INTRODUCTION Dysmenorrhea is very common gynecological problem in women of reproductive age worldwide .Reports of dysmennorhea are greatest among individuals in their late teens and 20s and usually deckling with age . Although dysmenorrhea is not life threatening, it can be painful for many adolescents .It begins with the rst ovulatatory cycle and occurs about two years after menarche and most of the severe episodes occurs before 25 years of age (1) .Dysmenorrhea word is derived from Greek words dys meaning difcult, painful or abnormal, meno meaning month and rrhoea meaning ow that means Painful menstrual ow. (2) The painful cramping sensation in the lower abdomen is often accompanied by some other symptoms including sweating ,lower backache ,fatigue ,diarrhea ,headache ,nausea ,vomiting , dizziness and in severe cases syncope etc (3,4) It is one of the leading cause of recurrent short term absenteeism of young women in school and workplaces , affecting their performances , social and sports activities (5) This situation has not only signicant impact on personal health but also have a global economic impact . (6) Unani Scholars have also discuss the various causes and management of dysmenorrhea under the chapter of waj-e- rahim, dared-e-rahim,Usre tamth ,Uterine pain (4) They worked on the theory of temperament and succeeded in locating the relationship between disease , various humours and disturbance in temperament . According to Unani Scholars, it is the altered temperament (Sue mijaz) that causes obstruction in ow of menstruation uid that results difcult menstruation. (7). Treatment is therefore, aimed directly at restoring balance to patient's temperament and humours. There are different method of treatments and regimen used to minimize the ef fec ts o f dysmenorrhea inc luding pharmacological, non pharmacological such as taking non steroid anti inammatory drugs (NASAID), herbal dietary therapies, yoga meditation, and acupuncture. Even through primary dysmenorrhea is not a life threat but can affecting the quality of female's life and in case of severity it might lead to disability and inefciency. Moreover dysmenorrhea can cause mental problems of the female resulting in their loneliness and reduced participation in different social activities. In adolescents, moderate to severe pain that affects life style and does not respond to pharmacological treatment requires professional attention and appropriate diagnosis of possible underlying pelvic disease. The exact prevalence of dysmenorrhea is difcult to determine because of variety of diagnosis criteria and the subjective feature of the symptoms .In many countries primary dysmenorrhea is the principal cause of recurrent short term absenteeism in young girls and women. The objective of the present study was to assess the menstrual pattern and its associated symptoms and the prevalence of dysmenorrhea among young both married and unmarried girls coming for the treatment at Central Research Institute of Unani Medicine, Lucknow. MATERIAL AND METHOD This is an Institute based cross sectional study especially design to assess the incidence of dysmennorhea and its distress , impact, discomfort and complications .The study was conducted on 233 young women attending General Out Patients Department ( female ) of Central Research Institute of Unani Medicine , Basaha Kursi Road Lucknow from April 2018 to November 2018 . The young women come with complaints of menstrual discomfort and associated symptoms from one month to ve years duration .The symptoms of lower back pain , lower abdominal pain , leg cramp , polyurea , anorexia ,nausea , vomiting and generalized weakness before and during the menstrual cycle . A detail obstetric and gynecological history along with general history and previous medical illness .The study was conducted on the basis of some questionnaire / case record form, which was designed especially for the study, data was recorded on a standardized pre designed questionnaire. And women were given treatment according to their complaints. They were treated by the drugs available in Central Research Institute of Unani Medicine Luck now, and the drugs are Sharbat bazooro Motadil, Sharbat-e-Deenar, Habb-e-Rewand, Habb-e Tinkar, Habb-e-Mubarak, Habb-e-Shifa, Habb-e-Mudir and Habb-e- Banadiq-ul-Bazoor etc. Distribution according to Marital status Table 1 INCIDENCE OF DYSMENORRHEA AND ITS DISTRESS AMONG YOUNG WOMEN IN LUCKNOW Original Research Paper Dr. Najmus Saher Reaserch Ofcer, Central Research Institute Of Unani Medicine Lucknow. Medicine Dysmenorrhea is very common gynecological problem in women of reproductive age worldwide. It begins with the rst ovulatory cycle and occurs about two years after menarche. Although it is not life threatening, it can be painful for many adolescents .It is one of the leading cause of recurrent short term absentee in school and work place. Objective of the present study is to assess the menstrual pattern and its common associated symptoms, at Central Research Institute of Unani Medicine Lucknow. An institute based cross-section was done during the April 2018 to November 2018 on 233 participants come to the Institute for their treatment of dysmenorrhea and their associate symptoms. Data were recorded on standardized pre design questionnaire for the study. At the end of the study it is found that the low back pain is the most common (95.27%) complaints before and during the