Journal articles on the topic 'Menstrual Abnormalities Menarche Adolescence'

Background: Adolescence is the period of life between the ages of 10 and 19. This period is essentially dominated by puberty. The first menstruation, called menarche, occurs, on average, at the age of 12–13. The period after menarche, especially the first 2 years, is characterized by anovulatory cycles, which can be accompanied by menstrual irregularities. This review aims to describe the current status of the diagnostic and therapeutic challenges of the physiological and pathological causes of menstrual irregularities in adolescence and evaluates the benefits from interdisciplinary collaboration to ensure optimal care. Methods: A systematic literature search was conducted in the PubMed database in April 2024 using the following term: “menstrual disorder adolescence”. A total of 1724 abstracts were screened, and relevant articles from the last 10 years were included. In addition, a supplementary topic-relevant literature search of the guidelines of the European Society of Human Reproduction and Embryology (ESHRE) and the guidelines of the Arbeitsgemeinschaft der wissenschaftlichen medizinischen Fachgesellschaft (awmf) was carried out. Results: In addition to cycle irregularities that occur physiologically as a result of anovulatory cycles in the context of the immaturity of the hypothalamic–pituitary–gonadal axis, there are other cycle abnormalities that can be classified as pathological and need to be recognized and treated. Conclusions: Increasing awareness of the various specialist disciplines of physiological and pathological cycle abnormalities in adolescence and interdisciplinary cooperation between them can have a positive influence on the quality of life of adolescent women with cycle abnormalities.

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. A diagnosis of PCOS is established when a patient exhibits two of three Rotterdam criteria: oligoovulation or anovulation, excess androgen activity, and polycystic ovarian morphology. The pathogenesis of PCOS, as it affects adolescents, is often discussed in terms of a “two-hit” theory. This refers to a stepwise process in which the first “hit” is an inborn congenitally programmed predisposition, while the second “hit” arises from a provocative factor such as insulin resistance. The dynamic physiological and anatomical changes which occur in puberty make for a challenging diagnosis in this group of patients. It is important to be mindful of the physiological particularities in adolescence which often mimic the symptoms of PCOS. In their first-year post-menarche, approximately 75% of menstruating adolescents report their cycle to last between 21–45 days. Recent studies have shown that regular menstrual cyclicity is only achieved within 2–3 years post-menarche. Anovulation, as a crucial diagnostic element for PCOS, features in about half of early-post-menarchal adolescents. Hirsutism and acne are the most common clinical manifestations of hyperandrogenism, and mild features are developed by most adolescents as a result of elevated androgen levels. Distinguishing between a pathological sign and normal features of maturation is often difficult. A polycystic ovarian morphology (PCOM) through ultrasound has been found in up to 40%, 35%, and 33.3% of patients when assessed at 2, 3, and 4 years, respectively, after menarche. PCOM in adolescence is not associated with future abnormalities in ovulatory rate or menstrual cycle duration. For this reason, international guidelines recommend against the use of pelvic ultrasound until 8 years post-menarche. The primary aim of management is focused mainly on improving hormonal and metabolic status, the prevention of future comorbid complications, and generally improving the overall quality of life in young women with PCOS. Considerable controversy surrounds the choice of optimal pharmacological treatment to address PCOS in adolescents. Reliable studies, which include this sub-section of the population, are very limited. There is a lack of robust and reliable trials in the literature addressing the use of combined oral contraceptives. Further work needs to be undertaken in order to provide safe and effective care to the adolescent population in this regard.

Primary dysmenorrhea is menstrual pain that is found without obvious abnormalities of the genital organs. Primary dysmenorrhea often occurs in adolescent girls aged 10-14 years (early adolescence). Primary dysmenorrhea refers to pain without obvious pathological pelvic disease or menstrual pain with normal pelvic anatomy, usually beginning in adolescence after their ovulatory cycle has established. The purpose of this study was to determine the relationship between age of menarche, duration of menstruation and exercise habits in adolescent girls in Sitinjau Laut District.
 This research is a quantitative research with a cross sectional design. Data collection was carried out in March-April 2021. The research population was... Young Women with a research sample of 198 young women. Sampling was done by using proportional random sampling technique. This study consisted of the independent variable "age of menarche, duration of menstruation and exercise habits" and the dependent variable "primary dysmenorrhea". Data analysis using Chi-Square test.
 The incidence of primary dysmenorrhea in adolescent girls is 74.2%. Factors related to the incidence of primary dysmenorrhea in adolescent girls were age at menarche (P=0.000; 1.870; 95% CI 1.371-2.552) and length of menstruation (P=0.001; 0.720; 95% CI 0.635-0.817). And there is no relationship between exercise habits (P=0.720; 1.184 95% CI 1.012-1.835).
 There is a relationship between the age of menarche with the incidence of primary dysmenorrhea and the length of menstruation in adolescent girls in the District of Sitinjau Laut.

