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Sexual health and rights

Multiple rights lead to a state of complete physical, social, and psychological well-being in all matters relating to the reproductive system, sexuality, and sexual relationships.

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01. Sexual and reproductive health and rights

A good sexual and reproductive health is a state of complete physical, social, and psychological well-being in all matters relating to the reproductive system, sexuality, and sexual relationships. It implies that people are able to have a satisfying and safe sex life, the capability to build health relationships and reproduce, and the freedom to decide if, when, and how often to do so. To maintain sexual and reproductive health, people must have access to accurate information, informed and empowered about safe and effective contraception methods to protect themselves from sexually transmitted infections. While SRHR covers a wide range of topics; sexual rights include the right to sexual education, freedom from sexual violence or coercion, and the right to decide whether or not to have children. 

While reproductive rights include access to contraception, access to menstrual products, access to safe and legal abortions and ensuring safe pregnancies and childbirth. They also deal with eliminating female genital mutilation or forced sterilisation and preventing sexually transmitted infections. What all these rights have in common is that they require access to health care services and medicines, health education and awareness-raising programmes. Thus, sexual, and reproductive health and rights constitutes a part of the healthcare system, and equal access to healthcare is guaranteed by the human rights convention on fundamental rights. So, in order to understand and fully recognise SRHR, it cannot be discussed as an option that a state has to consider. SRHR is essential, meaning that state institutions as the duty-bearers have an obligation to ensure access to SRHR, and failing to do so is inadmissibly a breach of our fundamental rights.

Access to quality sexual and reproductive health services and information is essential to protect youth health and their ability to plan their lives. Sexual and reproductive health is related to multiple human rights, including the right to life, the right to be free from torture, the right to health, the right to privacy, the right to education, and the prohibition of sexual abuse, violence, and discrimination. Violations of sexual and reproductive health and rights are often due to beliefs and societal values pertaining to sex, gender, and sexuality. Patriarchal concepts of girls' role within the family mean that as women, they are valued based on their ability to reproduce and raise children which often leads to domestic violence. Youth face significant barriers that undermine their sexual and reproductive health and rights, such as lack of access to comprehensive sexuality education. Because of states failures to enable, empower youth to access comprehensive reproductive health care, including contraception, abortion, and/or maternal health care; too many young people are not aware of specific sexual risks since they do not have access to essential information and affordable sexual and reproductive health services.

02. Why youth sexual health and rights matter

Sexually transmitted infections, unwanted pregnancies, sexual abuse, coercion, gender-based violence have been on the rise among adolescents. It is estimated that one in three women and/or LGBTIQ person has experienced some form of physical, sexual, and/or phycological violence since the age of 15, including sexual assault and harassment, sex-gender discrimination, and menstrual stigmatisation in the context of intimate partnerships and public life owing to entrenched sexual and gender prejudices and socio-cultural norms. Unavailability and lack of access to evidence-based sexual health and rights information or education violate youth across the world and is damaging to them in making informed choices about their own SHR which undermines healthier approaches to sexual abuse, coercion, and gender-based violence.

The fight for inclusive and diverse menstrual health and comprehensive sexuality education and the fight against sexual and gender-based violence are a matter of SHR. Indeed, the violations of sexual health and rights, including menstrual health breaches of many human rights, which hinder progress towards equitable distribution of resources and opportunities. Society's negative attitudes and myths surrounding menstruation influence sexual practices and reproductive health decisions, which are also strengthened by a lack of access and affordable health care services; disparities and inequalities in the realisation of SHR; lack of information about the effects of poor menstrual health management on physical, mental, and environmental health, and the insufficient protection measures against sexual abuse, discrimination, and violence based on age, sex, gender, race, disability, sex characteristics, sexual orientation, gender identity and expression.

