Introduction

The concept of reproductive health emerged in the 1990s. After the 1994 Cairo Conference, the Chinese government started to use “reproductive health” and “reproductive rights”. In 2020, the US CDC defined reproductive health as the condition of an individual’s reproductive system, processes and functions at every life stage, including physical and mental health related to reproduction1. Reproductive health is crucial for women’s health. The “2022 China Family Planning Association Work Plan” stated that in 2022, a reproductive health promotion action would be implemented. It aimed to address prominent reproductive health issues in adolescents, people of childbearing age and other specific groups. Also, a special action would be carried out to reduce induced abortions in unmarried people and unintended teen pregnancies, improving the public’s reproductive health level.

Women’s anatomical and physiological differences make them more vulnerable to poor hygiene habits than men2. Adolescent girls, affected by biological, social and economic factors, are more likely to be at high risk of poor sexual and reproductive health outcomes3. In their research, Wang Hanying and colleagues highlighted that female college students are at a key stage of reproductive system development and reproductive health knowledge acquisition. However, both universities and society at large currently fall short in awareness and attention to this critical demographic’s reproductive health. A knowledge gap in reproductive health exists among female college students. A survey by Zhang Fengyun et al. on non-medical female college students in Hangzhou showed that their grasp of basic reproductive health knowledge is weak. Their awareness of key topics like menstrual cycle regularity, ovulation timing, common reproductive disease prevention, and contraception methods is below 50%. Many also have misconceptions about AIDS transmission and prevention, with over 30% of students never actively seeking related knowledge4. This lack of knowledge can compromise their health decisions and increase risks of unintended pregnancies and sexually transmitted diseases.

Female college students need proper guidance to maintain their reproductive health; without it, their lack of knowledge may seriously affect their physical and mental well - being5. Clearly, it is very necessary to offer the course “Women’s Health Care” in colleges and universities. This not only helps female college students realize the importance of reproductive health but also facilitates the future work of women’s health care6. Also, educational interventions are effective in enhancing college students’ understanding of reproductive health issues like cervical cancer and HPV7.Health education is of great significance for improving the reproductive health of female college students, but the current situation is far from satisfactory. Although most universities offer relevant courses or lectures, they are plagued by problems. The content is often fragmented and lacks a comprehensive structure, making it hard for students to build a complete knowledge system. Teaching methods are usually traditional lectures, lacking interactivity and appeal, which makes it difficult to engage students. Additionally, insufficient class hours limit in - depth coverage of important knowledge points and restrict students’ mastery of the subject8.The role of the family in reproductive health education is also limited. Due to the restrictions of traditional concepts, most parents find it difficult to take the initiative to communicate with their children on such topics, so the family’s potential educational function in this area remains underutilized9.

Many studies have explored effective educational interventions to address this. In outpatient and peer - education interventions, female college students are given reproductive health education booklets by medical staff and provided with detailed explanations. After the intervention, there’s a significant increase in students’ understanding of key knowledge, such as menstrual cycle timing, ovulation period, HIV transmission routes, and prevention methods. This shows targeted education can effectively fill their knowledge gaps10.Moreover, educational interventions based on the Protection Motivation Theory (PMT) have also been very effective. By enhancing female college students’ awareness of reproductive health risks and their self - efficacy, the intervention encourages them to take active protective actions. These include correct contraceptive use and regular reproductive health check - ups, which effectively improve their reproductive health and reduce related health risks11. In terms of contraception awareness, a survey by Qi Zhaoran et al. of 2,225 non-medical unmarried female college students in Chengdu showed that only 33.0% of the students were aware of scientific contraception methods12. Yang Yuehua et al. found that the top five known methods are condoms, emergency contraceptives, combined oral contraceptives, fertility awareness - based methods, and withdrawal13. Oral contraceptives are globally recognized as effective. A survey in Ethiopia’s western region on 400 female students from three private universities showed that 51.4% of respondents knew about oral contraceptives14. A study of 347 female undergraduates at St. John’s University indicated that condoms and oral contraceptives were the most mentioned methods. However, despite most participants having contraception knowledge, the usage of oral contraceptives was relatively low15. A study in Guangzhou showed that female college students have limited awareness of sexual and reproductive health16. Qiu Mengying et al. found that most Chinese female students recognize common sexually transmitted diseases like syphilis, AIDS, and gonorrhea. But their overall understanding of sexual health is still limited, with some completely unaware17. In 2017, Yang Yi found the top three gynecological issues among female college students were menstrual irregularities, gynecological inflammation, and dysmenorrhea18. Approximately 40% of female college students have had reproductive system diseases, and 50% experience dysmenorrhea of varying degrees19. In recent years, unintended pregnancy and abortion rates among young Chinese females have risen yearly, causing significant physical and psychological harm20.

