take bath during periods, is it true?

False! Taking a bath/shower/washing the body during menstruation is necessary. It prevents a woman from getting infections. However, the practice of ‘douching’ (forcing water inside the vagina in order to clean it) can make pelvic infections more likely.

Sources: (House, Mahon, & Cavill, 2012)

 

23. Should [menstruating] women wash inside of their vaginas?

No! Women should never wash inside of their vagina with soap or any other cleaning solutions. The vagina is a self-cleaning part of the body and using soap or douches to wash inside of it can be harmful to the natural balance of your vagina and make pelvic infections more likely. Instead, wash around the outside with soap and water.

 

E.   ABSORBENT MATERIALS

 

24. What should I use to absorb blood when I have my period?

You have lots of options to absorb menstrual blood! You may want to try a few to see which works best for you. Some of these options are:

·       Disposable sanitary pad: This is an absorbent pad that is typically attached to the inside of your underwear by a sticky tape. It cannot be reused.

·       Reusable cloth pad or piece of cloth: This is a sanitary pad made of cloth that can be washed and reused. These can be bought or made from cloth.

·       Tampon: This is a mass of specially prepared absorbent material that is inserted in the vagina to absorb menstrual fluid. Sometimes women use these in combination with pads.

·       Menstrual cup: This is a flexible bell shaped cup usually made of silicone that is inserted in the vagina to collect the menstrual fluid to dispose it later. Menstrual cups can be washed and reused, and are specifically made for this purpose.

·       Absorbent underwear: This is underwear that is waterproof and has an absorbent layer. They are not available in all places right now.

Avoid using materials that could lead to infection, like newspaper or leaves, or unwashed rags.

Source: (Menstrupedia, 2017)

 

25. What is a sanitary pad?

Sanitary pad, which is also known as sanitary napkin or menstrual pad, is a thin pad made of absorbent material that absorbs the menstrual fluid during menstruation. Some sanitary pads are disposable and are meant for single use only. Most sanitary pads available in the market are disposable ones. Reusable sanitary pads are mostly cloth pads that can be washed, dried and reused over a number of times.

 

Sanitary pads come in different shapes and sizes, with different capacity to absorb for days of heavy and light menstrual bleeding. You will have to experiment with different kinds of sanitary pads to know which one best suits your needs.

Source: (Menstrupedia, 2017)

 

26. How do I use a sanitary pad or cloth?

Place a cloth, pad, cotton or tissue on your underwear. Never insert the material inside your vagina. Change the cloth, pad, cotton or tissue every two to six hours or more frequently if you think that the blood flow is getting heavy.

 

If you are using a reusable cloth, make sure to thoroughly wash it with hot water and soap and dry in the sunshine or iron before reusing it.

Sources: (House, Mahon, & Cavill, 2012)

 

27. How do I dispose of a used pad?

If you are using a pad, tissue or cotton, or want to dispose of your cloth, wrap it in paper to make a clean package and put it in the bin so it can be disposed with other rubbish or burnt later. Do not drop pads or cloth in the latrine pit as this can cause problems with emptying the pit and if it is a water seal pour flush pan it could easily become blocked.

Sources: (House, Mahon, & Cavill, 2012) (Sommer, 2009)

 

28. How often should I change my pad?

Pads should be changed 4-6 times per day depending on your menstrual flow. If you bleed heavily, you will need to change your pad more often. It’s best to change your pad before it becomes completely saturated with menstrual blood so that you avoid irritations of the skin or rash from the moist pad rubbing against your skin.

 

29. What is a menstrual cup and how to use it?

A menstrual cup is a bell shaped container made of soft rubber or silicone that is used to collect menstrual fluid. A menstrual cup is used by inserting it into the vagina and leaving it there. If properly inserted, the rim of the cup forms a seal with the walls of the vagina to prevent leakage. Menstrual cup should be changed after every 12 hours. To pull it out of the vagina, the stem at the base of the cup needs to be held tightly between the thumb and the index finger and pulled out. After disposing off the menstrual fluid, the cup can be rinsed with water and reused.

 

After your period is over, be sure to clean your cup with boiling water and dry it completely. When your next period begins, clean the cup again with boiling water to make sure that it is clean for you to use.

Source: (Menstrupedia, 2017)

 

30. What is a tampon?

A tampon is a mass of absorbent material that is used to absorb the menstrual fluid during menstruation. A tampon is worn inside the vagina, where it absorbs the menstrual fluid right after it is released from the uterus.

