• Nu S-Au Găsit Rezultate

View of Quality of Life in Adolescent Girls with Menstrual Disorders

N/A
N/A
Protected

Academic year: 2022

Share "View of Quality of Life in Adolescent Girls with Menstrual Disorders"

Copied!
10
0
0

Text complet

(1)

Quality of Life in Adolescent Girls with Menstrual Disorders

E.Abirami, K.Saraswathi, Yuvarani. R*

Department of Obstetrics & Gynaecology, Sree Balaji Medical College & Hospital Affiliated to Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

*Corresponding author e-mail id: [email protected]

ABSTRACT

This study on Quality of life in adolescent girls with menstrual disorders was conducted on 300 adolescent girls with menstrual irregularities in the age group between 13- 19years. Hypomenorrhea had better QOL score when compared to other menstrual irregularities.

Premenstrual Symptoms Significantly affects the total QOL score (P value<0.05) Abdominal cramps is the most common (54%) Premenstrual complaint observed in our study. Health education programmes for adolescents, remain an important area to improve their quality of life. Improving the quality of life in girls with menstrual abnormality will help to improve the empowerment of our nation.

Keywords: hypomenorrhea, dysmenorrheal and progestational endometrium.

1. INTRODUCTION

In Latin adolescence meaning – “to grow” or “to grow to maturity”. Maturity involves not only physical but also mental growth. Adolescence is the transitional period which fills the gap between childhood and adulthood, and is characterized by a spurt in physical, endocrinological, emotional and mental growth with a change from complete dependence to relative independence [1].Menarche is an important event for every female adolescent, because it marks the beginning of womanhood and the potential for reproduction [2,3]. Starting with menarche in young girls, it becomes a regular monthly event that culminates into social, sexual, and reproductive life that later terminates with menopause.

Menstruation is one of the physiological changes of puberty in the adolescent girl. It is defined as a „periodicand cyclical shedding of progestational endometrium, accompanied by loss of blood. The process is highly regulated by hormones in the hypothalamo-pituitary-ovarian axis4.

(2)

However, it could come with traumatic experience in some women and may be associated with menstrual syndromes. The initiation of menstruation takes place during early adolescent period.

Yet in India even the mere mention of the topic has been a taboo in the past and even to this day it is not freely discussed among family members. So cultural and social influence appears to come in the way of extending our knowledge for such bodily functions.[4]

Menstrual disorders is a major problem among women who attend gynaecological OPD.

Especially in adolescent girls, menstrual disorders constitute an even greater burden of gynaecological problems all over the world [5].Menstrual disorders include dysmenorrhea, HMB, premenstrual syndrome, amenorrhea, polymenorrhea, hypomenorrhea and oligomenorrhea6. These menstrual disturbances have been well documented to have an impact onthe physical and social activities of adolescent girls. Despitethe high prevalence of menstrual problems in adolescents, many girls either do not seek treatment or are undertreated.[6]

The management of adolescence is vital and essential, even though menstruation is a normal physiological process for all healthy girls; many societies have been surrounded by secrecy and myths. Since it is a stressful event, the mental health experiences of the adolescent girls depend on how well they received information about the onset of menstrual period and its aberrations which may cause psychological injury to them. [7]

Measurement of health and the effects of health care must include not only an indication of changes in the frequency and severity of disease but also an estimation of well being and this can be assessed by measuring the improvement in the quality of life related to health care[8].

2. MATERIALS AND METHODS

STUDY DESIGN: Descriptive cross sectional study

PERIOD OF STUDY: AUGUST 2016 to FEBRUARY 2018.

PLACE OF STUDY: Outpatient clinic and In-patients of Gynecology department, Sree Balaji Medical College and Hospital and also from schools and colleges of southChennai, TamilNadu

INCLUSION CRITERIA:

Adolescent girls of age between 13 and 19years of age, who

(3)

Adolescent girls with menstrualdisorders.

Adolescent girls willing to participate in thestudy.

EXCLUSION CRITERIA :

Girls less than 13 years and more than 19years of age.

Adolescent girls without menstrualdisorders.

Girls with significant medical or psychiatric disorder ondrugs and Girls on drugs which interfere with bleeding and clottingfactors.

