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Too little, too late: Young girls report poor menstrual health education

PSHE Pastoral issues Pupil wellbeing
Significant inadequacies in menstrual health education have left many students in the dark at a crucial time in their development – but things are improving.
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A study by academics has uncovered a lack of practical information being offered to young people, students being taught about periods too late, and attitudes which “perpetuate stigma”.

The study (Taylor & Greig, 2024), which has been led by the University of Bristol and Anglia Ruskin University, sought to understand what menstrual health education information is being delivered in schools in England – and how.

Based on responses from 140 young women, now aged 18 to 24, the study finds that 10% do not remember receiving any menstrual education whatsoever, while of those who were taught something, 1 in 5 did not receive lessons until after they had begun their period.

The research states: “On average, survey respondents reached menarche (the first menstrual cycle or first menstrual bleeding) at age 12.5, although this varied quite considerably, with an age range of 9 to 18. The age at which survey respondents were first taught about menstrual health at school ranged from 8 to 15, with a mean age of 10.5 years, often during the final year of primary school.”

The researchers found that lessons often focused on biological content with “a lack of practical information needed to help students manage menstruation and menstrual health”.

None of the participants were taught about menstrual health conditions and only a tiny minority were taught about potential abnormal symptoms. The young people in the study also said they had turned to other sources of information, particularly the internet and social media.

The age of the study’s participants means that many of them would have been taught before the latest statutory guidance on relationships and sex education (RSE) and health education was introduced in 2019.

The guidance stipulates that “puberty including menstruation should be covered in health education and should, as far as possible, be addressed before onset”.

Before the end of primary schools, pupils must be taught “key facts about puberty and the changing adolescent body, particularly from age 9 through to age 11, including physical and emotional changes”. They must also be taught “about menstrual wellbeing including the key facts about the menstrual cycle”.

Before the end of secondary, students must be taught “key facts about puberty, the changing adolescent body and menstrual wellbeing”.

The guidance adds: “The onset of menstruation can be confusing or even alarming for girls if they are not prepared. Pupils should be taught key facts about the menstrual cycle including what is an average period, range of menstrual products, and the implications for emotional and physical health.

“In addition to curriculum content, schools should also make adequate and sensitive arrangements to help girls prepare for and manage menstruation including with requests for menstrual products. Schools will need to consider the needs of their cohort of pupils in designing this content.”

The study’s findings show why this is so vital – some of the participants in the study admitted that they knew so little about menstruation that they did not seek medical attention for debilitating symptoms because they thought them normal, only to be later diagnosed with conditions such as endometriosis.

In extreme cases, the researchers said, some were so unprepared that when they started their periods they thought they were ill or even dying.

Some approaches to teaching also perpetuated stigma, the study finds. Separating girls from boys for these lessons “enhanced stigma” and “led to misunderstanding due the sense of secrecy it created and the feeling that menstruation should be hidden from males”. However, participants also reported problems with mixed classes in which “immaturity and shaming” from male students “perpetuated stigma and prevented others from engaging or asking questions”.

Ultimately, 62% of the participants rated the menstruation education they received as “poor” or “very poor” in preparing them.

However, since the study’s participants left school things do seem to have improved.

The latest young people’s RSE survey, an annual study carried out by the Sex Education Forum, found that 75% of respondents said they had learnt all they needed to know about puberty during their RSHE lessons – an improvement on previous years (SEF, 2024).

Poppy Taylor, a PhD researcher in Population Health Sciences at the University of Bristol, and corresponding author of the study, said: “Denying young people with information about their bodies risks significant long-term harm. Our findings suggest that for many young people, the menstrual health education they received failed to prepare them physically, mentally, or socially for their first period.

“We recommend that menstrual health education is improved through the delivery of earlier, more inclusive lessons with more practical content to ensure all young people are equipped to manage their menstrual health in a supportive environment.”