Awareness of reproductive health has a positive impact on related behaviors21. China’s reproductive - aged population faces serious reproductive health challenges22, and the reproductive health of female college students needs urgent improvement. Although many studies have explored women’s reproductive health in different regions and populations, there is still a significant research gap regarding female college students in the Xinjiang region. Previous research has mainly focused on women of childbearing age and those in perimenopause, with insufficient attention to the reproductive health of adolescent females, particularly female college students.

As a multi - ethnic region, Xinjiang’s unique cultural backdrop complicates the spread of reproductive health knowledge. Studies indicate that ethnic minority college students differ from Han students in reproductive health knowledge awareness and attitude openness, which is closely related to ethnic culture, traditional concepts, and educational background differences23. Regarding urban - rural disparities, rural areas suffer from inadequate educational resources, especially in reproductive health education investment. Reproductive health education is often neglected in rural families and schools, restricting students’ knowledge acquisition and attitude formation. Thus, rural female college students have higher physiological health needs than urban ones24.This study focuses on female college students’ reproductive health status, knowledge awareness, and behaviors. By surveying female students across different disciplines, it compares their reproductive health status, cognitive levels, and behaviors. The findings can help Xinjiang’s universities develop tailored reproductive health education and care measures and enhance the theoretical framework for women’s reproductive health in the region25. Innovatively, the study targets female students in Xinjiang universities, analyzing the differences in their reproductive health status, behaviors, and cognition, as well as multi - dimensional influencing factors. Including students from various majors in multiple universities, the study aims to fill existing research gaps and provide a scientific basis for reproductive health education and services in Xinjiang’s universities, promoting female students’ reproductive health.

Methods

Ethics approval and consent to participate

This study was approved by the Ethics Approval Committee of Urumqi Maternal and Child Health Hospital, and the approval form number is XJFYLL2022043. confirming that all research was performed in accordance with relevant guidelines/regulations and that informed consent was obtained from all participants.

Research participants

This study involved female college students from two universities in Urumqi (one comprehensive and one medical) and one comprehensive university in the Kashgar region of Xinjiang. During sampling, regions (Ürümqi and Kashgar) and university types (comprehensive and medical) were treated as different strata, while various majors and grades were considered as clusters.The sampling method was stratified cluster random sampling. Specifically, using student lists provided by the universities, multiple majors across grades one to four were randomly selected within each school as clusters. Then, all female students within the selected clusters were surveyed until the predetermined sample size of 625 was reached, including 346 from medical programs and 279from non-medical programs.The questionnaire survey on female college students’ reproductive health and related cognitive behaviors was conducted from April to May 2023.

Inclusion criteria

  1. ①

    Female college students currently enrolled;

  2. ②

    Those able to follow instructions and independently access and complete the online survey. Or, with necessary assistance (e.g., simple clarification of wording by surveyors), can basically understand the questionnaire and provide answers;

  3. ③

    After being explained the purpose and significance of the survey by the surveyors, they are willing to participate in the research.

Exclusion criteria

  1. ①

    Female college students who refuse to take part in the survey;

  2. ②

    Those who fail to fill out the questionnaire as required, such as leaving numerous questions blank or providing obviously random and illogical answers, which are deemed invalid by the surveyors.