 

Tampons have different absorbing capacities which are depicted clearly as its absorbency rating on the packet. You should use a tampon with the lowest absorbency rating that is enough to meet your requirements. A tampon should not be left inside the vagina for more than 6 hours because prolonged use of a tampon can cause a rare but potentially fatal illness called Toxic Shock Syndrome (TSS).

Source: (Menstrupedia, 2017)

 

31. What is toxic shock syndrome? Will I get TSS if I use a tampon?

Toxic shock syndrome is a rare, life-threatening complication of certain types of bacterial infections. Toxic shock syndrome historically has been associated primarily with the use of superabsorbent tampons. However, since manufacturers pulled certain types of tampons off the market, the incidence of toxic shock syndrome in menstruating women has declined.

Don’t worry, you can use tampons safely and avoid toxic shock syndrome! Change your tampon regularly (every 4-6 hours) and choose a tampon with the lowest absorbency needed to manage the menstrual flow. It is also recommended to interrupt tampon usage by using a sanitary pad from time to time during the period.

Source: (House, Mahon, & Cavill, 2012) (Mayo Clinic, 2017)]

 

32. How often should I change my tampon?

Tampons should be changed every 3-4 hours depending on your flow. While the risk of Toxic Shock Syndrome is less common now that it was, it is still best to change your tampon frequently. Tampons that are left inside for too long can cause an increase in odour or a build-up of bacteria which can be harmful to the vagina. However, when used properly, tampons do not have negative health effects.

 

33. Does using a tampons cause me to lose my virginity?

No! Using a tampon is not the same as having sexual intercourse and has no effect on your virginity.

The hymen - which is sometimes broken during sex - is a stretchy tissue that surrounds or partially covers the vaginal opening. When you insert a tampon for the first time, the tampon will most likely pass through without breaking your hymen, or your hymen will stretch to allow the tampon to pass through.

 

 

F.   PAIN

 

34. Does it hurt to have my period?

Some girls feel no pain at all when they have their period, some have slight pains below their naval and in their lower back, and some have a lot of pain and may need to take pain relieving medicine. Usually, any pain is not bad and does not last long. Cramps are caused by the muscles of the uterus contracting. It is this contraction that pushes out the lining of the uterus each month.

Source: (House, Mahon, & Cavill, 2012)

 

35. Is it normal to have pain during menstruation?

Yes! Many women and girls to suffer from period pains such as abdominal cramps, nausea, fatigue, feeling faint, headaches, back ache and general discomfort. You may also experience emotional and psychological changes (eg heightened feelings of sadness, irritability or anger) due to changing hormones. This varies from person to person and can change significantly over time.

Sources: (House, Mahon, & Cavill, 2012)

 

36. What should I do about pain during menstruation?

Put a bottle with hot water on your stomach area when resting.

Try to do some exercises and keep your body active.

You can take painkillers every four to six hours on most painful days. Seek advice from a doctor or pharmacist.

Sources: (House, Mahon, & Cavill, 2012) (Sommer, 2009)

 

 

G. HEALTH, NUTRITION, AND SEX

 

37. My cycle is irregular, is it normal?

Yes! Especially when you are a teenager, you may have an irregular cycle. The menstrual cycle is usually around 28 days but can vary from 21 to 35 days.

Sources: (House, Mahon, & Cavill, 2012)

 

38. My menstrual flow is heavy, is it normal?

Having a heavy menstrual flow can be normal for some women. However, if your flow is very heavy and painful, we recommend that you talk to your doctor.

 

39. My menstrual flow is light, is it normal?

Having a light menstrual flow can be normal for some women. However, if your flow is very light and or you frequently miss periods, we recommend that you talk to your doctor.

 

40. I have lots of clots/clumps in my menstrual flow, is it normal?

It is normal to have blood clots! Many women have clots in their menstrual blood from time to time. The clots may be bright red or dark in color. Often, these clots are shed on the heaviest days of bleeding. The presence of multiple clots in your flow may make your menstrual blood seem thick or denser than usual but it is nothing to be concerned about.

 

41. The colour of my menstrual flow changes – sometimes it’s dark and other times it’s light, is it normal?

It’s normal to have the color of your period blood change! You may notice that your menstrual blood becomes dark brown or almost black both at the beginning and as you near the end of your period. This is a normal color change. It happens when the blood is older and not being expelled from the body quickly. Blood at the beginning of your period is darker because it’s sometimes leftover blood from the previous period. Blood is usually lighter in the middle of your period because it’s being pushed out more quickly. The color of your blood might change a lot from one period to the next and within the same period.

