DENVER — A menstruation education program delivered in schools has the potential to improve students’ self-esteem and confidence in preparing to manage menstruation, meeting a “critical health need” in the community, according to a study presented at the American Academy of Pediatrics (AAP) 2025 National Conference.

“Preliminary evidence suggests that this program is well received by educators, parents, and youth,” reported Hannah Chiu, a medical student at the Tulane University School of Medicine, New Orleans. “Students remain actively engaged and ask questions openly despite initial expectations that they may shy away due to the taboo nature of menstruation.”

The program, called Period Prepared, was developed for grades 3-12 with the input of menstruators, teachers, parents, and physicians and covered period hygiene, cramps and cravings, choosing an appropriate menstrual product, as well as more specific topics such as pelvic floor therapy and playing sports during a period.

Hands-on activities included designing a “period pouch,” making DIY heating pads with socks and rice, and practicing tampon insertion with a grapefruit. Although medical student volunteers teach the classroom sessions, parents and teachers can also facilitate workshops on their own using the online curriculum and with training from medical student volunteers.

Michelle W. Escovedo, MD, an adolescent health specialist at Cedars-Sinai Guerin Children’s, Los Angeles, who was not involved in this study, expressed enthusiasm about the program to Medscape Medical News.

“Puberty and adolescence are filled with so many physical and psychosocial changes, including menstruation, that should be normalized and not stigmatized,” Escovedo said. “Our younger generation of both guys and girls should be informed about the ins and outs of periods so that the responsibility of menstruation is not solely left to those with uteruses.”

In Louisiana, where the program was developed, sexual education in schools is not mandated, and only 11% of middle school and 24% of high school students received comprehensive sexual education in 2020, which does not explicitly cover menstruation, Chiu said.

“Lack of period preparedness can negatively impact body image, cause distress and confusion, and reinforce stigmatization,” she reported. “Most of us have picked up scraps of information along the way: how to choose a period product, insert a tampon, or track your cycle — usually through trial and error,” Chiu said in a prepared statement. “But imagine a generation of young menstruators who felt informed instead of afraid.”

Escovedo said that having knowledge and preparation about menstruation can also help youth know when they should speak to a healthcare provider about issues they are experiencing.

“I think basic education about what is normal and not normal in terms of period duration, flow, and frequency would help patients know when they should reach out to their doctors,” Escovedo said.

According to the abstract presented, the most effective delivery method involved sessions with groups of less than 10 students of a similar age compared to larger groups from across more than four grade levels. The program used anonymous index cards for asking questions, permission slips from guardians, and online workshop material demonstrations.

“Notably, pre-menstruators (ages 8-10) showed enthusiasm for more advanced topics, reinforcing the idea that preparedness fosters confidence,” Chiu reported. “Small-group learning, engaging activities, and peer support converge through Period Prepared to create an empowering environment for menstruators to learn about their health.”

Escovedo was not surprised that children aged 8-10 years were the most enthusiastic about the program.

“This is generally when the first pubertal changes of breast development are occurring and a time when there are probably a lot of questions about what is coming,” she said. “As pediatricians, we can begin to give patients anticipatory guidance about the timeline of puberty,” such as when to expect a period to start. “I tell families to prepare menstrual kits with an extra set of underwear, shorts, menstrual pads, and wipes to have ready in their backpacks and to have multiple repeated conversations with their tweens about menstruation and what to expect.”

The study did not use any external funding. Escovedo and Chiu had no disclosures.

Tara Haelle is a science/health journalist based in Dallas.