Menstrual hygiene management remains a significant challenge for adolescent girls and young women (AGYW) in sub-Saharan Africa, where access to affordable and sustainable menstrual products is limited. Menstrual cups, a cost-effective and reusable alternative to disposable pads, have been introduced as a potential solution in various initiatives. The Yathu Yathu trial in Lusaka, Zambia, sought to explore the acceptability and experiences of using menstrual cups among AGYW aged 15–24, providing valuable insights into community-based distribution strategies.
The Yathu Yathu trial was a cluster-randomized study designed to provide community-based HIV and sexual and reproductive health (SRH) services to young people in Lusaka, Zambia. The intervention included access to menstrual products such as pads and menstrual cups, distributed through peer-led hubs. The goal was to understand AGYW’s knowledge of menstruation, their perceptions of different menstrual products, and their experiences with using menstrual cups.
AGYW were able to access menstrual products through community hubs, where peer educators provided information on menstrual health. To assess the acceptability and experiences of menstrual cup users, researchers conducted four focus group discussions and eight in-depth interviews with AGYW who had accessed menstrual cups. The study participants included both those who had used other menstrual products and those who had specifically chosen cups. Thematic analysis was used to evaluate the data collected from these discussions and interviews.
For many AGYW, their first exposure to menstrual cups was met with surprise and fear. Several misconceptions were noted, including concerns that the cup could cause cancer, get stuck inside the vagina, or lead to vaginal enlargement and loss of virginity. These misconceptions, rooted in cultural beliefs and lack of information, initially discouraged some AGYW from trying the cup.
Despite these concerns, curiosity and the desire to explore an alternative menstrual product encouraged some young women to access menstrual cups. Information provided at the hubs played a crucial role in easing fears and fostering interest in the product.
Once AGYW started using menstrual cups, many found them to be comfortable, cost-effective, and durable. Compared to disposable pads, menstrual cups were praised for their advantages, including:
- No odor – Unlike pads, cups prevent menstrual blood from being exposed to air, reducing unpleasant smells.
- Environmental sustainability – As a reusable product, the cup generates less waste.
- Ease of maintenance – AGYW noted that menstrual cups are easy to clean and maintain.
- Long-term cost savings – Unlike pads, which need to be purchased monthly, a menstrual cup can last for several years.
However, challenges were also reported. Some AGYW experienced discomfort and pain, particularly during the first few uses, due to incorrect insertion or difficulties with removal. Others faced initial struggles in understanding how to position the cup properly. To address these challenges, AGYW returned to the community hubs for additional guidance and demonstrations on proper use.
Despite initial fears and misconceptions, menstrual cups were ultimately found to be acceptable among AGYW in Lusaka. The findings suggest that free distribution of menstrual cups can help improve menstrual health management among young women. However, to enhance acceptability and usage, the following steps are recommended:
Increase Awareness and Education – Providing accurate information about menstrual cups, addressing misconceptions, and demonstrating proper usage is critical.
Community Engagement and Support – Peer-led education programs and safe spaces, such as the Yathu Yathu hubs, help AGYW feel more comfortable discussing menstrual health.
Ongoing Guidance and Follow-Up – As menstrual cups are a new product for many AGYW, continued support through community hubs is necessary to ensure proper usage and to address challenges.
The Yathu Yathu trial highlighted the potential of menstrual cups as a sustainable solution for menstrual hygiene management among adolescent girls and young women in Zambia. Although initial skepticism and misinformation posed barriers, education and peer support played a vital role in encouraging acceptance and successful use. By expanding access to menstrual cups and strengthening community-based education, menstrual health challenges among AGYW in sub-Saharan Africa can be effectively addressed, promoting dignity, sustainability, and overall well-being.
