Menstrual Health and Hygiene among Adolescents in the United States

Abstract

Study objective: Menstrual health in adolescents has been understudied in the United States. We aimed to assess patient and provider perspectives surrounding menstrual health management and screening.

Design: Our mixed-methods approach consisted of provider surveys, patient surveys, and patient interviews.

Setting: Participants were recruited from a pediatric gynecology practice or an adolescent medicine clinic at an urban tertiary academic center.

Participants: Providers were pediatrics faculty or residents. Patients aged 13-24 years were eligible.

Intervention: Participants completed an anonymous survey or semi-structured interview about their experiences with menstrual health.

Main outcome measures: Descriptive statistics and thematic content analysis were used for quantitative and qualitative data, respectively. Convergent parallel analysis elucidated key findings in both data sets.

Results: The provider survey response rate was 65% (69/106); 15% (9/69) of providers consistently asked patients about menstrual products, whereas 44% (27/68) were concerned patients could not afford products. The patient survey response rate was 85% (101/119); 19% (19/101) of respondents reported menstrual hygiene insecurity, 55% (55/101) missed commitments during menses, and 45% (45/101) discussed menstrual products with providers. Fifteen patients were invited for qualitative interviews; 10 were conducted, and thematic saturation occurred. Interviews highlighted the importance of comprehensive early menstrual health education and providers' role in menstrual management.

Conclusion: Adolescence is a crucial point of entry into health care. Because taboos surrounding menstruation could limit access to health care, menstrual health education must be emphasized. Menstrual health education is provided piecemeal by parents, schools, and providers. Current practice should be reevaluated to consider comprehensive educational approaches in which health care leads.

Keywords: Adolescence; Menstrual education; Menstrual health.