Thus, SRH services are essential healthcare services that should be available and accessible to all and include comprehensive, evidence-based information, and youth-centred menstrual, sexuality, and relationship education supported by confidential and unbiased counselling and services for sexual and menstrual health and well-being. It includes information or counselling on contraception; accessible safe spaces for the victims and survivors of incidents of sexual abuse or violence; prevention and treatment of STIs; and services aimed at detecting, preventing, and responding to gender-based violence. So, a rights-based and gender-sensitive approach to youth sexual and menstrual health and gender literacy are the key to inclusive and devise youth public health system. It brings about an evidence-based, non-discriminatory, inclusive, and diverse menstrual health, sexuality, and gender literacy grounded in a rights-based and gender-sensitive approach in order to facilitate responsible menstrual, sexual, gender behaviours among youth by raising awareness and empowering young people to claim, exercise, and enjoy their rights to sexual and menstrual health and gender education.

03. Challenges to youth sexual health and rights

Menstrual health, sexuality, and gender education is not sufficiently integrated nor addressed in youth education and training; it is often provided by youth workers who are not trained and without evidence-based learning and training resources. Even though the SHR learning and training tools, and methods have evolved, still many youth-oriented organisations focus solely on preventing the negative aspects of sexuality but never on the healthier sexual behaviours and the effects of menstruation on the physical, mental, and environmental health. Most youth and youth workers respond that sexuality education they received in the school system did not take into account aspects of menstrual health or hygiene; sex characteristics; sex and gender discrimination in accessing healthcare services; sexual orientation, gender identity, and expression; and emotional expression, sexual desire, and sexual practices. Instead, they enter their adulthood with such a knowledge, skills, and capability gap on the very things that affect their daily life.

So, the fact that such a crucial education lacks or is not appreciated in the formal school systems, many young people are hardly reached by this education to make informed choices regarding their SHR, to ensure their right to bodily integrity and personal autonomy. So, what they will come to learn in life is deeply determined by social values and cultural norms, and this is how many challenges and obstacles to SHR, Menstrual Heath, Gender-based violence prevention arise: legal, financial, cultural, and information-related obstacles; such as the lack of access to universal, quality accessible SHR, menstrual healthcare, and GBV responsive services and education, especially the enjoyment of SHR for LGBTIQ persons which is severely hindered owing to omission of the diversity of sexual orientation and gender expression in sex education programmes, including the denial of medical care based on personal beliefs; legal restrictions and practical barriers in accessing sexual health care and services.

So, there is a need to build and strengthen young people’s capacity and skills to be aware of and empowered to claim, exercise, realise, and enjoy their sexual health and rights through inclusive, diverse community-based participatory interventions by addressing socio-cultural norms and power dynamics that limit young people from developing the health behaviours necessary to achieve an adequate state of sexual and menstrual health and well-being, and gender diversity. It is a youth work that can provide youth workers and youth-oriented organisations with Open Educational Resources and digital youth work tools in the context of non-formal education and train them using and applying them to address sexual and menstrual health and gender-related education in their youth work: sexual anatomy, consent, intimate relationship, and menstruation; sexuality, contraception, and STIs; and gender diversity.

04. Sexuality, sexual desire, and intimacy

Sexuality refers to the ways in which people express and experience their sexual desires and interests. It includes a wide range of aspects related to sex, such as attraction, orientation, behaviour, identity, pleasure. This includes heterosexual, homosexual, bisexual, asexual, and other orientations. Sexuality is a complex and multifaceted aspect of the human experience, which is influenced by biological, psychological, social, cultural, and environmental factors. Sexual desire is a specific component of sexuality that refers to the individual's level of interest or attraction to sexual activities. It can be influenced by a variety of factors such as physical and emotional well-being, hormonal changes, psychological factors, or relationship status, and cultural values. 

