Indigenous peoples’ experience and understanding of menstrual health

Abstract

Australia, Canada, and New Zealand were colonised by the British who brought their own cultural beliefs regarding menstruation; however, we know very little about the beliefs and practices related to menstruation of the various Indigenous or first peoples of these countries – the First Nations Australians, the Indigenous peoples of Canada and the Māori of New Zealand. Given most Indigenous people have consistently poorer health outcomes for a range of chronic conditions, it is crucial to comprehensively map and understand menstrual health literacy in Indigenous people within these countries, how it may impact their health care and what steps may need to be taken to ensure health equity. Methods Due to the likelihood of minimal data in this area, a sequential, exploratory mixed methods approach was undertaken with two phases. Data from respondents who identified as Indigenous were compared to those who were non-Indigenous. Results Only five studies from Australia and New Zealand on menstrual health met the inclusion criteria for Indigenous people. Concerningly, only one of these studies focused solely on menstrual health literacy among the Indigenous population. This highlights the severe need for more research in comprehending the menstrual health practices of the Indigenous populations in Australia, New Zealand, and Canada. Furthermore, there needs to be more information on how Indigenous beliefs of colonised people may differ from those of the broader society in which they live. Attitudes and perceptions linked with menstruation are often associated with emotions of shame and a sense of secrecy. These internalised taboos, combined with cultural secrecy, shame, and physical barriers such as shared accommodation and access to menstrual products, all contribute to the overarching theme of lack of knowledge. This lack of knowledge, in turn, leads to absenteeism from education and employment, a negative impact on relationships, and delays in the diagnosis of menstrual disorders such as chronic pelvic pain (CPP) and endometriosis. Due to the inconclusive findings of the scoping review (Phase 1) on menstrual health management and menstrual literacy, we then examined previously collected survey data (Phase 2) to explore if Australian Indigenous people reported any differences in management strategies, impacts of menstrual (e.g., absenteeism) or in accessing care and treatment for their menstrual conditions. Indigenous and non-Indigenous individuals reported similar experiences with their menstrual cycles and seeking assistance for their symptoms. We found a significant difference (P=0.024) in Indigenous respondents (86.6%) compared to non-Indigenous respondents (92.4%) when it came to experiencing pain below the belly button during the last three periods. Indigenous people were also more likely to use the maximum or more than the daily dose allowance of paracetamol, while there was a significant difference in the usage of heat in the form of a hot water bottle or heat pack, with Indigenous people less likely to use heat to manage their symptoms compared to non- Indigenous people. Both groups reported negative impacts on their education due to menstruation and pelvic pain, this was more commonly experienced by Indigenous respondents compared to non-Indigenous respondents, but the differences were not statistically significant.

Date of Award	2023
Original language	English
Awarding Institution	Western Sydney University
Supervisor	Mike Armour (Supervisor)