Abstract
Study Objective
To explore key aspects of menstrual health literacy and menstrual management in young
women at school or in tertiary education.
Design
Cross-sectional online survey.
Setting
Australia-wide.
Participants
A total of 4202 adolescent and young women (13-25 years of age; median age 17 years),
having reached menarche, living in Australia and currently attending school (n = 2421)
or tertiary education (n = 1781).
Interventions
Online survey hosted by Qualtrics between November 2017 and January 2018. Data were
collected on contraceptive use, management strategies, sources of information, and
knowledge of menstruation.
Main Outcome Measures
Information on prevalence and effectiveness of different management strategies, health-seeking
behavior, knowledge about menstruation, and common menstrual disorders such as endometriosis.
Results
The majority of young women did not seek medical advice for their menstrual symptoms,
but used information from the Internet (50%) and engaged in self-management, most
commonly with over-the-counter medications such as paracetamol (51%) or ibuprofen
(52%). Oral contraceptive use was relatively common (35%), and mostly for reduction
of menstrual pain (58%). Despite having significant dysmenorrhea, approximately one-half
of the participants (51%) thought that their period was normal. Women with higher
pain scores were more likely to rate their period as “abnormal” (P < .0001) but not more likely to consult a doctor (P = .13). Only 53% of those at school had heard of endometriosis.
Conclusion
Self-management of menstrual symptoms is common, but a significant minority of women
are underdosing or choosing ineffective methods. Most women do not seek medical advice
even when symptoms are severe, and cannot identify symptoms suggestive of secondary
dysmenorrhea. Improved education on menstruation is vital.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Pediatric and Adolescent GynecologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The prevalence and academic impact of dysmenorrhea in 21,573 young women: a systematic review and meta-analysis.J Womens Health (Larchmt). 2019; 28: 1161
- The Menstrual Disorder of Teenagers (MDOT) study: determining typical menstrual patterns and menstrual disturbance in a large population-based study of Australian teenagers.BJOG. 2010; 117: 185
- Prevalence and severity of dysmenorrhoea, and management options reported by young Australian women.Aust Fam Physician. 2016; 45: 829
- The prevalence and educational impact of pelvic and menstrual pain in Australia: a national online survey of 4202 young women aged 13-25.J Pediatr Adolesc Gynecol. 2020; 33: 511
- Health Literacy: A Prescription to End Confusion.National Academies Press, Washington, DC2004
- More than needles: the importance of explanations and self-care advice in treating primary dysmenorrhea with acupuncture.Evid Based Complement Alternat Med. 2016; 2016: 3467067
- Prevalence and impact of dysmenorrhea on hispanic female adolescents.Arch Pediatr Adolesc Med. 2000; 154: 1226
- Attitudes towards dysmenorrhoea, impact and treatment seeking among adolescent girls: a rural school-based survey.Aust J Rural Health. 2011; 19: 218
- Knowledge, attitudes, and consequences of menstrual health in urban adolescent females.J Pediatr Adolesc Gynecol. 2006; 19: 271
- Influence of dysmenorrhea and menorrhagia on academic performance among female students in tertiary institutions in Ondo State Nigeria.World J Soc Sci. 2016; 3
- Knowledge and attitudes towards dysmenorrhea among adolescent girls in an urban school in Sri Lanka.Nurs Health Sci. 2013; 15: 58
- Primary dysmenorrhea in young western australian women: prevalence, impact, and knowledge of treatment.J Adolesc Health. 1999; 25: 40
- World Endometriosis Society consensus on the classification of endometriosis.Hum Reprod. 2017; 32: 315
- Indigenous girls missing school during their periods: the state of hygiene in remote Australia.2017 (Available at:)
- Experiences and constructions of menarche and menstruation among migrant and refugee women.Qual Health Res. 2017; 27: 1473
- "In my culture, we don't know anything about that": sexual and reproductive health of migrant and refugee women.Int J Behav Med. 2017; 24: 836
- Sexuality education in Australian secondary schools 2010.Monograph Series. 2011; 80 (Melbourne: La Trobe University, the Australian Research Centre in Sex, Health & Society)
- 1249.0 Australian Standard Classification of Cultural and Ethnic Groups (ASCCEG).2019 (Available at)https://www.abs.gov.au/ausstats/[email protected]/Latestproducts/1249.0Main%20Features12019?opendocument&tabname=Summary&prodno=1249.0&issue=2019&num=&view=Date accessed: February 2, 2020
- Clinical assessment of the impact of pelvic pain on women.Pain. 2017; 158: 498
