title: Women's responses to menses and nonbleeding intervals in the USA, Brazil and Germany.
abstract: BACKGROUND
  Studies from several countries suggest women differ in their preferred length of nonbleeding intervals, yet studies to date have not explored the social determinants of such preferences.
  
  
  METHODS
  We report results from a menstrual preference and social survey of 1207 healthy women in three age groups (18-20, 25-34 and 45-49 years) and two educational strata (high and low educational attainment), from Campinas (Brazil), Heidelberg (Germany) and Ann Arbor (USA) ( approximately 400 women from each country).
  
  
  RESULTS
  Women's preferred length of nonbleeding intervals differed significantly between countries. In Ann Arbor, only 15.5% of women preferred to bleed monthly, vs. 30.2% in Heidelberg. In both Ann Arbor and Campinas, approximately one-third of women preferred to "never" have menses, compared to 8.2% in Heidelberg. Multivariate analyses indicated that country, church attendance, stress and menstrual pain were significant predictors of women's preferences.
  
  
  CONCLUSIONS
  The most common preference among women was to bleed once every 3 months, but preferences varied substantially by country groups. Preferences for nonbleeding intervals were, in part, explained by personal experiences of stress or menstrual pain, but unexplained cultural differences persist between country groups.
authors.affiliation: Department of Health Behavior and Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2020, USA. rcsnow@umich.edu
authors.forename: Rachel
authors.initials: R
authors.lastname: Snow
authors.forename: Ellen
authors.initials: E
authors.lastname: Hardy
authors.forename: Elsbeth
authors.initials: E
authors.lastname: Kneuper
authors.forename: Eliana M
authors.initials: EM
authors.lastname: Hebling
authors.forename: Grace
authors.initials: G
authors.lastname: Hall
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001290:Attitude; D001938:Brazil; D003431:Cross-Cultural Comparison; D005260:Female; D005858:Germany; D006801:Humans; D008598:Menstruation / Q000502:physiology* / Q000523:psychology*; D008875:Middle Aged; D011795:Surveys and Questionnaires; D014481:United States