Indigenous Peoples’ Experience and Understanding of Menstrual and Gynecological Health in Australia, Canada and New Zealand: A Scoping Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Research Question
2.2. Study Design
2.3. Search Strategy
2.4. Study Selection
- Included Australian, Canadian, and New Zealand Indigenous people (women and those assigned female at birth).
- The main subject area is related to menarche or menstruation or menstrual health disorders (including dysmenorrhea, premenstrual dysphoric disorder (PMDD), etc.) or gynecological disorders (such as PCOS, adenomyosis, endometriosis, etc.).
- Measured at least one of these outcomes and be connected to menstrual experiences, defined as:
- ○
- Personal knowledge, thoughts, feelings, beliefs, narratives;
- ○
- Practices related to menstruation and menstrual health disorders;
- ○
- Impact of menstruation on daily living;
- ○
- Pathways to treatment opportunities.
2.5. Data Charting and Synthesis
3. Results
3.1. Knowledge of Menstruation
3.2. Attitudes and Perception of Menstruation
3.3. Access and Barriers
3.4. Personal and Social Impact
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Databases | Search Terms |
---|---|
CINAHL | (menarche OR menstrua* OR dysmenorrhea OR endometriosis) AND (Indigenous OR aboriginal OR first nations OR maori OR torres OR canada OR australia OR new Zealand) |
PsycInfo | (menarche OR menstrua* OR dysmenorrhea OR endometriosis) AND (Indigenous OR aboriginal OR first nations OR maori OR torres OR canada OR australia OR new Zealand) |
PubMed | (menarche OR menstrua* OR dysmenorrhea OR endometriosis) AND (Indigenous [Title/Abstract] OR aboriginal [Title/Abstract] OR first nations [Title/Abstract] OR maori [Title/Abstract] OR torres [Title/Abstract] OR canada [Title/Abstract] OR australia [Title/Abstract] OR new zealand [Title/Abstract]) |
Grey Literature | Menarche, Menstrual Cycle OR Menstruation Disturbances OR menstrua* OR Menstruation; Menstrual Cycle; Dysmenorrhea; Endometriosis; Aboriginal Australians; Torres Strait Islanders; First Nations of Australia; Oceanic Ancestry Group; Indigenous Australian; Australian Aborigine; Indigenous Australians; Aboriginal; Indigenous Peoples—similar relevant terms for Canada and New Zealand. |
Country | Australia (4) |
New Zealand (1) | |
Canada (0) | |
Outcome measure | Knowledge of menstruation (5) |
Attitudes and perception of menstruation (5) | |
Access and Barriers (5) | |
Personal and social impacts (5) | |
Study type | Qualitative—Co-design (2) |
Quantitative—Cross sectional online survey (3) | |
Study population | Mature Aged—assigned female at birth (1) |
10–18-year-olds—assigned female at birth (1) | |
13–25-year-olds—assigned female at birth (2) | |
18–74-year-olds—assigned female at birth (1) |
Study ID | Study Characteristics | Study Participants | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Study Design | Methodology | Age Range | Race/ Ethnicity | Socio-Economic Status | Region | Population | 1. Knowledge | 2. Attitudes/Perception | 3. Access and Barriers | 4. Personal and Social Impact | |
Krusz (2019) [27] | Co-designed qualitative | Qualitative—Yarning circle | Mature age demographic | Australian First Nations People | Low socio-economic | Brisbane (Queensland, Australia) | n =12 Aboriginal and Torres Strait Islander women and n = 8 non-Indigenous co-researchers and practitioners from urban, rural and remote areas. | Lack of contemporary, comprehensive puberty education that includes information on menstruation and menstrual hygiene. | Menstruation is considered private ‘women’s business’ in many Aboriginal and Torres Strait Islander cultures, making it a particularly sensitive topic to discuss. Stigma, secrecy, and shame involved with discussing menstruation and bleeding may prevent older women from exploring those issues with young people. | Barriers: storing and transporting products, overcrowded housing, multiple residences, lack of privacy for safe keeping of personal items. Financial barriers. | Impact on girls’ self-esteem, sexual and reproductive health, and school attendance. Need to improve MHH without distraction from engaging in full societal participation. |
