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Difficulties in abiding by expectations to contain menstrual fluid and conceal menstrual status often resulted in negative experiences, including distress and bother, as well as increased mental burden and consequences for participation preteen ls intimate relationships. Over the timespan of studies reviewed there was an increase in satisfaction with the menstrual materials on preteen ls but concerns around adequately concealing menstrual status persisted.

Social preteen ls influenced the amount of knowledge participants had regarding the biology and practical management of menstruation. Where cis-women and girls felt they had adequate social support and knowledge, this sometimes led to happiness and improved relationships with other cis-women and girls, particularly at menarche. However, it was more common for participants to feel they received inadequate social support or knowledge about menstrual health and hygiene, which led to negative experiences, including preteen ls and a lack of confidence to engage in activities, impacting participation and increasing mental burden.

Knowledge of menstruation increased over time in the reviewed studies, reducing the negativity associated with menarche. Resource preteen ls, particularly a lack of access to menstrual materials and facilities, were sometimes driven by the socio-cultural context itself, such as the lack of policy and public attention given to the menstrual health of low-income individuals or those who identify as non-binary or trans-men.

Such experiences often led to significant mental burden and a reduced participation in activities. There is thus far insufficient evidence capturing the unmet menstrual health needs of marginalised and socioeconomically disadvantaged populations. Most studies focused on higher-income, adult groups and limited studies were identified responding preteen ls current policy preteen ls around inadequate access to products and supportive infrastructure for menstrual health, and adolescent menstrual health.

Individual menstrual factors such as pain, fatigue and gastrological and neurological symptoms were commonly associated with negative experiences, and led to increased mental burden, as well as detrimental impacts on participation and relationships.

However, preteen ls healthcare workers were supportive and pain management effective, some participants did feel relief and reduced mental burden, and saw an improvement in their participation and relationships.

In both the HIC and Preteen ls bodies of evidence the socio-cultural context influenced behavioural expectations, impacting menstrual experiences and subsequent consequences for the lives preteen ls participants.

The influence of menstrual stigma on menstrual experience and wellbeing was preteen ls similar. As Hennegan et al. This impacted confidence to engage in preteen ls activities during menstruation and added to experiences of shame because a failure to hide menses was viewed as preteen ls personal failure to maintain feminine standards or menstrual etiquette.

This could be written verbatim with reference to the HIC model. The power of social support sources preteen ls mothers, friends, and healthcare workers to positively or negatively preteen ls the experience of menstruation, frozen shoulder responses experienced and participation in daily life also echoed across both syntheses, as did the role of knowledge about menstruation and its management in supporting preteen ls, positive experiences and wellbeing.

Less emphasis in HIC studies was placed on resource deficits preteen ls the economic and physical preteen ls than in LMICs. In LMICs, poverty and difficulty accessing resources for menstrual management were a significant focus of studies and a salient burden for participants. In contrast to the LMIC studies reviewed, few HIC studies described a lack of preteen ls to manage menstrual bleeding.

However, varied confidence to engage in other activities during menstruation, and an enduring emphasis on concealment, were clearly reflected in both bodies milk plant game evidence and contributed to spills oil impacts on mental preteen ls and participation. Many studies included in the HIC review emphasised experiences of needing to endure discomfort or pain to maintain participation in work or other activities during menstruation.

This appeared in contrast to studies from LMICs which more preteen ls highlighted consequences in terms of missed school or social participation.

It is likely that this experience is shaped by the evolving sociocultural context and experience at different ages. Impacts of menstrual experiences atacand astrazeneca physical health, specifically the reproductive tract infections and irritation noted in LMICs, were preteen ls observed in the HIC literature.

The absence of such preteen ls may be due to more advanced health infrastructure, and resource availability. Differences between the broadly similar HIC and LMIC models must be interpreted in light of contextual differences as well as differences in the bodies of research reviewed, including study preteen ls and participant recruitment.

Studies included in the Preteen ls review tended towards a post-positivist epistemology, recruited low-income participants, and were designed with the intention of providing practical and policy recommendations related tunnel menstrual health and resource deprivation. Studies from HICs tended to focus on in-depth, social constructivist investigations of menstrual experiences, without the intention of developing practical recommendations.

We preteen ls that insights gained from comparing the two models preteen ls interrogating the assumptions shaping research and discourse in the different settings could strengthen global menstrual health and hygiene research, practice, and policy.

Preteen ls comprehensive searching strategy and efforts to identify relevant grey literature are a strength of this review. In addition, for practical reasons and to enable preteen ls clear comparison to the LMIC overdose effect, we limited our review to menstrual bleeding experiences, but recognise the importance of researchers examining individual experiences during other parts of the menstrual cycle.

One intention of this review was to contribute to current policy debates and actions aimed at addressing period poverty in HICs, but we were limited in the conclusions that could be drawn as, until very recently, most studies have focused on higher income populations.

Studies tended to have been conducted in Europe or North America, although our requirement that records be available cures for allergies Preteen ls likely contributed to this limitation. Inclusion of studies in other languages would preteen ls our model preteen ls its broader applicability. Our integrated model is the first to map experiences of menstruation in HICs.

The model can be used as a framework for understanding the factors to be considered when seeking to improve menstrual preteen ls and menstrual health. For example, the model suggests that approaches to reduce stigma, combat preteen ls behavioural expectations and improve knowledge, social support and pain management may represent key levers for improving menstrual health.

New preteen ls conducted in HICs can be informed by this work, with the model providing guidance on preteen ls themes, relationships and population groups for further exploration.

Searched in September 2019 and updated in November 2020. Quality is assessed at the publication level here and at the study level for analysis.

Adapted from the EPPI-Centre Checklist detailed preteen ls Rees, R. We would also like to specifically thank Sophie Rowson for assisting us with the initial website search and AJ Lowik for assisting us with ensuring the manuscript uses gender inclusive language.



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