- Self-care strategies and sources of knowledge on menstruation in 12,526 young women with dysmenorrhea: a systematic review and meta-analysis.PLoS One. 2019; 14e0220103
- Dysmenorrhea in adolescents: diagnosis and treatment.Paediatr Drugs. 2008; 10: 1-7
- Nonsteroidal anti-inflammatory drugs for dysmenorrhoea.Cochrane Database Syst Rev, 2015: CD001751
- Significant, long-lasting pain relief in primary dysmenorrhea with low-dose naproxen sodium compared with acetaminophen: a double-blind, randomized, single-dose, crossover study.Curr Med Res Opin. 2019; 35: 2139
- Perceived ineffectiveness of pharmacological treatments for dysmenorrhea.J Womens Health (Larchmt). 2020; (Epub ahead of print)https://doi.org/10.1089/jwh.2020.8581
- What women say about their dysmenorrhea: a qualitative thematic analysis.BMC Womens Health. 2018; 18: 47
- Unmet needs and experiences of adolescent girls with heavy menstrual bleeding and dysmenorrhea: a qualitative study.J Pediatr Adolesc Gynecol. 2020; 33: 278
- Is my period normal? How college-aged women determine the normality or abnormality of their menstrual cycles.Women Health. 2007; 46: 41
- Menstrual symptoms, attitudes and consulting behaviour.Soc Sci Med. 1985; 20: 1065
- Menstruation: symptoms, management and attitudes in university students.Int J Gynaecol Obstet. 1991; 35: 147
- Menstruation during a lifespan: a qualitative study of women's experiences.Health Care Women Int. 2014; 35: 600
- Dysmenorrhoea, menstrual attitude and GP consultation.Br J Nurs. 1996; 5: 480
- Menstrual health and hygiene among Indigenous Australian girls and women: barriers and opportunities.BMC Womens Health. 2019; 19: 146
- Nonsteroidal anti-inflammatory drugs and hormonal contraceptives for pain relief from dysmenorrhea: a review.Contraception. 2010; 81: 185
- Diagnosis and management of dysmenorrhoea.BMJ. 2006; 332: 1134
- Oral contraceptive pill for primary dysmenorrhoea.Cochrane Database Syst Rev. 2009; 4: CD002120
- Prevalence of menstrual pain in young women: what is dysmenorrhea?.J Pain Res. 2012; 5: 169
- A Scottish postal survey suggested that the prevailing clinical preoccupation with heavy periods does not reflect the epidemiology of reported symptoms and problems.J Clin Epidemiol. 2005; 58: 1206
- Factors predisposing women to chronic pelvic pain: systematic review.BMJ. 2006; 332: 749
- A longitudinal study of adolescent dysmenorrhoea into adulthood.Eur J Pediatr. 2019; 178: 1325
- Girls in power: gender, body, and menstruation in adolescence.State University of New York Press, Albany, NY2006
- Examining self-care behaviors and their associated factors among adolescent girls with dysmenorrhea: an application of Orem's self-care deficit nursing theory.J Nurs Scholar. 2015; 47: 219
- Endometriosis education in schools: a New Zealand model examining the impact of an education program in schools on early recognition of symptoms suggesting endometriosis.Aust N Z J Obstet Gynaecol. 2017; 57: 452
- Big data and dysmenorrhea: what questions do women and men ask about menstrual pain?.J Womens Health. 2018; 27: 1233
- Exploring the unmet needs of parents of adolescent girls with heavy menstrual bleeding and dysmenorrhea: a qualitative study.J Pediatr Adolesc Gynecol. 2020; 33: 271
- Prevalence of pain symptoms suggestive of endometriosis among Finnish adolescent girls (TEENMAPS Study).J Pediatr Adolesc Gynecol. 2016; 29: 97
- Dysmenorrhea, absenteeism from school, and symptoms suspicious for endometriosis in adolescents.J Pediatr Adolesc Gynecol. 2014; 27: 258
- Spectrum of symptoms in women diagnosed with endometriosis during adolescence vs adulthood.Am J Obstet Gynecol. 2018; 218: 324.e1
- Endometriosis and chronic pelvic pain have similar impact on women, but time to diagnosis is decreasing: an Australian survey.Sci Rep. 2020; 10: 16253
- The cost of illness and economic burden of endometriosis and chronic pelvic pain in Australia: a national online survey.PLoS One. 2019; 14: e0223316
- Fertility and endometriosis.Clin Obstet Gynecol. 2017; 60: 497-502
- Period Talk.(Available at:)
- PEPP Talk.(Available at:)
- Schools Program.(Available at:)
- Webinars.(Available at:)
- 2016 Census.2017 (Available at)https://www.abs.gov.au/censusDate accessed: February 2, 2020
Article info
Publication history
Published online: November 11, 2020
Footnotes
All the authors reported no conflict of interest.
As a medical research institute, NICM Health Research Institute receives research grants and donations from foundations, universities, government agencies and industry. Sponsors and donors provide untied and tied funding for work to advance the vision and mission of the Institute. This study was not specifically supported by donor or sponsor funding to NICM.
Identification
Copyright
© 2021 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
