{
  "abstract": "Menstrual health remains a neglected public health challenge in India, where persistent stigma, incomplete education, inadequate sanitation, and limited access to menstrual health resources can adversely affect health and social participation. Institution-based educational programs represent an underexplored opportunity to improve menstrual health literacy while promoting more inclusive discussions surrounding menstruation. Bridging this gap, an exploratory, prospective educational evaluation was conducted at a hospital in Coimbatore, Tamil Nadu and an engineering college in Wayanad, Kerala. Anonymous pre- and post-course surveys assessed menstrual health knowledge, attitudes, practices, perceived barriers, and perspectives on emerging digital health technologies. Quantitative responses were summarized descriptively, and open-ended responses were reviewed to identify recurring perspectives that contextualized the quantitative findings. The standardized educational program integrated evidence-based menstrual health education with discussions of bioengineering and wearable technologies. Eighty-three participants completed the pre-course survey, 68 attended the educational program, and 20 completed the post-course survey. Because responses could not be linked at the individual level, the survey cohorts were compared descriptively. At baseline, 80 of 82 respondents (97.6%) recognized menstruation as a biological process, yet only 38 of 82 (46.3%) indicated that it was not solely a womans issue. The mean agreement that menstruation remained taboo was 7.44 of 10 (SD 1.99; n=78), and 51 of 77 respondents (66.2%) reported that they or others avoided activities during menstruation. Painful periods were identified as a barrier by 56 of 67 respondents (83.6%), and 18 of 67 (26.9%) considered institutional or community toilets insufficiently clean and private for menstrual management. Open-ended responses illustrated how pain, fear of leakage, stigma, and inadequate facilities constrained participation in school, physical activity, and social life. These findings document a marked gap between basic biological recognition and the social normalization and practical support of menstruation in two South Indian institutions, and support further evaluation of gender-inclusive, context-responsive menstrual health education using paired assessments, stronger follow-up, comparison groups, and long-term outcomes.",
  "abstract_shown": true,
  "affiliations": [
    "Lehigh University"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "name": "R. Ravi"
    },
    {
      "name": "J. A. Amitrano"
    },
    {
      "affs": [
        0
      ],
      "name": "D. Seshadri"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7kss8h91ba5h9.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.16.26363278",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.16.26363278v1.full",
  "id": "7kss8h91ba5h9",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.16.26363278v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "public and global health"
    ],
    [
      "openalex",
      "2739|Menstrual Health and Disorders"
    ]
  ],
  "openalex": "W7214045573",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.16.26363278v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-16",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/7kss8h91ba5h9.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:10Z",
      "native_id": "10.64898/2026.09.16.26363278",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.16.26363278v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:public and global health",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Menstrual Health in South India: Knowledge, Stigma, and Barriers to Participation",
  "title_text": "Menstrual Health in South India: Knowledge, Stigma, and Barriers to Participation",
  "type": "preprint",
  "updated_at": "2026-10-30T12:19:10Z",
  "url": "https://research.draconitic.com/paper/7kss8h91ba5h9",
  "venue": "medRxiv",
  "versions": []
}