Research reveals menstrual education lacking in Australia

Research conducted by Western Sydney University reveals young people in Australia are not receiving adequate information or education about periods and menstrual management.

The research findings published in the Journal of Psychosomatic Research, report on the evaluation of a free web-based resource, Menstruation Matters, created by the University and health experts to help provide young people with a greater understanding of menstrual health, specifically around what a normal period is, how to identify menstrual issues and symptoms, and importantly when to see a doctor.

Of the pilot study's 75 participants, almost half (48%) said the resource had changed what they thought was a normal period, and 94% could now identify symptoms of endometriosis.

The web-based resource also provided a variety of evidence-based self-care menstrual management strategies that participants could do at home, including yoga postures, breathing exercise and dietary advice.

Furthermore, the study found that due to using the web-based resource and information presented:

• 85% would keep using at least one of the self-care practices they learned.
• 60% changed the way they managed their menstrual symptoms.
• 43% visited their doctor regarding their menstrual symptoms during the study and of those 84% did so due to the information presented on the resource.
• 54% who visited their doctor received a referral to a gynecologist.

Participants involved in the research were living in Australia, aged between 14 to 25 years, with 20 years the average age, had menstruated for at least 12-months, and had regular periods.

Project lead and first author, Dr. Mike Armour from Western Sydney University's NICM Health Research Institute says the findings reveal gaps in the menstrual health education delivered in school and what information is needed to develop young people's menstrual health literacy.

"From our study, only 40% of the participants reported they had learned about menstrual health in their Health and Physical Education (HPE) classes," says Dr. Armour.

"We know from our past research that most young people in Australia don't find what they learn about menstruation in these school classes helpful, as the classes are mostly about biology and very little on management or what is 'normal' when it comes to periods.

"Because period pain is so common, most people think it's just something you need to put up with. But this can lead to both poor pain and symptom management, or even worse, missing more serious underlying causes for period pain, like endometriosis.

"Menstrual issues such as period pain or heavy bleeding affect more than 90% of women aged under 25 in Australia and can affect attendance rates and concentration in school or higher education or work. Understanding how to manage period symptoms with medication and non-medication strategies like yoga can help reduce pain and in turn help young people be able to perform better at school or university, and able to participate in their normal activities," says Dr. Armour.

The researchers also highlight in the paper participant's increased uptake of self-care measures over the course of the study, especially in breathing/meditation exercises and acupressure.

Exercise has the most significant reduction in pain compared to other self-care measure, such as heat, but uptake was lower than other forms of self-care.

The study also provided participants with a self-screening tool (PIPPA), which if they scored high populated a letter for use with a doctor explaining the score received and relevance.

This letter may have given young people the confidence to present to a doctor and ask for more investigations.

"The feedback from participants has been very positive and the website is now available for everyone to access freely. We are exploring further ways to deliver the information, such as a smartphone app, to ensure that not only young people, but their teachers and parents/guardians, have access to accurate, evidence-based information on menstruation and its management," says Dr. Armour.

The researchers are currently surveying Australian parents, guardians, teachers, and young people to ensure the Menstrual Matters resource has everything needed for those involved in teaching or managing menstruation.

People interested in participating can complete the short online survey, available in English, Mandarin, Arabic, Cantonese, or Vietnamese, up until December 2022.

The pilot web-based resource, Menstruation Matters, was developed from research conducted in 2018 by the researcher team, which surveyed over 4,000 young women about periods and what they understood.

The project team included researchers from NICM Health Research Institute, the University's School of Health and Science, and the School of Education, as well as experts in period pain, women's health, health promotion and education.

The paper, "Evaluation of a Web-Based Menstrual Health Literacy Resource," is available online.