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Background There is a piece of growing evidence that associates menstrual practices with menstrual health. But menstruation has always been accompanied by various taboos and myths. Findings from qualitative studies have highlighted that these taboos and myths impact the psychosocial outcomes of the menstruators, ultimately affecting their menstrual health. However, no quantitative study has explored this link between menstrual practices and menstrual health. Thus, as a part of this study, we try to understand the role of taboos and myths as a mediator in explaining the relationship between menstrual practices and menstrual health. Methods The study uses the data from a cross-sectional survey of 683 active menstruators from India. First, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was used to develop and validate a new scale on Menstrual Health. Next, structural equation modeling was used to test the hypothesized relationship between menstrual practice and menstrual health. Results A clean one-factor scale was observed for the Menstrual Health scale using EFA and CFA with the fit measures (CFI= 0.99; RMSEA=0.059; SRMR=0.017; GFI=0.994). Data analysis, performed using structural equation modeling (CFI= 0.952; RMSEA=0.044; SRMR=0.047; GFI=0.959), revealed that the taboos and myths fully mediate the relationship between Menstrual Practices and Menstrual Health. The indirect effect reveals menstruators with perceptions of taboos and myths are more likely to have poor menstrual health. The ratio of the indirect effect to the total overall effect is 0.506. Conclusions Taboos and Myths are detrimental to the menstrual health of the menstruators. Different bodies like the government, policymakers, and NGOs should address this issue by conducting education and awareness programs for the menstruators, specifically targeting the socio-cultural aspects of menstruation to improve the menstrual practices and dissolve the taboos and myths around menstruation. Key messages Menstrual practices and taboos and myths are significant determinants for menstrual health. Educational interventions must be done to promote awareness around the myths and best menstrual practices that society can adopt.

Taboos and Myths as a mediator of the Relationship between Menstrual Practices and Menstrual Health