(043) Menstrual Stigma and the Role of Culture and Religion in the South Asian Diaspora: A Pilot Cross-Sectional Study of a Nation-Wide Cohort

Abstract Introduction Menstruation is a physiologic component of female reproductive health; however, equitable access to supplies, safe spaces to menstruate, and comfort during cycles-aspects of menstrual equity - continue to impact menstruators in the U.S. While the role of cultural and religious biases on menstrual equity has been observed in South Asian populations globally, their impact in the immigrant South Asian population in the United States-a growing community-remains sparse. Objective To explore the potential impact of cultural and religious values on menstrual attitudes and equity in the South Asian community in the US. Methods This cross-sectional exploratory study was conducted from March to November 2024 as part of a larger ongoing qualitative study evaluating South Asian beliefs regarding menstruation. The survey was distributed via multiple social media channels inviting South Asian identifying menstruators to complete a 33-item Menstrual Attitudes Questionnaire, which evaluated beliefs about menstruation and personal menstruating experiences. Quantitative data was evaluated using descriptive statistics and univariate linear regression modelling. Results One hundred and one respondents completed the survey. Most were between ages 11-12 years (53.5%) at menarche and reported regular cycles (59.4%). About 11.9% characterized their bleeding as heavy, with some reporting use of non-standard hygiene products such as toilet paper (20.6%), paper towels (7.5%), and rags (3.1%). Most respondents were moderately familiar (34.7%) or very familiar (43.6%) with menstrual products, with sanitary pads most commonly cited (53.8%), followed by tampons (16.2%). Over time, most became more comfortable discussing menstrual needs with family. Regression models suggested individuals more strongly influenced by cultural or religious values were more likely to deny these effects on their views of menstruation. Conclusions Self-identified cultural and religious menstrual influence did not directly alter perceptions of and stigma around menstruation within the South Asian community in the United States. Further studies should include development of a validated scale to better capture the modern and diverse menstrual experiences of South Asian communities-a necessary tool to achieve menstrual equity in the U.S. Additionally, the early menarche reported by nearly half the respondents emphasizes the need for physicians to recognize the effects of environmental exposures, diets changes, lifestyle habits, and acculturation on South Asian bodies to understand and prevent early menarche, particularly in a community already vulnerable to metabolic disease. Disclosure No.