• Nu S-Au Găsit Rezultate

View of Primary Dysmenorrhea and its Impact on Academic Performance Among Adolescent Females– A Cross Sectional Study.

N/A
N/A
Protected

Academic year: 2022

Share "View of Primary Dysmenorrhea and its Impact on Academic Performance Among Adolescent Females– A Cross Sectional Study."

Copied!
9
0
0

Text complet

(1)

Primary Dysmenorrhea and its Impact on Academic Performance Among Adolescent Females– A Cross Sectional Study.

1Dharshini, 2*A.V.Anuja, 3A.Sangeetha, 4 Hemachandrika C

1 I MBBS, Saveetha Medical College, Chennai, Tamilnadu, India.

2*Department of Physiology, Saveetha medical College and hospital, Chennai, Tamilnadu, India.

3 Department of Physiology, Saveetha medical College and hospital, Chennai, Tamilnadu, India.

4 Department of Physiology, Saveetha medical College and hospital, Chennai, Tamilnadu, India.

*Corresponding author Name: Dr. A. V.Anuja ABSTRACT:

Introduction: Menstrual cycle is an important indicator of women's reproductive health.

Primary dysmenorrhea (PD) is the most common of gynaecologic complaints. It affects half of all female adolescents today and represents the leading cause of periodic college/school absenteeism among that population. Aim: The aim is to assess the association between dysmenorrhea and academic performance. Materials and Method: A cross sectional study was conducted among 103 adolescent females. The participants were asked to complete a self-reported questionnaire. Questions were related to menstruation elucidating variations in menstrual patterns, history of dysmenorrhea and its severity, pre-menstrual symptom and absenteeism from college and /or class; participants were given 30 minutes to complete the questionnaire. Result: Pearson Chi-square test revealed that severity of pain among dysmenorric students had effect on their class absenteeism (x2 = 15.7, p<0.05). The result also showed that statistical significance evidence was found among severity of pain and working ability (x2 = 44.8, p<0.05). Conclusion: Primary dysmenorrhea is a common problem among adolescent females and had a negative impact on social, academic, sports and daily activities. Therefore, to combat these effect students most probably expected to change their lifestyle particularly on diet and regular physical exercise. Moreover, awareness should be brought both adolescent girls and teaching faculty about dysmenorrhea to provide psychological and academic support to affected students.

Keywords: Menstrual pain, Absenteeism, Anemia, Exercise

INTRODUCTION:

Menstruation is a normal physiological process that occurs approximately once a month in women of reproductive age as a result of the breakdown of the endometrial tissue.

(2)

Dysmenorrhea refers to the occurrence of painful menstrual cramps of uterine origin. It is the most common gynaecologic complaint in adolescents and young women [1]. Majority of women experience some degree of cramping, especially in the first year of their reproductive life (2). Pain may radiate to the back of the legs or the lower back. Menstruation is associated with nausea, vomiting, diarrhoea, headache, weakness and major symptoms, including pain, adversely affects daily life and school performance, causing recurrent short-term school absenteeism among female adolescents [3] Primary Dysmenorrhea (PD) is a key women’s health burden [4] and is also one of the public problems in the world [5].

Global statistical data shows that 51% of the population comprises of female adolescents (6,7). Globally, the prevalence rates have been reported to be as high as 90% and as low as 43% (8,9). Primary dysmenorrhea is the leading cause of work or school absenteeism in women and a leading cause of recurrent short-term school absenteeism among adolescent girls [10]. Several research findings showed that the proportions of PD and/or dysmenorrhea in young females are higher. Dysmenorrhea is highly prevalent among female medical students; it is related to college/class absenteeism, limitations on social, academic, sports and daily activities. Maximum participants do not seek medical advice and self treat themselves with prostaglandin inhibitors; like Ibuprofen [11,12]. The lacunae identified were that there is little attention given to the need to compensate lost classes and improve poor performance of the students suffering from dysmenorrhoea. Therefore, this study aimed to assess the prevalence of dysmenorrhea and its effect on academic performance and seek appropriate strategy as a remedy.

