Study objectiveTo assess the knowledge of ovulation and menstruation of adolescent females in Western Australia. MethodsA validated adolescent ovulatory menstrual health literacy questionnaire was used in a cross-sectional study, which included an open-response question inviting participants’ reflections. ResultsParticipants (n=297) were from two single sex and seven co-educational schools of varied socio-educational advantage. Mean chronological age was 15 years and mean gynaecological age was two years. The prevalence of dysmenorrhoea was 69%. Primary sources of information included mothers (91%), friends (61%) and, for post-menarcheal participants (n=274), mobile applications (52%). Most adolescents enjoyed finding out information about ovulatory menstrual health, and understood the information given to them. However, participants’ knowledge of ovulation, menstruation and their occurrence in the cycle were low. Attendance at a single sex or Catholic school or use of mobile applications did not confer a knowledge advantage overall (p<0.05), except for knowing the meaning of cervical mucus. Thematic content analysis of open-ended responses resulted in five themes, including normality, menstrual flow, charting, ovulation and dysmenorrhoea. ConclusionInadequate functional ovulatory menstrual health literacy hampers progression to acquiring complete health literacy. This has negative implications for progressing towards the interactive and critical ovulatory menstrual health literacy domains, which include providing an accurate menstrual history when engaging with healthcare providers.