 

42. What does it mean if a girl misses her period one month?

If a girl who menstruates every month misses a period, and she has had sexual intercourse, it may mean she is pregnant. But girls can also miss periods if they are feeling stressed, if they become too thin or they have been travelling. It is also possible when girls’ bodies are developing that their period may not be regular at first and can skip months.

Sources: (House, Mahon, & Cavill, 2012)

 

43. I have discharge / white stuff in my undies, is it normal?

Yes, every girl and woman may have vaginal fluid that varies throughout her cycle. The fluid may be thin and clear, thick and mucous-like, or long and stringy. A discharge that appears cloudy white, and/or yellowish when dry on clothing is normal. The discharge will usually change at different times in the menstrual cycle and for various other reasons, including emotional or sexual arousal, pregnancy and use of oral contraceptive pills.

The following can be a sign of abnormal discharge and could indicate a health problem:

·       Discharge accompanied by itching, rash or soreness.

·       Persistent increased discharge.

·       White, lumpy discharge (like curds).

·       Grey/white or yellow/green discharge with a bad smell.

You should talk to your doctor if you have any of these issues.

Source: (House, Mahon, & Cavill, 2012)

 

44. I have (some health related problem) with my period. What should I do?

Unfortunately, we can’t give you medical advice since we are not physicians and are there to consult with you! We recommend that you consult with a doctor about your symptoms.

 

45. Can I have sex during menstruation?

While you can have sex during your period and it is not harmful, some women may feel uncomfortable having sex during because there is blood present. You are free to make whatever choice is best for you depending on your physical, emotional, and mental state on that day. Remember to always use a condom when you have sex to protect you from sexually transmitted infections and unwanted pregnancy. It’s unlikely, but you can still get pregnant if you have unprotected sex during your period if you ovulate early.

 

46. What should I eat when I have my period?

All types of food as you normally would eat. Menstruating girls need to eat foods that contain iron to replace iron losses during bleeding like red meat, red lentils, and green leafy vegetables. Also eating fresh fruit and foods high in calcium can help keep them healthy and alleviate some symptoms of premenstrual syndrome (PMS).

Source: (House, Mahon, & Cavill, 2012)

 

47. What food items should I NOT eat during menstruation?

You can eat all food during your period!

 

48. Does eating cold food cause cramps?

Eating cold food will not give a menstruating woman cramps.

Source: (House, Mahon, & Cavill, 2012)

 

49. Does eating certain foods cause the odour of my menstrual blood to change?

Eating food does not change the odour of your menstrual blood. You can eat anything you would like while you are on your period! Menstruating girls need to eat foods that contain iron to replace iron losses during bleeding like red meat, red lentils, and green vegetables. Also eating fresh fruit and foods high in calcium can help keep them healthy and alleviate some symptoms of premenstrual syndrome (PMS).

 

50. How are iron deficiency (anaemia) and menstruation related?

After a girl’s first period, girls may not eat enough iron in their diet to offset menstrual losses, resulting in iron deficiency, called anaemia. Feeling tired or dizzy could be symptoms of anaemia, though you should talk to your doctor about any health problems that you have. You can prevent anaemia by eating iron rich foods such as red meat, red lentils, and green leafy vegetables. Your doctor will be able to give you more information on diagnosing and treating anaemia.

Sources: (World Health Organization, UNICEF, & UNU, Iron deficiency anaemia assessment, prevention, and control: a guide for programme managers, 2001) (World Health Organization, 2011)

 

51. Should I exercise during menstruation? Should I participate in physical education (P.E.)/gym class during menstruation?

Yes. Exercise helps to regulate your blood flow and may help you to manage pain and cramping.

Source: (House, Mahon, & Cavill, 2012)

 

52. Can I go to school when I have my period?

Yes! Menstruating girls are free to participate in any normal activity. To be prepared at school, you might want to keep essential items like underwear, sanitary pads, and anything else you normally need to manage your period in your school bag. If you are unprepared for your period, ask a trusted friend or adult like a teacher for help.

A.  MYTHS, FEAR, SHAME

 

Text Box Note to Country Offices Myths are highly context-specific and this section will need to be adjusted to your particular situation You can refer to MHM formative research for common myths in your country or simply hold a small consultation on this to inform the FAQs In responding to myths follow the principle of do no harm In some cases myths are emotionally or physically harmful to girls in other cases not following a social or religious norm could place a girl at risk Find a response that balances the two

 

1.    I am afraid to have my first period.

Don’t be afraid. It can be scary to see the blood on your underwear, but it is normal and natural. Talk to other girls and women, such as your mother, sister, aunt, grandmother, female friend or older woman in your community. If at school, tell the matron, female teacher or fellow student. Be proud! Your body is developing into that of a young woman.