Sexual desire and intimacy are closely related concepts in human sexuality, and so, pertain to human relationships and interactions, often intertwined with the concepts of sex and/or gender, since gender identity can influence sexual desire and intimate relationships. Sexuality refers to a person's sexual identity, and behaviour and sexual desire refers to the drive to engage in sexual activity. Though both can be shaped by beliefs, values, attitudes, thoughts, fantasies, and relationships. Thus, sexuality and sexual desire encompass a wide range of experiences and expressions, including romantic, sexual, and platonic. Intimacy is a closeness and emotional connection between people, often characterised by trust, openness, accountability, and mutual support. While intimacy is often associated with sexual behaviour, it is not limited to romantic and sexual relationships and can exist in a variety of relationships, including friendships, familial relationships, and romantic partnerships. 

Sexuality can be a way of expressing intimacy between partners, but it is not the only way, and not all forms of sex involve intimacy. Intimacy and sexuality can complement each other, but they are not interchangeable. Some people may feel comfortable engaging in sexual activity without a strong emotional connection, while others may need a high level of emotional intimacy before feeling comfortable engaging in any sexual activity. Sexual desire is often indicated as being a key factor in the development of sexuality and intimacy in romantic relationships since pleasure and closeness contribute to both satisfaction and relationship stability. However, despite the connectivity between these three concepts: Sexuality, sexual desire, and intimacy they do not have to exist simultaneously. A person may have a high level of intimacy with a partner without being sexually active or may engage in sexual activity without feeling a deep level of intimacy. Though Sexuality, sexual desire, and intimacy are all interconnected aspects of the human experience and have a significant impact on an individual's well-being and relationships.

05. Self-confidence, self-esteem, and wellbeing

Respect is an important component of healthy relationships, both with oneself and with others, and plays a crucial role in relationships and in community life. Respecting ourselves is individual self-respect, which means giving and defining the individual own worth and value as a human being, and so, treating ourselves with kindness, compassion, and care. It also involves setting healthy boundaries, recognising our own needs and desires, and prioritising our own well-being. More specifically self-respect refers to the level of dignity and value an individual places on themselves and involves having a positive self-image and recognising one's own worth and capabilities. Having self-respect means setting boundaries, treating oneself with both kindness and compassion, and not engaging in self-destructive behaviours.

 It also means standing up and not allowing to be treated in a manner that is inconsistent with one self-values and beliefs. In a similar way, respecting the others means recognising the inherent worth, value, and dignity of every person, regardless of their colour, sex, language, religion, political or other opinions, national or social origin, property, or birth. It involves treating others with empathy apart from divergence or disagreements, listening to and valuing their perspectives and treating them with dignity and respect, regardless of differences in beliefs, values, or backgrounds. It also means recognising and respecting their boundaries and seeking to understand and support their needs and desires. Self-respect is accepting one's own strengths and weaknesses and working on one’s self-improvement where necessary, and respecting the others, means accepting the differences between people, which is the foundation of healthy relationships. Developing respect awareness is a process that requires active effort and conscious choice, which should be practised throughout life. Another aspect related to respecting oneself and others is self-confidence. 

Self-confidence refers to a belief in one's abilities and judgments, while self-esteem refers to an overall sense of self-worth. Both concepts are closely related to self-respect as they contribute to a positive self-image. It is an important aspect of self-respect, as it allows us to trust ourselves and our decisions.  Having self-confidence can help us to take risks, pursue our goals, and handle setbacks with resilience. A more confident person is not as defensive with others and is more open to accepting different ideas, opinions, and collaboration between peers since is not so concerned about protecting one's ego or image. In this way, stronger interpersonal relationships are built and maintained, contributing to the well-being of everyone involved. In order to build and maintain healthy relationships, it is important to cultivate self-respect and respect for others. This can involve practising self-care, such as engaging in activities that promote physical and emotional well-being.

