Abstract
On average, women menstruate for approximately half of their lives. Little is known about whether and how health-related quality of life (HRQOL) differs across users of different types of menstrual products. To answer this question, this study collected data from 1,245 female university students in Taiwan through an anonymous online survey and compared users of different types of menstrual products in four HRQOL domains. Multivariate linear regression analysis revealed significant differences in all four domains. For instance, regarding physical health, tampon users reported better HRQOL (β = .054) than pad users; regarding social health, tampon (β = .059) and menstrual cup (β = .071) users both reported better HRQOL than pad users. Furthermore, factors influencing HRQOL also differed between pad and tampon users. For example, having many premenstrual symptoms affected both pad (β = -.115) and tampon (β = -.172) users’ physical HRQOL; while pad users with many premenstrual symptoms also had worse psychological (β = -.085), social (β = -.100), and environment (β = -.104) HRQOL, their tampon-using counterparts were not significantly affected. Bisexual tampon-using college women reported worse social HRQOL (β = -.149) than their heterosexual peers. In addition, relationship status and varsity team membership had differential significant associations with the four domains. Future menstrual health education could focus more on introducing the different features of various menstrual products. Our empirical findings can help empower women to make informed decisions about which menstrual products could best suit their needs and improve their HRQOL.
Similar content being viewed by others
References
Bhartiya, A. (2013). Menstruation, religion and society. International Journal of Social Science and Humanity, 3(6), 523–527. https://doi.org/10.7763/ijssh.2013.V3.296
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
Chen, Y. Y., & Huang, J. H. (2015). Precollege and in-college bullying experiences and health-related quality of life among college students. Pediatrics, 135(1), 18–25. https://doi.org/10.1542/peds.2014-1798
Chern, K.-C., & Huang, J.-H. (2018). Internet addiction: Associated with lower health-related quality of life among college students in Taiwan, and in what aspects? Computers in Human Behavior, 84, 460–466. https://doi.org/10.1016/j.chb.2018.03.011
Chrisler, J. C. (1996). PMS as a culture-bound syndrome. In J. C. Chrisler, C. Golden, & P. D. Rozee (Eds.), Lectures on the psychology of women (pp. 107–121). McGraw Hill.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates.
Czajkowska, M., Drosdzol-Cop, A., Galazka, I., Naworska, B., & Skrzypulec-Plinta, V. (2015). Menstrual Cycle and the Prevalence of Premenstrual Syndrome/Premenstrual Dysphoric Disorder in Adolescent Athletes. Journal of Pediatric and Adolescent Gynecology, 28(6), 492–498. https://doi.org/10.1016/j.jpag.2015.02.113
Das, P., Baker, K. K., Dutta, A., Swain, T., Sahoo, S., Das, B. S., Panda, B., Nayak, A., Bara, M., Bilung, B., Mishra, P. R., Panigrahi, P., Cairncross, S., & Torondel, B. (2015). Menstrual Hygiene Practices, WASH Access and the Risk of Urogenital Infection in Women from Odisha, India. PloS One, 10(6), Article e0130777. https://doi.org/10.1371/journal.pone.0130777
Diaz, A., Laufer, M. R., & Breech, L. L. (2006). Menstruation in Girls and Adolescents: Using the Menstrual Cycle as a Vital Sign. Pediatrics, 118(5), 2245–2250. https://doi.org/10.1542/peds.2006-2481
Farrokh-Eslamlou, H., Oshnouei, S., Heshmatian, B., & Akbari, E. (2015). Premenstrual syndrome and quality of life in Iranian medical students. Sex and Reproductive Healthcare, 6(1), 23–27. https://doi.org/10.1016/j.srhc.2014.06.009
Frank, R. T. (1931). The Hormonal Causes of Premenstrual Tension. Archives of Neurology and Psychiatry, 26(5), 1053–1057. https://doi.org/10.1001/archneurpsyc.1931.02230110151009
Fredriksen-Goldsen, K. I., Kim, H. J., Barkan, S. E., Balsam, K. F., & Mincer, S. L. (2010). Disparities in health-related quality of life: A comparison of lesbians and bisexual women. American Journal of Public Health, 100(11), 2255–2261. https://doi.org/10.2105/AJPH.2009.177329
Gao, E., Zuo, X., Wang, L., Lou, C., Cheng, Y., & Zabin, L. S. (2012). How does traditional Confucian culture influence adolescents’ sexual behavior in three Asian cities? Journal of Adolescent Health, 50(3 Suppl), S12-17. https://doi.org/10.1016/j.jadohealth.2011.12.002
Garg, S., & Anand, T. (2015). Menstruation related myths in India: strategies for combating it. Journal of Family Medicine and Primary Care, 4(2), 184–186. https://doi.org/10.4103/2249-4863.154627
Gharacheh, M., Ranjbar, F., Hajinasab, N., & Haghani, S. (2021). Acceptability and safety of the menstrual cups among Iranian women: A cross-sectional study. BMC Women’s Health, 21(1), 105. https://doi.org/10.1186/s12905-021-01259-8
Grad, F. P. (2002). The Preamble of the Constitution of the World Health Organization. Bulletin of the World Health Organization, 80, 981–982.