MATERIALS &METHODS:

Institutional basedcross sectional study was conducted among medical undergraduates in Saveetha Medical College & Hospital to assess the prevalence of dysmenorrhoea, its effect on academic performance among female students. The study proposal was approved by the board of the institute (SMC/IEC/2019/01/IRB23). The study performed on a total of 250 girls with age range between 17-24yrs. Participants with endocrine disorders, bleeding disorders, and hypothyroidism were excluded from the study. A structured questionnaire comprising of 20 items were developed, which included menarche age, anaemia before 6 months, exercise routine, menstrual pain, pain intensity, menstrual symptoms. In addition, questions about whether dysmenorrhoea affects their routine physical activities and academicperformance

(3)

were also solicited. The study was conducted maintaining the anonymity and confidentiality of the participants.

Data analysis:

Statistical analysis was done using SPSS Version 22.0. Descriptive variables were reported (Mean with standard deviation, Percentage) for all demographic variables. Chi- square test was used to assess association between pain intensity and working ability. The significance level was set at 0.05.

RESULT:

The majority of the participants, around 51% of the girls were 18 years, and in the remaining population, 36% were of 19 years, 9% were of 20 years, 2% were of 17 years, and the rest were 21-24 years. The average age of the majority of the participants [54%] were between 13-14 years. And the rest 29% started menstruating in the age 10-12 years and 17% started menstruating at the age of 15-17 years. Majority of participants [82.5%] have reported menstrual pain and 17.5% have reported to not have any menstrual pain. And those participants who have menstrual pain seems to have 1-2 days pain in majority [40%], and the rest 30% have pain for one day, 15% have pain for 2-3 days,3% have pain for 3 days and the rest 12% unaffected [Table 1].

Only 4% of the total participants take analgesics such as acetaminophen, ibuprofen, or naproxen. And 9% of the participants take home medications like fenugreek seeds, brown sugar water, hot pack, etc., Majority of the participants have menstrual symptoms that is almost 55% of them, and the rest 45% show no symptoms. And females with menstrual symptoms show back pain, mood swings, menstrual cramps, breast soreness, face puffiness, headache, lower abdominal pain before and in the course of menstruation, leg aches, acne, pimples, etc., [Table 2]. Around 61% of the participants have reported that due to menstrual symptoms their working ability has been moderately affected and 34% of them it has not been an issue and the rest 5% it is completely inhibited. It also affects the academics, 21% of the participants have reported taking a day leave from classes due to the menstrual symptoms and 9 % with half day leave, and 3% with 2 days of absenteeism, and the rest unaffected [Table 3]. Because of these the participants have also been suffering from lagging of topics and also lack of concentration in studies.

(4)

Table 1: Details of Prevalence, severity and symptoms of dysmenorrhea among female students

Table 2: Details of Menstrual Pain, Pain Length, Pain Intensity Among Female Adolescents:

PARAMETER NUMBER PERCENTAGE

Menstrual Pain Yes 85 82.52

No 18 17.47

Pain length 1 day 31 30.1

1-2days 41 39.80

2-3 days 15 14.56

PARAMETER NUMBER PERCENTAGE Mild Mod Severe

Age 17 3 2.91 26 28 1

18 51 49.51

19 37 34.95

20 10 9.70 1 28 15

21 1 0.97

23 1 0.97 1 0 4

Religion Hindu 80 77.7

Christian 12 11.65

Muslim 4 3.88

Others 7 6.8

Family Nuclear 86 83.5

Joint 16 15.53

Extended 1 0.97

SES High 20 19.41

Medium 75 72.81

Low 8 7.8

Family history in

Menstrual pain

Yes 52 50.48

No 51 49.51

Menarche age 10-12 30 29.12

13-14 56 54.36

15-17 17 16.50

Anemia

(before six months)

