Date of Award

1-28-2026

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Graduate Department of Clinical Psychology

First Advisor

Nahanni Freeman

Second Advisor

Amber Nelson

Third Advisor

Kenneth Logan

Abstract

Menstrual health remains an underexamined area within psychological and reproductive health research despite its relevance to emotional functioning, self-advocacy, health literacy, and overall well-being. Limited education about the menstrual cycle, combined with persistent stigma and misinformation, may leave many individuals unprepared to understand their bodies and communicate effectively with healthcare providers. The present study aimed to develop and provide a preliminary psychometric evaluation of the Menstrual Health Literacy and Empowerment (MHLE) Questionnaire, a novel measure designed to assess menstrual cycle knowledge, menstrual attitudes, and empowerment-related processes associated with psychological well-being. Participants were recruited through community and university-based sampling methods and completed the MHLE Questionnaire alongside external validation measures, including the Beliefs About and Attitudes Toward Menstruation Questionnaire; the Ask, Understand, Remember Assessment; the Self-Efficacy in Addressing Menstrual Needs Scale; a 12-item menstrual biology quiz; and demographic questions. Exploratory factor analysis using principal axis factoring was conducted to examine the latent structure of the MHLE Questionnaire. Preliminary analyses supported the suitability of the data for factor analysis, with a Kaiser-Meyer-Olkin value of .826 and a significant Bartlett’s Test of Sphericity, χ2(3081) = 10,509.94, p < .001. Although initial extraction suggested 18 factors with eigenvalues greater than 1.00, examination of the scree plot supported a more interpretable four-factor model. Following item reduction, the final 39-item MHLE Questionnaire retained four factors: Personal Competence and Self-Regulation, Menstrual Shame, Menstrual Acceptance, and Menstrual Cycle Knowledge. Internal consistency was strong across all factors (α = .830–.909), and construct validity was supported through correlations with external measures and objective menstrual knowledge. These findings provide preliminary evidence that the MHLE Questionnaire is a reliable and multidimensional measure of menstrual health literacy and empowerment and may serve as a useful tool for research, education, and clinical dialogue in

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