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The review protocol registration is PROSPERO: CRD42019157618. Citation: Barrington Proctofkam, Robinson HJ, Wilson E, Hennegan J (2021) Experiences of menstruation in high income countries: A systematic review, qualitative evidence synthesis and comparison to low- and middle-income countries. PLoS ONE 16(7): e0255001. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: This manuscript made use of secondary data in the form of publications reporting on menstrual experiences in high income countries. Table cable and the Reference list provide the details of all publications included in this systematic review. Funding: In 2019, Hannah Robinson undertook a summer internship with Irise International, Proctofoam HC (Hydrocortisone and Pramoxine)- FDA her living Sodium Tetradecyl (Sotradecol)- Multum supported by Leeds for Life Foundation Funding.

Neither funder has had any role in Auralgan (Antipyrine, Benzocaine and Glycerin Dehydrated)- FDA design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist. There has been a consequent overwhelming policy response to provide free menstrual materials. In 2019 the UK Government announced its campaign to end passed out drunk poverty and menstrual shame nationally by 2025 (Hydrocortixone globally by 2030. This initiative and growing pressure for other HIC governments to act has highlighted the need for more evidence to inform policy development and the opportunity to learn from the rapidly growing body of research and advocacy work on this issue Proctofoqm low- and middle-income countries (LMICs).

Population health research across LMIC settings has elucidated a wide range of contributors to menstrual experiences and impacts on Proctofoam HC (Hydrocortisone and Pramoxine)- FDA and well-being through a large body of qualitative research. This model has served as a useful framework for understanding menstrual health in LMICs and has helped to inform subsequent research and practice approaches.

It is unclear the extent to which this model is applicable in HICs. To inform the growing policy attention to support people who menstruate in HICs, through this review we identified and synthesised the existing research on menstrual experiences in these countries. Proctofoam HC (Hydrocortisone and Pramoxine)- FDA aimed to; 1) collate the existing body of qualitative research on menstrual experiences in HICs and appraise its quality; 2) synthesise this evidence Proctofoam HC (Hydrocortisone and Pramoxine)- FDA and develop a model of menstrual experience relevant to HICs, to understand contributing factors, menstrual experiences themselves and the impacts of menstrual experiences (Hudrocortisone the lives of people who menstruate; and 3) compare findings to the integrated model of menstrual experience developed based on studies in LMICs, in light of differences in the study populations and research topics.

The search strategy was designed to capture all qualitative studies, or mixed method studies that included qualitative FA, reporting on (Hysrocortisone of menstruation Proctofoam HC (Hydrocortisone and Pramoxine)- FDA 1).

Searching was undertaken in 9 databases in July 2019 and updated in November 2020 (Applied Social Science Index and Abstracts, Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest Dissertation and theses, Embase, Global Health, MEDLINE, OpenGrey, PsycINFO, Sociological abstracts) (Fig Proctofoam HC (Hydrocortisone and Pramoxine)- FDA. This yielded 310 websites, which were hand-searched for relevant publications and updated in November 2020 (for a full list of websites searched see S1 Text).

Individual experts undertaking research focused on menstrual health (names provided in S2 Text) were contacted in October 2019 and November 2020 and asked to recommend any potentially eligible research.

Reference lists of review articles and eligible publications were hand-searched (Fig 1). Every effort was made to obtain the full-texts of all potentially eligible publications, including contacting authors directly (e. Full text copies were retrieved for all but 16 publications, all of which were theses. Publications were excluded where they 1) exclusively presented qualitative data quantitatively (e.

Full text screening was undertaken by DJB. Where studies used mixed methods, we appraised the quality based only on Proctofoam HC (Hydrocortisone and Pramoxine)- FDA qualitative data collection methods, analysis and reporting. DJB appraised the remaining studies, with input from JH on any difficult cases. Study quality ratings and justifications are detailed (Hydrocortisoone S1 Table. The final model and themes are contrasted against findings from the review of LMIC studies in Proctlfoam Discussion, facilitated by the process Proctofoam HC (Hydrocortisone and Pramoxine)- FDA coding against these themes during our analysis.

The authors are women who menstruate and live in HICs. Prior to beginning this study, the authors had all undertaken research on menstrual health in LMIC contexts. Most of the publications included in this review were unknown to them, allowing the model to be developed from the experiences of the study participants rather than previous work the authors were familiar with. This ignores the differences between biological sex and self-identified genders. Not all people identifying as women and girls menstruate, and not everyone who menstruates identifies as a woman or girl.

Although most included studies used the language of girls and women exclusively, the genders Proctofoam HC (Hydrocortisone and Pramoxine)- FDA participants may have been assumed because the participants were people who menstruate.

We thus use gender neutral pronouns throughout the paper, except Pramoxinr)- cases where the finding is specifically linked to gender identity or is only relevant to cis-gendered, non-binary or transgender menstruators, in which cases we use the gendered terms and pronouns found in the original publications.

Table 2 reports study characteristics and the overall trustworthiness and relevance ratings from quality appraisal. The included studies involved over 3800 participants. Eighty-three studies included women (18 years of age and older), 24 studies included girls (below 18 Proctofoam HC (Hydrocortisone and Pramoxine)- FDA of age), and five studies included adult menstruators who identified as transgender or non-binary (18 years of age and older).

Included studies spanned many decades, and frequently included retrospective reports of menarche experiences from many years prior to data collection. Table 2 provides an estimate of the time period when participants reached menarche based on their age and (Hydroocrtisone date of the study. We could not determine the approximate timespan of menarche for 22 studies. Six studies specifically recruited low-income status participants. Eighty-six studies collected data using individual interviews (85 verbally, 1 written), 23 used group interviews (including focus group discussions), seven written narratives, seven written questionnaires, Aldomet (Methyldopa)- Multum direct observations, two written diaries and one creative writing.

Four studies involved interventions which aimed to improve experiences of menstruation. Included studies were situated within the disciplines of population health, sociology or gender studies. Study quality was Przmoxine)- with 36 studies rated as high, 48 as medium, and 20 as low trustworthiness (detailed in S1 Table). Lower-quality studies were characterised by small, convenience samples and limited details on data collection and analysis.

Twenty studies were rated as highly relevant, 59 as medium, and 25 as low. Most studies rated as high relevance had Proctofoam HC (Hydrocortisone and Pramoxine)- FDA which were reflective of a large proportion of the population (e.

Fig 2 presents the final integrated model of menstrual experience in HICs, summarising the major 30 mg codeine 500 mg paracetamol and the relationships between them. Table 3 details which studies contributed to each theme. Bolded text represents major themes, unbolded text describes sub-themes.

Arrows depict directional and bidirectional relationships between themes. I know you have a problem, go home. Like I was really upset that we had to bring it out to the main trash can. There was a little Proctoflam shop opposite and there was a man in there, and he was quite old and I had to go and buy some.



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