Pediatricians’ knowledge, attitudes and practices surrounding menstruation and feminine products

Abstract

ObjectiveThis study investigates whether primary care pediatricians adhere to the American Academy of Pediatrics (AAP) recommendations by routinely evaluating patients’ menstrual cycles and educating patients about menstruation and feminine products. Additionally, this study examines pediatricians’ knowledge and attitudes surrounding menstrual health topics.MethodsA 53-item online questionnaire was developed to evaluate pediatricians’ knowledge, attitudes and clinical practices regarding menstruation-related topics. The questionnaire was emailed to 2500 AAP members using a geographically-stratified sampling approach, with pediatricians in each state selected randomly. Mann-Whitney U tests, t-tests, and logistic regressions were used to assess associations between correlates and pediatricians’ knowledge, attitudes and practices.ResultsFive hundred and eighteen out of 2500 pediatricians participated (response rate = 20.7%), 462 met inclusion criteria; 78.8% were female, 79.2% were Caucasian. The majority of the pediatricians (58.2%) were “not at all” or only “slightly” familiar with the AAP guidelines on anticipatory guidance surrounding menarche. Many reported they do not routinely provide anticipatory guidance regarding menstruation to pre-menarchal patients (24.7%), discuss menstruation with post-menarchal patients (33.1%) or ask patients the date of their last period (28.4%). The majority were unlikely to discuss feminine products with patients. Gaps in menstruation-related knowledge were noted. Male pediatricians were significantly less likely to evaluate patients’ menstrual cycles and provide patient-education regarding menstruation-related topics, and had significantly lower self-rated and measured knowledge of these topics.ConclusionsA concerning number of pediatricians in a national sample do not abide by AAP recommendations surrounding menstruation and exhibit knowledge gaps in this area. To effectively address the health needs of female patients, pediatricians should better incorporate menstrual health care into their clinical practice.

Incorporating menstrual health into routine pediatric primary care

“…A recent national survey of AAP members found that 25–33% reported either not routinely providing AG, not asking about the last menstrual period (LMP), or not discussing menstruation at all. 7 Male pediatricians were less likely to provide AG, ask about menses patterns, and had overall lower knowledge of the menstrual cycle. 7 A review of electronic medical records (EMR) from New Jersey adolescents aged 12–21 found less than five percent and ten percent of family physicians and pediatricians, respectively, obtained a history inclusive of menarche, LMP, length of cycle, and presence of associated symptoms.…”

Menstrual Health Stigma in the United States: Communication Complexities and Implications for Theory and Practice

“…18 Prior research has noted that male pediatricians are less likely to discuss menstruation with postmenarchal patients and report feeling less knowledgeable about menstruation than their female colleagues. 18 This same survey also revealed variability in pediatricians' ability to correctly answer questions about the average length of bleeding during menstruation and their self-reported levels of understanding regarding tampons, pads, and menstrual cups. 18 Considering midwives' expert clinical knowledge and specialization in relationship-based, reproductive health care that focuses on communication, health education, diversity awareness, and community health, 6 midwives are in a unique position to recognize and address the general lack of understanding regarding menstruation in a sensitive, culturally competent, and effective way.…”

“…Furthermore, and quite alarmingly, knowledge limitations regarding what constitutes a normal menstrual cycle also extend to health care professionals 18 . Prior research has noted that male pediatricians are less likely to discuss menstruation with postmenarchal patients and report feeling less knowledgeable about menstruation than their female colleagues 18 .…”

“…Furthermore, and quite alarmingly, knowledge limitations regarding what constitutes a normal menstrual cycle also extend to health care professionals 18 . Prior research has noted that male pediatricians are less likely to discuss menstruation with postmenarchal patients and report feeling less knowledgeable about menstruation than their female colleagues 18 . This same survey also revealed variability in pediatricians’ ability to correctly answer questions about the average length of bleeding during menstruation and their self‐reported levels of understanding regarding tampons, pads, and menstrual cups 18 .…”

Social media exposure, interpersonal network, and tampon use intention: A multigroup comparison based on network structure

“…Additionally, tampons can better satisfy women’s needs for physical exercise (e.g. swimming) when menstruating ( Singer et al, 2020 ). As such, tampons may benefit many Chinese women’s health, well-being, and quality of life during menstruation.…”