06. Reproductive health: the purpose of reproduction

Reproductive health refers implies that people can have a satisfying and safe sex life, the capability to reproduce, and the freedom to decide if, when, and how often to do so. Every young person will one day have life-changing decisions to make about their sexual and reproductive health. But yet research shows that the majority of adolescents lack the knowledge required to make those decisions responsibly, leaving them vulnerable to coercion, sexually transmitted infections, and unintended pregnancy. Reproductive health is not well acquired for the entire population due to multifactorial reasons, such as insufficient knowledge about sexual health, sexuality, inadequate reproductive health information, and the spread of high-risk sexual behaviour, and discriminatory social customs, and gender roles regarding sex and reproduction. 

Risks in reproductive health: Risks in reproductive health refer to potential negative consequences or hazards that can affect the reproductive system and the overall reproductive well-being of individuals. These risks can arise from a variety of factors, including biological, environmental, social, and behavioural factors. They can impact both physical and mental health and can range from minor to severe. It is important to identify and address these risks to promote reproductive health and well-being, as well as to prevent negative consequences for individuals, families, and society as a whole. Therefore, this can involve a range of strategies, such as education, access to healthcare, contraception, early detection and treatment of health issues, and advocacy for policies that promote reproductive health and rights. Table 7 shows some of the potential risks that affect reproductive health.

Reproductive health is a crucial goal to achieving the United Nations Sustainable Development Goals (SDGs), namely, to ensure healthy lives and promote well-being for all at all ages; achieving gender equality and empowering all women and girls and reduce inequality within and among countries. Reproductive health includes a range of services and the interventions that support the reproductive health and rights of individuals, including: (1). Family planning: This involves the use of contraception to prevent unwanted pregnancy, and the planning and spacing of pregnancies to optimise health outcomes for both the mother and child. (2). Infertility management: This involves the diagnosis and treatment of infertility, and the provision of support services to individuals and couples experiencing difficulty in conceiving. (3). Maternal health: This includes the provision of prenatal care, safe and hygienic childbirth, and postnatal care to ensure the health and well-being of both the mother and the child. And (4). Prevention and management of reproductive cancers: This includes the screening, diagnosis, and treatment of cancers that affect the reproductive system, such as breast, cervical, and ovarian cancers.

07. Reproductive health: sex versus reproduction

Sex and reproduction are related concepts, but they are not the same thing. Sex is the act of sexual intercourse between the individuals, usually involving genital contact with the goal of sexual pleasure and/or reproduction. During the sexual intercourse, both partners may experience physical and emotional sensations of pleasure and intimacy. Human reproduction refers to the biological process by which offspring are produced, by the combination of genetic information of two individuals of different sexes. While sex is often necessary for reproduction to happen, sexual activity can occur without resulting in reproduction, being also a form of intimate communication, bonding, and pleasure between partners. It is important to note, however, that sexual intercourse should always be consensual and safe, with the use of the appropriate protection against sexually transmitted infections and unwanted pregnancies. 

So, reproduction refers to the biological process by which new individuals of a species are produced. Reproduction is the process by which offspring are produced through the fusion of gametes (sperm and egg) from two individuals. In most sexually reproducing species, males and females have distinct sex organs and roles in the reproductive process. From an evolutionary viewpoint, sexuality has been driven by the imperative to reproduce. During the 20th century, however, reproduction and sexuality began to move independently from each other, and today they can be, in many ways, considered separate, if not independent. And while sex is often associated with reproduction, not all sexual activities and behaviours lead to reproduction; sex without reproduction and/or sex for pleasure. In many species, sexual behaviour serves other purposes, such as social bonding, pleasure, or dominance displays. 

Though not all reproduction involves sexual behaviour, as asexual reproduction is common in many other organisms. Another approach is reproduction without sex. It is undeniable that in modern world, sexual activity will play a decreasing role in reproduction. Several technological advances have made a reality almost complete separation of sexuality and reproduction since in vitro fertilisation is increasing. Access to knowledge about both sex and reproduction is essential for achieving the foundation for one’s values, attitudes, and behaviours and for empowering the individual to make informed decisions about their bodies, their relationships, and their lives. Therefore, when sexual and reproductive health needs are not met, individuals are deprived of the right to make crucial choices about their own bodies and futures, with a cascading impact on their families’ welfare and future generations. And because women bear children, and also often bear the responsibility for nurturing them, sexual and reproductive health and rights issues cannot be separated from gender equality. The denial of these rights exacerbates poverty and gender inequality.

