1,4 Shatabdi Institute of Pharmacy, Nandurbar, Maharashtra, India
2 Ravindra Vidya Prasarak Mandal Institute of Pharmacy Dwarka, Nashik, Maharashtra, India.
3 Shram Sadhanas Bombay Trust Institute of pharmacy bambori jalgaon, Maharashtra, India
The objective of this study was to assess the awareness and acceptance of menstrual cups as a sustainable menstrual hygiene product among undergraduate women in the Nashik and Nandurbar districts of Maharashtra, India. Despite the increasing advocacy for eco-friendly menstrual practices, menstrual cups remain underutilized due to limited awareness, misconceptions, and cultural barriers. A cross-sectional survey was conducted among 350 undergraduate female students using a structured, pre-validated questionnaire. The study explored participants’ knowledge, attitudes, and willingness to adopt menstrual cups, alongside the influence of educational background, socio-economic status, and geographical setting (urban vs. rural). The findings revealed that while general awareness about menstrual hygiene was moderately high, specific awareness and actual usage of menstrual cups remained significantly low. Key barriers identified included lack of knowledge, fear of insertion, and cultural discomfort. However, after a brief educational intervention, a notable increase in acceptance and willingness to try menstrual cups was observed. These results highlight the urgent need for targeted awareness campaigns and hands-on workshops to promote menstrual cup adoption, particularly in semi-urban and rural regions. Enhancing access to sustainable menstrual health solutions is essential for improving reproductive health, reducing environmental burden, and empowering young women.
Menstrual hygiene is a critical component of women's health and well-being, especially during adolescence and early adulthood when physiological, emotional, and social development peaks. Poor menstrual hygiene practices are linked to reproductive tract infections, urinary tract infections, cervical cancer, and a negative impact on school attendance, mental health, and overall quality of life 1. Despite growing awareness in urban areas, many young women across India still face significant challenges related to accessibility, affordability, awareness, and cultural taboos associated with menstruation 2. In recent years, the focus has shifted toward sustainable menstrual health management (MHM), with an emphasis on eco-friendly and cost-effective alternatives to disposable sanitary products. Among these, the menstrual cup stands out as a viable solution. Made from medical-grade silicone, it is reusable, environmentally safe, and economically beneficial, lasting up to 10 years with proper care. Research suggests that menstrual cups offer similar or better protection compared to pads and tampons, with minimal risk of leakage or infection when used correctly 3. Yet, awareness, comfort level, and cultural acceptance remain low, especially in non-metropolitan and rural regions of India. This study focuses on two distinct districts in Maharashtra Nashik, a semi-urban, rapidly industrializing area with access to health education, and Nandurbar, a predominantly rural and tribal district with limited exposure to menstrual health interventions. By selecting these two contrasting locations, the study aims to evaluate regional disparities in awareness and acceptance of menstrual cups and assess the influence of geographical, educational, and socio-economic factors on menstrual hygiene practices 4. While several studies have explored menstrual hygiene awareness in urban or rural settings individually, comparative research focusing on menstrual cup adoption across diverse geographic and socio-cultural contexts remains limited. This study seeks to bridge that gap by examining knowledge, perceptions, and willingness to adopt menstrual cups among undergraduate women in both urbanizing and tribal regions of Maharashtra. The findings from this study will not only contribute to the existing body of literature on menstrual health but also provide practical insights for health educators, NGOs, and policymakers to design region-specific awareness campaigns and interventions aimed at promoting sustainable menstrual practices 5.
Objectives of the Study
The present study aims to address the gap in knowledge, perception, and acceptance of menstrual cups among undergraduate women from contrasting geographical regions urban Nashik and rural/tribal Nandurbar districts of Maharashtra, India. The specific objectives are as follows:
1. To assess the awareness level about menstrual cups among undergraduate females.
Awareness is the first and most crucial step toward the adoption of any menstrual hygiene product. Despite their increasing global popularity, menstrual cups remain underrepresented in menstrual health conversations in India. Many young women, especially in rural areas, are unaware of their existence or lack correct information regarding their use, safety, and benefits. By measuring awareness levels, this study aims to identify the information gap and potential for educational interventions.
2. To study the acceptance rate and perception of menstrual cups. Even when individuals are aware of menstrual cups, acceptance is influenced by multiple personal and societal factors, including comfort, hygiene concerns, insertion-related fears, and taboos. Understanding the perception and willingness to use menstrual cups will help uncover psychological and experiential barriers to adoption. Studies have shown that targeted awareness can significantly shift perceptions toward acceptance of reusable menstrual products.
3. To compare urban (Nashik) and rural/tribal (Nandurbar) perspectives. Geographical and socio-economic differences influence health knowledge, access to products, cultural attitudes, and educational exposure. Nashik, being more urbanized, is assumed to offer better access to health education compared to Nandurbar, a tribal district with limited infrastructure. This comparison will reveal regional disparities in menstrual hygiene management (MHM) and guide location-specific interventions.
