What if menstrual patterns are not just individual biology, but also reflect financial hardship, education, and overall health? This large Spanish survey finds striking links between social circumstances and menstrual experiences. Evidence on how menstrual characteristics may differ based on socioeconomic factors and self-rated health is significantly scarce.

The study investigates these associations among women and people who menstruate aged eighteen to fifty-five in Spain. The study treats menstruation and the menstrual cycle as vital signs for health. Its definition of menstrual health also includes access to accurate education, products, facilities, services, timely diagnosis, stigma-free experiences, and participation in social and civic life.

Menstrual equity and health are especially compromised among socioeconomically vulnerable women and people who menstruate, including those facing financial hardship, homelessness, displacement, and migration. Limited access to healthy menstrual management can affect reproductive, emotional, and general health.

Self-rated health is a known proxy for health status and an indicator for health equity. Yet menstrual health research had not further explored the potential association between menstrual characteristics and self-rated health. The study therefore examines menstrual characteristics alongside sociodemographic factors and self-rated health.

The goal is to understand menstrual characteristics in context and highlight the needs of vulnerable populations. This is a cross-sectional study from the Equity and Menstrual Health in Spain project. It uses a critical and feminist perspective to question androcentrism and systemic sociopolitical inequities of health.

Participants were women and people who menstruate aged eighteen to fifty-five living in Spain, while people who had entered menopause were excluded. Participants taking hormonal contraception were also excluded from this article’s analyses, totaling three thousand four hundred sixty-five exclusions.

The required minimum sample was one thousand five hundred thirty-five participants, based on a two-point-five percent confidence-interval precision and a five percent alpha risk. Sampling was non-probabilistic and purposive, using social media, healthcare centers, organizations, and snowballing.

The survey measured age at menarche, bleeding abundance, blood clots, bleeding duration, cycle duration, pain, pain management, and premenstrual symptoms. Premenstrual symptoms included emotional fluctuations and physical changes in the week or two weeks before bleeding.

Descriptive statistics summarized the sample and menstrual characteristics, while chi-square tests assessed differences according to age. Logistic and multinomial logistic regression models compared the odds of different menstrual characteristics.

Table one summarizes the sociodemographic, menstrual, and health characteristics of nineteen thousand three hundred fifty-eight participants. The mean age was thirty-three point eight years, seventy point seven percent had university education, and thirty-five point three percent identified as caregivers.

Menarche occurred at a mean age of twelve point four years, most commonly between eleven and twelve years, reported by forty-seven point eight percent. These details matter because they describe the population and provide context for interpreting the study’s menstrual-health findings.

The analysis included nineteen thousand three hundred fifty-eight women and people who menstruate, with a mean age of thirty-three point eight years. Most identified as women, most were born in Spain, and almost half reported financial problems in the previous twelve months.

Figure one shows the distribution of age at menarche for nineteen thousand seventy participants. The most common ages were twelve, at twenty-seven point four one percent, and thirteen, at twenty-two point five two percent; ages eleven and fourteen accounted for twenty point four three and fourteen point five two percent.

This supports the authors’ report of a mean age at menarche of twelve point four years, with most participants reporting menarche between eleven and twelve or thirteen and fifteen years. Mean age at menarche was twelve point four years. Most participants reported menarche between eleven and twelve years, or between thirteen and fifteen years.

Most reported bleeding lasting two to seven days and cycles lasting twenty-one to thirty-five days. Moderate or high intensity pain was common, while analgesics and natural remedies were the most frequently reported management strategies.

Participants aged forty-six to fifty-five had higher odds of light menstrual flow. Lower educational attainment was associated with more light flow and lower odds of flow over eighty milliliters. Caregivers had higher odds of abundant menstrual flow but lower odds of reporting blood clots.

More severe financial difficulties were associated with higher odds of abundant flow and blood clots. As age increased, the odds of short bleeding and short cycles were higher. Lower educational attainment was associated with short bleeding, short cycles, and long bleeding.

Older participants had lower odds of moderate and high intensity menstrual pain. More financial problems were associated with higher odds of both moderate and high intensity pain. Table five reports adjusted odds ratios for moderate and high-intensity menstrual pain, using low intensity as the reference, across age, education, caregiving, financial problems, and self-rated health.

The reported odds decrease with age, while frequent financial problems are associated with odds of one point eight seven for high-intensity pain. Self-rated health shows a graded pattern: poor health has an adjusted odds ratio of eight point three three for high-intensity pain, with a ninety-five percent confidence interval from four point nine seven to thirteen point nine four.

Worse self-rated health was associated with higher odds of moderate and high intensity menstrual pain. For poor self-rated health, the odds of high intensity pain were eight point three three. Being a caregiver appeared to be a protective factor for experiencing premenstrual symptoms always or many times, and sometimes.

Financial difficulties and worsened self-rated health were associated with higher odds of premenstrual symptoms. Poorer self-rated health was associated with higher odds of abundant bleeding, blood clots, short and long cycles, moderate and high intensity pain, and premenstrual symptoms.

These findings suggest a link between general health status and poorer menstrual health patterns. The study’s strengths include its social relevance, its innovation in Spain, and a large sample spanning the whole Spanish territory, although the sample was not representative.

Limitations include the digital divide, recall bias, and estimating bleeding abundance from menstrual products used. The study presents a detailed overview of menstrual characteristics among adults in Spain. Higher odds of heavy bleeding, moderate or high intensity pain, and premenstrual symptoms appeared among participants with less education, more financial hardship, and poorer self-rated health.

The findings suggest that social inequities may affect menstrual health and menstrual management. The study calls for community-based action, evidence-based policymaking, and healthcare-professional training that addresses social inequities.

The study suggests that poorer self-rated health, financial hardship, and lower educational attainment are associated with several potentially unhealthy menstrual patterns, supporting menstrual health as a public-health and equity issue.