08. Conception as a life tool: literacy to decide

Conception usually refers to fertilisation, by which sperm from a male fertilises an egg from a female, and which result in the formation of a new individual with a unique set of genetic traits, being the first step in the biological process that leads to pregnancy. Conception is key aspect of sexual reproduction that allows for genetic diversity and adaptation to the changing environmental conditions. Through sexual reproduction, the genetic traits can be mixed and recombined, leading to new combinations of genes that may be better adapted to a given environment. And this genetic variation also helps to reduce the risk of genetic disorders and diseases, as harmful genetic mutations are less likely to be passed on to offspring. However, conception also has some social and philosophical ideas about when human life begins, so when specifying the time when a sperm fertilises an egg, is more accurate to use fertilisation alone. 

From an evolutionary perspective, conception is a very crucial life tool that enables the survival and proliferation of a species. However, it is important to note that not all individuals may wish to conceive, and thus, there are many different paths to a fulfilling and meaningful life. Ultimately, the decision to conceive should be a personal one, based on an individual's own values, desires, and life circumstances. So, literacy is an important tool in making informed decisions about conception because it enables the individuals to access and understand relevant information about reproductive health and contraception. Literacy about human conception refers to the ability to identify, understand, interpret, and/or communicate about the process of fertilisation and development of a foetus into a new-born. These include knowledge of anatomy, physiology, and biology related to reproduction and information about contraception, pregnancy, childbirth, and postpartum care. 

Being literate about conception means having a basic understanding of the biological processes involved in reproduction, as well as knowledge of various options for preventing or achieving pregnancy. This includes understanding how contraception works, the risks and benefits of different types of contraception, and how to use contraception effectively. Moreover, literacy about conception involves understanding the potential consequences of pregnancy, parenthood, including the physical, emotional, and financial demands of raising a child. This may include knowledge about various stages of pregnancy, the risks associated with childbirth, and the responsibilities of parenthood. So, strengthening literacy about conception can empower individuals to make informed decisions about both their reproductive health and family planning and can contribute to positive outcomes for the individuals, families, and communities. Conception and sexual literacy enable people to protect and advocate for their sexual health, well-being, and dignity by providing them knowledge.

09. Risky sexual behaviour: sexually transmitted infections

It is important to practice safe and healthy sexual behaviours to protect oneself and others from negative sexual health outcomes. If one engages in risky sexual behaviour, it is thus important to seek medical attention and get tested for STIs and HIV/AIDS. Risky sexual behaviour refers to any sexual activity that increases the likelihood of negative consequences such as unintended pregnancy, sexually transmitted infections (STIs). Examples of risky sexual behaviours include having unprotected sex, having multiple sexual partners, and engaging in sexual activities under the influence of drugs and/or alcohol. The practice of safe sex between partners and making informed decisions about sexual health are both essential to reduce the risk of negative implications in life, including using barrier methods such as condoms, getting tested regularly, and limiting the number of sexual partners.

Here are some examples of risky sexual behaviours: (1). Unprotected sex: having sex without using condoms or other forms of protection can increase the risk of contracting STIs and unintended pregnancy. (2). Multiple sexual partners: having multiple sexual partners can increase the risk of contracting and spreading STIs. (3). Alcohol and drug abuse: abusing alcohol or drugs before or during sexual activity can impair judgment and increase the risk of engaging in risky sexual behaviours. (4). Sex with high-risk partners: having sex with partners who are known to have a high risk of STIs, such as sex workers or intravenous drug users, can increase the risk of contracting STIs. (5). Lack of communication: not communicating with sexual partners about sexual health and history can increase the risk of contracting STIs and unintended pregnancy. (6). Non-consensual sex: engaging in non-consensual sexual activity, such as rape, can lead to physical and emotional trauma, as well as the risk of contracting STIs.

