Hormonal health
Heavy and painful periods linked to lower grades and attendance, study reveals
New research has found that heavy periods and menstrual pain in teenage girls are linked to lower grades and increased school absences.
The study, described as the most robust to date on this issue, examined data from 2,698 girls aged 13 to 16 in the Children of the 90s study, linking health records to school attendance and GCSE results from the Department for Education.
Led by the University of Bristol with the University of Exeter and funded by Wellcome, the study found 36 per cent of girls experienced heavy or prolonged bleeding.
This group missed an extra 1.7 school days a year and had a 27 per cent lower chance of achieving five GCSE passes.
Meanwhile, 56 per cent reported menstrual pain, which was linked to missing 1.2 more school days a year and a 16 per cent lower chance of achieving five passes.
Girls reporting both heavy bleeding and pain were more likely to be persistently absent from school.
Researchers said absence alone did not fully explain the effect on grades, with existing evidence showing symptoms also affect 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 link between menstrual symptoms and education remained even after taking into account factors such as maternal education, financial difficulties, ethnicity and age at starting menstruation.
Teenage girls in a focus group described challenges such as difficulty concentrating during periods, limited toilet access, embarrassment and stigma and lack of period products.
Gemma Sharp, professor of epidemiology at the University of Exeter who supervised the research, said: “We know from previous research that heavy and painful periods can impact attendance and concentration, and this study tells us that there’s also a link with attainment.
“It’s clear that people are capable of functioning at a high level regardless of their cycle, but we need a society that’s better set up to support them, particularly if they are experiencing heavy bleeding and pain.”
A team of researchers, led by Professor Sharp, has secured US$4.5m in funding from Wellcome Leap, obtained with support from regional university alliance GW4.
The funding will support new research to tackle the widespread and often overlooked issue of heavy menstrual bleeding in women.
Professor Sharp will use data from Bristol’s Children of the 90s and Born in Bradford cohorts to investigate biological factors underlying heavy bleeding.
This research forms part of the US$50m Missed Vital Sign programme – a global initiative aimed at earlier identification of heavy menstrual bleeding and the development of faster, more personalised care for women worldwide.
Menopause
IBSA UK launches non-hormonal injectable for menopause symptoms
IBSA UK has introduced Hyaluxelle, a non-hormonal menopause treatment for vulvo-vaginal atrophy, easing vaginal dryness and pain during intercourse.
Hyaluxelle is given as deep intradermal injections to the vulvar vestibule, the area at the vaginal opening, in two sessions one month apart, followed by clinical reassessment.
IBSA UK is the UK subsidiary of Swiss pharmaceutical company IBSA.
Vulvo-vaginal atrophy is a key feature of genitourinary syndrome of menopause, a long-term condition caused by low oestrogen that affects genital, urinary and sexual health.
At least half of post-menopausal women are affected, yet many do not seek help, often assuming symptoms are part of ageing.
The condition stems from thinning and drying of vaginal and vulval tissues linked to low oestrogen, leading to symptoms such as dryness, discomfort, altered pH and pain during intercourse.
Hyaluxelle combines high and low molecular weight hyaluronic acid, a moisture-retaining substance found naturally in the body.
The company says this creates a lower-viscosity injection at what it describes as the highest concentration available in the UK, supporting tissue hydration, firmness and elasticity.
The formulation is said to rehydrate the vulvar vestibule and create conditions for restoring tissue structure through collagen and elastin production.
Clinical studies indicate Hyaluxelle improves several vulvo-vaginal symptoms, including reductions in discomfort and pain during intercourse.
Studies also report gains in sexual function domains and a positive trend in some aspects of health-related quality of life.
Histological analyses suggest increased epithelial thickness, enhanced tissue regeneration and reduced inflammatory infiltration after the procedure. In studies, the treatment was well tolerated with no reported major complications.
Joanna, a 59-year-old woman living with severe symptoms, described the personal impact of delayed diagnosis.
She said: “I lived for years with pain, UTIs, cystitis and a loss of sensation, but every visit to my GP, even a female GP, was treated as a bladder issue.
“Nobody suggested it might be linked to the menopause or joined the dots, and none of the treatments I was given helped. Without the right information or support, I became desperate for answers.
“The symptoms affected everything, what I wore, how I exercised, how I slept, but the hardest part was the impact on intimacy with my husband.
“I withdrew from our relationship because I was scared sex would hurt, and the loss of closeness was devastating, and I no longer felt like myself.
“Women deserve clear explanations and real options when their symptoms are not getting better.”
IBSA says Hyaluxelle offers clinicians an option for women whose symptoms persist despite first-line therapies, or for those who cannot receive or choose not to receive hormonal treatments.
Menopause
Flo Health and Mayo Clinic publish global perimenopause awareness study
The US ranks sixth for perimenopause knowledge, behind the UK, Ireland, Canada, Australia and the Netherlands, research by the Mayo Clinic and period tracker Flo has revealed.
Perimenopause is the transition leading up to a woman’s last menstrual cycle and includes the 12 months afterwards, after which menopause is established as hormone levels change.
It typically happens in the mid-40s and lasts an average of six years, though symptoms may start in the 30s.
The study surveyed more than 17,000 women aged 18 and over across 158 countries about their knowledge of perimenopause symptoms.
The US ranked sixth overall, despite growing public discussion of menopause linked to celebrity advocacy and new workplace policies.
Participants most often recognised common symptoms such as hot flushes (71 per cent), sleep problems (68 per cent) and weight gain (65 per cent).
Broader symptoms, including fatigue, irritability and digestive changes, were far less likely to be identified as part of the perimenopause transition.
Among women aged 35 and over who reported being in perimenopause, the five most common symptoms were physical and mental exhaustion (95 per cent), fatigue (93 per cent), irritability (91 per cent), sleep problems (89 per cent) and depressive mood (88 per cent).
Dr Anna Klepchukova, chief medical officer at Flo, said: “We need to normalise conversations around perimenopause and menopause, so women feel empowered to have honest conversations with their doctors and other support systems.
“This study demonstrates a prolonged commitment from both Flo Health and Mayo Clinic in helping women better understand their bodies and advocating for their health through perimenopause, and every other phase of their health journeys, through medically-backed insights and advice.”
International differences
Perimenopause knowledge scores were highest in higher-income countries such as the UK, Ireland and Australia.
Lower scores emerged in Nigeria, France and parts of Latin America.
Digestive issues ranked among the top three reported symptoms in Nigeria, South Africa, India, France, Ireland and several Latin American countries, while mood symptoms such as depressive mood and anxiety ranked among the top three in Germany, Spain, Venezuela, the Netherlands and India.
Dr Mary Hedges, principal investigator at Mayo Clinic, said: “There is a mismatch in knowledge and expectations of perimenopause and actual symptoms experienced during perimenopause.
Many women in perimenopause may not yet be experiencing hot flashes, and are more likely to be experiencing the cognitive and physical symptoms of fatigue, exhaustion, mood, sleep, or even digestive changes.
“The findings from this study illustrate the need to advance perimenopause research and education, so that we can equip both patients and healthcare clinicians with the knowledge and skills needed to address symptoms and improve the quality of care we provide to women.”
The survey ran from 6 December 2024 to 16 May 2025.
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