Sample size estimation

This study is a cross-sectional study. The sample size calculation formula for cross-sectional studies is as follows:

$$\:\text{n}=\left(\frac{{Z}_{1-\frac{\alpha\:}{2}}}{\delta\:}\right)\times\:P\times\:(1-P)$$

According to the 2022 China Reproductive Health Research Report on Women of Childbearing Age released by the Institute of Health Communication of Fudan University, abnormal menstruation, abnormal pubic and leucorrhoea, and abnormal breasts are the three most common gynecological symptoms of women of childbearing age, and their prevalence rates are 50.8%, 30.2% and 20.5%, respectively. The incidence of abnormal vaginal and leucorrhea is about 30%, that is, P = 0.3. Considering the expected loss rate during the survey process, such as students who may drop out due to time conflicts, lack of interest, or other personal reasons, as well as the variability in responses that could affect the reliability of the data, the allowable error is set to 0.04, \(\:\alpha\:\)= 0.05. Calculated according to the formula. Moreover, taking into account that the study adopted a stratified cluster random sampling method and to ensure the reliability of the research results, 20% of the research subjects were added on the basis of the sample content. The final sample of female college students participating in the reproductive health status and related cognitive behavior survey was determined to be 625 people.

Study design

This cross-sectional study aims to collect data via a one-time survey. It intends to describe and analyze the current reproductive health status and related cognitive behaviors of female college students in Xinjiang, as well as their influencing factors.

The survey content was designed by referring to questionnaires designed by Wu Na2, Zhang Yanli26, and others, with modifications made to suit the objectives of this study. The questionnaire consists of four sections with a total of 56 questions. The content includes:①Basic Information of Female College Students(age, place of origin, type of major, economic status, marital status, etc.).②Current Status of Reproductive Health(menstrual conditions, vaginal hygiene, sexual activity, and other gynecological-related situations, etc.).③Health Status and Behavior(height, weight, daily living habits, and unhealthy preferences, etc.).④Cognition of Reproductive Health: (understanding of the concept of reproductive health, common physiological knowledge and issues for both sexes, awareness of sexually transmitted diseases, and knowledge of contraception, etc.).Once the questionnaire was designed, experts in relevant fields were invited to evaluate and refine its content. A pilot survey was also conducted to assess the questionnaire’s feasibility, understandability, and acceptability. Based on the pilot survey results, the questionnaire was further improved to ensure its reliability, validity, and cultural sensitivity.

Body Mass Index (BMI) is a commonly used standard for assessing human body fatness, nutritional status, and physical development. It is calculated using the formula: BMI = weight (kg) ÷ height (m)2.

Quality control

When selecting subjects, strict inclusion and exclusion criteria were applied to ensure smooth research progress and generalizable results. The sample size was also appropriately increased. After the questionnaire was designed, it was evaluated by professionals and refined after a pilot survey to ensure quality. Surveyors received unified training to further guarantee questionnaire quality. After the survey, the completeness of the data was checked and logic verified. Additionally, 10% of the collected questionnaires were randomly selected for quality review. Data was entered twice, with designated personnel checking for consistency between the two entries against the original data. Before analysis, data was error-checked to exclude abnormal values and analyzed using appropriate statistical methods for different data types.

During data analysis, 56 variables were analyzed, covering basic information, reproductive health status, related health behaviors, and knowledge of reproductive health among female college students. To address the complexity, multiple statistical methods were used. Potential confounding factors (e.g., age, field of study, economic status) were identified through literature review and expert consultation. These were then included as covariates in multivariate regression models to assess their impact. Stratified analysis was also conducted to explore relationships between variables at different levels of confounding factors. This rigorous approach ensures the accuracy and reliability of the results.

Statistical analysis

An EpiData 3.1 database was established to import and manage the data. A dedicated person was responsible for verifying and inspecting the data to ensure its accuracy. Once confirmed, SPSS 26.0 statistical software was used for data analysis and processing. For categorical data, the chi-square test was employed for significance testing. For continuous data, t-tests or analysis of variance were used. Significant indicators were further analyzed using multivariate logistic regression analysis. P < 0.05 was considered statistically significant.

Results

This study selected three universities in Xinjiang as the research sites, including a total of 625 subjects, with 346 from medical majors and 279 from non-medical majors. The study compared the reproductive health status, knowledge cognition, and related behaviors of subjects from different academic disciplines, explored the influencing factors of reproductive health status, and analyzed the relationship and differences between reproductive health status and academic disciplines.

