Awareness of menstrual health disorders among Omani schoolgirls: a cross-sectional survey

Objectives Dysmenorrhoea is highly prevalent among adolescents and can substantially affect educational and daily functioning, yet healthcare seeking for menstrual symptoms remains low. Limited menstrual health awareness and the normalisation of severe menstrual pain may contribute to a disconnect between symptom burden and recognition of symptoms warranting medical assessment. In Oman, contemporary evidence on adolescents’ awareness and perceptions of menstrual symptoms is lacking. We aimed to assess awareness of menstrual health disorders among Omani schoolgirls, examine perceptions and normalisation of severe menstrual pain, and evaluate educational and functional impact and healthcare-seeking behaviour. Design Cross-sectional survey. Setting Public high schools across six wilayats in the Muscat Governorate, Oman. Data were collected between 21 September 2025 and 20 November 2025. Participants Omani schoolgirls aged 15–19 years (grades 10–12) who had experienced menarche. Main outcome measures Awareness of dysmenorrhoea, heavy menstrual bleeding and endometriosis; perception of menstrual pain as normal; educational and functional impact; and healthcare-seeking behaviour. Results Of 957 respondents, 934 were included in the final analysis. Dysmenorrhoea was reported by 93.0% of participants, of whom 54.9% experienced severe pain. Among participants with severe dysmenorrhoea, 82.7% perceived menstrual pain as normal, compared with 46.1% of those with mild-to-moderate dysmenorrhoea. In the fully adjusted modified Poisson regression model, severe dysmenorrhoea remained associated with normalisation of menstrual pain after adjustment for prior menstrual health education, age and menstrual regularity (adjusted prevalence ratio (PR) 1.72, 95% CI 1.53 to 1.94; p<0.001). Awareness of dysmenorrhoea, heavy menstrual bleeding and endometriosis was reported by only 21.6%, 18.5% and 2.2% of participants, respectively. Overall, 85.0% of participants with dysmenorrhoea reported some degree of school absenteeism attributable to menstrual pain; this was more prevalent among those with severe than mild-to-moderate dysmenorrhoea (92.0% vs 76.5%; PR 1.20, 95% CI 1.13 to 1.28; p<0.001). Fewer than 10% of participants with dysmenorrhoea reported seeking professional medical care for menstrual symptoms. Conclusions Severe dysmenorrhoea was highly prevalent and frequently normalised among Omani schoolgirls, despite substantial educational and functional impact. The coexistence of low menstrual health awareness, frequent symptom normalisation and limited healthcare seeking highlights an important gap between symptom burden and recognition of symptoms that may warrant medical assessment.