Keep period pain a secret? Expanding the theory of planned behavior with endometriosis knowledge and menstrual stigma to explain women's intentions to talk about menstrual discomfort

OBJECTIVE: Endometriosis is a chronic gynecological condition often characterized by severe menstrual pain. It takes 7 years on average to diagnose endometriosis, with menstrual stigma being an estimated factor for this delay. METHOD: In this preregistered study, both the Theory of Planned Behavior and Stigma Theory are included in an online survey to understand conversation intentions about menstrual symptoms and the impact of menstrual stigma in daily life. With a partial least squares structural equation model including 776 participants, the research investigates the facilitators and barriers influencing participants' intentions to seek advice for severe menstrual discomfort across different social contexts, including conversations with friends, medical experts, and coworkers. RESULTS: The results highlight that the perceived public stigma surrounding menstruation is associated with higher self-stigmatization, decreased attitudes, and decreased perceived behavioral control, which in turn significantly decreases conversation intentions. CONCLUSIONS: The study's results inform targeted interventions to promote open dialogue about menstrual health and reduce stigma. (PsycInfo Database Record (c) 2025 APA, all rights reserved).