A social media survey of U.S. adolescent preferences for menstrual bleeding patterns

Study Objective Assess preferences for menstrual pattern and acceptability and knowledge about safety of induced amenorrhea among adolescents and young adults Methods We conducted a cross-sectional online survey of U.S. residents aged 14-24 years at least one-year post-menarche. Online recruitment was via the social media platform “TikTok” on a teen reproductive health channel. Survey questions focused on menstrual history, menstrual pattern preferences, and demographics. The primary outcome was the proportion of post-menstrual individuals who would prefer amenorrhea versus scheduled bleeding. Results From 5,113 potential respondents who accessed the eligibility screening, 3,001 completed surveys and met inclusion criteria. Most were age 14-18 (63.7%), distributed proportionally among all U.S. Census Regions. When asked if they could pick their period-bleeding style without any permanent impacts, almost three-quarters chose no bleeding at all (amenorrhea; 71.5%) compared to scheduled periods; 28.5%). However, 63.7% agreed or were uncertain when faced with the statement: “It might be unsafe if hormone medications stop your period-bleeding.” After adjusting for age, gender expression, race, religion, heavy bleeding, and frequent bleeding, factors associated with preference for amenorrhea versus regular bleeding were younger age, masculine gender expression, white race, and non-Christian religious background. Baseline bleeding amount and frequency were not associated with preference for amenorrhea. Conclusions More than two-thirds of U.S. adolescents and young adults indicated a preference for medication-induced amenorrhea if the method was assured to not have any permanent effects on the body, despite highly prevalent misconceptions about health and safety.