Recommended Progression of skills, knowledge and understanding about menstruation and reproductive health education for Key Stages 1- 5*
The update of the new Relationships Education, Relationships and Sex Education (RSE) and Health Education statutory guidance for England has recently been published. The section on menstruation education has been expanded in the Statutory Relationships and Sex Education guidance for 2020 document but does not include details.
Through Period Positive research with teachers, health experts, parents and young people, former head of PSHE, qualified teacher and menstruation education researcher Chella Quint has developed a comprehensive programme of study.
This programme of study is offered as a guide for menstrual literacy curriculum pThis programme of study is offered as a guide for menstrual literacy curriculum planning across all Key Stages of the National Curriculum in England. It can be applied to curriculum models in other parts of the UK and abroad by adapting the age ranges of the content to suit different schooling models.
If you would like to offer feedback, support this work or contribute your own lessons to a collection of peer-reviewed and evidence-based lesson plans, please get in touch via the web contact form.
Founder of Period Positive
*A note on Key Stages in England: Other countries may not use the same stage, year or learning levels. KS1 and 2 cover approximately age 4-11 and KS 3 is approximately age 11-13. KS 4 and 5 covers age 14 – 19.
At Key Stage 1, pupils should be able to name their external genitalia as is recommended for safeguarding, but also as a foundation for learning about their internal reproductive organs in KS2. Also included at this age is the sort of information very young children may ask about if they have younger siblings or a parent who is pregnant or who menstruates. This level of basic information is helpful for preventing a young person from believing their questions or curiosity are bad, or that periods or reproductive health are something embarrassing or that will get them in trouble if they ask about it.
S1 able to name external sex organs using correct terms (alongside or instead of colloquial words) –eg. vulva, clitoris
K1 sometimes blood comes out of someone’s vagina and it is called a period or menstruation
K2 menstruation can be managed with cloth or disposable pads, tampons, period pants or menstrual cups, and you may see these items in your house or in someone else’s bathroom
U1 this blood is not an illness or injury and shouldn’t usually cause worry
U2 it is something that most growing or grown up girl’s and women’s bodies can do
U3 periods are usually a way to know the body is healthy
U4 periods usually stop during pregnancy because the blood helps protect the growing baby
U5 periods come out of the vagina, but wee comes out of a different opening
KS2 (everything from KS1 plus the following)
At Key Stage 2, it’s time for what many people will recognise as the first ‘period talk’ (and it should be the first of many!). Although it may seem early to some adults – especially those who started periods later themselves or who are particularly wary of preadolescents seeming more and more mature these days – it is essential that young people learn about puberty before it starts. The average age range for menarche (the first period) is 9-16, and some children experience early periods as a part of precocious puberty, so from a wellbeing point of view, the time is right. All pupils learning together prevents stigmas around this being a ‘girls only’ topic, and also ensures male staff plus trans and non-binary menstruators are included in the conversation.
S1 can label simple internal reproductive organs on a diagram – ovary, fallopian tube, uterus, cervix, vagina
S2 can place the steps of the menstrual cycle in the correct sequence
S3 can name the 4 types of menstrual products – internal, external, disposable and reusable (or inside, outside, throw away, keep using) and use correct terms rather than euphemisms
S4 can choose or recommend different menstrual products for different purposes (eg. for swimming, on holiday, sustainable options, comfort, cost, convenience, materials, flow)
K1 menstruation happens about once a month and can start from around age 9 -12, or earlier for those who start puberty early, and a few girls may never menstruate
K2 the start of menstruation is called menarche (pronounced MEN-ar-kee)
K3 it happens around 2 weeks after ovulation, when an egg is released from the ovary
K4 after around age 50 or so for those who menstruate, their body will slowly begin the process of no longer having periods – this is called the menopause
U1 menstruation is one of the signs of puberty for most girls
U2 it is part of the reproductive cycle, which is how the growing body gets ready to have babies
U3 physical maturity is not a sign of emotional maturity, and people can choose to have a baby when they grow up, but periods don’t mean they need to have babies straight away. Not everyone chooses to have a baby when they grow up, and sometimes it’s not possible even if they want to
U4 menstruation is something people may choose to keep private, but it does not need to be kept secret – it is usually healthy and normal
U5 if periods are very painful, heavy, or last a long time, or someone has any other worries about it, they should ask for help from a parent, teacher or doctor
U5 mocking or teasing someone for menstruating is bullying
KS3 (build on KS 1 and 2, link to science curriculum)
At Key Stage 3, pupils can retain more complex information about menstrual cycles, and will be most likely to have periods or have close friends and classmates who do. An important element of navigating the early menstruating years – for both those with periods and their friends and teachers – is normalising talking about it. Knowing what’s typical, what’s not, how to recognise medical symptoms, and how to get help or offer help to someone whose periods are causing discomfort are key tools for a KS3 period talk toolkit. Managing menstruation is now something pupils should be able to articulate preferences around, with an awareness of environmental, financial, comfort and health impacts of different products. Using media studies skills to unpick issues of menstrual shame and stigma is an important transferable skill that equips pupils to be more informed consumers, assertive healthcare self-advocates and better at self care as they navigate puberty.
