Menstrual History-Taking at Annual Well Visits for Adolescent Girls

To determine the rates at which primary care providers elicit menstrual histories from adolescent girls at well visits.

Retrospective chart review.

The departments of Pediatrics, Adolescent Medicine, and Family Medicine of Cooper University Healthcare from January 1, 2010 to June 1, 2016.

Women aged 12-21 years who were seen for a well visit in the described setting.

None.

We searched physician well visit notes for documentation of the following aspects of menstrual history: menarche, last menstrual period, usual length of cycle, and the presence or absence of associated symptoms (such as pain and cramps). The presence or absence of each aspect was recorded in a binary fashion in a deidentified data set.

A total of 954 unique charts were analyzed: 415 from Adolescent Medicine, 289 from Family Medicine, and 250 from General Pediatrics at Cooper University Healthcare. Adolescent Medicine was 6.44 times more likely to take a complete menstrual history than Family Medicine (P < .0001) and 5.80 times more likely than Pediatrics (P < .0001). There was no statistical difference between Pediatrics and Family Medicine (odds ratio, 0.55; P = .3150).

Menstrual history-taking is often incomplete and can vary between departments, even within the same institution. These results indicate opportunities to raise awareness about the importance of a complete menstrual history and to develop quality improvement initiatives to increase documentation of the complete menstrual history.