Sources: (House, Mahon, & Cavill, 2012)

 

2.    I am ashamed when I have my period.

Your period is nothing to be ashamed of! It means that your body is healthy and strong. Did you know that in some places in the world, there are even period pride celebrations? Become a champion in your community and help your friends and neighbours to feel confident about their periods, too!

 

3.    Why are there so many myths about menstruation?

Menstruation was a mystery before science could explain it. So, a lot of different ideas and beliefs were created to explain periods in ancient societies and cultures. Many such ideas and beliefs have been proven wrong by science, but they are still followed in current societies and may at times even be justified on religious grounds. We call these ideas menstrual myths or taboos. Many myths tend to suggest that menstruation is a disease or a curse and it leads up to beliefs like a woman's body is polluted when she is experiencing periods. Such beliefs cause discrimination against women and at times, can lower your self-esteem and opportunities for growth. Talk to your teacher and your friends to plan how you can help to dispel these myths!

Source: (Menstrupedia, 2017)

 

4.    I heard that a menstruating woman is impure, dirty, sick or even cursed. Is this true?

No! This has no scientific basis. Periods are natural and normal for women. Menstrual fluid is just a harmless mixture of blood and tissue. This myth is often used as a reason to stop women, who are having their periods, from taking part in various social events, work, school or religious events. Talk to your teacher and your friends to plan how you can help to dispel these myths!

Source: (Menstrupedia, 2017)

 

5.    Taking a bath/shower/washing the body during menstruation causes infection or infertility

This is false! Keeping clean during menstruation is necessary and prevents women from getting infections. However, avoid the practice of “douching” – or forcing water through the vagina to clean it – because it may make pelvic infections more likely.

Source: (House, Mahon, & Cavill, 2012)

 

6.    Improper disposal of a pad / blood causes bad impacts on a girl or her community.

This is false! It is important to dispose of menstrual blood hygienically to keep yourself and your environment clean, but it will not cause any bad impacts on you. Burning or burying are safe and hygienic methods of disposing of used sanitary materials.

Source: (House, Mahon, & Cavill, 2012)

 

7.    Does menstruation mean that a girl is ready to get married?

This is false. A girl’s body is still growing and developing after she has started menstruating. Getting married and having a baby before the age of 18 can lead to health problems for the mother and child.

Source: (House, Mahon, & Cavill, 2012)

 

8.    A woman should eat / sleep / stay separately from her family during menstruation.

There is no scientific basis for this belief. There is no reason for a woman or girl to eat or otherwise live separately while having her period.

Source: (House, Mahon, & Cavill, 2012)

 

9.    A girl should not attend religious functions or prepare food when menstruating.

There is no scientific basis for this belief.

Source: (House, Mahon, & Cavill, 2012)

 

10. I heard that jumping, running, swimming, falling & lifting heavy things can affect my period.

There is no scientific basis for this belief. Jumping, running, swimming, falling or lifting heavy objects during your period will not affect you. It will not cause you to have a heavier menstrual flow or increase the pain. In fact, exercise helps to regulate your blood flow and may help you to manage the pain and cramping.

Source: (House, Mahon, & Cavill, 2012)

 


Bibliography

House, S., Mahon, T., & Cavill, S. (2012). Menstrual hygiene matters - A resource for improving menstrual hygiene around the world. London, UK: WaterAid.

Mahon, T., Tripathy, A., & Sahin, M. (2015). Putting the men into menstruation:. Waterlines.

Mayo Clinic. (2017, April 14). Diseases and Conditions: Toxic shock syndrome. Retrieved from Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/toxic-shock-syndrome/basics/definition/con-20021326

Menstrupedia. (2017, April 14). What is a sanitary pad? . Retrieved from Menstrupedia: https://www.menstrupedia.com/articles/hygiene/sanitary-pad

Sommer, M. (2009). Vipindi vya maisha; Growth and changes. New York: Macmillan Aidan.

UNICEF. (2008). Sharing simple facts: a guidance book on menstrual hygiene management. New Delhi, India: UNICEF.

World Health Organization. (2011). Guideline on Intermittent iron and folic acid supplementation in menstruating women. Geneva: World Health Organization.

World Health Organization, UNICEF, & UNU. (2001). Iron deficiency anaemia assessment, prevention, and control: a guide for programme managers. Geneva: World Health Organization.