Introduction
Menstruation
Menstruation is the dismissal of the endometrial lining of the womb. Menstruation it is of different names such as period, menses, date, menstrual period. It is normal bleeding per vaginal that happens in every month of a woman reproductive cycle.1
Menstrual cycle
The cycle of an adult female is 28days, some can be 22days, some can be 45 days.30-60ml of blood is passed through the vagina in the form of the menstrual fluid. During the 1-7days period it is considered as the initial phase of the menstrual cycle.2
Menstrual Complications
Dysmenorrhea
This term is used for painful menses or periods that might be caused by uterine shrinkage and it is stated as dysmenorrhea.3
Oligomenorrhea
Oligomenorrhea is the medical term for having infrequent menstrual periods. A normal menstrual cycle occurs every 28 days and lasts from four to seven days. Your period can range from every 21 days to every 35 days and still be considered normal.4
Menorrhagia
Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. Although heavy menstrual bleeding is a common concern.5
Hypomenorrhe
Hypomenorrhea also known as scanty menstruation is a medical condition that is characterized by extremely light flow of blood during menstruation and the duration of menstruation may be shortened also.4
PCOD
Polycystic ovarian syndrome, people may not get their periods monthly when they have PCOS and contain too much production of a hormone called androgens in the body. In PCOS at the outer corner of the ovary, smaller sacs of fluid may develop which are named as cysts.6
Urinary tract infections
A urinary tract infection is a very common type of infection in your urinary system. It can involve any part of your urinary system. Bacteria especially E. coli are the most common.7
Materials and Methods
The study has been conducted in Government schools and private schools of Hanamkonda and Warangal. A prospective observational study conducted within the period of six months. Study includes female children between the age group of 11-16 years and exclusion criteria includes less than 10 years of age group, adult women and non-menarche age group population were excluded. The data collection form includes student demographic details, age of menarche, days of menstruation, number of sanitary pads, colour while bleeding, clots while bleeding, regularity and pain in menstruation, manifestations combined with menstruation. The data was collected throughout six months from 600 school children in different schools analysed and interpreted through Microsoft excel.
Results
Table 1
Age wise distribution among students:
|
Age group |
No. of students |
Percentage |
|
11 |
2 |
0.3% |
|
12 |
62 |
10.3% |
|
13 |
142 |
23.6% |
|
14 |
181 |
30% |
|
15 |
160 |
26.6% |
|
16 |
53 |
8.8% |
According to this Table 2 it shows the age distribution. Out of 600 school children our survey includes 11 years of age were 2(0.3%),12 years of age were 62(10.3%),13 years of age were 142(23.6%),14 years of age were 181(30%),15 years of age were160(26.6%),16 years of age were53(8.8%).
Table 2
Age of menarche among students:
|
Age of Menarche |
No. of Students |
Percentage |
|
10years |
20 |
3.3% |
|
11years |
149 |
24.8% |
|
12years |
176 |
29.3% |
|
13years |
166 |
27.6% |
|
14years |
72 |
12% |
|
15years |
15 |
2.5% |
According to this Table 3 shows the age of menarche. Out of 600 school children 10 years of age were 20(3.3%), 11 years of age were 149(24.8%), 12 years of age were 176(29.3%), 13 years of age were 166(27.6%), 14 years of age were 72(12%), 15 years of age were 15(2.5%).
Table 3
Days of menstruation in students
|
Days of menstruation |
Number of students |
Percentage |
|
2 days |
5 |
0.8% |
|
3 days |
67 |
11.1% |
|
4 days |
82 |
13.6% |
|
5 days |
371 |
45.6% |
|
6 days |
79 |
13.1% |
|
1 week |
77 |
12.8% |
|
8 days |
15 |
2.5% |
|
9 days and 3 months |
1 |
0.1% |
According to the Table 4 shows days of menstruation. Out of 600 school children, 2days were 5(0.8%), 3days were 67(11.1%), 4days were 82(13.6%), 5days were 371(45.6%), 6days were 79(13.1%), 1week were 77 (12.8%), 8 days were 15(2.5%), 9 days and 3 months were 1(0.1%), 10 days were 2(0.3%).
