Title : Exploring the relationship between violence and menstrual health in adult menstruators: A mixed-methods systematic review
Abstract:
Title: Exploring the Relationship Between Violence and Menstrual Health in Adult Menstruators: A Mixed-Methods Systematic Review.
Purpose: There is growing evidence that menstrual health inequalities negatively affect adolescents’ physical and psychosocial health. However, little is known about the relationship between violence and menstrual health among adult menstruators aged 18 years and above. Existing research has largely focused on younger populations, leaving a critical gap in understanding how experiences of violence intersect with menstrual health across adulthood. To ensure inclusivity, this review uses the term menstruators to encompass individuals who menstruate but may not identify as women. This systematic review aims to synthesise evidence on the bidirectional relationship between violence and menstrual health, examining how menstrual health challenges may increase vulnerability to violence and how exposure to violence may affect menstrual, physical, and psychosocial health outcomes
Methods: A systematic search of PubMed, CINAHL, MEDLINE, Embase, the Cochrane Library, and Taylor & Francis Global Health was conducted, alongside searches of grey literature sources including WHO, UNFPA, UNICEF, UN Women, and WaterAid. Two reviewers independently screened titles and abstracts, with full-text screening currently underway. The review follows PRISMA 2020 guidelines and has been registered with PROSPERO. Data extraction captures study characteristics, types of violence, prevalence estimates, associated risk factors, and impacts on menstrual, physical, mental, and psychosocial health. Data synthesis follows a convergent integrated mixed-methods approach, with qualitative findings synthesised thematically and quantitative data transformed to enable integration. Methodological quality is assessed using Joanna Briggs Institute (JBI) Critical Appraisal tools, certainty of evidence using the GRADE approach, while reporting quality of qualitative studies using COREQ, and grey literature using the AACODS checklist.
Results: The search identified 3,094 records. After removal of duplicates, 1,519 records were screened at title and abstract level, of which 131 studies were included for full-text review. Full-text screening and data synthesis will be complete in February 2026. Preliminary screening indicates substantial heterogeneity in study design, settings, and outcome measures.
Conclusions: By synthesising evidence on the intersections between violence and menstrual health among adult menstruators, this review aims to inform policy, programming, and preventive strategies across health and social sectors and identify critical gaps to guide future research.
