A recent study published in the Journal of Pediatric & Adolescent Gynecology reveals significant gaps in functional ovulatory menstrual health literacy among adolescent females in Western Australia. The cross-sectional study, using a validated adolescent ovulatory menstrual health literacy questionnaire, assessed 297 participants aged 13.5 to 17 years from nine schools, including both single-sex and co-educational institutions. The objective was to evaluate adolescents' understanding of key menstrual cycle events, such as ovulation and menstruation. Participants had an average age of 14.9 years, with a mean of two years since the onset of menstruation.
Just over half of the participants (51.4%) accurately recognized that the first day of the menstrual cycle begins with the start of menstruation. Participants were most familiar with identifying the Fallopian tubes, with 88.5% correctly recognizing them, while the vulva was the least recognized, identified by only 37.7%.
The findings revealed that while 61.6% of participants expressed interest in learning about menstrual health, functional knowledge of key menstrual events was limited. Only 8.4% of participants correctly identified ovulation's timing within the menstrual cycle. Attending a single-sex or Catholic school, or using mobile health apps, did not confer a significant overall advantage in menstrual health knowledge. However, app users demonstrated better anatomical understanding, particularly regarding the cervix (66.9%) and uterus (77.5%). Catholic school attendees were less able to identify certain anatomical parts (cervix, vagina, vulva) compared to those from Independent schools.
More than half (52.2%) of participants who had begun menstruating reported using menstrual tracking apps. The most frequently used apps included Flo (58 users), Clue (26 users), Period Tracker (15 users), Apple (13 users), and Fitbit (9 users).
The study reported that 69% of participants experienced dysmenorrhea, a decrease from the 80% prevalence reported in a 1999 study of Western Australian adolescents. Notably, 24.5% of participants reported missing at least one day of school in the past semester due to menstrual disturbances. Mothers (91%), friends (61%), and mobile applications (52%) were identified as the primary sources of information.
Qualitative analysis of open-ended responses highlighted five recurring themes: normality, menstrual flow, charting, ovulation, and dysmenorrhea.
The authors suggest that a review of menstrual health education is warranted, given the overall low functional ovulatory menstrual health literacy. They note that incomplete foundational knowledge likely hampers progression to acquiring complete ovulatory menstrual health literacy.
The study was supported by the Australian Government Research Training Program Scholarship, and the authors reported no conflicts of interest.