Trial reportBMJ open2016
Menstrual cups and sanitary pads to reduce school attrition, and sexually transmitted and reproductive tract infections: a cluster randomised controlled feasibility study in rural Western Kenya.
Trial report in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 92 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
92 citing papers in PubMed, 9 syntheses or guidelines pooled it, 199 citations in OpenAlex.
- Effect of menstrual cups on vaginal health, reproductive tract and urogenital infections: a systematic review and meta-analysis.EBioMedicine · 2026Pooled it
- Pooled it
- Pooled it
- Earning pocket money and girls' menstrual hygiene management in Ethiopia: a systematic review and meta-analysis.BMC women's health · 2022Pooled it
- Systematic review of educational interventions to improve the menstrual health of young adolescent girls.BMJ open · 2022Pooled it
- Measurement in the study of menstrual health and hygiene: A systematic review and audit.PloS one · 2020Pooled it
- Menstrual cup use, leakage, acceptability, safety, and availability: a systematic review and meta-analysis.The Lancet. Public health · 2019Pooled it
- Women's and girls' experiences of menstruation in low- and middle-income countries: A systematic review and qualitative metasynthesis.PLoS medicine · 2019Pooled it
- Puberty and menstruation knowledge among young adolescents in low- and middle-income countries: a scoping review.International journal of public health · 2019Pooled it
- Characterizing the bacterial surface profiles of menstrual cups and their association with user characteristics and vaginal microbiomes in an adolescent cohort from western Kenya.Gates open research · 2026Trial
- Culture, self-esteem and menstrual hygiene management among adolescent girls in Uganda: the impact of economic and family strengthening.BMC women's health · 2025Trial
- Water, sanitation and hygiene at sex work venues to support menstrual needs.Frontiers in public health · 2024Trial
- Trial
- Does distribution of menstrual products through community-based, peer-led sexual and reproductive health services increase use of appropriate menstrual products? Findings from the Yathu Yathu trial.Reproductive health · 2023Trial
- Building menstrual health and hygiene-supportive environments: exploring teachers' experience in rural Western Kenya.Frontiers in public health · 2023Trial
- Trial
- Effects of sanitary pad distribution and reproductive health education on upper primary school attendance and reproductive health knowledge and attitudes in Kenya: a cluster randomized controlled trial.Reproductive health · 2021Trial
- Use of menstrual cups among school girls: longitudinal observations nested in a randomised controlled feasibility study in rural western Kenya.Reproductive health · 2018Trial
- A Framework for Women's Health Engineering Education: Pedagogical Foundations and Practical Implementation.Annals of biomedical engineering · 2026Review
- Menstrual Hygiene Knowledge and Its Determinants Among Adolescent Secondary Schoolgirls in Nasarawa West Senatorial Zone, Nigeria: A Cross-Sectional Study.Health science reports · 2026Article
32 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 7 institutions in 3 countries.
Funding
Abstract
objectivesConduct a feasibility study on the effect of menstrual hygiene on schoolgirls' school and health (reproductive/sexual) outcomes.
design3-arm single-site open cluster randomised controlled pilot study.
setting30 primary schools in rural western Kenya, within a Health and Demographic Surveillance System.
participantsPrimary schoolgirls 14-16 years, experienced 3 menses, no precluding disability, and resident in the study area.
interventions1 insertable menstrual cup, or monthly sanitary pads, against 'usual practice' control. All participants received puberty education preintervention, and hand wash soap during intervention. Schools received hand wash soap. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary: school attrition (drop-out, absence); secondary: sexually transmitted infection (STI) (Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoea), reproductive tract infection (RTI) (bacterial vaginosis, Candida albicans); safety: toxic shock syndrome, vaginal Staphylococcus aureus.
resultsOf 751 girls enrolled 644 were followed-up for a median of 10.9 months. Cups or pads did not reduce school dropout risk (control=8.0%, cups=11.2%, pads=10.2%). Self-reported absence was rarely reported and not assessable. Prevalence of STIs in the end-of-study survey among controls was 7.7% versus 4.2% in the cups arm (adjusted prevalence ratio (aPR) 0.48, 0.24 to 0.96, p=0.039), 4.5% with pads (aPR=0.62; 0.37 to 1.03, p=0.063), and 4.3% with cups and pads pooled (aPR=0.54, 0.34 to 0.87, p=0.012). RTI prevalence was 21.5%, 28.5% and 26.9% among cup, pad and control arms, 71% of which were bacterial vaginosis, with a prevalence of 14.6%, 19.8% and 20.5%, per arm, respectively. Bacterial vaginosis was less prevalent in the cups (12.9%) compared with pads (20.3%, aPR=0.65, 0.44 to 0.97, p=0.034) and control (19.2%, aPR=0.67, 0.43 to 1.04, p=0.075) arm girls enrolled for 9 months or longer. No adverse events were identified.
conclusionsProvision of menstrual cups and sanitary pads for ∼1 school-year was associated with a lower STI risk, and cups with a lower bacterial vaginosis risk, but there was no association with school dropout. A large-scale trial on menstrual cups is warranted.
trial registrationISRCTN17486946; Results.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.