Date of Award


Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)



First Advisor

Teri Aronowitz

Second Advisor

Ling Shi

Third Advisor

Chris Bobel


Background. The value of pubertal education in protecting women from lifelong negative menstrual experience is underestimated. This is particularly true for Palestinian adolescents and young women because the society is patriarchal and imposes restrictions on women choices.

Purpose. The purpose of this study was to examine Palestinian college women’s pubertal education in relation to their menstrual symptoms. It was hypothesized that (a) Higher levels of menstrual knowledge, positive menstrual attitudes, and pubertal education were associated with lower levels of menstrual symptoms; and (b) Pubertal education would mediate the relationship between menstrual knowledge, attitudes, and symptoms.

Methods. A cross-sectional study was employed. A sample of 363 college women (age 18-26) enrolled at Al Quds University during Spring 2019 were recruited. Besides descriptive analysis of the sample, knowledge and attitudes regarding menstruation as well as sources of pubertal education were measures to examine their effect on menstrual symptoms.

Analysis. Descriptive statistics of participants’ sociodemographic characteristics were provided. Bivariate analysis was conducted to examine relationships between individual variables. Hierarchical regression was employed to assess whether pubertal education mediated the relationship between menstrual knowledge, attitudes, and symptoms.

Results. There was no relationship between menstrual knowledge and menstrual symptoms (r =.009, p = .87). Higher levels of negative menstrual attitudes were associated with higher levels of menstrual symptoms (β = .504, p < .001). Pubertal education was not associated with menstrual symptoms (β = .074, p = .16). However, there was a slight interaction between pubertal education and attitudes on menstrual symptoms (β =.094, p = .038), indicating that pubertal education moderated the relationship between menstrual attitudes and menstrual symptoms.

Conclusion. Social norms of the patriarchal society, as represented by negative menstrual attitudes, increased college women’s reported levels of menstrual symptoms. College women have reported a number of sources of pubertal education; the effect of menstrual attitudes on menstrual symptoms was increased by the increase of pubertal education levels.


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