A recent Oregon Health & Science University study in the Journal of Pediatric & Adolescent Gynecology found significant misconceptions among young people about the safety of period management options — gaps in understanding that can limit quality of life and feed cycles of misinformation.
Using an online survey of U.S. residents ages 14 to 24 via the social media platform TikTok, researchers posed questions related to menstrual history and menstrual pattern preferences — specifically, period suppression and the absence of bleeding.
It's possible to delay or prevent a period with extended or continuous use of birth control pills or other types of hormonal medication, for example by skipping the non-hormonal placebo pills in a monthly birth control package. This method, known clinically as medication-induced amenorrhea, is normal, safe and does not cause any long-term consequences to health or fertility.
More than two-thirds of study participants indicated a preference to avoid any bleeding — if the method was assured to not have any permanent effects on the body. However, there were widespread misconceptions about the safety of this method: More than 63% of survey respondents felt it might be unsafe if hormone medications stop your period bleeding.
"Due to insufficient menstrual health education at school, these conversations are often left to families and friends, who may be perpetuating myths rooted in religious or cultural norms and biases. This can create a dangerous cycle of misinformation," said Maureen Baldwin, M.D., M.P.H., associate professor of obstetrics and gynecology in the OHSU School of Medicine and co-author of the study.
"Our goal as clinicians and researchers is to continue to normalize conversations about periods so young people can better understand their own bodies and make informed decisions about their health."
Standardized curriculum
The study is a continuation of OHSU's efforts to understand levels of menstrual health literacy across the country and the effect of various demographics, including geography, religion and age.
The OHSU-led research team in July published a study which found that, in this same online population of teens, health literacy is lower among adolescents with certain religious backgrounds and among those who live in the South.
These findings demonstrate the need for an evidence-based national curriculum for menstrual health, Baldwin said, including information that addresses the safe and effective use of hormonal medications for menstrual suppression, and the signs and symptoms of abnormal bleeding.
Currently, only 24 states in the U.S. mandate reproductive health as part of their schools' curriculum, and only 20 require information about contraceptive options.
"There's always a lot of discussion around sexual education, but if you look at any school curriculum, there is no other health education that's standardized in schools," Baldwin said. "There's no mandate that teaches kids at an age-appropriate level what a normal period should look and feel like, and the options available to help optimize quality of life when menstruating.
"Until we improve health education around menstruation, we will continue to battle rampant misinformation."
Looking forward, Baldwin and colleagues at the OHSU Center for Women's Health are focused on identifying the various components of a successful menstrual health curriculum. The team is working with clinicians to determine the elements to be included in the curriculum and at what age and grade levels certain topics, such as physiology and hormones, should be introduced.
"Periods are a normal, biological function experienced by half of the world's population," Baldwin said. "It's crucial we break down the stigma around this topic and empower young people to make health decisions that are best for them and their unique circumstances and preferences."
Research reported in this publication was supported by the National Institutes of Health (NIH) under Award Number K12HD085809. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