Background Adolescents often experience menstrual irregularity in the first few years after menarche. Abnormal menstrual cycles may increase the risk of polycystic ovary syndrome.
 Objective To determine the menstrual cycle patterns of adolescent females in Indonesia and associated factors.
 Methods This cross-sectional study was conducted at two senior high schools in Surakarta, Central Java, from September to October 2016. Subjects were healthy female students whose parents have given written informed consent. Girls taking hormonal drugs or with chronic diseases were excluded. Subjects filled questionnaires on menstrual cycle, diet, ethnicity, and physical activity. All subjects underwent anthropometric measurements (height and weight). Kruskal-Wallis test was used for data analysis.
 Results Four hundred and forty-four subjects met the inclusion criteria. Mean age at menarche was 12.27 (SD 1.08) years. Mean menstrual cycle length was 31.1 (SD 6.5) days. Abnormal menstrual cycle occurred in 30.6% of subjects (24.5% oligomenorrhea, 5.9% polymenorrhea, and 0.2% amenorrhea). Ethnicity (Javanese, Chinese, or Arab) was significantly associated with menstrual cycle category (P<0.05). Girls with Chinese ethnicity having the largest proportion of oligomenorrhea. Other factors (body mass index, age, age at menarche, nutritional status, physical activity, and fat intake) were not found to be associated with menstrual cycle abnormalities.
 Conclusion Menstrual abnormalities, especially oligomenorrhea, are common in Indonesian adolescent girls. Oligomenorrhea is more frequent in girls of Chinese ethnicity, compared to those of Javanese or Arab ethnicity.

Background: In recent years, endurance running as a sport has become very popular. This trend has led to the identification of specific problems during the female athlete's life, especially with regard to reproduction, delayed sexual mafuration, menstrual abnormalities and early osteoporosis.Methods: Bone mineral density (BMD) and menstrual function were compared between a group of long-distance female adolescent runners (N:17) from five schools in Pretoria and an age-matched inactive control group of adolescents (N:18). Groupswere matched for body height, mass index (BMI l8 to 25) and eating habits.The SAHARA Clinical Sonometer was used to measure BMD on the calcaneus. Menstrual function was denoted by onset of menarche, duration of menstrual periods (days) and number of menstrual periods per year.Results: Baseline BMD was significantly higher in the athletic group: mean = 0,6126g/cm3 and SD = 0,1217, versusn on-athletes: mean = 0,5329g/cm3 and SD = 0,0733 (p = 0,0228).There was a significant delay in the onset of menarche in the athletes: mean = 14,873 and SD = 1,37798, in comparison to the non-athletes: mean = 13,468 and SD = 1,2194 (p = 0,0030). The athletes had a significantly higher incidence of menstrual abnormalities(p = 0,005).Conclusions: BMD at the focus of strain for running (the legs) is higher in endurance adolescent female runners. Endurance runners have a significantly higher incidence of menstrual abnormalities.

This paper represents an international collaboration of paediatric endocrine and other societies (listed in the Appendix) under the International Consortium of Paediatric Endocrinology (ICPE) aiming to improve worldwide care of adolescent girls with polycystic ovary syndrome (PCOS)1. The manuscript examines pathophysiology and guidelines for the diagnosis and management of PCOS during adolescence. The complex pathophysiology of PCOS involves the interaction of genetic and epigenetic changes, primary ovarian abnormalities, neuroendocrine alterations, and endocrine and metabolic modifiers such as anti-Müllerian hormone, hyperinsulinemia, insulin resistance, adiposity, and adiponectin levels. Appropriate diagnosis of adolescent PCOS should include adequate and careful evaluation of symptoms, such as hirsutism, severe acne, and menstrual irregularities 2 years beyond menarche, and elevated androgen levels. Polycystic ovarian morphology on ultrasound without hyperandrogenism or menstrual irregularities should not be used to diagnose adolescent PCOS. Hyperinsulinemia, insulin resistance, and obesity may be present in adolescents with PCOS, but are not considered to be diagnostic criteria. Treatment of adolescent PCOS should include lifestyle intervention, local therapies, and medications. Insulin sensitizers like metformin and oral contraceptive pills provide short-term benefits on PCOS symptoms. There are limited data on anti-androgens and combined therapies showing additive/synergistic actions for adolescents. Reproductive aspects and transition should be taken into account when managing adolescents.