Description of basic information of female college students from the three universities

The basic information surveyed included age, origin of student, economic status, and marital status, which were described and analyzed according to different academic disciplines. The average age of the subjects was 23.43 ± 0.50 years. There was no statistically significant difference in age, distribution of origin of student, and marital status between students from medical and non-medical majors (P > 0.05). In terms of economic conditions, the majority of students in both groups have a monthly income ranging from 3000 to 8000 yuan, and the difference between the two groups is statistically significant (P < 0.05). For more details, see Table 1; Fig. 1.

Table 1 Summary of basic information.
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Fig. 1
figure 1

Distribution of demographic characteristics of female college students in different majors (*<0.05, **<0.001, ***<0.0001, ns no statistical difference).

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Current status of reproductive health

Analysis of the current status of reproductive health

The results showed that 73.4% of the subjects had a regular menstrual cycle, but 51.8% were troubled by dysmenorrhea. The rate of dysmenorrhea was significantly higher among female medical college students than among non - medical ones (P < 0.05). 17.2% of the subjects had abnormal leucorrhea, with no significant difference across different fields of study. See Table 2 for details.

Table 2 Analysis of the reproductive health status of female college students.
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Analysis of menstrual habits

The results show that 78.1% of female college students pay attention to keeping warm during menstruation, and 81.9% of female college students do not often wash with cold water during menstruation. There are differences in the attitudes of female college students of different disciplines towards keeping warm and washing with cold water during menstruation (P < 0.05). See Table 3 for details.

Table 3 Analysis of menstrual habits of female college students.
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Reproductive health-related behaviors

There are statistically significant differences among female college students of different disciplines in the choice of vulvar cleaning methods, cleaning products, wiping after urination, the direction of wiping the anus after defecation, whether to use sanitary pads, and the cleaning of underwear (P < 0.05). Female medical students showed better hygiene practices, such as wiping after urination, wiping front - to - back after defecation, and washing underwear separately. 52.2% of female college students chose 100% cotton underwear, which is proved to be a protective factor against vaginal microbiota imbalance in polycystic ovary syndrome patients. See Table 4 for details.

Table 4 Hygiene and care of the genital area.
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Current health status and unhealthy behaviors

The results show that there is no significant difference in the BMI index among female college students of different disciplines (P > 0.05). 71.8% of the students are at a normal level, 19.7% are underweight, 7.8% are overweight, and 0.6% are obese. See Table 5 for details.

Table 5 BMI index analysis of female college students.
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The results show that there is no significant difference in the incidence of dysmenorrhea among female college students with different BMI levels (P > 0.05). See Table 6 for details.

Table 6 The impact of BMI on dysmenorrhea in female college students.
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The results show that there is no significant correlation between different BMI levels and menstrual regularity among female college students (P > 0.05). See Table 7 for details.

Table 7 The impact of BMI on menstrual regularity in female college students.
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Among common lifestyle habits, there are statistically significant differences among female college students of different disciplines in terms of frequently consuming fast food, daily laptop usage duration, daily mobile phone usage duration, preference for taking hot baths or soaking in hot water, and daily water and alcohol intake (P < 0.05). See Table 8 for details.

Table 8 Analysis of health-related behaviors of female college students.
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Awareness of reproductive health

Among the 625 female college students surveyed, 78.1% were aware of and understood the concept of reproductive health. 97.28% of the female college students believed that receiving reproductive health education was necessary. The differences between the two groups were statistically significant (P < 0.05). See Table 9 for details.

Table 9 Statistics on awareness and attitudes towards reproductive health concepts.
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Female students in medical programs demonstrated a significantly higher awareness of reproductive health concepts compared to their non - medical counterparts. When it comes to common physiological knowledge and issues in males and females, female college students exhibit a rather one-sided understanding, particularly showing insufficient knowledge of male physiology. See Table 10 for details.

Table 10 Statistics on awareness of common physiological knowledge and issues for males and females.
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Regarding awareness of sexually transmitted diseases, the awareness rates of HIV, gonorrhea, and syphilis are generally high among female college students of different disciplines. The awareness rates of condyloma acuminatum and genital herpes among medical female students were 66.5% and 61.8%, respectively, while those among non - medical female students were 31.5% and 30.8%, respectively. The differences between the two groups were statistically significant (P < 0.05). See Table 11 for details.

