Exploring knowledge and attitudes about menstruation and menstrual hygiene management among adolescent boys aged 15-19 years in urban slum, Dhaka, Bangladesh

Abstract

Introduction: In male-dominated societies, menstruation is often considered a taboo topic for men, perpetuating gender inequality in menstrual hygiene management. Limited attention has been given to boys' knowledge and attitudes of menstruation, particularly in low- and middle-income countries, where cultural norms and socio-economic barriers exacerbate stigma and misinformation. In Bangladesh, menstruation is viewed as a feminine concern, excluding boys from education on the subject and hindering support for menstruating peers, particularly in urban slums. This gap fosters shame and creates barriers to educational and gender equity for girls. Evidence suggests that engaging boys in menstrual health education can reduce stigma and promote supportive practices, yet research on boys' attitudes remains limited, highlighting the need for qualitative, in-depth studies in contexts like Dhaka's urban slums. The purpose of this study was to appreciate how boys view and understand menstruation and menstrual hygiene management (MHM) practices and the role that they can play to make women who are menstruating more comfortable. Method: A qualitative, exploratory design was used and data was collected via in-depth interviews, photo elicitation and case vignettes with 12 adolescent boys aged 15–19 who lived in Kallyanpur slum. Respondents were sampled purposively that allowed the researcher to identify participants who were most likely to yield relevant information about the study topic, focusing on the unique social and cultural perspectives within this community. Data analysis made use of thematic approaches in attention to the recurrent themes and the gaps in the knowledge. Findings: The results indicate that boys have a relatively poor understanding of menstruation, coupled with widespread misconceptions. While two thirds of the participants were aware of menstruation, this was often due to unverified information from friends and social media rather than formal education. It was evident that stigma and cultural beliefs were strong as the majority of the boys shied away from talking about menstruation. However, there were exceptions who were ready to participate and give support, provided that appropriate knowledge was available. Education and age were important, as older (17-19 years) and more educated (SSC and above) boys seemed to have a better understanding and a greater willingness. Constraints such as lack of adequate health education, discomfort and the social context hampered their engagement in (MHM) talks and practices. Conclusion: With targeted education and community-based initiatives the study concludes that engaging adolescent boys can help to normalize menstruation, reduce the stigma and promote gender equity. By high school, around half of boys believe they understand menstruation well, a level of awareness that is essential if they are to be supportive and sensitive to their menstruating counterparts, but it isn't without problems; menstruation stigma is pervasive and leaves marks on society that all men should take accountability for. Schools and community programs can further close the information gap by developing and implementing curricula around menstrual health that includes boys and addresses the stigma, moving toward a more equitable and supportive environment for all.