Greene, R., & Dalton, K. (1953). The Premenstrual Syndrome. British Medical Journal, 1(4818), 1007–1014. https://doi.org/10.1136/bmj.1.4818.1007
Hofmeister, S., & Bodden, S. (2016). Premenstrual Syndrome and Premenstrual Dysphoric Disorder. American Family Physician, 94(3), 236-240. https://www.ncbi.nlm.nih.gov/pubmed/27479626
Hoppenbrouwers, K., Roelants, M., Meuleman, C., Rijkers, A., Van Leeuwen, K., Desoete, A., & D’Hooghe, T. (2016). Characteristics of the Menstrual Cycle in 13-Year-Old Flemish Girls and the Impact of Menstrual Symptoms on Social Life. European Journal of Pediatrics, 175(5), 623–630. https://doi.org/10.1007/s00431-015-2681-7
Houston, A. M., Abraham, A., Huang, Z., & D'Angelo, L. J. (2006). Knowledge, Attitudes, and Consequences of Menstrual Health in Urban Adolescent Females. Journal of Pediatric and Adolescent Gynecology, 19(4), 271-275. https://doi.org/10.1016/j.jpag.2006.05.002
Howard, C., Rose, C. L., Trouton, K., Stamm, H., Marentette, D., Kirkpatrick, N., Karalic, S., Fernandez, R., & Paget, J. (2011). FLOW (Finding Lasting Options for Women): Multicentre randomized controlled trial comparing tampons with menstrual cups. Canadian Family Physician, 57(6), e208-215. https://www.ncbi.nlm.nih.gov/pubmed/21673197
Huang, P.-T., & Huang, J.-H. (2020). Menstrual Cup Use Intention and the Moderating Effects of Sexual Orientation and Gender Characteristic Among Female University Students in Taiwan: A Theory-Driven Exploration. Archives of Sexual Behavior, 49(4), 1355–1366. https://doi.org/10.1007/s10508-019-1412-y
Isik, H., Ergol, S., Aynioglu, O., Sahbaz, A., Kuzu, A., & Uzun, M. (2016). Premenstrual syndrome and life quality in Turkish health science students. Turkish Journal of Medical Sciences, 46(3), 695–701. https://doi.org/10.3906/sag-1504-140
Karlsson, T. S., Marions, L. B., & Edlund, M. G. (2014). Heavy menstrual bleeding significantly affects quality of life. Acta Obstetricia et Gynecologica Scandinavica, 93(1), 52–57. https://doi.org/10.1111/aogs.12292
King, M., & Ussher, J. M. (2012). It’s not all bad: Women’s construction and lived experience of positive premenstrual change. Feminism & Psychology, 23(3), 399–417. https://doi.org/10.1177/0959353512440351
Knox, B., Azurah, A. G., & Grover, S. R. (2015). Quality of life and menstruation in adolescents. Current Opinion in Obstetrics and Gynecology, 27(5), 309–314. https://doi.org/10.1097/GCO.0000000000000199
Latka, M. (2001). Female-initiated barrier methods for the prevention of STI/HIV: Where are we now? where should we go? Journal of Urban Health, 78(4), 571-580. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3455872/pdf/11524_2006_Article_53.pdf
Lau, L. B. Y. H., & Leung, T. K. P. (1996). The 'superior' product that failed in Hong Kong. Journal of Health Care Marketing, 16(1), 16. https://www.proquest.com/scholarly-journals/superior-product-that-failed-hong-kong/docview/232349633/se-2?accountid=14229
Mooncup. (2016). Introduction of moon cup. http://www.mooncup.com.tw/
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