S1 can label complex diagrams of the reproductive organs and sequence the reproductive cycle
S2 can name hormones responsible for ovulation and menstruation and chart a sample cycle
S3 can choose or recommend different menstrual products for different purposes (eg. for swimming, on holiday, green options, comfort) and confidently manage own menstruation (if they menstruate) or help others (if not), i.e. where and how to manage menstruation in different situations and how to use or advise others on products and self-care
K1 the menstrual cycle is about 28 days long but a wider average range of 21 – 35 days is still normal
K2 signs of healthy and unhealthy menstruation (average cycle length and flow amount, spotting or bleeding mid cycle, variations on menstrual blood and tissue, PMT, ranges of pain)
K3 awareness of symptoms of fibroids, polycystic ovary syndrome (PCOS), endometriosis, PMDD, and womb-related cancers.
K4 awareness of signs of ovulation and healthy vs potentially unhealthy discharge
K5 awareness of range of physical and emotional responses to menstruation and advice for self care at different stages of the cycle
K6 examples and history of menstrual taboos
K7 how to recognise and challenge negative messages about menstruation
K8 the environmental and economic impact of disposable menstrual products
U1 not everyone menstruates, even if you expect them to – some people do not menstruate if they are trans, intersex, have physiological differences, hormonal issues or have experienced illnesses or trauma that could stop menstruation
U2 most people who menstruate were assigned female at birth and identify as female, and some menstruators identify as non-binary or as trans men
U3 some people feel shame or anger about menstruation, some are very proud, some feel neutral about it, and some people may feel these feelings at different times and to varying degrees
U4 some of the language and images used to describe menstruation contribute to feelings of menstrual shame
U5 adverts for menstrual products can use shaming language to manipulate consumers; menstrual taboos in advertising can be challenged/avoided
U6 some of the history of menstrual taboos comes from cultural and medical beliefs and myths about menstruation
U7 Menstrual shame can have negative consequences for diagnosing illnesses, asking for menstrual products, and feeling confident in public. This shame can be challenged through knowledge about where it came from, getting more facts about periods and the menstrual cycle, and building confidence to talk more openly about menstruation
KS4 +5 (build on KS 1, 2 and 3, link to science curriculum)
At Key Stages 4 and 5 and even into higher education, young adults should be equipped with more nuanced issues around menstruation than most received in that typical primary school period talk. Dovetailing with contraception and consent lessons, sexual health topics should also include fertility awareness and knowledge of infertility, how to recognise symptoms of womb related illnesses, and signs of and stigmas around the menopause transition. Wider issues around reproductive justice and global health inequalities where they intersect with menstruation knowledge and cultural lore will be of interest to those unpicking menstrual shame or seeking to know more about this fascinating topic at the academic or policy level.
S1 can identify signs of ovulation and list methods of hormonal contraception, how they work, and potential side effects and considerations for different types
S2 can identify aspects of menopause and perimenopause
S3 can navigate and troubleshoot unexpected menstruation management situations for self or others – e.g. leaks, caught short of supplies, menstruation during an exam, advocating for diagnosis of troubling symptoms
S4 can suggest or role-play what to say to healthcare practitioners when given scenarios with symptoms or worries
K1 menstruation can be interrupted by hormonal contraception
K2 a detailed overview of fertility, infertility and assisted conception
K3 links between historic and current cultural menstrual taboos
K4 links between historic and current menstrual product advertising messages
K5 current campaigns challenging menstrual taboos and current issues to do with reproductive justice worldwide
U1 menstruation can be interrupted by hormonal contraception, but not by using barrier methods alone
U2 contraception and reproduction are issues of consent and access, and choice is a human right
U3 menstruation is not a definite sign that you cannot get pregnant – on rare occasions ovulation occurs more than once a cycle
U4 some people feel good during their cycles, some bad, some neutral, and this changes throughout the menovulatory lifetime
U5 some people feel more sexually aroused at ovulation, premenstrually or during menstruation
U6 some people enjoy penetrative and oral sex during menstruation and readily consent to this, some people do not, and it is a choice
U7 the media discourse around menstruation mostly upholds taboos, which can lead to embodied shame for those who menstruate; this can be challenged and these challenges and changes are starting to happen
U8 menstrual taboos can contribute to barriers to reproductive health access – you can assert the right to this access on your own behalf and on behalf of others