The Reliability Of Adult Female’s Recall Of Their Menstrual Cycle Characteristics And Physical Activity Status At The Onset Of Menses.

Abstract

BACKGROUND: Menstrual cycle (MC) characteristics (i.e., presence, regularity) change across a female’s lifespan. MC disturbances are particularly common post-menarche and can have implications later in life. The Health and Reproductive Survey (HeRS) is a retrospective tool designed to collect reproductive history and physical activity status among females to comprehensively understand MC variations across the lifespan. PURPOSE: To determine the ability of women to reliably recall their MC characteristics and physical activity status at menarche. METHODS: This survey was assessed in a test-retest design across a 4-month span to determine recall reliability of survey responses and focused on questions pertaining to menstrual cycle regularity and physical activity status. For the recall reliability of survey questions, a Cohen’s Kappa agreement was performed using the following cut points: 0 = chance; 0.1-0.2 = slight; 0.21-0.4 = fair; 0.41-0.6 = moderate; 0.61-0.8 = substantial; 0.81-0.99 = near perfect; 1 = perfect. To determine absolute error between values reported at baseline and 4-months, 95% Limits of agreement (LOA) were reported. RESULTS: Of the 144 females (age: 32.73 +/- 11.9) who completed the HeRS at both time points, females reliably recalled their status and the number of hours completed per week when asked to categorically describe physical activity. 43% reported irregular cycles (>12 cycles or < 10 cycles per year) and 18% reported physician diagnosis of disordered MCs. Recall reliability of the ‘average number of MC per year’ was within 1.5 years in 95% of the cases (LOA = -0.04+/-1.5 yrs), while recall of ‘whether a cycle stopped for 2+ months’ had moderate-substantial agreement (0.61). The ability to recall the ‘longest length of time a cycle stopped’ was more variable (95% LOA = 1.5 +/- 13.1 mo). There was moderate agreement (0.58) of one’s ‘ability to recall being diagnosed with a MC disturbance’ (e.g. amenorrhea), while the ability to recall use (0.9) and form (0.8) of birth control revealed substantial-near perfect agreements. CONCLUSIONS: The findings of this study revealed more diagnoses of MC disorders than previously reported, and largely support the fidelity of utilizing the HeRS to retrospectively assess menstrual characteristics and physical activity status at the onset of menses.