Period pain and heavy bleeding linked with lower school attendance and GCSE results
Previous studies have reported that many young people take time off school and struggle to concentrate in school because of difficult experiences related to menstruation.
However, the role of specific period symptoms and their effect on exam performance and attainment are not well understood. Our recent study examined whether menstrual pain and heavy bleeding – an under-researched symptom – may have implications for school attendance and attainment.
Menstrual-related pain and heavy bleeding are commonly experienced menstrual symptoms. For many, these symptoms may be minor and have few consequences. For others they can be severe and have a significant impact on daily life.
Normalisation of these symptoms makes it difficult for people, especially young people, to identify whether their symptoms are problematic. Societal pressures to hide or conceal menstruation and menstrual stigma also foster feelings of shame, making it challenging to have conversations about periods or ask for help. As a result, many people struggle with menstrual symptoms that affect their health and wellbeing.
We conducted research using data from the Children of the 90s study, which has followed a group of children in the UK from birth into adulthood. In this study, 2,698 teenagers who experienced periods between the ages of 13 and 16 were asked about their experiences of heavy or prolonged bleeding and menstrual-related pain.
We linked this information with data from the Department for Education about the amount of school absences the young people in the study had in year 11. This is the final year of compulsory schooling in the UK, when 15- and 16-year-olds take their GCSE exams. We also linked it with their GCSE results.
Over a third of the teenagers (36%) reported heavy or prolonged bleeding. We found that participants reporting heavy or prolonged bleeding were absent from school 1.7 additional days across year 11. They scored roughly one grade lower in their GCSEs, and were 27% less likely to achieve five A*-C passes including maths and English compared to those without heavy bleeding.
More than half (56%) of the teenagers reported menstrual pain. We found that those with pain were absent from school 1.2 additional days in year 11. They were 16% less likely to achieve five A*-C passes compared to those without pain. These relationships were observed after accounting for other possible causes including ethnicity, socioeconomic position, childhood adversity, age at first period, mother and child mental health, body mass index and intelligence quotient (IQ).
Wider implications
The results from this study fit with many previous studies that have shown menstrual issues can result in more absences and difficulties focusing and concentrating. They also provide further evidence that qualifications can be affected. This shows that menstrual difficulties can restrict the ability of young people to reach their full potential, with possible implications on access to further education or employment prospects.
A recent report from the Higher Education Policy Institute, a higher education thinktank, has found similar effects on absences at university: it estimates that an average student could miss up to six weeks across a three-year university course.
Other studies have shown these effects can persist in the workplace, including a large-scale study in the Netherlands and research on endometriosis by the Office for National Statistics.
The findings that those with heavy or painful periods, on average, were absent from school more and scored lower in their GCSEs are not due to different capabilities among these teenagers. Better treatments and support are needed for people who suffer with these symptoms, as they can lead to issues such as worse sleep quality, fatigue and iron-deficiency anaemia. This can make it more challenging to attend and perform well in school.
Society in general is also not designed to provide enough support to those who menstruate, especially those who suffer with problematic symptoms. Menstrual health literacy is generally low in teenagers. However, this also persists in adults and even medical professionals.
This means it is challenging for young people to identify symptoms. If they do identify them and seek help, they may often be met with attitudes that invalidate their symptoms, discouraging them from continuing to seek help.
Teenagers can face challenges managing menstruation at school. These may include restrictions on when they can go to the toilet, or inaccessibility of period products.
This can lead to many feeling that school is not a safe and supportive environment when menstruating. They may end up missing school entirely, or struggling to concentrate if they do attend school due to worries about managing and coping with menstruation and associated symptoms. Better support is needed for young people who menstruate and who struggle with problematic menstrual symptoms, so they are able to achieve their full academic potential.
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Gemma Sawyer is supported by a Wellcome Trust PhD studentship in Molecular, Genetic and Lifecourse Epidemiology (ref: 218495/Z/19/Z). The funders had no role in study design or analysis.
Gemma Sharp receives funding from the Medical Research Council (MR/Z504634/1).

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