Prevalence of Menstrual Inequity in a Pediatric Emergency Department

Between 10 and 25% of adolescents in the United States experience menstrual inequity, or insufficient access to menstrual products or education. The emergency department (ED), which often serves as a safety net for adolescent health access, has been identified as a strategic venue for public health interventions. The Child Opportunity Index (COI) is a validated, multidimensional neighborhood measure of structural opportunity that can impact child health and development. Therefore, the purpose of this project was to measure the prevalence of menstrual inequity in a pediatric ED and examine associations with the COI.

This cross-sectional study analyzed electronic survey data from adolescents 13-21 years old who visited a pediatric ED from January 2024 to February 2025. Participants were included if they had started menstruation and responded to validated questions that assessed menstrual inequity. Home addresses were geocoded into census tracts and linked to COI version 3.0. The prevalence of menstrual inequity was calculated, and logistic regression was used to measure associations between menstrual inequity and COI.

One-third reported experiencing menstrual inequity during the past 12 months. Patients living in areas with low neighborhood opportunity had higher odds of experiencing menstrual inequity than those in high-opportunity areas.

Menstrual inequity is common among adolescent pediatric ED patients, particularly among those from low-resourced neighborhoods. Future work should explore increasing advocacy efforts at the institutional level through menstrual product drives and distribution, as well as larger, national-level efforts to influence policy changes.