Menstrual History-Taking at Annual Well Visits for Adolescent Girls

Abstract

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

Design: Retrospective chart review.

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

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

Interventions: None.

Main outcome measures: 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.

Results: 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).

Conclusion: 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.

Keywords: Adolescent medicine; Documentation; Menstrual cycle; Primary care.