Girls’ Gaps in Menstrual Health Knowledge Surprising

For more than half of the people, menstruation is a fact of life. You would expect that most would be well versed in the ins and outs of menstrual health but that is simply not true for young women.

When asked, the gaps in knowledge are surprising. Girls’ understanding of how the female reproductive system works is low. Their basic knowledge of anatomy is poor, confusing the vagina with the vulva. Even with those who have had periods for about two years, only about half of them knew when their cycle starts. Less than 9% could determine when ovulation occurs.

Does this differ between different types of schools Catholic v independent, single-sex v co-ed? Not really, turns out shortfalls in knowledge are present across all systems according to researcher Dr Felicity Roux from Curtin University.

“Since girls prefer learning about this subject without boys present, we hypothesised that students at girls-only schools might have better knowledge than students at co-educational schools because these lessons may be more easily facilitated with all-female cohorts than mixed,” Dr Roux said.

“Additionally, since the Catholic Church promotes natural fertility regulation requiring comprehensive knowledge of the menstrual cycle, we hypothesised that students at Catholic schools might have better knowledge. Finally, it was postulated that apps have the facility to communicate cycle information, which may give users an advantage in knowing when ovulation and menstruation occur. In all three instances, there was little difference found.”

Understanding menstrual health is important. Menstrual cycles are a material reality for half of the world’s reproductively mature population. Menstrual cycles last for about 40 years and embodies liminal milestones of menarche, fertility, and menopause.

Menstruation has been considered a negative and stigmatizing experience, which risks cascading into shame around other healthy functions such as breastfeeding.

The menstrual cycle can be used as a personal health monitor. There is a high prevalence of menstrual dysfunctions which have been ignored for too long (e.g., Australian adolescents 93% self-report period pain, 96% premenstrual symptoms, 41% heavy bleeding, 73% with mood disturbance.

Understanding menstrual health makes possible the restoration of good health by co-operating with the cycle to resolve or manage dysfunctions using medications and/or surgery.

“Menstrual health is taught in puberty around Years 5/6. Some schools may invite external facilitators in additional years. Often, such facilitators will address problems, such as pain. One major concern is the quality of the materials used.

“Schools have been invited to train their teachers in Health and in Science for menstrual education, and to train their school health care team for menstrual health care. Additionally, resourcing community guest speakers is beneficial. Getting teachers, healthcare staff and community guest speakers to work together in lockstep and deliver the same consistent message has already been achieved in a recent trial conducted in Western Australia by Curtin University.

“Ideally, schools and parents work together to gently and appropriately inform girls of their menarche before it happens. Thereafter, education ideally is on-going as a series of developmentally appropriate conversations as girls’ bodies mature with establishing ovulatory regularity,” Dr Roux says.

Just as there is no “one-size-fits-all” with the cycle, so there is no “one-size-fits-all” for how schools can implement menstrual health education and care. Use of the WHO’s Health Promoting School framework allows this flexibility and adaptation to context. Details are in this publication: Mixed Method Evaluation of My Vital Cycles®: A Holistic School-Based Ovulatory Menstrual Health Literacy Program.

The project website for this is www.myvitalcycles.com

“Our ongoing research seeks schools who are willing to be trained in delivering this in their own schools.

“Not understanding their cycles means they are more likely in instances of dysfunction, to give an inaccurate history to their doctor; and an inability to follow their doctor’s directives in taking cycle-timed tests to aid diagnoses,” Dr Roux says.