Menstrual Perceptions and Beliefs among Female Adolescents in Secondary Schools in Suburban Edo State, Nigeria: Sociodemographic Correlates

Abstract

Menstrual perceptions are shaped by biological understanding, social beliefs and culturally embedded interpretations of menstruation. Although menstrual-health research has expanded across sub-Saharan Africa, evidence on how adolescent girls interpret menstruation in suburban Nigerian settings remains limited. This paper examined menstrual perceptions and beliefs among female secondary-school students in suburban Edo State and assessed their associations with selected sociodemographic characteristics. A descriptive cross-sectional survey was conducted among female adolescents who had attained menarche in three randomly selected secondary schools in Okada, Edo State, Nigeria. Of 344 questionnaires prepared for administration, 310 were completed and analysed, giving a response rate of 90.12%. Menstrual perception was assessed using 12 statements covering physiological understanding, supernatural and disease beliefs, reproductive anatomy, menstrual hygiene requirements, menstrual materials and disposal. Each item was scored 1 for a correct response and 0 for an incorrect or uncertain response. A composite score of more than 80%, corresponding to 10-12 correct responses out of 12, was classified as positive perception; scores of 0-9 were classified as needing improvement. Descriptive statistics and Pearson's chi-square tests were used, with statistical significance set at p < .05. Positive menstrual perception was recorded among 57.42% of respondents. Most strongly rejected the view that menstruation is a curse from God and 88.4% strongly rejected its classification as a disease, while 84.5% strongly recognised menstruation as a physiological process. Correct anatomical understanding was less consistent, with 61.9% strongly identifying the uterus as the source of menstrual blood. Most respondents also rejected the view that sanitary pads were unnecessary, while 84.5% strongly agreed that special hygiene was required during menstruation. Responses concerning dry cloth, washing and reuse of menstrual materials, and disposal of used pads were more varied. Positive perception differed significantly by age, χ² = 26.162, p < .001; school class, χ² = 112.821, p < .001; and religion, χ² = 9.361, p = .002. Menstrual perception among the surveyed adolescents was mixed. Strong recognition of menstruation as a normal physiological process coexisted with incomplete anatomical understanding and more variable beliefs concerning menstrual materials and disposal. The significant sociodemographic differences indicate that menstrual perceptions were not uniformly distributed across the sampled population. Menstrual-health education should therefore extend beyond basic biological normalisation to include reproductive anatomy, misconceptions and contextually appropriate guidance on menstrual hygiene and material management.