Abstract
Menstruation plays an important role in women’s lives as it accompanies about half of their living years. However, little is known about women’s intention to use menstrual cups, a relatively new menstrual product in Taiwan. Therefore, this study aimed to systematically explore the factors associated with menstrual cup use (MCU) intention among female university students in Taiwan, using the Theory of Planned Behavior (TPB). Data from 1245 female university students in Taiwan were collected using an anonymous online survey based on the TPB from December 2016 through January 2017. Multivariate logistic regression found the following TPB factors associated with high MCU intention: positive attitudes about positive (adjusted odds ratio [AOR] = 4.35, 95% confidence interval [CI] 2.87–6.60) and negative (AOR = 2.32, 95% CI 1.54–3.49) outcomes of MCU, supportive subjective norms (AOR = 1.88, 95% CI 1.33–2.65), and high perceived control over MCU under constraining conditions (AOR = 3.40, 95% CI 2.24–5.16). Sexual orientation and gender characteristic were also found to have moderating effects. For example, bisexual college girls with masculine characteristic who perceived high control over MCU under constraining conditions had elevated MCU intention (AOR = 2.45, 95% CI 1.04–5.76). Therefore, to improve women’s menstrual health, future health education could focus more on introducing the different features of various menstrual products, including menstrual cups, and help users make informed decisions about which menstrual products could best suit their needs.
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References
Ajzen, I. (1991). The Theory of Planned Behavior. Organizational Behavior and Human Decision Processes,50(2), 179–211. https://doi.org/10.1016/0749-5978(91)90020-T.
Ajzen, I. (2006). Constructing a Theory of Planned Behavior questionnaire. Retrieved February 2, 2019 from http://people.umass.edu/aizen/pdf/tpb.measurement.pdf.
APHRC. (2010). Use of menstrual cup by adolescent girls and women: Potential benefits and key challenges (Policy Brief No. 22). Retrieved February 2, 2019 from the African Population and Health Research Center (APHRC), Nairobi, Kenya website: http://www.susana.org/en/resources/library/details/985.
Armitage, C. J., & Conner, M. (2001). Efficacy of the Theory of Planned Behaviour: A meta-analytic review. British Journal of Social Psychology,40(4), 471–499. https://doi.org/10.1348/014466601164939.
Beksinska, M., Smit, J., Greener, R., Maphumulo, V., & Mabude, Z. (2015). Better menstrual management options for adolescents needed in South Africa: What about the menstrual cup? South African Medical Journal,105(5), 331. https://doi.org/10.7196/SAMJ.9205.
Biran, A., Curtis, V., Gautam, O. P., Greenland, K., Islam, M. S., Schmidt, W. P., … Torondel, B. (2012). Background Paper on Measuring WASH and Food Hygiene Practices–Definition of Goals to be Tackled Post 2015 by the Joint Monitoring Programme. Retrieved February 2, 2019 from the London School of Hygiene and Tropical Medicine website: https://pdfs.semanticscholar.org/8f1a/9dc7a7955ef88ba91dbb18ddaefdaade1acc.pdf.
Chang, C.-T., Huang, J.-H., & Wu, S.-C. (2015). An exploration of tampon use intentions among female college students based on the Theory of Planned Behavior: Examining sexual orientation and gender characteristic as effect modifiers. Taiwan Journal of Public Health,34(4), 424–436. https://doi.org/10.6288/TJPH201534104012.
Cheng, C.-M., & Huang, J.-H. (2018). Moderating effects of sexual orientation and gender characteristic on condom use intentions among boys’ senior high school students in Taiwan: An exploration based on the Theory of Planned Behavior. Journal of Sex Research,55(7), 902–914. https://doi.org/10.1080/00224499.2017.1372354.
Chu, J.-H., & Huang, J.-H. (2018). A theory-based exploration of condomless anal intercourse intention among young men who have sex with men of different sexual roles in Taiwan. Archives of Sexual Behavior,47(7), 2041–2050. https://doi.org/10.1007/s10508-017-1081-7.
Courts, L. B. (1993). The portrayal of the menstruating woman in menstrual product advertisements. Health Care for Women International,14(2), 179–191. https://doi.org/10.1080/07399339309516039.
Darbyshire, S. (2011). Developing a product for the feminine hygiene sector in KTP Associates Conference. Retrieved February 2, 2019 from http://eprints.brighton.ac.uk/id/eprint/8409.
Das, P., Baker, K. K., Dutta, A., Swain, T., Sahoo, S., Das, B. S., … Bilung, B. (2015). Menstrual hygiene practices, WASH access and the risk of urogenital infection in women from Odisha, India. PloS ONE,10(6), 1–16. https://doi.org/10.1371/journal.pone.0130777.
Davidson, A. (2012). Narratives of menstrual product consumption: Convenience, culture, or commoditization? Bulletin of Science, Technology & Society,32(1), 56–70. https://doi.org/10.1177/0270467612444579.
Hammill, H. (1989). Unusual causes of vaginitis (excluding trichomonas, bacterial vaginosis, and Candida albicans). Obstetrics and Gynecology Clinics of North America,16(2), 337–345.
Held, S. S. (2013). Menstrual madness: Female athletes and menstruation (Master’s thesis, San Diego State University). Retrieved from http://hdl.handle.net/10211.10/4284.
Hoerster, K. D., Chrisler, J. C., & Rose, J. G. (2003). Attitudes toward and experience with menstruation in the US and India. Women and Health,38(3), 77–95. https://doi.org/10.1300/J013v38n03_06.
Jorm, A. F., Korten, A. E., Rodgers, B., Jacomb, P. A., & Christensen, H. (2002). Sexual orientation and mental health: Results from a community survey of young and middle-aged adults. The British Journal of Psychiatry,180(5), 423–427. https://doi.org/10.1192/bjp.180.5.423.