Sexually transmitted infections (STIs), also known as sexually transmitted diseases, are infections which are passed from one person to the other during sexual activity. STIs can be caused by bacteria, viruses, parasites, or other microorganisms. The STIs can be prevented by practising safe sex, such as using condoms or other forms of protection during sexual activity, getting regular STI testing, or limiting sexual partners. STIs can be treated with antibiotics, antivirals, other medications, but it is important to seek medical attention if an individual suspects that they might have an STI. Untreated STIs can lead to serious health problems such as infertility, cancer, and organ damage. STIs can have a range of symptoms, from mild to severe, and can have serious consequences if left untreated with a profound impact on sexual and reproductive health. STIs, such as HIV and syphilis, can have long-term health implications and may be life-threatening. STIs are among the most common causes of illness and have far-reaching health, social and economic consequences.

10. Practising healthy intimate relationships

Healthy intimate relationships are about being true to oneself; communication; respect; trust; support; fulfilment; equality; independence, and boundaries. Thus, gender literacy plays an important role in building healthy intimate relationships since gender literacy foresters understanding and knowledge of gender roles, norms, cultural values, and expectations in society. Therefore, healthy intimate relationships are built on a foundation of open and honest communication, and where partners support each other emotionally, physically, and mentally. These relations bring more happiness in one’s life than stress. Being in healthy intimate relationships, partners learn how to establish and maintain clear boundaries and openly express their needs and desires. They are also able to resolve conflicts in a respectful and non-violent manner and maintain their individuality while being committed to the relationship with another.

Sex and intimacy are different, but they are interrelated. Some individuals need to feel loved and cared for to be sexually intimate, and some need to engage in sexual activities to demonstrate that their love and care. And thus, there are four key forms of intimacy: (1). Physical, which means being in the same place at the same time and spending quality time together, like on a date night. (2). Emotional, which means sharing emotions and thoughts and connecting on a both an emotional and feeling level. (3). Sensual, which means physical touch and pleasure and other ways to physically connect that do not involve sexual acts, such as hugging and kissing. And (4). Sexual, which includes vaginal, anal, or oral sex, and other forms of sexual contact.

Though each person is different, all people, in the one way or the other desire different forms of intimacy to varying degrees in their relationships. Intimacy, in all its forms, has a variety of health benefits for body and mind. Healthy intimate relationships can have positive impacts on physical and mental health and can provide a sense of security, comfort, and happiness.  Gender literacy helps create a more inclusive, respectful, and fulfilling relationship where both partners feel safe, supported, valued. Gender literacy involves recognising and challenging gender stereotypes, respecting gender identity and expressions, communicating openly about gender issues, sharing responsibilities, and respecting boundaries. It requires ongoing education and open-mindedness to overcome deeply ingrained societal norms, cultural values, and expectations. Thus, gender literacy contributes to healthy intimate relationships through: (1). Understanding and challenging gender stereotypes: gender stereotypes create rigid expectations and limit the freedom and expression of individuals. (2). Respect for diversity: respect for diverse gender identities and expressions, allowing partners to embrace each other's differences and celebrate them.

11. Sexual health and hygiene

Sexual health and hygiene are important aspects of our overall health and well-being. Practising safe and healthy sexual habits, is the best way to maintain good sexual health and prevent health problems. Regular check-ups and consultations with a healthcare provider help to maintain a good sexual health and well-being. According to WHO, sexual health is a state of physical, emotional, mental, and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction, or infirmity. The WHO definition of sexual health reduces stigma by helping researchers, educators, clinicians, or policymakers acknowledge positive sexuality and sexual experiences as the key to adequate public health outcomes. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, and possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence. 

