Introduction
Menstrual hygiene defined as the practice of using clean materials to absorb menstrual blood safely, hygienically, and as needed throughout the duration of the menstrual cycle [1]. It affects multiple areas across the sustainable development goal agenda including health, education, gender equality, and water and sanitation. [2]
Menstruation is commonly defined normal biological process experienced by every female. [1] Adolescent period is the important in the life of a woman. There is a lack of knowledge and awareness in females regarding reproductive health that can be due to various barriers. [3] menstrual hygiene management as females using a clean menstrual management material to absorb or collect blood that can be changed  in the duration of the menstruation  using soap and water for washing and having access to facilities to dispose of used menstrual management materials [2]

Menstrual hygiene management (MHM) practices vary by socio-cultural factors like educational background and economic status [1, 2]. MHM is known by the methods of washing, drying and storing reusable pads as well as other various factors like menstruation-related changing and washing practices. These practices can be influenced by water, sanitation and hygiene facilities at the household level [3]. MHM practices can be unhygienic with poor wash access [3] and have been found to be associated with different reproductive tract infections {BV, and vulvo-vaginal candidiasis (VVC⁾ [3].

Type of infections

Urogenital infections
Poor menstrual hygiene is related to the several infections. Women who use something other than a disposable pad are suffering from urogenital infections or non-sexually transmitted infections.

Yeast infection
Washing hands after changing sanitary napkins is always necessary. Those who   do not do can suffer from the risk of suffering from a yeast infection or even Hepatitis B.

Fungal infections
Using unclean sanitary napkins can lead to several health problems one of them are being fungal infections.

Urinary tract infection
Urinary tract infection is one of the most common forms of infection in girls and women of menstruating age caused mainly due to unhygienic menstrual practices.

Cervical cancer
Unhealthy menstrual practices are linked to cervical cancer.

Bacterial vaginosis
It is a type of infection which occurs due to the poor menstrual practices to be a risk factor for preterm delivery.

Factors affecting hygiene practices and then ultimately leading various infections.
Menstrual hygiene is a topic that is insuffuently acknowledged and has not received sufficient attention. Poor personal hygiene and unsafe sanitary condition leads to various gynecological problem i.e. cervix cancer.

Low socio –economic status
It is the most influencing facts on the behavior of female which is related to affordability it is the biggest reason why females are using clothes, and substandard menstruating absorbent. There is a link between low income/low social status and lack of knowledge, leading to poor menstrual hygiene practices. Repeated uses of same napkins or the improper cloth and napkins lead to microorganism causing vaginal infections.

Lack of information regarding personal hygiene.

There is a lack of Awareness regarding menstrual hygiene’s, Availability and quality of napkins, used during that period role of Regular water supply, Privacy, role of Proper disposal of napkins, Reproductive health education and Family support.

 Embracement and ignorance (traditional taboos)

 Poor water supply and sanitary conditions.
Due to poor water supply generally in rural areas females’ faces difficulty in     maintaining proper standards of hygiene in menstruation as it is very inconvenient t to move long distances for water. And due to the inappropriate designs of girls’ toilets and   poor sanitary facilities like lack of sanitary disposal in toilets i,e  lack of bins caused various problems for the females.

Infections and other health problems
There is relation between poor menstrual hygiene and health problems such as Urinary and Reproductive Tract Infections (UTI). There is a higher risk of infections during menstruation when the cervix opens up and creates a pathway for bacteria to enter the uterus and pelvic cavity scientifically  the pH in the vagina is less acidic and this creates a good environment for yeast infections such as Candidiasis during the  period of menstruation

Association between vaginal infections and cervix cancer
It leads to vaginal infections due to unhygienic practice i.e bacterial vaginosis linked to cervix cancer intraepithelial neoplasia, an abnormality of cervical cells bacterial vaginosis may be co –factors to the potentially cancer causing (HPV) and the relation between HPV and development of CIN and cervical cancer is well documented. Hygiene-related poor practices of females are considered important because it can increase vulnerability to Reproductive Tract Infections (RTI's). Mostly females in rural areas use rags and old clothes during menstruation, which leads to various infections. Poor menstrual hygiene is one of the major reasons for the high prevalence of RTIs in the country and contributes significantly to female morbidity.

Sanitary napkins can be a precautionary measure to reduce the risk of cervical cancer among women. Females face Reproductive Tract Infections, or other diseases developing from unhygienic menstrual practices. Other Then poverty and ignorance, superstition is also a discouraging factor in use of sanitary napkins. The body's immunity level being poor during the time of menstruation unsanitary practices lead to ailments, some of which might even lead to chronic, like cervical cancer.

Various Intervention strategies to improve menstrual hygiene management for females.

By improving female’s education and awareness programs regarding importance of MHM through advertisements. As there is essential need of empowering women about the menstrual hygiene because it is significantly related to the reproductive health of women through advertisements.

Providing sanitary pads in minimal charges, so that it can be affordable to the females from low income groups and initiating the Use of clean sanitary products (disposable or reusable) .various effective strategies are needed awareness  regarding the  use of Napkins/sanitary pads and its disposal..

Improved wash and female friendly facilities. Key aspects of WASH    interventions relevant to menstruation were derived from the WHO [5] report on Water, Sanitation and Hygiene standards for schools in low-cost settings, because inadequate wash facilities acts as a barrier in achieving in MHM, mainly the inavaiblitiy of clean absorbents.

Clean water supply for MHM (e.g., availability and access of water within latrine or private areas)

Provision of soap or disinfectant for body.

improvements in privacy or safety of females.

Conclusion
Lot of Ignorance and feeling of embarrassment of or being unable to apply proper means of menstrual hygiene has a negative impact on the physical and mental wellbeing of females and it is mainly due to low socio-economic status, poor and inadequate sanitation and water supply conditions are causing no of infections in female which is further causing gynacoloeogical problems as well as their educational level is also playing a important role and it is the biggest reason of girls from being unaware. Improving females’ menstrual hygiene practices and providing more insight in the female reproductive cycle are hence of paramount importance. To maintain good hygienic standards, it is important to kill harmful bacteria that cause infections by using sanitary pads properly. The lack of necessary facilities, including safe water and appropriate toilet facilities, and the absence of opportunities and proper amenities to keep clean and change pads and menstrual cloths .There is a need to provide all the basic amenities require for maintaining good menstrual management .and through advertisement should be done to make females aware about the importantance of MHM. .and there is need have make various intervention strategies to improve menstrual hygiene management for females .There is need to provide the feasibilable, efficacious methods to improve the  impact of health education interventions in improving the standard  of knowledge, attitude and practices of women related to menstrual hygiene management  and make the  cost-effective strategy through information, education, and behavior changes related to the menstrual hygiene management .

No requirement of ethical approval

Financial support and sponsorship : Nil

Conflicts of interest: There are no conflicts of interest