The health of the younger generation is a public value. Today, the state of health of teenage girls is of particular concern due to its progressive deterioration. Purpose - to study the features of the clinical course of menstrual function disorders in adolescent girls with comorbid mental health disorders. Materials and methods. 154 girls aged 11-17 were examined with menstrual cycle disorders (77 with oligomenorrhea (OM) and 77 with abnormal uterine bleeding (AUB)). Assessment of physical and sexual development, age of menarche was carried out. Depending on the examination by a psychiatrist, all girls with OM and AUB were divided into groups: without deviations in mental status, with anxiety-phobic disorders and depressive states. Results. It was found that the average growth indicators were probably higher in girls with OM in relation to adolescents with AUB, especially in the presence of psychopathology. The use of BMI did not reveal a significant difference when comparing patients with OM and AUB. Abnormalities of sexual development were probably more often registered in patients with AUB, with its advance, this acquired a significant difference (p˂0.01) and depended on both body mass index (BMI) and psychopathology. If the percentage of patients with disorders of sexual development did not differ depending on psychopathology in girls with AUB, then in adolescents with OM, the specific weight of girls with abnormalities of sexual development increased with the appearance of psychopathology. The average age of menarche was significantly lower in patients with AUB compared to patients with OM (p˂0.003). Early menarche was more typical for AUB. Much more often in adolescents with AUB, it was registered with normative fluctuations of BMI and its excess, as well as with anxiety-phobic disorders both with AUB and OM. Conclusions. The analysis of the conducted studies indicates reliable differences regarding the clinical course of menstrual function disorders by the type of OM and AUB with comorbid psychopathology. It was established that there are significant differences in such indicators as growth, puberty, time of menarche, which depended on the type of menstrual disorders and comorbid psychopathology. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.

Introduction: Adolescence is a significant period between childhood and adulthood when physical and psychological changes occur along with menstruation. The onset of puberty is governed by genetic, endocrinal, neuronal, socioeconomic, and environmental factors. Endocrine abnormalities in adolescents are not uncommon and can lead to menstrual disorders. This study's objective is to identify the prevalence of underlying endocrine abnormalities and their association with menstrual disorders among adolescents at a tertiary care hospital in Pakistan. Material and Methods: We conducted a cross-sectional study of adolescent girls presenting with menstrual disorders at the Department of Obstetrics and Gynecology at Liaquat National Hospital, Karachi, Pakistan, from January 1, 2020, to January 1, 2021. We collected a detailed history from each patient. All physical examinations were performed in the presence of a female nurse, and we carefully maintained patient privacy. The physical examinations consisted of recording the patient's height, weight, body mass index (BMI), and thyroid examination. We also noted the patient's hirsutism score and the presence or absence of secondary sexual characteristics. All the patients received a hormonal evaluation in which we measured their thyroid-stimulating hormone levels, and follicle-stimulating hormone (on day two of their menstrual cycle and random FSH was measured for amenorrhea patients), prolactin, and free androgen index. Results: The study included 143 adolescent girls aged 10 to 19 with menstrual disorders such as primary amenorrhea, secondary amenorrhea, frequent menstrual bleeding, infrequent menstrual bleeding, shortened menstrual bleeding, heavy menstrual bleeding, and intermenstrual bleeding. The mean menarcheal age of the patient population was 12.1 ± 0.4 years, and the mean BMI was 25.27 ± 5.02 kg/m2. One hundred twenty-four patients (86.7%) reported polycystic ovarian syndrome (PCOS). Most PCOS patients had infrequent menstrual bleeding (85.5%), 46% had biochemical signs of hyperandrogenism, and 18.5% of PCOS patients showed clinical signs of hyperandrogenism. The most common menstrual problems reported by the patients were infrequent menstrual bleeding (74.1%), followed by shortened menstrual bleeding (61.5%), and heavy menstrual bleeding (9.8%). Thyroid dysfunction was present in the form of hypothyroidism (67.4%) and hyperthyroidism (32.6%). Over half of the hypothyroid patients (58.1%) presented with infrequent menstrual bleeding,41.9% presented with shortened menstrual bleeding and 41.9% with heavy menstrual bleeding .Infrequent menstrual bleeding (73.3%) and shortened menstrual bleeding (66.7%) were the most common menstrual problems in hyperthyroid patients. We found a significant association between thyroid disorder and infrequent menstrual bleeding (p=0.037), heavy menstrual bleeding (p<.001), and shortened menstrual bleeding (p=0.051). Heavy menstrual bleeding was also significantly related to hyperprolactinemia (p=0.036). Conclusions: Our study showed that endocrine abnormalities in thyroid dysfunction, PCOS, hyperprolactinemia, and hyperandrogenism could cause various menstrual problems in adolescent girls. Hence, underlying endocrine abnormalities need to be investigated and treated to improve adolescents' physical and mental well-being.