Table 11 Statistics on awareness of sexually transmitted diseases.
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Only a minority of the study subjects knew that emergency contraceptives are ineffective if taken more than 96 h after coitus. This suggests a significant misunderstanding among female college students regarding contraceptive and family planning knowledge.See Table 12 for details.

Table 12 Statistics on awareness of contraception and family planning knowledge.
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Binary logistic regression analysis of factors affecting reproductive health status

Reproductive health status was used as the dependent variable, and discipline type, level of reproductive health knowledge, place of origin, family monthly income, and age were used as independent variables for binary logistic regression analysis. The results show that the level of awareness can significantly affect reproductive health status. Compared with female college students with a high level of awareness, the risk of poor reproductive health status due to insufficient awareness is increased by 1.983 times [OR (95%CI): 1.912(1.210,3.251)]. See Table 13 for details.

Table 13 Analysis of factors affecting the reproductive health status of female college students.
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Current status and demand for reproductive health education

Among the 625 female college students surveyed, 22.72% had never received systematic reproductive health education. The largest proportion, 36.48%, first received systematic reproductive health education in junior high school. Another 22.72% of female college students indicated that they had never received systematic reproductive health education.See Fig. 2 for details.

Fig. 2
figure 2

Time of first receiving systematic reproductive health education.

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Among female college students, common ways to obtain reproductive health knowledge include school education, online platforms, family education, and books and periodicals. However, 1.8% of the students indicated that they had no access to sources of reproductive health knowledge.See Fig. 3 for details.

Fig. 3
figure 3

Common channels for acquiring reproductive health knowledge.

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The structure and function of reproductive organs; knowledge related to pregnancy, contraception, and induced abortion; the physiological process of reproduction are the most desired knowledge among female college students regarding the structure and function of the reproductive organs, knowledge related to pregnancy, contraception, and induced abortion, and the physiological process of reproduction, with proportions of 89.3%, 82.7%, and 81.1%, respectively. In addition, in other supplements, some female students believe that it is also necessary to master knowledge about reproductive health care, basic theories and practices of population and family planning, etc. See Fig. 4 for details.

Fig. 4
figure 4

Desired reproductive health knowledge.

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Discussion

Analysis of reproductive health status, behaviors, and cognitive levels

This study was conducted in three universities in Xinjiang, with a total of 625 participants, including female college students from various majors such as clinical medicine, preventive medicine, tourism management, statistics, history, and others, from the first to the fourth year. Overall, 73.4% of the participants had relatively regular menstrual cycles. However, the study found that 51.8% of the participants suffered from dysmenorrhea. When comparing different disciplines, the incidence of dysmenorrhea among medical female students was higher than that among non - medical female students. This is consistent with the findings in this study regarding the use of cold water during menstruation and the consumption of ice cream and cold drinks. Female students who consume raw and cold food and do not take warming measures are more likely to experience dysmenorrhea27. In addition, Lu Jingya et al. also found in their study that the incidence of dysmenorrhea among female college students majoring in medicine is relatively high. This may be because, compared with female students in non - medical majors, those in medical majors have a heavier academic burden and greater mental stress28.

Medical students shoulder heavy academic demands. They need to master a vast amount of professional knowledge and skills to get ready for future career challenges. This kind of prolonged intensive study can lead to a significant rise in mental stress. Stress, as a psychological factor, has been proven to have a connection with the occurrence of dysmenorrhea29. Moreover, the expectations and role definitions for medical students in socio - cultural contexts may also impact their reproductive health. In traditional concepts, the medical profession is often regarded as a high - intensity, high - stress field. This idea may push female university students in medical programs to more likely disregard or endure symptoms when facing physical discomfort, in order to meet the expectation of the “tough” image of medical students. These psychological and socio - cultural mechanisms not only influence their perception and response to dysmenorrhea, but may also further increase the frequency and severity of dysmenorrhea. In addition to psychological and socio - cultural factors, the irregular schedules of medical students may also negatively impact reproductive health. Due to heavy study tasks, they often can’t guarantee adequate sleep and regular meals. Such irregular routines can lead to endocrine disorders, thus increasing the risk of dysmenorrhea.