For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected, and fulfilled. Sexual health and hygiene guidelines are important to maintain overall sexual health and prevent sexually transmitted infections (STIs) and other negative consequences. Some general guidelines for sexual health and hygiene include sexual health as an important aspect of overall health and well-being. Sexual hygiene refers to the practices and habits that promote and maintain sexual health. Some guides to promote sexual health and hygiene are: (1). Communication between sexual partners: Open communication about sexual health, desires, and boundaries. Educate yourself about sexual health and communicate openly with your partner(s) about your sexual health history and STI testing status. (2). Practicing safe sex: using condoms or other forms of protection during sexual activity to prevent sexually transmitted infections (STIs) and unwanted pregnancies.

(3). Practicing good hygiene: keeping genitals clean and dry to prevent infections. Washing hands before and after sexual activity. Avoiding sharing personal items such as towels, razors, or sex toys that can spread infections. (4). Regular STI tests: getting tested for STIs regularly, especially if in a situation of multiple sexual partners. Early detection and treatment can prevent serious health problems. (5). Practice self-care: taking care of physical and mental health can support sexual well-being. Avoid sexual activity under the influence of drugs or alcohol, as this can impair judgment and increase the risk of negative consequences. (6). Seeking medical help if needed: any sexual health concerns, such as pain, discomfort, or abnormal discharge, require seek medical help from a healthcare provider. Regular gynaecological exams to maintain sexual and reproductive health helps to maintain sexual health.

12. Menstrual health and hygiene

Menstruation has always been present in the human species, but its significance varies substantially between societies, where in some societies, menstruators are considered sacred and powerful or dirty and impure. So, it is crucial to challenge cultural taboos and stigma surrounding menstruation and to promote menstrual health as a basic right and part of overall reproductive health. This is important as menstruation is a target of incomprehension, inequality, and discrimination. To understand menstruation deeply, or clearly, requires going beyond dominant preconceptions, beginning with the fact that menstruation is not only a “female” issue since we are not all binary people. The term menstrual health and hygiene (MHH) is used to describe the needs and experiences of people who menstruate, including easy and safe access to menstrual health information, supplies, and infrastructure needed to manage periods with dignity and comfort: referred to as menstrual hygiene management. 

It includes the systemic factors that link menstruation to other health, gender, sexual social, and cultural factors, and focuses on the empowerment youth to acquire knowledge and awareness needed to ensure menstrual health and hygiene. Menstrual health and hygiene are important aspects of reproductive health for the individuals who menstruate. Menstruation is a natural process that occurs when the lining of the uterus sheds and is expelled from the body through the vagina. So, menstrual blood contains blood, tissue, and other substances, and typically lasts for three to seven days. Maintaining good hygiene by washing the genital area before and after sexual activity and using clean and fresh menstrual products during periods, are crucial to maintain overall health and well-being. 

Some guidelines for menstrual health and hygiene are: (1). Using the right menstrual products: using menstrual products that are comfortable and appropriate for the flow. This may include tampons, pads, menstrual cups, or period panties. (2). Washing hands: Washing hands with soap and water before and after changing menstrual products. (3). Maintaining good genital hygiene: cleaning genital area with mild soap and water regularly to prevent infections. (4). Changing menstrual products regularly: changing menstrual products every 4 to 6 hours or as needed to prevent odour and leakage. (5). Using a backup method: using a backup method such as a panty liner or menstrual cup to prevent leakage during heavy flow. (6). Disposing menstrual products properly: wrapping used menstrual products in toilet paper or a bag and disposing them in the trash. Not flushing menstrual products down the toilet, as it can cause plumbing problems. (7). Practicing healthy lifestyle habits: good nutrition, regular exercise, and stress management can all help to maintain menstrual health. (8). Taking care of emotions: Menstruation can be a challenging time emotionally, so it is important to take care of the emotional health.

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