To the best of our knowledge, this is the very first study delineating the knowledge on the above matters and the sexual behavior of young people in Poland altogether. In recent years, the need for sexual education has become a frequently discussed topic in Poland, sparking a public debate regarding the introduction of various forms of such education at the school level. The current generation of adolescents has not been systematically exposed to formal sexual education programs. This study evaluates the level of knowledge among this group regarding the physiology of the menstrual cycle, awareness of contraceptive methods, risks, and sexual safety. The purpose of the study was to identify the most pivotal areas of insufficient knowledge on the menstrual cycle, contraception, as well as their correlation with willingness to undertake risky sexual behavior. Knowledge regarding these aspects is the cornerstone for a healthy sexual and reproductive life. The findings of our study reveal decent general awareness regarding menstrual cycle and lower knowledge of contraception risks among the Polish youth. Even some of the specific questions were answered correctly by the majority, for instance, about the Pearl Index (Appendix 1) or the occurrence of sperm cells in the pre-ejaculate. On the other hand, astonishingly, some questions posed significant difficulty. The fate of an unfertilized ovum was known by only 42.5% (286), with 52.6% (354) believing it transforms into corpus luteum. Moreover, our study showed that the majority of the Polish youth do not know the contents of hormonal contraception. Not only did they lack knowledge of that, but they also struggled with indicating potential side effects of hormonal contraception, especially cholelithiasis or increased risk of endometrial cancer. The knowledge on these matters was particularly low in the 15–18 age group but was not much higher among older respondents.

There are numerous studies assessing certain populations’ knowledge of menstrual cycle or contraception risks. Belayneh et al. found that 68.3% of adolescent female participants in the study displayed poor knowledge of menstruation. The majority of them believed that menses is a result of a disease, or it is a lifelong process. This cross-sectional study conducted in Ethiopia also showed that 27.7% believed menstruation is a curse (Belayneh and Mekuriaw 2019b). Similar results were observed in a study, which reported deficient awareness of menstruation and poor hygienic practices among adolescents in Nigeria (Adinma and Adinma 2017). The findings of these African studies are significantly different from our results, which show that Polish youth have more substantial knowledge of this matter. Poor knowledge about menses was also observed in India, Zambia, and Cameroon (Webb 2000; Shanbhag et al. 2012; Munakampe et al. 2018). Moreover, the level of knowledge reported in our study is similar to that of many developed countries. A 2022 study of 1086 female athletes from 57 different sports in Sweden and Norway found that 26% perceived their knowledge about female athlete health concerning menstrual cycle or side-effects of hormonal contraceptives as poor or very poor. The study also found that 53% of athletes perceived the knowledge of their coaches regarding this health aspect as poor or very poor, with a significantly higher proportion of athletes with a female coach rating their coach’s knowledge as very good or good compared to those with a male coach (von Rosen et al. 2022). A study conducted in Spain, which involved a population of nursing students, revealed a percentage of correct answers to general questions regarding sexuality and the menstrual cycle of around 90% (Scarano-Pereira et al. 2023). The above results remain in line with our study’s findings. Furthermore, there has been a study evaluating the knowledge of Polish women of reproductive age concerning contraception and sexuality. The paper reported that 62.2% had given correct answers to at least five out of seven questions regarding the menstrual cycle. There were significant differences in the ratio of correct answers between respondents. Frequency of gynecological appointments, age, and education level were found to be statistically important factors (Warzecha et al. 2019). The level of knowledge reported in this study is slightly lower in comparison with Warzecha et al. The potential reasons involve a lower average population age, fewer participants, and the inclusion of male participants who did not perform as well as female participants in our study. Another study in Poland focused on dietary aspects related to the menstrual cycle. Most of the participants were aware that unsaturated fatty acids or molecules such as zinc or selenium contribute to a healthy menstrual cycle. However, merely 35.4% knew that simple sugars could be detrimental (Ciołek et al. 2023b). The study presents an interesting take on women’s knowledge regarding the menstrual cycle, and its conclusions align with ours, as it reports decent general and unsatisfactory specific knowledge.

Another area analyzed in our study was the knowledge regarding contraception. Krauss et al. reported that most of the young European sexually active citizens do not use contraceptive methods (Krauss et al. 2012). Studies have reported significant gaps in knowledge and identified the internet and peers as the most trusted source of information on sexuality (Szpiech and Kowalski; Sokkary et al. 2013; Espinoza et al. 2020). Previous research indicates that 38% of the first intercourses are protected, and condoms are the most used as a contraception method (Rada et al. 2013). Our survey revealed that 73.3% of respondents used condoms as contraception during their risky sexual behavior. Moreover, 8.1% used postcoital contraception. Surprisingly, only 26.1% feared becoming ill with an STD following their intercourse. One-third of respondents believed alcohol played an important role in their decision-making process. A study in Portugal revealed a general awareness among adolescents of 87.3% with very limited specific knowledge regarding Chlamydia or Neisseria gonorrhea bacteria and the possibility of their transmission (Silva et al. 2022). A study conducted in another developed country, Singapore, depicted a general awareness of oral contraception of 89.2% and a good knowledge of 64.9% (Gosavi et al. 2016). Once again, the results of our study on the Polish population do remain in line with those in other countries of good socioeconomic status. The knowledge of contraception among the Polish population was also measured by Warzecha et al. in 2019. The study reported that 71.1% considered oral contraception as the most effective. However, barrier methods (27.6% of answers in general) were mostly selected by younger women (26.8 y.o. vs. 28 y.o.; p < 0.001) (Warzecha et al. 2019). Our survey included questions focusing on different aspects of contraception, such as side effects or the risk of STD transmission. Hence, there was a difference in the ratio of correct answers, which in our study was very good for general questions and unsatisfactory for specific ones.

The last area assessed in our study was sexual behavior. Risky sexual behavior (RSB) increases the risk of contracting STDs and is associated with other significant health problems such as anxiety or depression (Karle et al. 2023). Numerous studies indicate a correlation between RSB and being male, the use of narcotics, or the use of online applications to seek sex, as well as poor mental health (Choudhry et al. 2014; Anyanwu and Tamwesigire 2023). Our study reported that 67% of young Poles admitted previous RSB. Contrary to other studies, women had a higher percentage of RSB than men (68.7% vs 43.5%, respectively). Our analysis showed a correlation with the age group 19–29, as well as a lack of knowledge regarding hormonal contraception. We believe this proves the importance of sexual education to raise the awareness of the youth and avoid unwanted pregnancies or STDs. A study by Choudhry et al. reported a strong association between alcohol consumption, multiple sexual partners, and unprotected intercourse (Choudhry et al. 2014). On the contrary, our study reveals that the majority of respondents (53.2%) underwent RSB with no prior alcohol consumption. Moreover, 37.2% did not use any form of contraception during their intercourse. The most common contraceptive method was a condom.

The limitations of our study include a potential selection bias due to the voluntary nature of participation in the online questionnaire. In addition, the sample is biased toward women (93.2%), which limits the generalizability of the results to young men. On the other hand, the strengths of our analysis comprise 1. A relevant and timely topic—given ongoing debates about sexual education in Poland, the study addresses a socially relevant and timely topic that could inform policy 2. Comparison with international data—the discussion contextualizes the results by comparing them with studies from other countries, enhancing the paper’s relevance to a broader audience. 3. Clear practical implications—the article highlights areas where educational interventions could reduce risky sexual behavior, providing actionable insights for public health policymakers.