Prevalence of Menstrual Inequity in a Pediatric Emergency Department

Gia M. Badolato, Center for Translational Research, Children's National Hospital, 111 Michigan Avenue NW, Washington, D.C., 20010.
Riya S. Mehta, Center for Translational Research, Children's National Hospital, 111 Michigan Avenue NW, Washington, D.C., 20010.
Emma Duling, Center for Translational Research, Children's National Hospital, 111 Michigan Avenue NW, Washington, D.C., 20010.
Natasha Kaushal, Center for Translational Research, Children's National Hospital, 111 Michigan Avenue NW, Washington, D.C., 20010.
Alicia Rolin, Center for Translational Research, Children's National Hospital, 111 Michigan Avenue NW, Washington, D.C., 20010; Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, 2121 I Street NW, Washington, D.C., 20052; Department of Emergency Medicine, School of Medicine and Health Sciences, George Washington University, 2121 I Street NW, Washington, D.C., 20052.
Jessica Marshall, Center for Translational Research, Children's National Hospital, 111 Michigan Avenue NW, Washington, D.C., 20010.
Monika K. Goyal, Center for Translational Research, Children's National Hospital, 111 Michigan Avenue NW, Washington, D.C., 20010; Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, 2121 I Street NW, Washington, D.C., 20052; Department of Emergency Medicine, School of Medicine and Health Sciences, George Washington University, 2121 I Street NW, Washington, D.C., 20052.
Meleah Boyle, Center for Translational Research, Children's National Hospital, 111 Michigan Avenue NW, Washington, D.C., 20010; Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, 2121 I Street NW, Washington, D.C., 20052. Electronic address: mdboyle@childrensnational.org.

Document Type

Journal Article

Publication Date

11-10-2025

Journal

Journal of pediatric and adolescent gynecology

DOI

10.1016/j.jpag.2025.11.004

Keywords

Adolescents; Emergency Department; Menstrual health

Abstract

STUDY OBJECTIVE: Between 10-25% of adolescents in the United States experience menstrual inequity, or insufficient access to menstrual products or education. The emergency department (ED), which often serves as a safety net for adolescent health access, has been identified as a strategic venue for public health interventions. The Child Opportunity Index (COI) is a validated, multidimensional neighborhood measure of structural opportunity that can impact child health and development. Therefore, the purpose of this project was to measure the prevalence of menstrual inequity in a pediatric ED and examine associations with the COI. METHODS: This cross-sectional study analyzed electronic survey data from adolescents 13-21 years old who visited a pediatric ED from January 2024-February 2025. Participants were included if they had started menstruation and responded to validated questions that assessed menstrual inequity. Home addresses were geocoded into census tracts and linked to COI version 3.0. The prevalence of menstrual inequity was calculated, and logistic regression was used to measure associations between menstrual inequity and COI. RESULTS: One-third reported experiencing menstrual inequity during the past 12 months. Patients living in areas with low neighborhood opportunity had higher odds of experiencing menstrual inequity than those in high opportunity areas. CONCLUSION: Menstrual inequity is common among adolescent pediatric ED patients, particularly among those from low-resourced neighborhoods. Future work should explore increasing advocacy efforts at the institutional level through menstrual product drives and distribution, as well as larger, national-level efforts to influence policy changes.

Department

Pediatrics

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