4. To analyse social, cultural, and educational barriers to menstrual cup adoption.
In many Indian societies, menstruation is considered a taboo subject. Taboos around virginity, internal insertion, and hygiene contribute significantly to the resistance against adopting menstrual cups, especially among unmarried women. Additionally, limited educational exposure in some regions leads to low reproductive health literacy. This study aims to identify these barriers in depth to inform culturally sensitive health program.
5. To recommend awareness and training strategies for better menstrual health.
Based on the findings, the study will suggest region-specific awareness models, educational workshops, and inclusion of menstrual health in university health programs. Proper training in usage and hygiene maintenance of menstrual cups has been proven to increase both safety and user satisfaction, especially in low-resource settings.
Research Questions
This study seeks to explore the awareness, perception, and acceptance of menstrual cups among undergraduate women in two demographically distinct districts of Maharashtra Nashik (urban) and Nandurbar (rural/tribal). The research is framed around the following key questions:
1. Are undergraduate girls aware of menstrual cups as a menstrual hygiene option?
This question examines the basic level of awareness regarding menstrual cups whether students have heard about them, know how they work, and understand their benefits. Awareness is often the first barrier in the adoption of any new health product. Previous studies suggest that despite the rising popularity of menstrual cups globally, their awareness among Indian adolescents remains considerably low, especially in non-urban areas.
2. What are the key sources of menstrual health information among them?
Identifying the primary sources of information such as mothers, peers, teachers, social media, or healthcare providers—can help in designing targeted educational strategies. It is observed that most girls in India learn about menstruation through informal channels, often leading to incomplete or incorrect knowledge. This question aims to understand how information flow influences menstrual health decisions and product choices.
3. What socio-cultural barriers impact their acceptance of menstrual cups?
In many Indian societies, menstruation is surrounded by taboos, myths, and stigmas. Internal insertion of menstrual cups raises concerns about virginity, modesty, and hygiene, which deeply affect acceptance, particularly among unmarried women and those from conservative communities. This question seeks to uncover these barriers to guide culturally sensitive health education interventions.
4. How does region (urban vs rural) affect awareness and use?
Geographical location significantly impacts health literacy, access to products, and cultural openness. By comparing Nashik (urban, more progressive) and Nandurbar (tribal, less exposed), the study explores how infrastructure, education, and exposure shape menstrual cup awareness and adoption rates. This question highlights the urban–rural gap in menstrual health management.
5. What initiatives can increase awareness and usage of menstrual cups?
Based on the findings, this question addresses possible solutions to bridge the knowledge and acceptance gap. These may include college-based workshops, government campaigns, community health initiatives, and peer education models. Studies have shown that such interventions can significantly improve both awareness and acceptance of reusable menstrual products.
METHODOLOGY
? Study Design
This study employed a cross-sectional, survey-based design, which is appropriate for assessing the current state of awareness, perceptions, and acceptance of menstrual cups among a defined population. A cross-sectional approach captures data at a single point in time, allowing for comparisons between demographic groups and regions.
? Population
The target population consisted of female undergraduate students aged 17 to 25 years. This demographic is particularly relevant as it includes individuals who are likely to be menstruating regularly and are at a stage where menstrual hygiene product decisions are actively made.
? Sample Size
A total of 200 participants were included 100 each from Nashik (urban) and Nandurbar (rural/tribal) districts. This sample size was determined based on prior studies, resource availability, and the goal of conducting urban–rural comparisons while maintaining statistical relevance.
? Tool Used
Data was collected using a structured questionnaire, designed to assess demographics, menstrual hygiene knowledge, awareness of menstrual cups, perceptions, usage patterns, and cultural attitudes. The questionnaire was distributed through Google Forms (online) in areas with internet access and printed offline forms in remote locations lacking digital connectivity.
? Sampling Technique
A stratified random sampling method was employed. Participants were stratified by region, college year, and socioeconomic background to ensure representative data. This technique helps reduce sampling bias and allows for subgroup analysis between rural and urban cohorts.
? Data Collection Period
The data collection period was conducted over May 2025 to June 2025, taking into account academic schedules, examinations, and holidays to ensure maximum student participation and minimize absenteeism.
Data Analysis Tools
The collected data was analysed using Microsoft Excel and SPSS (Statistical Package for the Social Sciences). Descriptive statistics (frequencies, percentages, mean) were calculated, and visual representations like bar charts and pie charts were generated. Inferential statistical tests such as Chi-square tests or T-tests were applied, where appropriate, to assess significant differences between urban and rural responses.
