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OHSU study finds significant gaps in menstrual research and clinical care

Physician-scientists with OHSU Center for Women’s Health urge prioritization of sustainable, accessible, inclusive menstrual technology
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Alyssa Colwill, M.D., assistant professor of obstetrics and gynecology in the OHSU School of Medicine, left, and Bethany Samuelson Bannow, M.D., assistant professor within the OHSU division of hematology/medical oncology. (Contributed photo)
Alyssa Colwill, M.D., assistant professor of obstetrics and gynecology in the OHSU School of Medicine, left, and Bethany Samuelson Bannow, M.D., assistant professor within the OHSU division of hematology/medical oncology. (Contributed photo)

Following a review of research and clinical knowledge related to menstrual technology, Oregon Health & Science University researchers found alarming gaps, and emphasized that understanding current technologies is foundational to ensuring menstrual wellbeing and improving women’s health outcomes.

New menstrual technologies — including underwear, menstrual cups and discs — have been able to address more diverse needs and imrpove sustainability, discretion and inclusivity. However, these new technologies are not routinely integrated into clinical care and research, which instead typically evaluate menstrual flow based on the use specific products, like the traditional tampon or pad.

The review study, published today in Obstetrics and Gynecology, aims to advance clinical understanding of current menstrual technologies, which is essential to improving reproductive health outcomes and empowering individuals to make educated decisions related to their menstrual health.

“Menstrual health is a key patient-reported outcome and can be an important general indicator of health and fertility, so it’s alarming that menstruation is so understudied,” said Abigail Liberty, M.D., M.S.P.H., instructor and complex family planning fellow in OHSU’s department of obstetrics and gynecology, and co-author of the study. “Individuals deserve to understand the options available to them so they can make informed decisions about their menstrual health, and it’s crucial that clinicians have the knowledge and resources to be able to support their patients in these conversations.”

Half the human population has a personal experience with menstruation; in the United States alone, this includes approximately 72 million individuals. Reproductive health experts — obstetricians and gynecologists, pediatricians and primary care providers — have a critical role in menstruation experiences, including education, identifying and assessing potential problems, and providing guidance and follow up care.

To provide the best assessments and guidance, Liberty’s team said it is important for clinicians to ask patients about the type of menstrual products they use, and have up-to-date knowledge of all the product options in order to answer questions, provide counseling and understand what may require treatment. Additionally, improved data on emerging technologies and their absorbency, use and patient preferences is essential.

Multidisciplinary studies at OHSU led by Bethany Samuelson Bannow, M.D., assistant professor within the OHSU division of hematology/medical oncology, and Alyssa Colwill, M.D., assistant professor of obstetrics and gynecology in the OHSU School of Medicine, are addressing this gap in knowledge, investigating the use of alternative menstrual products in people with heavy bleeding. With these data, clinicians and researchers could adapt how they evaluate patients and provide education and guidance by considering the specific type of menstrual products used by patients.

Promoting menstrual health equity is also a key consideration, Liberty said. Globally, menstrual hygiene products represent a $38.9 billion market, yet many individuals still don’t have access to adequate menstrual hygiene tools and education. Oregon has begun to address this issue with the 2021 Menstrual Dignity Act, which requires provision of free menstrual products in public K-12 schools. However, it remains unclear to what extent new menstrual technologies will be included in that initiative.

“We know there are still significant disparities for certain populations, like adolescents, in receiving menstrual counseling and care and accessing menstrual products,” Liberty said. “Ultimately, patients are the experts in their lived experiences, and updating research and clinical care to align with those experiences can begin to break down these barriers and empower people in new ways.”

This research is one of OHSU’s latest efforts in support of reproductive rights and women’s health. Last month, OHSU announced the establishment of the Center for Reproductive Healthy Equity, which will investigate disparities affecting reproductive health research, education and clinical care.

In addition to Liberty, co-authors of the study include OHSU Center for Women’s Health physician-scientists Bannow, Colwill, and Alison Edelman, M.D., M.P.H.

Table 2 Menstrual Products by Cost and Volume

 

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