title: The effect of wearing sanitary napkins of different thicknesses on physiological and psychological responses in Muslim females.
abstract: BACKGROUND
  Menstruation is associated with significant unpleasantness, and wearing a sanitary napkin (SN) during menses causes discomfort. In addition, many Muslim women use a thick type of SN during menses due to the religious requirement that even disposable SNs be washed before disposal. Therefore, the objective of this study was to measure the physiological and psychological responses to wearing SNs of different thicknesses during menstruation and non-menstruation phases at rest and during physical activity/exercise among Muslim women.
  
  
  METHODS
  Eighteen Muslim females were randomly assigned to wear an ultra slim type (US, thin) or a maxi type (MT, thick) SN on two different occasions (i.e., during non-menses and menses). Each subject tested both types of SN. Upon arriving at the laboratory, each subject was equipped with an ambulatory electrocardiograph and rested in a seated position for 10 min. She was then given either an US or MT SN, put it in place, and rested in a seated position for 10 min. Each subject then walked at 3 km/h for 10 min, sat resting for 10 min, and then walked at 5 km/h for another 10 min. At the end of each 10-min stage, subjects marked their feelings of discomfort on the visual analog scale (VAS). Perceived exertion during exercise was evaluated using the Borg scale. Heart rate and low frequency-to-high frequency ratio (LF/HF) of heart rate variability were continuously recorded during rest and exercise.
  
  
  RESULTS
  During both the non-menses and menses trials, VAS and LF/HF were significantly lower in subjects using the US SN compared to the MT SN. These results indicate that when wearing the US SN, subjects were more comfortable and did not increase sympathetic activities. Meanwhile, perceived exertion during exercise had no significant difference between US and MT although the means of the scores for US tended to be lower than those of MT.
  
  
  CONCLUSIONS
  The results of this study (VAS and LF/HF) indicate that wearing an US SN induces less physiological and psychological stress compared to wearing a MT SN. Thus, use of the former will empower women to live their lives with vitality during menses.
authors.forename: Nazirah G
authors.initials: NG
authors.lastname: Mohamed
authors.forename: Nurdiana Z
authors.initials: NZ
authors.lastname: Abidin
authors.forename: Kim S
authors.initials: KS
authors.lastname: Law
authors.forename: Mika
authors.initials: M
authors.lastname: Abe
authors.forename: Megumi
authors.initials: M
authors.lastname: Suzuki
authors.forename: Ahmad M Che
authors.initials: AM
authors.lastname: Muhamed
authors.affiliation: Lifestyle Science Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam, 13200 Kepala Batas, Penang, Malaysia. rabindar@amdi.usm.edu.my.
authors.forename: Rabindarjeet
authors.initials: R
authors.lastname: Singh
mesh_terms: D000328:Adult; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007514:Islam; D052576:Menstrual Hygiene Products / Q000706:statistics & numerical data*; D008598:Menstruation / Q000523:psychology*; D064232:Visual Analog Scale; D016387:Women's Health; D055815:Young Adult