Researchers call for comprehensive menstrual education in British schools

Teaching about periods in schools is still too focused on basic biological facts with insufficient information around how menstruation can affect a woman's mood and wellbeing, problems associated with menstrual bleeding and the impact on physical and academic performance, concludes a new study by UCL (University College London) researchers.

The survey and focus group-based research, published in the academic journal Women's Health, also suggests that periods should be taught amongst mixed sex groups as well as single sex at both primary and secondary schools, something which some schools don't currently do.

Sex (also known as relationships) education has been compulsory in English primary and secondary schools since 2020, and earlier this year was updated to include topics such as endometriosis, polycystic ovary syndrome (PCOS) and heavy menstrual bleeding. Sex education, including on periods, is also compulsory in Welsh schools, but isn't in Scotland.

But, the researchers say, for many pupils in Britain, that amounts to just two lessons about periods in their whole school career, one in primary school and one in secondary school.

Now the academics behind the UCL study are calling for lessons on periods in British schools to be much more comprehensive.

Professor Joyce Harper (UCL Institute for Women's Health) said: "Educating pupils about periods may now be compulsory in schools in England and Wales, but we know that for many of them that still only amounts to two lessons in their entire school career.

"Our survey suggests that those lessons are still very much concerned with the basic biological facts around menstruation – what we and the women who participated in our study are calling for is that lessons on menstruation need to be much more comprehensive, and cover everything from what effect periods can have on a girl or woman's well-being and academic and sporting performance, to what abnormal bleeding looks like.

"Our focus groups were also of the view that boys need to be part of that education. It was agreed that classes should not be segregated by gender, believing mixed sessions are crucial for boys' education.

"Although some saw value in single-sex classes to allow students to speak more freely, they still felt mixed sessions were essential to improve overall understanding.

"They suggested this could help boys understand and support their friends and future partners through menopause.

"Through work with the International Reproductive Health Education Collaboration and Wellbeing of Women, we are providing teachers with resources to support teaching about menstruation."

Fifty-five women took part in the study divided into two groups based on age: 26 women aged 18 to 25 and 29 women aged 26 to 40. Five focus groups were conducted for each group.

They were recruited via the researchers' social media accounts and on that basis the scientists believe they were mostly living in the UK. Many were educated before the topic on menstruation became mandatory in English and Welsh schools.

As part of the survey each participant was asked the following questions: how do you feel about having a period?; how does your period affect your well-being?; how do you manage your period and menstrual cycle, and what support do you need (e.g. food, exercise, period trackers, work)? Do you talk to your friends or partner?; and how could we improve education around menstruation, and how was your education at school?

One participant pointed to a serious lack of education around periods:

"The priority should be to teach the practical application of these hormonal changes; how might we expect these changes to affect our mood, social battery, physical performance and academic performance throughout the month."

In their report, the researchers said that menstruation continues to be "highly stigmatised" and that a "lack of education and normalisation of difficult periods restricts individuals from seeking help".

Co-author Caroline Musulin (UCL Institute for Women's Health), who conducted the 18-25-year-old study group, said: "Many women endure menstrual problems longer than they should due to the inability to speak openly about uncertainties, fears of being dismissed by healthcare professionals, the view that it's 'just' a painful period or feelings of shame.

"Stigma, secrecy, and the expectation to 'cope' with painful periods contribute to the systemic dismissal of menstrual discomfort.

"Strict behavioural expectations to conceal menstruation and resource limitations contribute to negative experiences, where dissatisfaction with menstrual practices and management environments exist, along with feelings of disgust if participants feel they have failed to manage their menstruation discreetly."

Co-author Dr. Natania Yeshitila (UCL Institute for Women's Health) who conducted the 26-40- year-old study group, said: "The participants felt very strongly that this was missing from the education they had received.

"Many believed normal physiological processes, like vaginal discharge, were abnormal. The lack of education on how external factors, such as stress and contraceptive methods, can impact menstrual cycles was another point of confusion."

Limitations

The recruitment via social media and word of mouth may have introduced sampling bias by attracting people of a similar demographic to the researchers.

Also, the study only included cisgender women and further studies need to be conducted on gender-diverse individuals, the researchers said.