menstrual cycle, and after that leg cramp (91.84%) , lower abdominal pain (83.69%) , nausea (62.23%) , headache (57.08%) , generalized weakness (51.07%) , poly urea (46.35%) , fever (49.78%) and anorexia (49.78%). The result of the study revealed that highest common symptoms are low back pain. ABSTRACT KEYWORDS : VOLUME-8, ISSUE-10, OCTOBER-2019 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra Dr. Maqbool Ahmad Khan* Deputy Director Central, Central Research Institute Of Unani Medicine Lucknow. * Corresponding Author Marital Status Number of participants Percentage Unmarried 169 72.53 Married 64 2746 Total 233 100 104 X GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS Distribution according to Dietary habits Table 2 Distribution according to Socio economic status Table 3 Classication according to education level Table 4 Classication according to living area Table 5 Classication according to life style Table 6 Classication according to general appearance / look Table 7 Classication according to built Table 8 Classication according to sign and symptoms of Dysmenorrhea Table 9 DATA COLLECTION AND MANAGEMENT The data collection tools used in the study was adopted from studies and prepared in English, this was asked to the in local language and then ll in English .The questionnaire has three parts which focuced on socio demographic characteristics and menstruation characteristics and the treatment given to the participants. RESULT AND DISCUSSION Table no 1 shows the marital status of the participants ,out of 233 there are 64 participants have marital status and other 169 have unmarried status .The married participants are 27.46 % and unmarried are 72.53 % , the data shows that the incidence of the disease is more prone in unmarried than married . The table no 2 shows the distribution according to dietary habits ,it reveals that maximum number of participants follow the non vegetarian diet , it reects the relation between diet and prevalence of the disease .There are 173 (74.25 %) out of 233 follow the non vegetarian diet and 60 (25.25 % ) participants follow the vegetarian diet . A study done by Nastaran Naja et al to evaluate dietary pattern relation to menstrual pain .In this study , the results indicate that adherence to snacks pattern is associated with an increased risk of moderate to severe dysmenorrhea during menstruation among young women . The diet characterized by high consumption of sugars, salty snacks, sweets and desserts, tea and coffee, salt, fruits juices and added fat (labeled as “snacks” Pattern), is associated with an increased risk of dysmenorrheal among young women (8). Further study is needed to evaluate the dietary habits relation with the disease. Table number 3 is classied according to socio economic status of the participants, there are only 21 participants out of 233 were belongs to high income group. Table number 4 shows distribution according to education level of the participants ,there are ill literate to post graduate degree holders are participated in the study ,07 (03.00%) participants are ill literate and had no formal education, never gone to rdschool .1(00.42%) participants had got education up to 3 class, 21 (09.01%) participants out of 233 had got education up thto 5 class .There was 06 (02.57 %) participants had obtain the theducation up to 6 class, 10 (02.29%) participants out of 233 thhad the education up to 7 class , 17 (7.29%) out of 233 th th & 10thparticipants had get education up to 8 class . Up to 9 class ththere were 20 (8.58%) 0ut of 233 and 10 class 34 (14.59%) participants respectively. Only 4 (01.71%) participants have th thobtained their formal education up to 11 class , and up to 12 class 38 participants (16.30%) 0ut of 233. Highest number of participants have got their formal education up to graduation level, there are 70 (30.04%) out 233, and only 5 (2.14%) participants have their education up to post graduation level. Table number 5 is classied according to living area it means urban and rural accordingly. There are highest number of participants living in sub urban area that's are 94 participants out of 233 (40.34%) and after that living in urban area 86 out of 233 participants (36.90%). 47 (20.17%) participants had come VOLUME-8, ISSUE-10, OCTOBER-2019 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra Dietary Habits Number of participants Percentage Vegetarian 60 25.75 Non Vegetarian 173 74.25 Total 233 100 Socio-economic status Number of Participants Percentage High 21 9.01 Middle 170 72.96 Low 42 18.02 Education level Number of Participants Percentage Nil 7 03.00 3rd class 01 00.42 5th class 21 09.01 6th class 06 02.57 7th class 10 04.29 8th class 17 07.29 9th class 20 08.58 10th class 34 14.59 11th class 04 01.71 12th class 38 16.30 Graduation 70 30.04 Post graduation 05 2.14 Living area Number of participants Percentage Metro 06 02.57 Urban 86 36.90 Suburban 94 40.34 Rural 47 20.17 Total 233 100.00 Life style Number of Participants Percentage Active 52 22.31 Moderate 120 51.50 Sedentary 61 26.18 Total 233 100.00 Appearance Number of Participants Percentage Healthy 200 85.83 Unwell 31 13.30 Ill 01 00.42 Aesthetic 01 00.42 Total 233 100.00 Built Number of participants Percentage Bulky/Fatty 20 08.58 Muscular 16 06.86 Short 10 04.29 Normal 82 35.19 Tall 19 08.15 Thin 86 36.90 Total 233 100.00 Sign and symptoms Number of participants Percentage Low back pain 222 95.27 Leg cramp 214 