BACKGROUND: This study aimed to identify the attitudes of adolescent girls towards menstruation, peri-menstrual symptoms, and coping. METHODS: A convenience sample of 521 adolescent girls was obtained from two middle schools and two high schools in M city. Data were collected through questionnaires about menstrual attitudes, menstrual symptoms, and coping. Data was analyzed by descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression using SPSS/WIN 17.0 program. RESULTS: Subjects showed both negative and positive attitudes toward menstruation. There were significant correlation between attitudes toward menstruation and peri-menstrual symptoms. Subjects having a positive attitude toward menstruation needed a nursing mediator to provide relief for menstrual symptoms during the peri-menstrual period. Attitudes toward menstruation explained 11.0% variance of menstrual symptoms, and factor 4, in particular, (event whose onset can be predicted and anticipated) correlated strongest with menstrual symptoms and explained 21.5% variance of menstrual symptoms. CONCLUSIONS: Our results show that evidence-based strategies for positive attitudes toward menstruation, menstrual symptom, and coping should be included in a comprehensive approach to a nursing intervention to help adolescent girls.