Table 4
Number of sanitary napkins/days used by students:
|
Number of sanitary napkins/days |
No. of students |
Percentage |
|
1pad/day |
67 |
11.1% |
|
2pads/day |
206 |
34.3% |
|
3pads/day |
200 |
33.3% |
|
4pads/day |
99 |
16.5% |
|
5pads/day |
20 |
3.3% |
|
6pads/day |
6 |
1% |
|
7 and 8 pads/day |
1 |
0.1% |
According to Table 5 shows the number of sanitary napkins per day. Out of 600 school children, 1 pad per day was 67(11.1%),2 pads per day was 206(34.3%),3 pads per day were 200(33.3%),4 pads per day was 99(16.5%),5 pads per day was 20(3.3%),6 pads per day was 6(1%),7 pads and 8 pads per day was
Table 5
Clots while bleeding among students during menstruation:
|
Clots while bleeding |
No. of students |
Percentage |
|
Yes |
372 |
62% |
|
No |
228 |
38% |
According to Table 6, shows clots while bleeding. Out of 600 school children clots while bleeding with yes-372(62%), no-228(38%).
Table 6
Colour while bleeding among students during menstruation
|
Colour while bleeding |
No. of students |
Percentage |
|
Red |
331 |
55.1% |
|
Dark red |
79 |
13.1% |
|
Brown |
63 |
10.5% |
|
Reddish black |
18 |
3% |
|
Reddish brown |
106 |
17.6% |
|
Dark brown |
1 |
0.1% |
|
Orange brown and blue |
1 |
0.1% |
Table 7
Menstrual flow among students during menstruation:
|
Menstrual flow |
No. of students |
Percentage |
|
Average |
369 |
61.5% |
|
Heavy bleeding |
231 |
38.5% |
The Table 7 shows the menstrual flow. Out of 600 school children flow of menstruation was an average was 369(61.5%), with heavy bleeding being 231(38.5%).
Table 8
White discharge among students during menstruation:
|
White discharge |
No. of students |
Percentage |
|
Transparent |
127 |
21.6% |
|
Thick texture |
127 |
21.6% |
|
Foul smell |
20 |
3.3% |
|
Curdy texture |
74 |
12.3% |
|
Yes |
122 |
20.3% |
|
No |
172 |
29.5% |
The Table 8 shows the white discharge chart. Out of 600 school children with curdy texture 74(12.3%), foul smell 43(7.1%), transparent 127(21.6%), thick texture 20(3.3%), yes 122(20.3%), and without white discharge 172(29.5%).
Table 9
Regularity of menstruation in students:
|
Regularity of menstruation |
No. of students |
Percentage |
|
Yes |
379 |
63.1% |
|
No |
221 |
36.8% |
The Table 9 shows the regularity of menstruation. Out of 600 school children regular menstruation was 379(63.1%), and irregular menstruation was 221(36.8%).
Table 10
Complications during menstruation among students:
The Table 10 shows that the complications during menstruation among students. Out of 600 school children, dysmenorrhea 167(27.8%) individuals, oligomenorrhea 27(4.5%), hypomenorrhea 12(2%), anemia 1(0.1%), dysmenorrhea and anemia 7(1.1%), dysmenorrhea and menorrhagia 169(28.1%), dysmenorrhea, oligo and UTI 1(0.1%), dysmenorrhea, oligo and menorrhagia 26(5.2%), dysmenorrhea and UTI 10(1.6%), dysmenorrhea and hypomenorrhea 23(3.8%), dysmenorrhea, hypomenorrhea and anemia 2(0.3%), dysmenorrhea, oligo and anemia 2(0.3%), oligo and menorrhagia 6(1%), oligo and hypomenorrhea 37(6.1%), UTI 2(0.3%), menorrhagia 30(5%), oligo and anemia 14(2.3%).
Table 11
Site of pain during menstruation in students:
|
Site of pain |
No. of students |
Percentage |
|
Lower abdomen |
222 |
37% |
|
Pelvic pain |
105 |
17.5% |
|
Lumbar pain |
70 |
11.6% |
|
Abdominal pain radiating to back |
203 |
33.8% |
The Table 11 shows the site of pain. Out of 600 school children’ s sites of pain at the lower abdomen were 222(37%), abdominal pain radiating to the back 203(33.8%), pelvic pain105(17.5%), lumbar pain 70(11.6%).
