16 Girls overall reported feelings of stigma, with almost half stating they felt embarrassed by their period. 16 Additionally, one in four felt unprepared for menarche. Plan International UK reports in a survey of 1000 girls and young women aged 14–21 living in England and Northern Ireland that one in seven girls did not understand what was occurring in their bodies at the start of menses. 14 15įurther evidence suggests that menstruation issues in adolescence are not solely confined to LMICs. 12 13 Studies conducted on the menstrual experiences of adolescents in LMICs, particularly a recent scoping review by Coast et al, highlight the limited understanding of puberty and menstruation among adolescents and the need for more robust evidence to evaluate the consequences of menstrual stigma on a young girl’s overall well-being and the efficacy of ongoing interventions in these settings. 11 Examples of interventions and initiatives to promote menstrual health and education are typically emphasised in low-income and middle-income countries (LMICs), such as programmes for reusable pads and the Water, Sanitation and Hygiene (WASH) curriculum for menstrual hygiene and education. 11 Limited understanding of menarche and menstruation can contribute to misunderstandings surrounding the process of fertilisation and pregnancy, and poor menstrual hygiene leaves one at risk of urinary and reproductive tract infections that can have lasting implications. These prepubertal and peripubertal years are a time when women build an understanding of their sexual selves and can make decisions that may impact their long-term reproductive and sexual health. 10 These findings have far-reaching implications on well-being, particularly if evidence suggests greater knowledge gaps in younger women, including adolescent girls.Īdolescence is an important time in a young person’s life, especially for young women. 10 Additionally, the authors noted significant differences in knowledge gaps by age, with more gaps being present among younger women aged 18–24. 9 In a larger survey of 1000 women in the USA of various ethnic, socioeconomic and educational backgrounds, about 40% of respondents demonstrated an incomplete understanding of the ovulatory cycle, and knowledge gaps in contraception and infertility risk factors were identified. 7 8 In a survey of 125 women in the USA, 52.8% of participants expressed knowledge of the ovulatory cycle and 50.4% knew the average length of a menstrual period. Despite its ubiquity, issues related to menstruation remain unaddressed or underaddressed, including the area of menstrual education.

Menstruation is a monthly marker of a woman’s reproductive potential. 5 6 While reproductive health research covers a wide array of topics, less work has been done to understand the various factors related to another key component of health: menstruation and menstrual health. 3 4 In considering some markers of reproductive health, the USA has higher rates of unplanned pregnancy and maternal mortality compared with other industrialised nations. Management of reproductive health issues remains a challenge for women of reproductive age in the USA, with disparities noted across racial/ethnic, socioeconomic and regional lines. 1 2 This period of reproductive potential is critical for both the health of the woman and any children she may bear. Women of reproductive potential aged 15–50 comprise about one-quarter of the US population.

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