Adolescence is a period between puberty and psychophysical maturity, marked by endocrinological, metabolic, and somatic changes. Menstrual cycle disorders are among the most common abnormalities during this period. Objective — to study the features of physical and sexual development as well as the establishment of menstrual function in adolescent girls with oligomenorrhea, depending on the duration of the disease. Materials and methods. The study involved 194 adolescent girls aged 12—18 years with oligomenorrhea (OM). Depending on the duration of OM at the time of examination, they were divided into four groups. Physical and sexual development as well as the age of menarche onset were evaluated. Results and discussion. The majority of girls had growth within the optimal range. Minor deviations in growth, both delays and advancements, were observed in approximately one-third of patients (26.7 %). Among significant deviations, tall stature predominated, and these changes gradually increased with the duration of oligomenorrhea (OM). With physiological BMI indicators, growth changes were noted in 81.3 % of patients. Hirsutism manifestations intensified with the progression of the disease, potentially signaling the development of polycystic ovary syndrome. The level of sexual development in the vast majority of patients with OM (83 %) was within chronological age. However, acceleration was observed in 75 % of girls aged 11—13 years, while delays were noted in 7.2 % of girls aged 14—18 years. Thus, deviations in sexual development were most frequently registered in younger girls (12—13 years). Early and late menarche occurred significantly more often in adolescents with OM lasting more than 2 years. Conclusions. It was established that oligomenorrhea (OM) in nearly half of the girls (49.5 %) is accompanied by disturbances in physical development, the nature and severity of which depend on the duration of OM. A characteristic feature for younger adolescents with OM was accelerated sexual development (76.7 %). A combination of physical and sexual development disorders was recorded in 61.1 % of the girls. Early menarche was registered in 10.7 % of patients and was a predictor of disease chronicity. Hirsutism increased with prolonged OM duration, suggesting a risk for developing polycystic ovary syndrome.

Primary dysmenorrhea is menstrual pain that occurs without any abnormalities in the genital organs and almost always appears for the first time in women aged 20 years or younger after their ovulation cycle has stabilized. The prevalence of dysmenorrhea worldwide is substantial, with more than 50% of women in each country experiencing menstrual pain. This study is an analytical study using a quantitative approach with a cross-sectional design. Data were collected through a survey method using questionnaires that had been tested for validity and reliability, and analyzed using univariate and bivariate analysis. Among 187 adolescent respondents, 137 (73.3%) experienced dysmenorrhea. Of these, 110 (58.8%) had experienced early menarche, 115 (61.5%) experienced stress, while 72 (38.5%) did not. Additionally, 141 respondents (75.4%) reported regular fast-food consumption behavior. The Chi-Square statistical test showed that the majority of dysmenorrhea cases occurred among respondents with early menarche (p-value = 0.003; OR = 2.87), those who experienced stress (p-value = 0.014; OR = 2.40), and those with fast-food consumption behavior (p-value = 0.04; OR = 2.19). There is a significant relationship between early menarche, stress, and fast-food consumption behavior and the incidence of primary dysmenorrhea among female adolescents at SMPN 01 Sukabumi. Recommendation: Strategic steps should be taken to educate adolescents on healthy lifestyles, including meeting nutritional needs through a balanced diet as per the "Isi Piringku" guidelines, providing counseling to reduce potential stress, and raising awareness about the risks associated with fast-food consumption.

