The US lacks adequate education around puberty and menstruation for young people – an expert on menstrual health explains

One thing few people have been talking about since Roe v. Wade was overturned is how abortion restrictions will affect young girls across the United States.

Around the time of their first period, many young people learn the basic mechanics of managing their periods, such as how to put on a pad or tampon and that it happens once a month. Traditionally they might also receive some admonishment to keep their period hidden. Young people may get information about menstruation from a family member, friends or a teacher, or by searching on the internet.

But often it is only later that they learn and truly understand the more complex details about the menstrual cycle. This includes guidance around regular and irregular patterns and when to seek medical care for any shifts in timing, duration or the overall experience, including the severity of menstrual pain or heavy bleeding. These conversations also have clear implications for ovulation and pregnancy prevention.

Now, with the overturning of Roe v. Wade, young people who begin to menstruate will also need to learn early on how to recognize a missed period as soon as possible. In the past, a young person’s delay in mentioning that a period was late or skipped a few months might not have presented any particular urgency. However, going forward, in contexts where a ban on abortions beyond a very short period of weeks exists, even one missed period could have serious implications for a young person’s life.

Conversely, it’s critical that young people know that irregular periods can be normal and that it’s not always cause for alarm.

I have been researching young people’s experiences with menarche – the onset of menstruation – around the world for almost 20 years. In 2018, my team began to explore the experiences of American girls with their periods, including their recommendations for what all young girls need to know as they enter puberty and begin to menstruate.

Based on those suggestions and insights, we published “A Girl’s Guide to Puberty and Periods,” a body-positive illustrated graphic novel-style book that includes first period stories, advice and questions written by girls.

Globally, I have learned that girls growing up in Africa, Asia and here in the U.S. often receive inadequate information and support about their periods.

Information about menstruation is inadequate

Menstrual health literacy, or a person’s understanding of the menstrual cycle and its intersection with one’s health and well-being, is essential from the time leading up to the first menstrual period through menopause.

Both the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics have recommended that just as doctors and nurses check someone’s blood pressure or temperature at each visit, they should also ask about periods.

These professional societies suggest that health care providers prepare girls and their families for the onset of menstruation and ensure that they understand the variation in menstrual patterns.

My team’s U.S. study focused on adolescent girls in Los Angeles, New York and Chicago. Our findings, along with research on state-level menstruation education standards across the country, suggest that the U.S. is a long way from delivering menstrual health literacy to the population. Our research indicated that many girls received no guidance before their first period or had been given information that felt dated and hard to relate to. Think educational videos made in the 1990s.