Overall, 17.2% of the participants had abnormal vaginal discharge, but there was no significant difference between different disciplines. Abnormal vaginal discharge is often caused by vaginal infections. According to the research results of Jiang Lijuan et al., long - term wearing of tight - fitting pants, synthetic underwear, and the use of sanitary pads during non - menstrual periods are prone to cause fungal vaginitis30. In this study, 52.2% of female college students chose 100% cotton underwear. Studies have shown that cotton underwear is a protective factor for the imbalance of vaginal microbiota in patients with polycystic ovary syndrome31. This may be because cotton products are hygroscopic and breathable, soft and comfortable, and less likely to breed bacteria compared with other materials.

The results of this study show that medical female students have better hygiene habits than non - medical female students. Medical female students are better than non - medical female students in wiping after each urination, wiping the anus from front to back after defecation, washing underwear separately, and undergoing gynecological - related examinations. This may be related to the systematic hygiene and nursing knowledge that medical students have received. Zhang Yan et al. also showed in their study that bad hygiene habits such as not wiping after urination, washing underwear together with other clothes, and using sanitary napkins for too long can cause infections in the female reproductive system32. Therefore, it is extremely important to develop good hygiene habits to prevent and treat reproductive system infections.

When comparing different disciplines, medical female students have a higher awareness rate of the concept of reproductive health than non - medical female students. Binary logistic regression analysis also found that awareness of the concept of reproductive health is a protective factor affecting the current status of reproductive health. Regarding common physiological knowledge and problems for both males and females, overall, the level of awareness among female college students is still relatively one - sided, which is consistent with the research results of scholars such as Li Luyao33. The survey results show that compared with male physiological knowledge, female college students have a better understanding of their own physiological knowledge. Therefore, it is possible to carry out popular education on physiological knowledge to make up for the knowledge deficiencies in this area. In terms of contraceptive knowledge, only a small part of the research subjects know that emergency contraceptives will be ineffective if taken more than 96 h after intercourse. This is consistent with the conclusion pointed out by Liu Yuanyuan in his research that female college students have insufficient understanding of oral contraceptives and there are obvious misunderstandings34.

Main factors affecting reproductive health

The main factors affecting women’s reproductive health are risky sexual behaviors35, poor hygiene habits, major - related factors, social bad mores, economic conditions36, as well as the mother’s education level, place of residence, and sleep time37, childhood abuse, parental conflicts, etc38. In addition, some studies have pointed out that lifestyle habits can also affect the awareness of AIDS prevention and control measures39. The novel coronavirus can also infect the female reproductive system, thereby triggering a series of reproductive system diseases40.

This study only explored the impact of two factors - poor hygiene habits and major - related factors - on women’s reproductive health. Poor hygiene habits can increase the risk of reproductive system infections, leading to a gradual increase in the incidence of various reproductive system infectious diseases and AIDS. In terms of major - related factors, medical female students have a better understanding of reproductive health knowledge than non - medical female students and pay more attention to their own reproductive hygiene. However, no significant statistical differences were found in the current status of reproductive health. In a study conducted by Tao Xiangxiu et al., it was discovered that BMI can have an impact on primary dysmenorrhea41. However, no correlation between BMI levels and the incidence of dysmenorrhea among female college students was found in this study.

In Xinjiang, traditional views and cultural background remarkably impact women’s reproductive health education. As a multi - ethnic region, Xinjiang has significant cultural and lifestyle differences among its ethnic groups, which profoundly affect attitudes towards women’s reproductive health and education methods. In some ethnics with strong traditional views, reproductive health is a private topic. Families and schools are conservative in education, leaving students with few ways to get relevant knowledge. This causes non - medical female university students to lack reproductive health knowledge, and feel shame and silent when facing related problems.

However, medical female students, with systematic hygiene and nursing education, have better reproductive health knowledge and self - care awareness. This shows systematic reproductive health education can effectively improve students’ cognition and self - care consciousness. Thus, universities should consider the social and cultural background in reproductive health education, and adopt suitable teaching strategies for students from different backgrounds.