Female genital tract malformations are often a challenge not only for obstetricians and gynecologists, but also for doctors of other specialties. This pathology often leads to negative obstetric and perinatal consequences, the emergence of gynecological complications that significantly impair the quality of life of patients at different ages. The incidence of female genital abnormalities in the general female population ranges from 5.5 to 6.7% and is on average three times higher among patients with reproductive health disorders. The objective: to assess the frequency of reproductive disorders and determine the sequence of use of clinical and instrumental methods of examination in patients with female genital tract malformations. Materials and methods. We conducted a retrospective assessment of the relationship between menstrual disorders and the presence of female genital tract malformations. We observed 124 patients with a confirmed diagnosis of female genital tract malformations. The age of women ranged from 22 to 42 years. The diagnosis was based on complaints, medical history and life, as well as data from clinical, laboratory and instrumental examinations. Results. The mean age of patients was 29.2±3.8 years. From the moment of the patient’s first visit to the gynecologist until the final verification of the diagnosis took from 6 months to 7 years. Dysmenorrhea occurred in 70.2% of patients with abnormalities in the development of the female genital organs, late menarche – in 12.1%, primary / secondary amenorrhea – in 11.3%, irregular menstrual cycle – in 9.7%, violation of the menstrual cycle – at 28.2%. The combination of female genital tract malformations with various defects of the urinary system occurred in 24 (19.4%) women. Conclusion. In 81.2% of patients from adolescence there were clinical manifestations associated with female genital tract malformations. Screening ultrasound examination of the pelvic organs and gynecological examination is shown to all girls aged 15 years. It is advisable to determine the karyotype in patients with primary / secondary amenorrhea. Renal ultrasound should be performed in all patients with suspected female genital tract malformations. In case of suspicion of ultrasound examination for abnormal development of the female genitals, patients before sexual intercourse are recommended to perform MRI examination; in the presence of sexual life with a preserved menstrual cycle, it is advisable in the second phase of the cycle to conduct transvaginal 3D ultrasound, which can be supplemented by MRI. Keywords: genital abnormalities, dysmenorrhea, menstrual function.

Menstruation disorders can decrease physical activity of teenager. The most common menstrual disorders occur at the beginning and end of the reproductive period is under the age of 19 and over the age of 39 years. Menstruation disorders need to know where the adolescent reproductive organs is very important in the development of subsequent health. Menstruation disorders experienced by adolescents mostly dysmenorrhoea. It was a descriptive research using simple random sampling. The sample in this study was 30 respondents from SMK 3 Muhammadiyah Klaten. Most of the respondents had menstruation abnormalities were 21 students (70%), the majority of respondents average experience menarche at age 14 as many as 10 students (33.3%) and most knowledge of young girls about menstruation disorders was good as many as 25 students (83.3%).

Background of the Study: Adolescence is the time between the commencement of puberty and the start of adulthood. Menarche is a significant occurrence in the lives of adolescent females because it is one of the signals that puberty has begun. Puberty is marked by a series of physical and mental changes. Toward the end of adolescence, menstrual abnormalities are a regular occurrence. About 75% of females have some form of monthly problem, such as painful, irregular, delayed, or heavy menstrual bleeding. Materials and Methods: Quantitative research approach was used in the study, 300 adolescent girls having problem of dysmenorrhea was selected as a samples. Quasi-experimental (comparative study) research design with three groups pre-test and post-test design approach was used as a research design. In this study probability, purposive sampling technique was utilized. Results: The study results in pre-test mean 26.79 and SD5.55, post-test mean 12.1 and SD 5.99 for oil massage on dysmenorrhea level, pre-test mean 21.17 and SD 6.91, post-test 14.75 and SD 6. Oil massage on perceived stress. The results show significant Effectiveness (P < 0.05). Pelvic floor exercise on dysmenorrhea pre-test shows mean 25.63 and SD 5.95, while post-test shows mean 7.74 and SD 6.45. The pre-test showed mean 21.96 and SD 6.43, while the post-test showed mean 13.12 and SD 6.49. Pelvic floor exercise on level of perceived stress, the resultsshow significant effectiveness (P < 0.05). For Jacobson’s relaxation technique Pre-test showed mean 26.63 and SD 5.59, whereas post-test showed mean 8.65 and SD 6.90. Level of perceived stress, with pre-test mean 22.67 and SD 6.32 and post-test mean 11.86 and SD 6.66 results show significant Effectiveness (P < 0.05). Conclusion: This means that oil massage therapy, pelvic floor exercises, and Jacobson’s relaxation techniques are effective ways to reduce Dysmenorrhea and Perceived Stress, even pelvic floor exercises are better than oil massage therapy and Jacobson’s relaxation technique for reducing dysmenorrhea, oil massage therapy and Jacobson’s relaxation technique are better for reducing stress in teenage girls than pelvic floor exercises and oil massage therapy.

