panacea Final 2014

Prevalence of dysmenorrhea among girl students in a
medical college

1 2
Dass Ruhi , Kulkarni Meenal

1 2
IIIMBBS Student, Associate

Professor, Department of
Community Medicine,
NKPSIMS & RC, Digdoh Hills,
Hingana Road, Nagpur-440019.
meenalkulkarni76@gmail.com

Abstract :
Menstruation is a phenomenon unique to the females. Dysmenorrhea is the most common and least understood and
addressed complaint. Prevalence of dysmenorrhea was found to be 54 % to 87%. Dysmenorrhea has its impact
on academic performance, college, sports and social activities of girls. But very few girls seek health care for this
problem. A cross-sectional descriptive study was conducted in a medical college attached to a tertiary care
hospital to find out prevalence of dysmenorrhea among medical college girl students, to study its impact on various
activities and to assess health care seeking behavior during dysmenorrhea.Allgirl students (first to final MBBS) from
a medical college who were willing to participate included in the study (N=150). Data was analyzed in
proportions, mean and standard deviation.Prevalence of dysmenorrhea was found to be high (66%).
Premenstrual syndrome was present among 44% girls. Nearly half of the girls reported dysmenorrhea every month

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and among 1/3 girls intensity of pain of dysmenorrhea was severe. Common relieving factor was found to be rest.
45% girls reported absenteeism from colleges due to it. 87% girls reported limitations in various activities due to

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dysmenorrhea. Only 1/3 girls were seeking health care for dysmenorrhea. Maximum number of girls (89%)
reported 'no need of treatment' during dysmenorrhea. Hence it was concluded that dysmenorrhea was found to be
common problem.There is need to increase awareness among girls regarding importance of health care seeking
during dysmenorrhea.
Keywords : Dysmenorrhea, Impact, Healthcare seeking.

Introduction:

Menstruation is a phenomenon unique to the females. The
onset of menstruation is one of the most important changes
occurring among girls .The first menstruation occurs
between 11 and 15 years (1). Although reproductive health in
particular related to maternal health and reproductive tract
infections is recognized as a health priority in developing
countries,much less attention is paid to menstrual health and
menstrual disorders.Of all menstrual complaints
dysmenorrhea is by far most common and arguably,the least
understood and addressed complaints (2). Primary
dysmenorrhea is defined as painful menses in women with
normal pelvic anatomy usually beginning during
adolescence. It is characterized by crampy pelvic pain
beginning shortly before or at the onset of menses and lasting
1 to 3 days. It not only disturbs their routine but also causes
humiliating suffering (3). Prevalence of dysmenorrhea was
found to be 54 % to 87% from various studies (4-10).
Dysmenorrhea has its impact on academic performance,
college, sports and social activities of girls. But very few girls
seek health care for problem of dysmenorrhea.
So the present study was designed to study the prevalence
and impact of dysmenorrhea among medical college girls and
to assess health care seeking behavior among them.

Material and Methods:

A cross-sectional descriptive study was conducted in NKP
Salve Institute of Medical Sciences and Research Center,

Nagpur. The study was conducted from June 2011 to
September 2011. All healthy girl students (first to final
MBBS) from a medical college (NKPSIMS, Nagpur) who
were willing to participate were included in the study
(N=150). After taking permission from IEC, the project was
started. Girls from different semesters from the institute were
contacted after finishing their classes or clinics in the college.
After taking informed consent the data was collected in self-
administered predesigned pretested questionnaire.
Questionnaires were collected immediately in 15- 20
minutes. Information regarding pattern of menstrual cycle,
pre- menstrual syndrome (pre-menstrual syndrome-a change
in mood or behavior or appearance of some abnormal vague
symptoms noticed in second half of menstrual cycle), details
of dysmenorrhea (dysmenorrhea-painful menstruation of
sufficient magnitude so as to incapacitate day to day
activities). During last 6 months, impact of dysmenorrhea on
various activities and health care seeking behavior during
dysmenorrhea was collected. Data was analyzed by using Epi-
Info statistical package by calculating simple proportions,
mean and standard deviation.

Results:

The girls were in the age range of 18 to 22 years. Mean age of
menarche was found to be 12.98±1.44 Maximum number of
girls (84%) had attained menarche between 11 to 14 years of
age. Most of the girls (79.33%) reported mother as a source of
information about menstrual cycle. 81.33% girls reported
regular menstrual cycle. Nearly 70% girls had duration of

PJMS- Volume 4 Number 1: Jan - June 2014

Original Article

menstrual cycle between 3-5 days and length of menstrual
cycle between 28-32 days.18% girls reported excess and 7.34
% girls reported scanty blood flow during menstrual cycle.
Out of total 150 students, 99 students reported
dysmenorrhea so prevalence of dysmenorrhea was found to
be 66% (Fig. 1).

Figure 1: Prevalence of dysmenorrhea among medical students (N=150)

44% girls were having premenstrual syndrome. Irritability,
headache, constipation and nausea were common
complaints present during premenstrual syndrome. Out of
total 99 girls, approximately half of the girls (n=49)were
suffering from dysmenorrhea every month. More than half
(63%) of girls were having dysmenorrhea of moderate or
severe intensity(Table 1).

Table1: Frequency and intensity of dysmenorrhea(N=99)

Out of total 99 girls with dysmenorrhea, 45 (45.45%) girls
h a v e r e p o r t e d a b s e n t e e i s m i n c o l l e g e d u e t o
dysmenorrhea.Among 45 girls who remained absent,25 girls
(55%) reported absenteeism from college for one or more
than one day (Table2).