Adolescent girlswhohavenotgivenconsent.

This study was approved by the Ethical committee board of Sree Balaji Medical College and Hospital. The purpose of the study was explained to the girls and an informed consent was obtained in their own language.

The data were collected from 300 adolescent girls by adopting a structured questionnaire on Evaluation of quality of life and menstruation in girls who met the inclusion criteria were chosen after getting permission from the school and college authorities and their parents.

3. RESULTS

TABLE 1 : DISTRIBUTION OF AGE AMONG THE STUDY POPULATION (N = 300)

Age Cases with MenstrualProblems Percentage

13 108 36 %

14 94 31 %

15 37 12 %

16 24 8 %

17 19 6 %

18 14 5 %

(4)

EDUCATIONAL QUALIFICATION

6%

14%

Secondary Higher Secondary UnderGraduate

80%

19 4 1 %

Total 300 100 %

Among the total girls with menstrual disorders, maximum of 36 % were from the age of 13 years, 31 % belonged to the age group of 14 years, 12 % were from the age group 15 years, 8 % belonged to the age group 16, 6% were from the age group 17, 5 % were from the age group. The educational qualification was spread among the study population as 80 % from secondary, 14 % from higher secondary and 6 % from under graduate.

FIGURE 1 : DISTRIBUTION OF EDUCATIONAL QUALIFICATION AMONG THE STUDY POPULATION

TABLE 2: DISTRIBUTION OF PLACE OF RESIDENCE AMONG THESTUDYPOPULATION (N = 300)

Place ofResidence No of cases Percentage %

Urban 198 66 %

Rural 102 34 %

Total 300 100 %

(5)

TYPE OF FAMILY

60

50

40

30

20

10

0

Joint Nuclear Others

The study population was distributed as 66 % from urban and 34 % from rural.

FIGURE 2 :DISTRIBUTIONOF TYPE OF FAMILY AMONG THE STUDYPOPULATION

56

4 40

TABLE 3 : DISTRIBUTION OF AGE OF MENARCHE AMONG THE STUDY POPULATION (N = 300)

AGE OFMENARCHE No of cases Percentage %

10 5 02

11 65 22

12 112 36

13 71 24

14 47 16

Total 300 100 %

Mean 12.3

S D 0.963

(6)

MENSTRUALIRREGULARITIES

100 90 80 70 60 50 40 30 20 10 0

MENSTRUAL IRREGULARITIES

Regarding the age of menarche, among the study population 02 % attained menarche at the age of 10 & 22 % at the age of 11 years. However, 36 %, 24 % & 16 % attained menarche at the age of 12, 13 & 14 years respectively. Mean age of menarche is 12.3years.

FIGURE 3 : PREVALENCE OF MENSTRUAL IRREGULARITIES AMONG THESTUDY

POPULATION

38 27

21 3

11

FIGURE 4: COMPARISON OF MEAN TOTAL QOL SCORE WITH MENSTRUAL DISORDERS AMONG THE STUDY POPULATION

PERCENTAGE

MENSTRUAL DISRODERS VS TOTAL QOL SCORE

130 117

120 110 100 90 80 70 60 40 50 30 20 10 0

92

74 81

53

MEAN SCORE

(7)

Menorrhagia

TABLE 5 :DISTRIBUTIONOF HOSPITAL VISITS FOR MENSTRUAL DISORDERS AMONG THESTUDY

POPULATION(N=300)

Menstrual Disorders No of cases

No of cases with hospital

visits

Percentage

%

Polymenorrhea 32 23 72 %

Dysmenorrhea 113 95 84 %

Heavy menstrualbleeding 82 77 92 %

Oligomenorrhea 62 37 60 %

Hypomenorrhea 11 05 4 %

Total 300 237

Among the total cases, 80 % seek medical advice.

It is evident that 72 % of the adolescent girls who had polymenorhoea, 84 % who had dysmenorrhea, 92 % who had HMB, 60 % who had oligomenorrhea and 4 % who had hypomenorrhea visitedhospitals.