Koff, E., & Rierdan, J. (1995). Preparing girls for menstruation: Recommendations from adolescent girls. Adolescence,30(120), 795–811.
Kumar, A., & Srivastava, K. (2011). Cultural and social practices regarding menstruation among adolescent girls. Social Work in Public Health,26(6), 594–604. https://doi.org/10.1080/19371918.2010.525144.
Lahme, A. M., Stern, R., & Cooper, D. (2016). Factors impacting on menstrual hygiene and their implications for health promotion. Global Health Promotion,25(1), 54–62. https://doi.org/10.1177/1757975916648301.
Li, M.-J., & Huang, J.-H. (2018). Healthcare seeking intention if diagnosed with HIV among young MSM in Taiwan: A theory-based comparison by voluntary counseling and testing experience. AIDS and Behavior,22(8), 2480–2490. https://doi.org/10.1007/s10461-018-2169-3.
Lin, C.-S. (2008). Female infertility from the perspective of Chinese medicine. Journal of Nursing,55(6), 22–27.
Liu, H.-L., Chen, K.-H., & Peng, N.-H. (2012). Cultural practices relating to menarche and menstruation among adolescent girls in Taiwan—Qualitative investigation. Journal of Pediatric and Adolescent Gynecology,25(1), 43–47. https://doi.org/10.1016/j.jpag.2011.08.006.
Macsween, K. F., & Ridgway, G. L. (1998). The laboratory investigation of vaginal discharge. Journal of Clinical Pathology, 51(8), 564–567. Retrieved from http://jcp.bmj.com/content/51/8/564.full.pdf.
Matthews, A. K., Hotton, A., Li, C.-C., Miller, K., Johnson, A., Jones, K. W., & Thai, J. (2016). An internet-based study examining the factors associated with the physical and mental health quality of life of LGBT cancer survivors. LGBT Health,3(1), 65–73. https://doi.org/10.1089/lgbt.2014.0075.
Mooncup. (2016). Introduction of moon cup. Retrieved February 2, 2019 from http://www.mooncup.com.tw/.
Paavonen, J., & Stamm, W. (1987). Sexually transmitted diseases. Lower genital tract infections in women. Infectious Disease Clinics of North America,1(1), 179–198.
Peplau, L. A., Frederick, D. A., Yee, C., Maisel, N., Lever, J., & Ghavami, N. (2009). Body image satisfaction in heterosexual, gay, and lesbian adults. Archives of Sexual Behavior,38(5), 713–725. https://doi.org/10.1007/s10508-008-9378-1.
Ross, L. E., Siegel, A., Dobinson, C., Epstein, R., & Steele, L. S. (2012). “I don’t want to turn totally invisible”: Mental health, stressors, and supports among bisexual women during the perinatal period. Journal of GLBT Family Studies,8(2), 137–154. https://doi.org/10.1080/1550428X.2012.660791.
Sahin, M., Mason, L., Laserson, K., Oruko, K., Nyothach, E., Alexander, K., … Ngere, I. (2015). Adolescent schoolgirls’ experiences of menstrual cups and pads in rural western Kenya: A qualitative study. Waterlines,34(1), 15–30. https://doi.org/10.3362/1756-3488.2015.003.
Sommer, M., Caruso, B. A., Sahin, M., Calderon, T., Cavill, S., Mahon, T., & Phillips-Howard, P. A. (2016a). A time for global action: Addressing girls’ menstrual hygiene management needs in schools. PLoS Med,13(2), 1–9. https://doi.org/10.1371/journal.pmed.1001962.
Sommer, M., Chandraratna, S., Cavill, S., Mahon, T., & Phillips-Howard, P. (2016b). Managing menstruation in the workplace: An overlooked issue in low-and middle-income countries. International Journal for Equity in Health,15(1), 1–5. https://doi.org/10.1186/s12939-016-0379-8.
Tang, C. S.-K., Yeung, D. Y.-L., & Lee, A. M. (2003). Psychosocial correlates of emotional responses to menarche among Chinese adolescent girls. Journal of Adolescent Health,33(3), 193–201. https://doi.org/10.1016/S1054-139X(03)00049-1.
Tzeghai, G. E., Ajayi, F. O., Miller, K. W., Imbescheid, F., Sobel, J. D., & Farage, M. A. (2015). A feminine care clinical research program transforms women’s lives. Global Journal of Health Science,7(4), 45–59. https://doi.org/10.5539/gjhs.v7n4p45.
Upashe, S. P., Tekelab, T., & Mekonnen, J. (2015). Assessment of knowledge and practice of menstrual hygiene among high school girls in Western Ethiopia. BMC Women’s Health,15(1), 1–8. https://doi.org/10.1186/s12905-015-0245-7.
Wright, E. R., & Perry, B. L. (2006). Sexual identity distress, social support, and the health of gay, lesbian, and bisexual youth. Journal of Homosexuality,51(1), 81–110. https://doi.org/10.1300/J082v51n01_05.
Acknowledgements
Preparation of this article was supported in part by grants MOST 105-2410-H-002-143-MY2, MOST 103-2410-H-002-225-MY2, NSC 102-2410-H-002-220-, and NSC 100-2410-H-002-174-MY2 from the Ministry of Science and Technology, Taiwan (formerly, National Science Council), awarded to Dr. Jiun-Hau Huang.
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Huang, PT., Huang, JH. Menstrual Cup Use Intention and the Moderating Effects of Sexual Orientation and Gender Characteristic Among Female University Students in Taiwan: A Theory-Driven Exploration. Arch Sex Behav 49, 1355–1366 (2020). https://doi.org/10.1007/s10508-019-1412-y
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DOI: https://doi.org/10.1007/s10508-019-1412-y