Yes 18 17.47

No 85 82.52

Exercise Yes 28 27.18

No 17 15.53

Sometimes 60 57.28

(5)

Entire period 4 3.88

Nil 12 11.65

Pain intensity Mild 26 25.24

Moderate 57 55.33

Severe 20 19.41

Menstrual symptoms Yes 57 55.33

No 46 44.66

Frequency of dysmenorrhea

Less frequently 26 25.24

More frequently 36 34.95

Rarely 41 39.08

Taking analgesics Yes 4 3.88

No 90 87.37

Sometimes 9 8.73

Absenteeism Unaffected 68 66.01

½ day 9 8.73

1 day 22 21.35

2days 3 2.9

3 days 1 0.97

Working ability Moderately affected

63 61.2

Unaffected 36 34

Clearly inhibited 7 5

Table 3: Association between pain intensity and working ability among female students:

Paramete r

Pain intensity

Paramet er

N Mild Moderate Severe Chi

square

p Value Age

(Yrs)

17-18 yrs 19-20 yrs 21-24 yrs

52 45 4

13(10.81) (0.44) 7(9.36) (0.59) 1(0.83)(0.03)

30(26.77) (0.39) 20(23.17) (0.43) 2(2.06) (0.00)

9(14.42) (2.03) 18(12.48)(2.45) 1(1.11) (0.01)

6.386

.17208

Menarch e age

10-12 yrs 13-14 yrs 15-17 yrs

30 57 17

8(7.50)(0.03) 12(14.25)(0.36) 6(4.25)(0.72)

10(15.87)(2.17) 35(30.14)(0.78) 10(8.99)(0.11)

12(6.63)(4.34) 10(12.61)(0.54) 1(3.76)(2.03

11.076 .0257**

SES Low

Medium High

8 74 20

1(1.96)(0.47) 21(8.14)(0.45) 3(4.900(0.74)

5(4.31)(0.11) 40(39.90)(0.00) 10(10.78)(0.06)

2(1.73)(0.04) 13(15.96)(0.55) 7(4.31)(1.67)

4.092

.3935

Anemia No Yes

85 19

20 (20.43)(0.01) 5(4.57)(0.04)

48(45.77)(0.11) 8(10.23)(0.49)

17(18.80)(0.17) 6(4.20)(0.77)

1.586 .4523 Exercise Yes 28 9(6.19)(1.27) 12(13.38)(0.14) 7(8.42)(0.24) 11.306 .0233**

(6)

No

Sometimes

16 59

2(5.75)(2.45) 14(13.05)(0.07)

10(12.42)(0.47) 32(28.19)(0.51)

14(7.82)(4.88) 13(17.75)(1.27) Absentee

ism

2days 1day Half day unaffected

4 22 9 68

1(1.01)(0.00) 1(5.55)(3.73) 3(2.27)(0.23) 21(17.17)(0.86)

1(10.89)(0.07) 10(10.89) 3(4.46)(0.48) 37(33.670(0.33)

2(1.01)(0.97) 11(5.55)(5.34) 3(2.17)(0.23) 10(17.17)(2.99)

15.725

.0153**

Working

Ability

1.Moderately Affected 2.Unaffected 3.Clearly Inhibited

63 36 7

8(18.49)(5.95) 18(6.46)(20.64) 1(2.05)(0.54)

35(25.34)(3.69) 1(8.85)(16.96) 1(2.82)(1.17)

20 (19.17)(0.04) 3(6.70)(2.04) 5(2.15)(3.87)

44.887

.0233**

**Table 3 shows a statistically significant values between pain intensity and absenteeism and working ability (p<0.05).

DISCUSSION:

Primary dysmenorrhea was a common problem among female students, which encompass many symptoms physically and emotionally. According to a study in India the quality of life is highly affected in dysmenorrhic females, which is a significant public health problem that requires attention. We found 82.52% of females suffering from primary dysmenorrhea in the selected population. It is comparatively higher than that of the referred study [13]. It is evident from the results that nearly 70% dysmenorrheic females experienced moderate to severe dysmenorrhea. The possible reasons for discrepancy among the estimates could be the difference in use of selected age group, perception of pain during menstruation. In our study, subjects suffering from dysmenorrhea presented with the following symptoms like backpain, mood swings, menstrual cramps, breast soreness, face puffiness, headache, lower abdominal pain before and in the course of menstruation, leg aches, acne, pimples, etc.,Considering the severity of dysmenorrhea, the result in the present study revealed that the majority of students suffered from moderate dysmenorrhea and secondly mild dysmenorrhea and a less number of people with severe dysmenorrhea. This result is consistent with other studies, which found that more than half of their study’s participants had moderate pain [14-17].

In the present study 36% and 41% dysmenorrhic girls reported having pain more frequently and rarely. A study from India indicated 68.3% females experience dysmenorrhea more frequently (every month). In comparison to this study, we found a markedly lower occurrence 34.95% of frequent dysmenorrhea. The chi square test of independence was performed to

(7)

examine the relation between the academic performance and the prevalence of dysmenorrhea, as for absenteeism to classes in the present study the chi square value is (x2=15.725;p=0.0153) , whereas the previous study is much higher than the observed value.

Females who suffered from moderate to severe dysmenorrhea are most likely to take leave for a day and very few females have taken leave for 2 days. This affects their academic performance in varied ways. Absenteeism was commonly encountered during dysmenorrheic period. The chi square test done for the working ability the value of chi square is (x2=44.87;

p<0.023) which is very similar to the previous study’s chi square value (18,19). As for the working ability more than 50% of the participants have reported that their work is moderately affected and a very few numbers have reported clear inhibition of work this also includes the lack of concentration in studies, poor performance in exams and tests, inability to concentrate in classes.

CONCLUSION:

Usually, girls with PD experience restricted activity, disturbed regular life. In addition to that the academic performance of the female students is also being affected. Performing regular exercise shows reduced symptoms of primary dysmenorrhea and also reduces the menstrual pain intensity. It is important for the girls to know the proper dietary intake during menses despite having dysmenorrhea. Appropriate medications use should also be educated to the students for effective relief of the dysmenorrhea and also a proper physician consultation can be promoted. This way the students’ performance can be improved in a better way. Therefore, early detection of the problems and management through change in students’ life style can be implemented for a better living of the students.

LIMITATIONS:

The small sample size from a single area of the country also limits generalizability. The current study had taken participants from only one institution. Details of routine physical activity like duration, type of exercise were not measured. Moreover, the study and the results are related to an urban area, so it might not be a good representative for rural areas.

CONFLICT OF INTEREST: No conflict of interest

(8)

REFERENCES:

1. Derseh BT, Afessa N , Temesgen M , Semayat YW , Kassaye M, Sieru S Prevalence of Dysmenorrhea and its Effects on School Performance: A Crosssectional StudyJ Women's Health Care 2017, 6:2

2. Mannix KL. Menstrual-related pain conditions: dysmenorrhea and migraine. J Womens Health. 2008;17(5):879–891. Ozerdogan N, Sayiner D, Ayranci U, Unsal A, Giray S. Prevalence and predictors of dysmenorrhea among students at a university in Turkey. Int J Gynaecol Obstet. 2009;107(1):39–43.

3. Dawood MY. Dysmenorrhea. J Reprod Med. 1985;30:154–1679.

4. Klein JR, Litt IF. Epidemiology of adolescent

dysmenorrhea. Pediatrics. 1981;68(5):661–664.

5. Singh A, Kiran D, Singh H, Nel B, Singh P, Tiwari P. Prevalence and severity of dysmenorrhea: a problem related to menstruation, among first and second year female medical students. Indian J PhysiolPharmacol. 2008;52(4):389–397.

6. Mario I, Ortiz IM. Primary dysmenorrhea among Mexican university students:

prevalence, impact and treatment. Eur J ObstetGynecolReprod Biol. 2010;152(1):73–

77.