FIGURE 5: DISTRIBUTION OF SOURCE OF AWARENESS AMONG STUDY POPULATION

SOURCE OF AWARENESS

2%

4% 15%

8%

71%

Mother Teacher Peer group Relatives Mass Media

(8)

4. DISCUSSION

This study was conducted among 300 adolescent girls with menstrual disorders from gynaecology Outpatient clinic and In-patients of Sree Balaji Medical College and Hospital and, also from schools and colleges from south Chennai.In our study SES was found to have significant association with the QOL (P

<0.004); with poor mean QOL score in both extremes of SES.[9]

In our study, BMI was found to be significant associated factor with the QOL (P value 0.008) and also with menstrual disorders (P value 0.000) Oligomenorrhea was more commonly associated in girls who are overweight (43%) and polymenorrhea was more prevalent in girls who are underweight (49%).This is indistinguishable from the study done by Anupriya et al which showed oligomenorrhea was associated with increasing BMI and polymenorrhea was seen associated with girls who are under weight. Dysmenorrhea is prevalent more among normal weight adolescent girls (80%) .This is comparable to the study.[10-13]

done by Khodakarami B et al (2015) showed who found the frequency and severity of dysmenorrhea to be higher in the normal-weight group than other subjects.The age of menarche did not vary from that of other studies. The age of menarche ranged from 10 -14 years, maximum between 12 - 13years, with mean of 12.3 years. This is similar to the study done by Lee & Chen et al from Malaysia (2006) showed age of menarche ranged from 9-17 years with mean of 12.3+/- 1 year.In our study the prevalence of polymenorrhea accounts for 11% which is similar to study done by Wasiu Olalekan Adebimpe et al from Nigeria showed polymenorrhea in 9.1% of adolescent girls.[14]

In the aspect of health and activity score, Lowest score (3) was observed in dysmenorrhea. This is similar to the study done by Abdul Ghani Nur Azurah (2013) where dysmenorrhea had poorest score in health and physical activity score. Next low score was seen in HMB in health and activity domain.

This is similar to the study done by Sule Gokyildiz et al (2013).[15]

In the psychosocial aspect of QOL , Oligomenorrhea has lowest score which is indistinguishable to the study done by Benita Knox et al (2015) where oligomenorrhea had negative impact on psychosocial aspects of QOL.In our study 80% of adolescent girls with menstrual disorder seek medical advice which is contrast to the result obtained in the study done by Anupriya et al where 5.9% of girls seek medical advice. [16] In our study 92% of girls with HMB, 84% with dysmenorrhea, 72% with polymenorrhea, 60% with oligomenorrhea had hospital visits which is contrast to the study done by Veena G. Rahatgaonkar et al where 25.7% girls with HMB, 26.7% with dysmenorrhea, and 33% of

(9)

be 36% in our study, while study done by Das Gupta et al (2007) showed 67.5% of girls having awareness regarding menstruation before menarche. In our study, girls with awareness of menstruation have good QOL score than girls who are unaware of it with P value of 0.016.[17]

Mother is the primary source of information regarding menstruation which accounts for 71 % which is similar to the study done by Cakir Murat et al, Lee & chen et al, Eyitope O. Amu et al. Mass media was the source of awareness on menstruation in about 30% of girls in the study conducted by Lee

& Chen et al. Whereas media had as little as 2% role as the source of awareness in this study.[18]

CONCLUSION

Emphazising the quality of life in adolescent girls, truly brings optimism. It should be directed in a better way of understanding and tackling menstrual problem to avoid long term consequences. The concerns or worries of these young women about their menstrual problems may be different, depending on their knowledge of menstrual physiology, their interpretation of the probable etiology of the menstrual dysfunction, as well as their personal beliefs, acceptance, and cultural background. Adolescent girls need unhindered access to early counselling and parental guidance on menarche and menstrual issues.

Clinicians need to identify menstrual abnormalities as early as possible in order to minimize their possible consequences and sequelae, and to promote proper health. Besides, A need to emphasize on designing menstrual Health education programmes for adolescents, remain an important area to improve their quality of life. Improving the quality of life in girls with menstrual abnormality will help to improve the empowerment of our nation.

Funding: No funding sources

Ethical approval: The study was approved by theInstitutional Ethics Committee CONFLICT OF INTEREST

The authors declare no conflict of interest.