Lansbury (2021) [53] | Co-designed qualitative | Qualitative—Yarning circle | 10–18 years and adults supporting students. | Indigenous and non-Indigenous girls | Low socio-economic | Weipa (Far North Queensland, Australia) | Yarning circles with n = 72 plus n = 15 adult interviews; (n = 7 Indigenous people and n = 8 non-Indigenous people). | Lack of knowledge, puberty-related changes, product preferences, hormonal contraceptives, and cultural shame associated with menstruation. | Shame is often easily felt by Indigenous women when discussing menstruation. Stigma, secrecy, and shame are involved with discussing menstruation and bleeding. | Barriers to accessing and disposing of menstrual products. | Educational impact was potentially significant. |
Armour (2020) [10] | Quantitative | Quantitative—Cross sectional online survey | 13–25 years—(median range 17 years). | Australian Indigenous and Non-Indigenous | 37% lived in low socioeconomic area and 16% lived in a high socioeconomic area. | Australia | n = 4202 | Limited knowledge of menstruation. | Affected by both presenteeism and absenteeism with a detrimental impact on education. Menstrual stigma and a variety of ethical and cultural challenges. | Access to menstrual education is available but effectiveness has not been assessed. | Detrimental impact on education with both absenteeism and presenteeism, and concentration problems. Higher menstrual pain scores correlated to higher impact. |
Armour (2021) [14] | Quantitative | Quantitative—Cross sectional online survey. | 13–25 years—(median range 17 years). | Australian Indigenous and Non-Indigenous | 37% lived in a low socioeconomic area and 16% lived in a high socioeconomic area. | Australia | n = 4202 | Limited knowledge of menstruation and health literacy. Knowledge gained from the internet. | Participants reported problems with classroom concentration during menstruation: menstrual stigma and a variety of ethical and cultural challenges. | Lack of basic knowledge of menstruation and low health literacy leading to associated overall poorer health outcomes. | Impact is most women self-managing their symptoms with the use of ‘over the counter’ pain medications and hormonal contraceptives. |
Tewhaiti-Smith (2022) [36] | Quantitative | Quantitative—Cross sectional online survey | 18 and over (median 31.8 years) | European and Māori | Most reported university level education and most respondents were in the $501–$1500 (NZD) per week earnings. | Aotearoa New Zealand | n = 800 | Limited and often delayed diagnosis. | Endometriosis and CPP a negative impact to work, daily activities, and quality of life. Limited awareness | CPP often delayed diagnosis and increased the economic burden. | Impact of diagnostic delay—significant effects on all social domains, education, work, and sexual and other personal relationships. |
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Ciccia, D.; Doyle, A.K.; Ng, C.H.M.; Armour, M. Indigenous Peoples’ Experience and Understanding of Menstrual and Gynecological Health in Australia, Canada and New Zealand: A Scoping Review. Int. J. Environ. Res. Public Health 2023, 20, 6321. https://doi.org/10.3390/ijerph20136321
Ciccia D, Doyle AK, Ng CHM, Armour M. Indigenous Peoples’ Experience and Understanding of Menstrual and Gynecological Health in Australia, Canada and New Zealand: A Scoping Review. International Journal of Environmental Research and Public Health. 2023; 20(13):6321. https://doi.org/10.3390/ijerph20136321
Chicago/Turabian StyleCiccia, Donna, Aunty Kerrie Doyle, Cecilia H. M. Ng, and Mike Armour. 2023. "Indigenous Peoples’ Experience and Understanding of Menstrual and Gynecological Health in Australia, Canada and New Zealand: A Scoping Review" International Journal of Environmental Research and Public Health 20, no. 13: 6321. https://doi.org/10.3390/ijerph20136321