Menstrual health symptoms and literacy among young women in Aotearoa New Zealand: A nationwide cross-sectional survey.

Study objective: To explore menstrual cycle symptoms, information sources and menstrual health literacy in young women (aged 13-25) and those who menstruate in Aotearoa New Zealand.

Design and setting: Cross-sectional online survey in Aotearoa New Zealand.

Participants: 1334 respondents (age 13-25 years, mean age 19.8), who have had at least three periods and were currently living in New Zealand.

Interventions: Online survey hosted by Qualtrics between October 2021, and January 2022.

Main outcome measures: Information on menstrual cycle characteristics and symptoms, and menstrual health literacy.

Results and conclusions: Respondents reported high rates of regular dysmenorrhoea (89%), fatigue/tiredness (78.1%) and mood changes (72.5%) associated with menstruation. A higher proportion of rangatahi (younger generation) Māori reported irregular cycles (53.5%) compared to non-Māori respondents (41.7%). Normalisation of symptoms, especially pain (80.2%), was high. Most respondents recognised the need to see a doctor for period pain which impacted their daily lives (84.7%). However, non-cyclical pelvic pain (45.7%), heavy bleeding (39%) and intermenstrual bleeding (29%) were less likely to be recognised as symptoms that require a doctor's visit. The main sources of menstrual health knowledge prior to menarche were a family member (74.2%) and health and physical education classes at school (63.7%). Many young people reported receiving little or no information about periods prior to menarche (37.9%), with very few respondents receiving information on how to manage menstrual symptoms (15.1%). Menstrual symptoms are common and the provision of culturally safe information and opportunities to learn is important for young people, whānau, schools and healthcare practitioners.