ACKNOWLEDGMENTS

The encouragement and support from Bharath University, Chennai is gratefully acknowledged.

For provided the laboratory facilities to carry out the research work.

BIBLIOGRAPHY

1.

Das G - Developmental Psychology: King Books: Delhi2000

2.

WHO: Adolescenthealthand development:2018

3.

Hickey M, Balen A: Menstrual disordersin adolescence: investigation and

(10)

management. Hum Reprod Update 2003;9:493

4.

Demir SC, Kadayyfcy TO, Vardar MA, Atay Y. Dysfunctional uterine bleeding and other menstrual problems of secondary school students in Adana, Turkey. J Pediatr Adolesc Gynecol2000;13:171 –5.

5.

Adams HPJ. Menstruation in young girls: a clinical perspective. ObstetGynecol 2002;99:655–62.

6.

Adams Diaz A, Laufer MR, Breech LL. Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Pediatrics 2006;118:2245–250

7.

Carol S Burckhardt et al; The Qualityoflife scale;2003; doi.10.1186. J PediatrAdolescGynecol 26 (2013)102e108;

8.

Benita Knox et al ,Quality of life and menstruation in adolescents, Curropin Obstet Gynecol2015,27:309 -314

9.

Ravens-Sieberer U, Erhart M, Wille N, et al. Generic health-related qualit y-of life assessment in children and adolescents: methodological considerations. Pharmaco Economics 2006;24:1199–1220.

10.

WHO. Division of Mental Health. Measurement of quality of life in children MNH/PSF/94.5. Geneva: WHO ;1994.

11.

Elizabeth, H Quint, Yolanda R Smith, Journal of Midwifery Women‟s health AUB in adolescents,2003.

12.

Karlsson TS, Marions LB, Edlund MG. Heavymenstrual bleeding significantl y affects quality of life. Acta Obstet Gynecol Scand 2014;93:52–57.

13.

NurAzurah AG, Sanci L, Moore E, Grover S.The quality of life of adolescents with menstrual problems. J Pediatr Adolesc Gynecol 2013;26:102 –108.

14.

Varni JW, Burwinkle TM, Seid M, Skarr D. The PEDSQL_ 4.0 as a pediatric population health measure: feasibility, reliability, and validity. Ambul Pediatr 2003;

3:329–341.

15.

Goswami Sebatini, Dutta Rekha, Sengupta Sibini, Profile of adolescent girls withgynecological problems. J Obstet Gynecol India volume 55, no.4 2005, pg353- 355.

16.

Malhotra BD &Bhat Nagar s 1976, pattern and sequence of pubertal changes in semi urban girls of Haryana, J Obstet Gynecol India, 26; 128-132.

17.

Phillip CS, Faiz A, Dowlins N et al, Age and the prevalence of bleeding disorders in women with menorrhagia. ObstetGynecol, 2005; 105:61 -66.

18.

Lundstrom V, Acta, Obstet Gynecol, Scand 1972; 56:

Referințe

DOCUMENTE SIMILARE

Also from the linear Temkin equation, ΔQ was calculated and for all three dyes its value was higher than 0, proving that the adsorption of dyes onto chitosan beads is an

In this study, it has been aimed to investigate the effects of hydroxyurea-derived 1, 3, 4 - thiadiazole compounds, known to have many biological activities, on serum biochemical

At 24 and 48 hours, in normal mononuclear cell cultures number of living cells was decreased significant (p&lt;0.001) with the dose of irradiation was more.. Cells behavior

The proposed method is accurate, selective and precise hence can be used for the routine quality-control analysis and quantitative simultaneous determination of Lopinavir and

Even the fact that languages like Italian had predicative gerunds in past stages cannot be considered as evidence for the same structure, because when Italian predicative

In Contemporary Romanian the pronouns with neutral values are: the demonstratives asta / aceasta ‘this’, more rarely aceea ‘that’, the indefinite pronouns una

The urgency of this problem is that, on the one hand, it causes anincrease in the rate of gynecological pathology among teenage children in recent years, and on the other hand,

(30-49) compared with the age group (50-72) of patients, and also a significant decrease (p &lt;0.0001) was found in the levels of the hormone aldosterone among the group of