Table 2: Duration of absenteeism from college (N=45)

In most of the girls (68.75%) dysmenorrhea was relieved by
rest and 27% girls were taking medicines for relief.86(87%)
girls were having limitations due to dysmenorrhea (Fig. 2).

Figure 2: Limitations due to dysmenorrhea (N=99)

Limitations were present among 50(58.14%), 16(18.60%)
and 13(15.20%) girls in daily activities, in sports and in
academics respectively (Table3).

Table 3: Limitations in various activities due to dysmenorrhea (N=86)

Health care seeking behavior was found to be very poor and
only 34% girls were seeking health care during
dysmenorrhea. Almost all girls (90%) reported no need of
treatment as a reason for not seeking health care.

Discussion:

In present study mean age of menarche was found
12.98±1.44.Singh A et al (3) carried out study in 107 medical
college students and found mean age of menarche 12.5 ±1.52
years which is similar to the present study. Prevalence of
dysmenorrhea was 66% in the present study. Few authors (1,
5, 7) found prevalence of dysmenorrhea (85%,79.6%,83.2%
respectively) higher than the present study. SC Chan et al
(6),Sharma P, et al(8) and Nabia Tariq et al(10) reported
similar prevalence (68.7%,67.2%,67%) like the present
study.
Premenstrual syndrome is a prevalent menstrual morbidity
among college girls next to dysmenorrhea. Premenstrual
syndrome was reported by 44% girls. Sharma et al(8)reported
premenstrual syndrome amongst 63.1% girls which is more
than the present study. Dysmenorrhea was the commonest
cause of college absenteeism of girls . It also caused

PJMS- Volume 4 Number 1: Jan - June 2014

Original Article

Every month Most of the times Rarely
Dysme- 49(49.49%) 26(26.26%) 24(24.24%)
norrhea
Frequency Mild Moderate Severe
of pain
Intensity 36(36.36%) 35(35.35%) 28(28.28%)
of pain

Absenteeism Number %

Few periods 20 44.44

1 Day 19 42.22

2 Days 3 6.67

>2 Days 3 6.67

Limitations due to Number %
dysmenorrhea
Daily activities 50 58.14
Sports 16 18.60
Academics 13 15.12
Socialisation 7 8.14
Total 86 100

limitations in various activities of girls. 45.45% girls
remained absent from the college due to dysmenorrhea.
Agarwal A and Venkat A(7)also reported school absentees
among 24% girls.
Healthcare seeking behavior was found to be very poor. Only
34.34% girls sought healthcare for dysmenorrhea. Agarwal A
and Venkat A (7) conducted a study among secondary school
and college girls in Singapore and found that only 5.9% girls
were seeking medical advice, which is poorer than the
present study.

Conclusion:

Mother was found to be a common source of information
about menstrual cycle. Premenstrual syndrome was present
among 44% girls. Irritability and headache were found to be
common complaints during premenstrual syndrome.
Prevalence of dysmenorrhea was found to be high (66%).
Nearly half of the girls reported dysmenorrhea every month

rd
and among 1/3 girls intensity of pain of dysmenorrhea was
severe. Common relieving factor was found to be rest.
Dysmenorrhea had impact on various activities of girls.45%
girls reported absenteeism from colleges due to
dysmenorrhea. 87% girls reported limitations in various
activities due to dysmenorrhea and most of the girls were
having limitations in daily activities. Health care seeking
behavior for dysmenorrhea was found poor among girls. Only

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1/3 girls were seeking health care for dysmenorrhea.
Maximum number of girls (89%) reported 'no need of
treatment' as a reason for not seeking health care during
dysmenorrhea.

References:

1) Banikarim C, Chacko MR, Kelder SH. Prevalence and impact
of dysmenorrhea on Hispanic female adolescents.Arch
PediatrAdolesc Med 2000 Dec; 154(12):1226-9.

2) Patel V, TanksaleV,SahasrabhojaneeM,Gupte S,
NevrekarP.The burden and determinants of dysmenorrhea:
A population–based survey of 2262 women in Goa, India.
BJOG:An International Journal of Obstetrics and
Gynaecology2006 Apr;113(4):453-63.

3) SinghMM,Devi R, Gupta SS.Awareness and health seeking
behavior of rural adolescent school girls on menstrual and
reproductive health problems.Indian Journal of Medical
Sciences.1999 Oct; 53(10):439-43.

4) Atchuta KRA, Saibhargavi P. Dysmenorrhea in different
settings.IJCM2008 Oct;33(4):246-249.

5) Agarwal A, AgarwalA. A study of dysmenorrhea during
menstruation in adolescent girls. IJCM2010; 35(1):159-164.

6) SS Chan,KW Yiu, PM Yuen, DS Sahota, TK Chung. Menstrual
problems and health care seeking behavior in Hong Kong
Chinese girls. Hong Kong Med J2009; 15(1):18-23.

7) Agarwal A, Venkat A. Questionnaire study on menstrual
disorders in adolescent girls in Singapore. J Pediatr
Adolesc Gynaec 2009 Dec; 22(6):365-71.

8) Sharma P, Malhotra C, Taneja DK, Saha R Problems related
to menstruation among adolescent girls.Ind J Paediatr 2008
Feb; 75(2):125-9.

9) Hong-Gui Zhou. Prevalence of dysmenorrhea in female
students in a Chinese university: A prospective study. Health
2010; 2:311-314.

10) NabiaT, Jawad Hashim M,Jaffery T, SumairaIjaz S, Sana B,
Zainab A. Impact and healthcare-seeking behavior of
premenstrual symptoms and dysmenorrhea.BJMP 2009;
2(4):40-43.

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