Period pain and heavy bleeding negatively impact school grades

Teenagers who experience menstrual symptoms such as heavy or prolonged bleeding are more likely to miss more school and achieve lower exam results, new research shows.

The study found that teenagers with heavy bleeding missed around 17 per cent more school days than their peers and were 48 per cent more likely to have persistent absence, defined as missing at least ten per cent of school days, negatively impacting academic achievement.

The findings are published in npj science of learning, and the study is one of the first large-scale studies to examine how menstrual symptoms may interfere with school, highlighting the impact of menstrual health on academic achievement.

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The researchers analysed data from the Avon Longitudinal Study of Parents and Children (ALSPAC) in the UK, which included questionnaires completed by 2,698 teenagers who had menstrual symptom data within two years of the final years of compulsory schooling in the UK.

Over a third had heavy or prolonged bleeding

The teenagers reported whether they had heavy or prolonged bleeding and period pain, and researchers linked the data with school records on absences and exam results at ages 15 and 16. Other factors, which may include menstrual symptom exposure and school performance such as ethnicity, socioeconomic status, childhood adversity, child and maternal mental health, body mass index (BMI), intelligence quotient (IQ), and age at menarche, were also considered.

Girls with menstrual symptoms, including both heavy bleeding and menstrual pain, missed more school than girls without symptoms. More than a third of participants (36 per cent) reported experiencing heavy or prolonged bleeding and these girls missed an average of 1.7 more days of school per year, an increase of 16 per cent. They were also 48 per cent more likely to have persistent absence.

Over half of the girls (56 per cent) reported menstrual pain and this group missed an average of 1.2 extra days per year, an increase of 12.8 per cent and had 42 per cent higher odds of persistent absence.

Association with lower exam scores

Heavy or prolonged bleeding was associated with lower exam scores and a 27 per cent lower likelihood of achieving five standard passes at GCSE. Menstrual pain also reduced exam scores slightly and lowered the chance of securing five passes by 16 per cent, although this evidence was statistically weaker than the findings for heavy bleeding.

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Further research is needed to understand the relationship between menstrual symptoms and poorer academic outcomes. The authors note that missed school days alone are unlikely to explain lower attainment, indicating that symptoms may also impair concentration.

Gemma Sawyer, PhD student at the University of Bristol, who conducted the research, said: ‘Our large-scale study provides the most convincing evidence to date that menstrual symptoms are associated with lower attendance and attainment. This work supports what young people have reported struggling with in previous studies.’

The researchers, whose next research will look at the underlying biological causes of heavy bleeding, say that we need a society that is better set up for women experiencing menstrual symptoms, including heavy bleeding and pain.

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Ms Sawyer added: ‘More education and support may help improve the menstrual health of adolescents and reduce inequalities in education outcomes.’