91.84 Lower abdomen pain 195 83.69 Nausea 145 62.23 Headache 133 57.08 General weakness 119 51.07 Poly urea 108 46.35 Fever 115 49.35 Anorexia 115 49.35 Total 100.00 X 105GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS from rural area and only 06 (02.57%) participants had come from metro area .Highest number of participants come from urban area it reects that urban people are mare conscious about their disease. Table number 6 were classied according to life style of the participants ,because in modern era it is related to life style .Life style a-is divided into three categories that's are active, moderate and sedentary .Highest prevalence of the disease observed in moderate life style there are 120 (51,50%) participants subsist the moderate life style out of 233 , 61 (26.18%) participants out of 233 participants were subsist sedentary life style and rest 52 (22.18%) participants habituated to follow active life style. Table number 7 classied according to over all look and general appearance of the participants that's was divided into four group aesthetic ,healthy, ill and unwell .Only 1 (00.42%) was observed the aesthetic and same observed ill out of 233 participants during the study, 200 (85.83%) participants observed healthy appearance out of 233 and 31 (!3.30%) shown their appearance unwell . Table number 8 shows the distribution according to built of the participants which is very important to nd out the dysmenorrheal. There were observed Fatty 20(08.58%) participants out of 233, muscular 16 (06.86%) out of 233, thin 86(36.90%) , short 10(04.29%) out of 233, tall 19(08.15%) out of 233 and normal built 82(35.19%) out of 233 of the participants. Graph 1& table number 9 shows the symptoms appeared before and during the menstrual cycle, it reects LBP (low back pain) is the most recurrent symptoms in young adolescent women, out of 233 ,there was reported by 222 (95.27%) participants only 1(04.29%) participants reported the she did not experienced the low back before and during the menstrual period. Leg cramp is reported by 214 (91.84%) out of 233 participants. Low abdomen pain is reported by the 195 (83.69%) and 38 participants had no experienced the low abdominal pain before and during the menstrual cycle. 145 (62.23%) out of 233 observed the nausea before and during the menstrual cycle, 88(37.76%) participants were did not observed the nausea. Headache is reported by 133 (57.08%) participants out of 233 and 100 (42.91%) participants had no experience of headache before and during the menstrual cycle. Out of 233 participants 119 (51.07%) felt generalized weakness before and during the menstrual cycle 114 (48.92%) participants did not feel the headache. The symptom of poly urea was experienced by 108 (46.35%) participants and 125 (53.64%) had no experienced the poly urea during and before the cycle. Fever is the very prominent feature of dysmenorrheal if it is occur before bad during the menstrual cycle , there was 115 (49.35%) suffered fever and 118 (50.64%) did not feel fever before and during the menstrual cycle . Anorexia was experienced by 116 (49.78%) participants and not reported by 117 (50.21%) out of 233 participants. CONCLUSION In this study it is found overall incidence and prevalence of dysmenorrheal among young girls of Lucknow district and surrounding areas urban, rural, sub urban and metro areas. Menstruation is physiological and important milestone for young women. Large number of participants experienced dysmenorrheal with their associated symptoms i-e low back pain, low bad pain, nausea, generalized weakness, poly urea, anorexia and fever .some of the participants were using medication to control their dysmenorrheal and associated symptoms they did not know about the adverse effect of the drugs. ACKNOWLEDGEMENTS Authors would sincerely thanks to participants and their guardians for cooperation to full ll the questionnaires during the data collection in General Out Patient Department of Central Research Institute of Unani Medicine, Lucknow, and Director General of the Central Council for Research in Unani Medicine, New Delhi. REFERANCES 1. Dawood .M.Y.1987: Dysmenorrhea and Prostaglandins in: Gold, J.J .Josimovich (eds) Gynecologic Endocrinology. 4th Ed New York: Plenum Press 405 2. Montoya.J.S .Cabezza,A.H.Rojas O.M Navarreteand R.C and Keeve M .A.V Menstrual Disorder in Adolescents .Bol Med Hosp Infant Mex. 2012.69 (1) 60- 72 3. Tan .K and Wan.L . A Prevalence Study of Dysmenorrhea in Female Resident Age 115-54 Y Clement . Ann Aced Med .1992 .21;323-327 4. Ibn Sina,2007 :Al Qanoon Fil Tib (Urdu translation by Kantoori G.H ), Vol 2 ,Idara Kitabul Shifa ,New Delhi 340-341 . 5. Wilson, C. Emmand .J .and Maneld.C .The Relationship of Calculated Percent Body Fat ,Sports Participation ,Age and Place of Residence on Menstrual Patterns , Adolesc Health CARE . 1985 J. 5;248-253 . 6. Dawood .M .Y, Ibuprofen and Dysmenorrhea, Am .J .Med 1984 .77 (1A )87-94 7. Ibn Sina, 2010 ,Al Qanoon Fil Tibb (Urdu translation by Kantoori G.H) New Delhi ,Ejaz Publication House, 447-448 ,1096,1118 8. Nastaran Naja , Hamidreza Khalkhali , and Rasoul Zarrin , Major dietary patterns in relation to menstruation pain : a nested case control study BMC Women's Health (2018) 18:69 http: //doi.org/10.1186/s12905-018-0558-4 VOLUME-8, ISSUE-10, OCTOBER-2019 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra 106 X GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS