Sex education in Poland - a cross-sectional study evaluating over twenty thousand polish women's knowledge of reproductive health issues and contraceptive methods.
BACKGROUND
Reproductive health is a part of a comprehensive definition of complete physical, mental and social well-being. Sex education is an important aspect of public health. Ignorance, due to the lack of sex education leads to risky sexual behaviors.


METHODS
Our cross-sectional study was aimed at investigating a representative group of Polish women's knowledge about the physiology of the menstrual cycle, contraceptive methods, infertility and cervical cancer prevention. The data were collected by face-to-face interviews and an anonymous electronic questionnaire.


RESULTS
The study group involved 20,002 respondents. Most of the women were of reproductive age (mean 27.7), parous (60.8%), of higher education (71%) and living in large cities (> 500 k citizens, 36.8%). 62.2% of the women gave correct answers to at least 5 of 7 questions concerning the physiology of the menstrual cycle. Three factors had a significant influence on the number of correct answers: higher education (p = 0.0001), more frequent gynecological appointments (p = 0.0001) and living in a larger city (p = 0.002). Women of higher education level had more often used some form of contraceptive method previously (87% vs. 78.4%, p = 0.001), recommended natural family planning methods to their peers (18.4% vs. 15%, p = 0.001) and regularly attended gynecological appointments (85.7% vs. 78.8%, p = 0.001) when compared with those women with lower educational levels. The three most effective contraceptive methods identified by respondents were: oral contraceptives (71.1% answers), intrauterine devices (50.2%) and parenteral hormonal contraceptives (30.4%). The effectiveness of natural family planning was more often emphasized by women who had never used any contraceptives before (20.1% vs 6.7%). Most of the participants (80.8%) believed that in-vitro fertilization is an effective infertility treatment and should be reimbursed in Poland. Also, 95.2% of the respondents reported that they had undergone a Papanicolaou test within the past 3 years, but only 3% of these women were aware of all the risk factors for cervical cancer mentioned in our survey.


CONCLUSIONS
It is very important to improve comprehensive reproductive health education in Poland, especially among women of lower educational levels and living in small centers. In future, educational programs and gynecologists should focus on implementing and improving these aforementioned issues.
['Warzecha|Damian|D|', 'Szymusik|Iwona|I|http://orcid.org/0000-0001-8106-5428', 'Pietrzak|Bronislawa|B|', 'Kosinska-Kaczynska|Katarzyna|K|', 'Sierdzinski|Janusz|J|', 'Sochacki-Wojcicka|Nicole|N|', 'Wielgos|Miroslaw|M|']
D000328:Adult D002947:Cities D003267:Contraception D003276:Contraceptives, Oral D003430:Cross-Sectional Studies D004522:Educational Status D005193:Family Planning Services D005260:Female D007722:Health Knowledge, Attitudes, Practice D006801:Humans D007246:Infertility D007434:Intrauterine Devices D010342:Patient Acceptance of Health Care D011044:Poland D060728:Reproductive Health D017584:Reproductive History D012309:Risk-Taking D012736:Sex Education D012725:Sexual Behavior D002583:Uterine Cervical Neoplasms D055815:Young Adult
‘Contraception’ ‘Infertility’ ‘Menstrual cycle’ ‘Sex education’ ‘cervical cancer prevention’