7. Chongpensuklert Y, Kaewrudee S, Soontrapa S, Sakondhavut C. Dysmenorrhea in Thai Secondary School students in KhonKaen, Thailand. Thailand J ObstetGynaecol. 2008;16(1):47–53.

8. Omidvar S, Amiri FN, Bakhtiari A, Begum K. A study on menstruation of Indian adolescent girls in an urban area of South India. J Family Med Prim Care.

2018;7(4):698-702.

9. Shete JS, Warbhe P, Padmini D (2012) Class absenteeism among female medical students: A study reflectLng its association with common menstrual disorders. Int J Recent 6cLentLfic Res 6: 5307-5309. 22. Singh A, Kiran D, Singh H, Nel B, Singh P, Tiwari P (2008)

10. Prevalence and severity of dysmenorrhea: a problem related to menstruation, among first and second year female medical students. Indian J PhysiolPharmacol 52: 389-397.

11. Singh A, Kiran D, Singh H, Nel B, Singh P, Tiwari P, et al. Prevalence and severity of dysmenorrhea: A problem related to menstruation, among first and second year female medical students. Indian J PhysiolPharmacol. 2008;52:389–97.

12. Negriff S, Dorn LD, Hillman JB, Huang B. The measurement of menstrual symptoms:

Factor structure of the menstrual symptom questionnaire in adolescent girls. J Health Psychol. 2009;14:899–908.

13. Patel V., Tanksale V., Sahasrabhojanee M., Gupte S., Nevrekar P., The burden and determinants of dysmenorrhoea: a population-based survey of 2262 women in Goa, India. BJOG. 113, 2006, 113:453–463.

14. Sundell G., Milsom I., Andersch B. Factors influencing the prevalence and severity of dysmenorrhea in young women. Br J ObstetGynaecol. 1990,;97:588–594.

15. Tangechai K, Titapant V, Boriboonhirunsarn D. Dysmenorrhea in Thai adolescents:

prevalence, Impact and knowledge of treatment. J Med Assoc Thai 2004;87:Suppl.3 69-73.

(9)

16. Hillen TIJ, Grbavac SL, Johnston PJ, Straton JAY, Keogh JMF, Primary dysmenorrhea in young western Australian women: prevalence, impact, and knowledge of treatment. J Adolesc Health 1999;25:40-5.

17. Ambade R, Sagdeo M. Age at menarche and the menstrual pattern of secondary school adolescents in central India. Int J Res Med Sci. 2017; 5:3610-4.

18. Polat A, Celik H, Gurates B, Kaya D, Nalbant M, Kavak E, Hanay F. Prevalence of primary dysmenorrhea in young adult female university students. Arch Gynecol Obstet.

2009;279 (4):527-32. 15.

19. Proctor M, Farquhar C. Diagnosis and management of dysmenorrhoea. BMJ.

2006;13;332(7550):1134-8.

Referințe

DOCUMENTE SIMILARE

The purpose of the study is to identify the degree of academic compatibility, mood disorders and moral anxiety among students, as well as to identify the

In this cross-sectional study withinthe general population of Basrah aimed to characterize the seroprevalence ofZIKV and assess its association with sociodemographic and

Methodology - A cross sectional study was conducted to assess the knowledge and attitude towards prenatal screening for Downs Syndrome among women of reproductive age group in

This study “Estimation of Salivary Calcium and Phosphorus in Children with different caries status – A Cross- Sectional observational study” has been authorized through the

Methodology - A cross sectional study was conducted to assess the knowledge and attitude towards prenatal screening for Downs Syndrome among women of reproductive age group in

The findings of the present cross-sectional study shows the knowledge and awareness about PCOS among medical students.. Majority of our participants had a good

The community based cross sectional descriptive study was conducted in the field practice area of Department of Community Medicine, Sri Lakshmi Narayana Institute

The objective of the current study was to observe the menstrual disorders among adolescent girls and to observe the demographic profile and assess hygiene practices