Table 12
Manifestations during menstruation in students:
The Table 12 shows that manifestations during menstruation among students. Out of 600 individuals, students are experiencing changing mood swings 25(4.1%), changing mood swings and loss of appetite 30(5%), CMS, constipation and stomach pain 4(0.6%), inability to concentrate 84(14%), CMS and giddiness 5(0.8%), constipation and giddiness 21(3.5%), diarrhoea and sleep disturbances 37(6.1%), increased appetite and sleep disturbances 68(11.3%), LOA and sleep disturbances 77(12.8), diarrhoea and increased appetite 50(8.3%), sleep disturbances 49(8.1%), stomach pain and constipation 103(17.1%) and students without symptoms are 47(7.8%).
Table 13
Economic status among students
|
Economic status |
No. of students |
Percentage |
|
High economic status |
200 |
33.3% |
|
Poor economic status |
400 |
66.6% |
The Table 13 shows the economic status of school children. Out of 600 school children with poor economic status 400(66.6%), and with high economic status 200(33.3%).
Table 14
Dietary changes among students:
|
Dietary changes |
No. of students |
Percentage |
|
Proper diet |
345 |
57.5% |
|
Improper diet |
255 |
42.5% |
The Table 14 shows the dietary changes. Out of 600 school children with a proper diet 345(57.5%), and with improper diet 255(42.5%).
Table 15
Awareness on menstruation among students:
|
Awareness on menstruation |
No. of students |
Percentage |
|
Awareness |
205 |
34.1% |
|
Non-awareness |
395 |
65.8% |
The Table 15 shows awareness based on menstruation. out of 600 school children, 205 children are aware of menstruation (34.1%), and 395 children are not aware of menstruation (65.8%).
Table 16
Body mass index in students:
|
BMI |
No. of students |
Percentage |
|
Low BMI |
462 |
77% |
|
High BMI |
8 |
1.3% |
|
Normal BMI |
130 |
21.6% |
The Table 16 shows that body mass index. Out of 600 school children, low BMI 462(77%) individuals, normal BMI 130(21.6%) individuals, high BMI 8(1.3%).
Table 17
Others
|
Others |
No. of students |
Percentage |
|
Early menstruation |
155 |
25.8% |
|
Body pains |
83 |
13.8% |
|
Stress |
32 |
5.3% |
|
Vomiting’ s |
59 |
9.8% |
|
Headache |
45 |
7.5% |
|
PCOD |
10 |
1.6% |
The Table 17 shows the others with any complications or Manifestations. Early menstruation 155(25.8%), body pains 83(13.8%), stress 32(5.3%), vomiting's 59(9.8%), headache 45(7.5%) and with PCOD 10 (1.6%).
Discussion
The study has been performed through an offline survey and 600 people were recruited in our study according to inclusion criteria. The data was collected in the data collection form by interviewing the female children and their parents. our data collection form includes demographics details, age of menarche, regularity of menstruation, usage of sanitary napkins, menstrual flow, complications during menstruation, daily dietary intake, sleeping habits, economic status and manifestations during menstruation and other problems like UTI, white discharge. According to our study the occurrence of menarche is mostly between 13-15 years of age. The menstrual flow was depended upon the diet, sleep, hormonal imbalances, and other disease conditions. Children with abnormal menstrual flow were informed to their parents for gynaecologist’ s opinion. We have collected data regarding sanitary pad usage during menstruation. We educated them regarding sanitary pad changing hours to prevent UTI infection and rashes. We have counselled them regarding a gynaecologist’ s opinion to prevent complications like anaemia and other diseased conditions. Children with a proper diet and with high economic status with regular menstruation when compared to improper diet and poor economic status. Complications of menstruation are different types include dysmenorrhea, hypomenorrhea, oligomenorrhea, menorrhagia, anaemia, and UTI. Students are experiencing changing mood swings, inability to concentrate, loss of appetite, constipation, and stomach pain. The economic status of school children varies. Lack of awareness about menstruation is the major factor for the development of complications in children. To improve the awareness in children and family members, we have conducted the awareness programmes regarding the menstrual cycle, menstrual flow and their complications in government and private schools.
Conclusion
With our overall thesis work, we concluded that oligomenorrhea, dysmenorrhea are the most common menstrual complications in school children during menstruation. The underlined cause to these complications is lack of proper nutrition, low BMI, and poor economic status. By conducting awareness programs in schools about menstruation and diet, basic knowledge has been provided, this may reduce further menstrual complications.
Abbreviation
UTI- Urinary tract infections, BMI- Body mass index, LOC- loss of concentration, CMS- changing mood swings.
Article DOI
