Mapping the health outcomes of menstrual inequity: a comprehensive scoping review

Menstrual inequity refers to the systematic and avoidable differences experienced by women and people who menstruate, based on having a menstrual cycle and menstruating. Given the paucity of prior research examining the impact of menstrual inequity on health, a scoping review was conducted to explore and map out the menstrual inequities and their association with health outcomes in women and people who menstruate within the published academic literature. Two searches were conducted in May 2022 and March 2024 in PubMed and Scopus. Academic literature published until December 2023 was included. Following the screening process, 74 articles published between 1990 and 2023 were included in the review. Results were then synthesised through narrative analysis and organised into nine categories. A range of both physical and emotional health outcomes were documented to be associated with menstrual inequity. Urinary tract infection, reproductive tract infection, and other genital discomforts (e.g. itching) were linked to certain menstrual discomforts (e.g. dysmenorrhea) as well as a lack of access to menstrual products, menstrual management facilities and/or menstrual information. The emotional health outcomes, especially anxiety, distress and depression, were salient and were shown to be related to menstrual stigma, the lack of menstrual information and the limited access to menstrual-related healthcare. The majority of the included studies were focused on menstrual management, being one of the most addressed themes concerning menstruation, and the health outcomes were mainly reproductive tract infection and emotional/mental health. Expanding the range of health outcomes studied will strengthen research and inform policy. Further research is needed to better understand the complex association between menstrual inequities and other potential health outcomes. Menstruation and the menstrual cycle are connected to the overall health of women and other people who menstruate. Menstrual inequity refers to the unfair situations and barriers that women and people who menstruate face because they menstruate. These include not having access to proper menstrual healthcare, menstrual education and knowledge, menstrual products, lacking services and facilities for menstrual management, experiencing menstrual stigma and discrimination, and the ability to fully participate in social, community, political and economic spheres. All these challenges can have an impact on their overall health. This study had the objective to explore these menstrual inequities and their association with health outcomes in women and people who menstruate in the published academic literature. We included information from 74 articles published until December 2023. The findings showed that menstrual inequity is linked to various health issues. For example, physical healthproblems, like urinary or reproductive tract infections, were often linked to difficulties managing menstruation. Moreover, emotional health issues like anxiety, distress, and depression were connected to experiences of menstrual stigma and discrimination, and having limited access to menstrual healthcare and education. This review also found that more research is needed about the relationship between menstrual inequity and health outcomes to fully understand how menstrual inequity affects women and people who menstruate. By doing so, researchers can provide better information to guide policies and improve health of women and people who menstruate.