Characterizing menstrual health and education needs among menstruating adolescents: A cross-sectional study on dysmenorrhea, cycle irregularities, and menstrual education

Purpose Recognizing normal and abnormal menstrual features is essential for the early detection of gynecologic conditions, facilitating timely medical care and preventing associated biopsychosocial impacts. However, there is limited information on menstrual cycle characteristics, clinical profiles, and education among menstruating adolescents in Puerto Rico, as well as how these factors relate to sociodemographic factors such as age, school type (public/private), region of residence (metropolitan/non-metropolitan and residential zone (urban/rural). Methods This cross-sectional study was designed to assess the menstrual cycle characteristics, symptoms and dysregulations, self-reported menstrual conditions, and sources of menstrual education available to menstruating adolescents across Puerto Rico. An anonymous online survey designed by the study team was disseminated via social media, text messaging, and in collaboration with the Department of Education of Puerto Rico. Differences in the likelihood of receiving education, sources, trusted figures, and level of understanding and comfort regarding menstrual health topics and clinical outcomes (moderate-severe menstrual pain, emergency room (ER) utilization) based on sociodemographics factors were assessed by logistic regressions. Results Analysis of data from 1094 menstruating adolescents showed high rates of menstrual symptoms, particularly severe dysmenorrhea and cycle irregularities, with substantial impacts on daily life. Participants living in urban areas had higher odds of reporting prior menstrual health education. Older participants were more likely to receive information through school classes, social media, and physicians. Students in public schools had lower odds of reporting media and physicians as key sources or trusted contacts. Comfort discussing menstrual health topics increased with age, while perceived understanding of the menstrual cycle did not differ significantly across sociodemographic groups. Moderate to severe menstrual pain was not associated with sociodemographic factors, whereas ER visits varied by age, region, and school type that may determine access to care. Conclusion This study revealed high prevalence of menstrual irregularities and pain among menstruating adolescents, emphasizing the need for improved menstrual health education and implementation of early intervention strategies. Significant disparities in education, trusted figures, comfort and ER utilization across demographics demonstrate the importance of tailoring menstrual health initiatives to address the unique needs of this population.