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*Corresponding
Author
390
Singh
et
al
INTRODUCTION
Menstrual disorders are a common
presentation by late adolescence, 75% of girls
experience some problems associated with
menstruation
(1). Dysmenorrhea
is
a
common problem in women of reproductive
age. Primary dysmenorrhea is defined as
painful menses in women with normal pelvic
anatomy, usually begins during adolescence
(2). It is unusual for symptoms to start within
first six months after menarche. Affected
women experience sharp, intermittent spasm
of pain usually concentrated in the suprapubic area. Pain may radiate to the back of
the legs or the lower back. Systemic
symptoms of nausea, vomiting, diarrhea,
fatigue, mild fever and headache or
lightheadedness are fairly common. Pain
usually develops within hours of the start of
the menstruation and peaks as the flow
becomes heaviest during the first day or two
of the cycle (3). It is usually possible to
differentiate
dysmenorrhea
from
pre
menstrual syndrome (PMS) based on patients
history. The pain associated with PMS is
generally related to breast tenderness and
abdominal bloating rather than a lower
abdominal cramping pain. PMS symptoms
begin before the menstrual cycle and resolve
shortly after menstrual flow begins (3).
Painful menstruation with pelvic pathology
is defined as secondary dysmenorrhea.
AND
METHODS
Prevalence
and
Severity
of
Dysmenorrhea
391
392
Singh
et
al
Fig. 1 :
Prevalence
and
Severity
of
Dysmenorrhea
393
Factors
BMI
Overweight
Average
Underweight
01
07
00
08
04
02
02
00
11
08
25
04
02
05
01
11
08
06
04
0
0
11
08
25
04
Habit)
06
05
07
01
21
04
04
00
11
08
25
04
13
12
03
01
25
04
Socioeconomic
High Upper
Upper Middle
Lower Middle
Conditions associated during menses.
TABLE I :
Menstrual cycle
characteristics
Number
of subjects
% (Percentage)
05
86
13
03
4.6
80.3
12.1
2.8
Total
bleeding
12
11.2
02
96
09
Total
Diet (Fast
Present
Absent
food
Total
Total
11
08
1.8
89.7
8.4
107
79
28
73.8
26.1
107
28
51
24
04
Total
26.1
47.6
22.4
3.7
107
symptoms
H/O
Grade of dysmenorrhea
Grade-0
Grade-1
Grade-2
Grade-3
Total
12.1
76.6
(days)
Total
Premenstrual
Yes
No
13
82
107
Total
Dysmenorrhea
Yes
No
Status
05
05
01
13
107
(n=04)
06
04
01
Total
Fig. 5 :
PCOD
Number
Percentage
Under wt(BMI<18.5)
Average (BMI 18.5-24.99)
Over wt( BMI>25.00)
13
82
12
12.14
76.63
11.21
Total
107
Positive
history
of dysmenorrhea
(n=79)
Negative
history
of dysmenorrhea
(n=28)
(n=107)
Underweight
Average weight
Overweight
08
60
11
05
22
01
13
82
12
Total
79
28
107
Factor
BMI
Total
(PMS)
65
42
107
60.7
39.2
2 = 3.011,
P = 0.22,
Not
Significant.
394
Singh
et
al
status
Number
Percentage
66
31
10
61.68
28.97
9.33
Total
107
Negative
history
of dysmenorrhea
(n=28)
(n=107)
1-High Upper
2-Upper Middle
3-Lower Middle
52
22
05
14
09
05
66
31
10
Total
79
28
107
2 = 3.91,
P = 0.14,
Not
Percentage
Yes
No
50
57
46.7
53.3
Total
107
Positive
history
of dysmenorrhea
(n=79)
Negative
history
of dysmenorrhea
(n=28)
(n=107)
Yes
No
35
44
15
13
50
57
Total
79
28
107
Factor
Exercise activity
(Daily outdoor)
2 = 0.71,
P = 0.39,
Not
Number
Percentage
Yes
No
85
22
79.43
20.56
Total
107
Positive
history
of dysmenorrhea
(n=79)
Negative
history
of dysmenorrhea
(n=28)
(n=107)
Yes
No
63
16
22
06
85
22
Total
79
28
107
Total
Significant.
Outdoor Exercise
(30 minute or more)
Factor
Dietary habits
(Fast food)
Positive
history
of dysmenorrhea
(n=79)
Factor
Socioeconomic
status
Total
Significant.
2 = 0.71,
P = 0.89,
Not
Total
Significant.
Prevalence
Factors
BMI
Underweight
(<18.5) (n=13)
Average
(18.5-24.99) (n=82)
Over weight
(>25) (n=12)
Premenstrual
symptoms
(n=65)
Absenteeism
H\O
(n=32)
Social
withdrawal
(n=32)
03 (23.0%)
02 (15.3%)
05 (38.4%)
53 (64.6%)
23 (28.0%)
42 (51.2%)
09 (75%)
07 (58.3%)
05 (41.6%)
65
32
52
51 (77.2%)
19 (28.7%)
38 (57.7%)
12 (38.7%)
13 (41.9%)
11 (35.4%)
02 (20%)
00
03 (30.0%)
65
32
52
24 (28.3%)
41 (48.2%)
08 (36.3%)
11 (50.0%)
32
52
Total
Socioeconomic
1. High-Upper
(n=66)
2. Upper-middle
(n=31)
3. Lower-middle
(n=10)
status
Total
65
65
32
29 (58.0%)
23 (40.3%)
52
Number of
subjects
Percentage
53
25
07
67.0
31.6
8.8
and
Severity
of
Dysmenorrhea
395
DISCUSSIONS
In present study the mean age of
menarche was 12.5 (1.52) years, which is
very similar to many other studies (14, 15).
Most of the girls related to one or more
menstrual problems. Dysmenorrhea is the
most common (73.83%) gynecological problem
associated with female medical students in
this study. Several other studies reported
its prevalence as 67.7% (1) and 59.7% (16).
The ranges of prevalence of dysmenorrhea
from 51% to 80% have been reported by
many other studies (17, 18). In this study,
6.32%, 30.37% and 63.29% participants were
suffering from severe, moderate and mild
grades of dysmenorrhea, while study by Jerry
et al (16) showed that 14% severe, 38%
moderate and 49% subjects were mild
sufferers. Other common disorders in present
study were abnormal menstrual flow,
abnormal duration of flow followed by
irregular length of cycle and polycystic
ovarian disease, while in the Malaysian
study (1) a long cycle was a common
menstrual disorder among adolescent girls;
this may be due to difference in their
gynecological age. In our study, all the girls
had menarche far more than three years,
while in reference study most of those with
abnormal cycle length were within two years
of achieving menarche, suggestive of
anovulatory cycles at the time of study. In
WHO study on menstrual and ovulatory
patterns in adolescent girls, the mean
menstrual cycle length was 50.7 days, in the
first cycle after menarche, and bleeding
lasted for an average of 4.7 days (19). The
female reproductive system usually requires
approximately two years to mature before
adolescent girls will have consistently
regular ovulatory cycles (19). In present
396
Singh
et
al
REFERENCES
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Lee
LK,
Chen
PCY,
Lee
KK,
Kaur
J.
Menstruation
among
adolescent
girls
in
Malaysia:
a
cross-sectional
school
survey.
Singapore Med J 2006; 47(10): 874.
4.
2.
French L. Dysmenorrhea.
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3.
Am
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Physician
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9.
adolescent
symptom
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and
Severity
of
Dysmenorrhea
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C,
Chacko
MR,
Kelder
SH.
Prevalence and impact of dysmenorrhea on
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female
adolescents.
Arch
Pediatr
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