THE WINDING ROAD TO WOMANHOOD. Adolescents´ attitudes towards menstruation, womanhood and sexual health - observational and interventional studies

Abstract

Menarche is a unique marker of female maturation representing the transition from childhood to womanhood. When entering adolescence, children face a number of challenges in areas such as the parent-adolescent relationship, development of the self and identity, an expanding network of social relationships, pubertal changes and the development of sexuality. Education may improve attitudes toward menstruation among adolescents thus increasing their awareness of risks and enabling them to protect themselves accordingly. This thesis aims to provide better understanding of these phenomenons and is based on four studies:

I. Twelve-year-old girls’ experiences of early puberty were described using content analysis of data from focus group interviews. Four themes were revealed: “Growing up - awareness, transition, longing”, “Mother - a close and important relationship”, “Menarche - a personal and important occurrence”, and “Sex and relationships”. The girls had many questions about sex and physical changes but felt adults had failed them in providing answers.

II. Twelve-year-old girls’ attitudes, thoughts and feelings towards menstruation and their bodies as well the ability to communicate on aspects of womanhood was elucidated using a questionnaire. Postmenarcheal girls were less positive towards menstruation than premenarcheal. Many girls did not reaffirm the statement “I like my body” and many claimed they had been verbally sexually harassed. Mothers were thought of as most easily “chatted” with about menstruation.

III. This study investigated the effect of a new, structured, interactive, multisensory, group learning education (IML) for 12-year-old girls compared with a standard intervention. Pre- and postmenarcheal girls answered accordingly adjusted questionnaires on attitudes toward menstruation before and six months after the intervention. If the girls received IML just prior to menarche it resulted in improvements in attitudes toward menstruation.

IV. Second-year adolescent high school students completed a questionnaire on sexual experience, sexual risk behavior and the impact of an educational program on STI. Boys took less responsibility for STI prevention than girls. Furthermore, boys perceived themselves less influenced by STI-education than girls. Girls had greater experience of same-sex sexuality than boys.