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Heavy, prolonged periods and severe menstrual pain are linked with lower school attendance and poorer GCSE scores, according to new research.
The England-based study found that more than a third of girls (36%) who participated experienced heavy or prolonged menstrual bleeding, which was associated with missing an additional 1.7 days of school every year.
These symptoms were associated with achieving about one grade lower at GCSE, as well as 27% lower odds of achieving five standard GCSE passes, often required to enable a student to go on to the next stage of their education.
Girls were also asked about severe cramps and pain during periods, which was experienced by more than half (56%) of participants and was linked with an additional 1.2 days off school and half a grade lower at GCSE.
“Our study suggests that heavy or prolonged bleeding and menstrual pain are associated with lower school attendance and educational attainment,” the report concluded.
“More research is needed to understand the mechanisms behind these associations and to develop strategies to tackle menstruation-related inequalities to mitigate negative impacts of menstrual symptoms on education.”
The authors suggested that menstrual anxiety, concerns about leaking, feelings of shame and embarrassment owing to menstrual stigma, bullying, challenges managing symptoms while in school, and difficulties accessing toilets during lessons, as well as the experience of debilitating symptom, may also be contributing to difficulties.
The findings were based on analysis of data from 2,700 girls aged 13 to 16 who were taking their GCSEs between 2006 and 2009, drawn from the Avon Longitudinal Study of Parents and Children.
The girls were interviewed four times over a three-year period about the nature of their periods, and their contributions were analysed alongside absence and educational attainment data.
“We have to be careful we do not label women as being less capable because of their periods,” said Gemma Sharp, associate professor of epidemiology at the University of Exeter, who supervised the research. “I would not say it’s because of their periods. It’s because society is not set up to support people whilst they are menstruating, particularly if they are experiencing heavy bleeding or pain.”
The study is out as a preprint but has not yet been published, and is under review at npj Science of Learning. Its findings will be presented at the Menstruation Research Conference in London next week by Gemma Sawyer, a PhD student at the University of Bristol who conducted the research.
Commenting on the study, Jaysan Charlesford, a lecturer in psychology at the University of Plymouth, said: “It’s a very important window into what’s happening in schools, and may also speak towards ‘pipeline’ issues whereby people with bad menstrual experiences in school are less likely to attain at a level that would allow them to enter higher education.
“Of course, given that this disproportionately impacts women and girls, it should be taken very seriously as a matter of inclusion and equity.”
A separate report on period inequality published this week found that school toilets are often kept locked and permission to be excused from lessons denied, “leaving some learners on their periods to bleed through their uniforms”.
Led by the phs hygiene services group, alongside the global menstrual justice charity Irise, the research suggests two in three students (65%) are unable to access toilets at their school freely at any time, with almost a third (29%) needing permission from a teacher to leave the classroom and 15% requiring a pass.
Chrissy Cattle, the chief executive of Irise International, said: “Restricted toilet access in schools remains a major barrier to education for young people who menstruate. Education is a right, and no student should have to choose between their period and their learning.”
Julie McCulloch, the senior director of strategy and policy at the Association of School and College Leaders, added: “Schools are doing their best to support pupils who are suffering as a result of heavy and painful periods, but clearly this is a serious issue that is having a real impact on their health and wellbeing.”