Pokhrel, D., Bhattarai, S., Emgard, M., von Schickfus, M., Forsberg, B. C., & Biermann, O. (2021). Acceptability and feasibility of using vaginal menstrual cups among schoolgirls in rural Nepal: a qualitative pilot study. Reproductive Health, 18(1), 20. https://doi.org/10.1186/s12978-020-01036-0
Ross, L. E., Dobinson, C., & Eady, A. (2010). Perceived determinants of mental health for bisexual people: A qualitative examination. American Journal of Public Health, 100(3), 496–502. https://doi.org/10.2105/AJPH.2008.156307
Sahin, S., Ozdemir, K., & Unsal, A. (2014). Evaluation of premenstrual syndrome and quality of life in university students. Journal of Pakistan Medical Association, 64(8), 915-922. https://www.ncbi.nlm.nih.gov/pubmed/25252518
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
van Eijk, A. M., Zulaika, G., Lenchner, M., Mason, L., Sivakami, M., Nyothach, E., Unger, H., Laserson, K., & Phillips-Howard, P. A. (2019). Menstrual cup use, leakage, acceptability, safety, and availability: A systematic review and meta-analysis. Lancet Public Health, 4(8), e376–e393. https://doi.org/10.1016/S2468-2667(19)30111-2
WHOQOL Group. (1993). Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL). Quality of Life Research, 2(2), 153–159. https://doi.org/10.1007/bf00435734
Yao, G., Chung, C. W., Yu, C. F., & Wang, J. D. (2002). Development and verification of validity and reliability of the WHOQOL-BREF Taiwan version. Journal of the Formosan Medical Association, 101(5), 342-351. https://www.ncbi.nlm.nih.gov/pubmed/12101852
Yao, K. (2005). Development and manual of the WHOQOL-BREF Taiwan version. Taipei, Taiwan, ROC: The WHOQOL Group.
Funding
Preparation of this manuscript was supported in part by grants MOST 109-2410-H-002-108-, MOST 108-2410-H-002-194-, MOST 107-2410-H-002-214-, and MOST 105-2410-H-002-143-MY2 from the National Science and Technology Council, Taiwan (formerly, Ministry of Science and Technology) awarded to Dr. Jiun-Hau Huang.
Author information
Authors and Affiliations
Contributions
P-TH and J-HH both contributed to the conception of the ideas, design of the study, development of the survey measures, analysis and interpretation of the data, as well as writing of the original draft and revision of the manuscript. P-TH contributed to data collection. J-HH conceptualized the research framework, supervised the study and development of the manuscript, and also revised and edited the earlier versions and final draft of the manuscript.
Corresponding author
Ethics declarations
Ethics Approval
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study protocol was reviewed and approved by the Research Ethics Committee of the National Taiwan University Hospital.
Consent to Participate
Informed consent was obtained from all individual participants included in the study.
Consent to Publish
Not applicable.
Competing Interests
The authors have no relevant financial or non-financial interests to disclose.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Huang, PT., Huang, JH. Comparisons of Health-Related Quality of Life among Users of Different Types of Menstrual Products: A Study of Taiwanese University Students. Sex Roles 89, 223–235 (2023). https://doi.org/10.1007/s11199-023-01367-9
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11199-023-01367-9