Recommendations for improving reproductive health status and cognitive levels in female college students and implications for education

Suggestions for Improving the Current Status and Awareness of Reproductive Health in Female College Students. First, conducting special reproductive health education is an important way to improve the reproductive health of female college students. Studies have shown that sexual knowledge directly and indirectly affects reproductive health behaviors42. Reproductive health education interventions have a significant impact on improving the reproductive health awareness of female college students43. Education departments and schools should cooperate with each other to increase the intensity of education and dissemination in all aspects44.Employ diverse teaching methods to boost student participation. Offering elective courses on female reproductive health can teach students how to monitor their basal body temperature, identify the characteristics of vaginal discharge, and perform breast self - examinations correctly. These measures can effectively prevent common gynecological diseases among female college students, such as menstrual disorders and reproductive tract inflammation, and promote their physical and mental health45.

Second, obtaining youth - friendly health services is crucial for ensuring the sexual and reproductive health and well - being of adolescents46. In other countries, there have long been evidence - based studies on the development, implementation, and evaluation of youth - friendly health services (YFHS). However, the research results show that most of the 115 indicators used to measure youth - friendly sexual and reproductive health services are not specifically tailored to the needs of young people47. Therefore, relevant departments should actively cooperate and formulate reproductive health service programs that meet the needs of different age groups, and include reproductive health - related projects in the physical examination programs for college students.Universities should collaborate with medical institutions to offer accessible reproductive health services.

Third, a management model should be established that includes planning, standardization and implementation, monitoring and management, as well as evaluation and assessment. This model will provide a favorable safeguard mechanism for the sexual and reproductive health of female college students. It aims to ensure a comprehensive improvement in their awareness of sexual and reproductive health, and to instill the concept of lifelong maintenance of sexual and reproductive health. The ultimate goal is to truly achieve the objective of universal access to sexual and reproductive health education for all female students during their university years48.Further explore the underlying factors influencing reproductive health - related behaviors and perceptions. Conduct longitudinal studies with expanded sample sizes to enhance the generalizability of the findings.

Advantages and limitations

A literature review revealed that while there have been studies on women’s reproductive health in Xinjiang, most of them focus on women of childbearing age and those in the perimenopausal period. There is a lack of research on the reproductive health of adolescent females. This project focuses on investigating the current status of reproductive health and the awareness of reproductive health knowledge among female college students. It also compares the reproductive health status and awareness levels of female students from different disciplines. This study helps to improve the theoretical system of women’s reproductive health in Xinjiang. The research findings can provide a basis for reproductive health education and the development of health - care measures for female college students in universities in Xinjiang.

This study is a cross - sectional survey conducted through an online platform. Despite thorough communication with teachers from various universities before the study, some participants still did not cooperate. There were also differences in the sample size obtained from different grades. In addition, the survey used in this study included some private questions, which may have led to some information bias. This study only selected a small number of female students from three universities in Xinjiang. The representativeness of the sample needs further consideration.

Conclusion

  1. 1.

    The prevalence of dysmenorrhea among female college students in Xinjiang (51.8%) is basically consistent with the domestic survey results (50%). The incidence of dysmenorrhea among medical female students is higher than that among non - medical female students. The proportions of female students with vulvar itching and abnormal vaginal discharge are 21.1% and 17.2%, respectively. The current status of reproductive health among female college students needs to be further improved.

  2. 2.

    There are widespread behaviors and habits that are not conducive to reproductive health among female college students, and their self - care awareness is relatively poor, which is not conducive to maintaining reproductive health.

  3. 3.

    Medical female students have a better understanding of reproductive health knowledge than non - medical female students. However, overall, female college students do not have a comprehensive grasp of the reproductive physiology of the opposite sex. They are also easily misled by the information they encounter in daily life, which is not conducive to establishing correct concepts of the two sexes.

  4. 4.

    Individuals, families, and society should all pay attention to the reproductive health of female college students. Schools and health departments should focus on the popularization of reproductive health education. In particular, non - medical colleges and universities can offer relevant courses to promote female college students’ understanding of reproductive health, thereby improving the overall status of reproductive health.