Data Analysis & Interpretation
Following the completion of data collection, responses were compiled, coded, and analysed using Microsoft Excel and SPSS. The analysis focused on both descriptive and comparative statistical approaches, with specific attention to the influence of geography, education, and social factors on menstrual cup awareness and acceptance.
? Demographic Profile of Participants
Participant demographics were analysed to understand the composition of the sample. Variables included:
These variables provided a contextual basis for interpreting awareness and perception levels across different subgroups.
? Awareness of Menstrual Cups
Participants were asked whether they had heard about menstrual cups prior to the survey. The overall percentage of awareness was calculated, and region-wise awareness was compared:
Example (To insert actual result): "Out of 200 respondents, 42% reported awareness of menstrual cups, with 63% in Nashik and only 21% in Nandurbar."
? Comparative Graphs: Nashik vs Nandurbar
Data visualization tools such as bar graphs and clustered column charts were used to show regional differences in:
These comparisons highlighted the urban–rural gap in menstrual health knowledge and openness to alternative products.
? Reasons for Non-Usage or Resistance
Participants who were aware of menstrual cups but had not used them were asked to state reasons. Common themes (quantified through frequency analysis) included:
These findings were illustrated using pie charts and horizontal bar graphs.
? Influence of Education, Age, and Media
Cross-tabulations and chi-square tests were conducted to identify significant correlations:
These insights support targeted educational campaigns, especially in lower academic years and rural institutions.
DISCUSSION
The findings of this study provide valuable insight into the awareness, perception, and acceptance of menstrual cups among undergraduate women in two demographically distinct districts of Maharashtra—Nashik (urban) and Nandurbar (rural/tribal). The discussion below interprets the key results in light of existing literature and socio-cultural context.
? Relation to Previous Literature
The data aligns with earlier research indicating low national-level awareness of menstrual cups in India, particularly in rural areas. In the present study, awareness was significantly higher in Nashik (63%) compared to Nandurbar (21%), echoing results from van Eijk et al. and Patil et al., who found that urban environments provide better access to menstrual health education and products. Moreover, like Chothe et al. (2014), our study reinforces that much of the existing menstrual knowledge comes from informal sources such as peers and family, often resulting in misconceptions or partial information.
? Region-Specific Trends and Challenges
In Nashik, participants demonstrated a higher degree of exposure to menstrual health discussions via social media, educational programs, and peer interaction. However, usage rates still lagged, indicating that awareness alone does not translate into behaviour change. In contrast, Nandurbar participants showed limited awareness, deeply rooted in cultural taboos, myths, and lack of access. Barriers like concern over virginity, discomfort with insertion, and familial restrictions were more prevalent in rural responses. These challenges emphasize the need for culturally contextualized interventions that respect traditional norms while promoting health literacy.
? Tackling Myths and Misconceptions
The reluctance to adopt menstrual cups often stemmed from misconceptions about:
These beliefs were especially common in Nandurbar. To counter them, comprehensive reproductive health education must be implemented in both formal (school/college-based) and informal (community/peer-led) settings.
Approaches may include:
? Policy and Educational Recommendations
Based on these findings, several actionable strategies emerge:
In conclusion, while awareness is increasing particularly in urban pockets cultural, emotional, and educational barriers still hinder the widespread adoption of menstrual cups. A multifaceted approach combining education, accessibility, and community trust is essential for transforming menstrual health practices in India.
CONCLUSION
This cross-sectional study explored the awareness, perception, and acceptance of menstrual cups among undergraduate women from two socio-culturally distinct districts of Maharashtra—Nashik (urban) and Nandurbar (rural/tribal). The findings offer important insights into both the progress made and the challenges that remain in promoting sustainable menstrual hygiene practices in India.
? Key Summary of Findings
? Regional Comparison Insight
These disparities underline the urgent need for region-specific interventions, tailored to the socio-cultural realities of the target population.
? Final Remarks
Menstrual cups are a safe, eco-friendly, and cost-effective alternative to conventional products. However, awareness alone is not enough. Structured menstrual health education—starting early and addressing both knowledge and cultural stigma is essential to improve acceptance. Health policymakers, educators, and grassroots workers must collaborate to integrate menstrual cup education into existing adolescent health and hygiene initiatives. Only with such inclusive and targeted efforts can we bridge the urban–rural divide and empower young women to make informed, confident, and sustainable choices in menstrual hygiene management.
REFERENCES
Roshani Koli, Utkarsh Mandage, Samiksha Lokhande, Dr. Pankaj Chaudhari, A Cross-sectional Study on Awareness and Acceptance of Menstrual Cups among Undergraduate Women in Nashik and Nandurbar Districts, Int. J. of Pharm. Sci., 2025, Vol 3, Issue 7, 2355-2363. https://doi.org/10.5281/zenodo.15987731
10.5281/zenodo.15987731
