Reproductive health education needs a radical overhaul, with appropriately trained teachers providing the education the pupils say they need, UCL researchers say.
In most schools in England, sex and reproductive health education is taught by form tutors and this can give a very patchy education for those students, depending on whether the teachers feel comfortable teaching the subject, the researchers say.
Within schools, we need teachers to be specialists in these subjects, so those lessons are taught effectively.
Personal, Social, Health and Economic (PSHE) education has been compulsory in English primary and secondary schools since 2020, and in 2025 it was updated to include topics such as endometriosis, polycystic ovary syndrome (PCOS) and heavy menstrual bleeding. Sex education is also compulsory in Welsh schools.
But in a new article, published in Health Education Journal, the researchers say these changes have not gone far enough, and argue that improving sex and reproductive health education requires not only curriculum updates but a more systematic approach - ensuring alignment between teaching resources, training and delivery.
In support of this, they say recent surveys have shown that teenagers still know very little about reproductive health and fertility when they leave school, meaning conditions such as difficult periods and endometriosis may be overlooked, leaving them unable to make informed choices about starting a family.
In some schools, PHSE teachers lead on giving the sex and reproductive lessons. In schools where that is done by form tutors, the researchers are calling for them to be given additional support to enhance the quality of lessons. The UCL team have been working on developing teachers' resources to provide this support both through their work with the International Reproductive Health Education Collaboration and the charity Wellbeing of Women.
Lead author Professor Joyce Harper (UCL EGA Institute for Women's Health) said: "There is an urgent need to improve the quality of the education that pupils receive about sex and reproductive health to help them make informed choices about their reproductive health and fertility.
"England is one of the few countries worldwide that explicitly incorporates reproductive health into its curriculum, but different approaches are used in different schools, and this can give a very patchy education.
"Through our various research projects, our international Reproductive Health Education Collaboration has developed free resources which are available to teachers, and we are evaluating with teachers as to the best way to use those resources in the classroom.
"We are also working with charity Wellbeing of Women to develop lessons plans on some of these topics which will be free for teachers to use.
"At the moment, because pupils are not getting the right education, too many people are only finding out that they are unable to have children when they start trying to have a baby years after leaving school."
In August, a separate study led by Professor Harper found that teaching about periods in schools was still too focused on basic biological facts with insufficient information around how menstruation can affect a woman's mood and well-being, problems associated with menstrual bleeding and the impact on physical and academic performance.
And in 2024, another study led by Professor Harper which surveyed schoolchildren in England found that almost half (45 per cent) said that they had concerns about future parenthood - expressing their fears about their ability to have healthy offspring and the lives their children might lead.
Corresponding author Professor Michael Reiss (UCL Institute of Education) said: "Successful education, on any topic, requires various factors to work together. We need alignment between the curriculum, textbooks, support materials, pedagogy, student assessment, school inspection, initial teacher education, teacher professional development and funding.
"Teacher confidence to provide sexual and reproductive health education is higher in countries where training and resources are provided and where there is adequate time on the curriculum.
"At the moment, we know of no country where all these factors are well-aligned for the provision of reproductive health education."
The researchers say studies they have conducted in other countries including Belgium and Japan have reached similar findings