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Abstract Abstract 3654 Background: Menorrhagia in adolescents could be the first sign of a bleeding disorder. Prior research has found occult bleeding disorders, e.g. von Willebrand disease, in women with menorrhagia. We hypothesized that most adolescents girls with menorrhagia do not seek medical attention; thus we performed a survey of adolescents girls in their schools. Methods: Between February and April, 2008 we presented the study to 705 adolescents girls in six schools. The presentation included a short lecture and completion of a questionnaire. Due to ethical regulations the questionnaire could include only general information without any identifying data. The adolescents were asked if the thought they had heavy periods. The answers options were “yes”, “no”, “sometimes”, and “do not know”. After providing parental and individual consent, 94 adolescents girls completed a detailed personal and family (Hospital for Sick Children) HSC bleeding questionnaire and a pictorial bleed assessment chart (PBAC) during the next menstrual cycle. A blood sample was taken from 62 adolescents (66%) for complete blood count, partial thromboplastin time, prothrombin time, factor VIII, von Willebrand factor (VWF) activity and antigen. The distribution of age, years since menarche and response to the initial question regarding heavy periods was similar among the entire approached population, those who consented and those who had laboratory evaluation (Table 1). Results: One hundred and five adolescents girls (15%) reported they had heavy periods on the initial questionnaire. An additional 21% reported to have heavy periods sometimes. Frequency of perceived menorrhagia was not associated with age or years since menarche. Among the 94 girls who completed the full questionnaires, menorrhagia based on a PBAC ≥ 100 and/or a positive answer on the HSC questionnaire was found in 34 adolescents (36%, 95% CI 26.5%-46.7%). Almost a third of those adolescents (11/34) did not perceive they had menorrhagia according to their response on the initial questionnaire. Prevalence of menorrhagia was not associated with age, years since menarche, family history of bleeding symptoms or evidence of other bleeding symptoms. Hemoglobin levels were significantly lower in those with vs. those without menorrhagia, mean±SD, 12.6±1 vs. 13.2±0.8 (p=0.025). Of the six adolescents with hemoglobin <12 g/dL, only two were aware they had anemia. Menorrhagia was not significantly associated with coagulation abnormalities. One girl with menorrhagia was found to have borderline VWF levels. Discussion: Menorrhagia is under-diagnosed in adolescents. By using standardized questionnaires, we were able to identify a group of girls with menorrhagia associated with higher risk of anemia. Importantly, some of these girls were not aware they had a problem. The lack of association between menorrhagia and coagulation abnormalities could be related to the small sample size or to the non-selective nature of the study participants (inclusion of girls with menorrhagia who did not seek medical attention). Yet, we believe that questioning adolescents for menorrhagia is important as it could contribute to their improved well-being. The low participation rate further highlights the difficulty in doing research in this area. Disclosures: No relevant conflicts of interest to declare.

OBJECTIVE: This analysis helps to find out the pattern of menstruation among college students in Tamilnadu India. Materials and Methods: In this cross-sectional study, a survey was conducted in various colleges in Dindigul District. These questionnaires were based on socioeconomic data, menarche, menstrual cycle flow, and their perception of menstruation. Results: The age of menarche was 77.7% of the students attaining earlier (9-12). Dysmenorrhea (65%), premenstrual syndrome (PMS) (71.2%), and irregular cycles (33.8%) were found to be common problems among teenagers. Conclusion: Adolescents need to be educated about menstrual health and menstrual disorder.

Тhe diagnosis of polycystic ovary syndrome (PCOS) in adolescence still raises many questions. The problem is that the characteristics of normal puberty often coincide with the symptoms of PCOS. The article presents the criteria of a normal menstrual cycle, clinical and laboratory hyperandrogenism. In the diagnosis of the latter, the most informative indicators are the determination of the index of free testosterone and androstenedione, and the assessment of free and total testosterone are relatively low sensitivity. Clinical hyperandrogenism in adolescents includes only severe acne and hirsutism. The level of antimullerian hormone has no independent significance. Irregular menstrual cycles during the first year after menarche represent a normal period of puberty. At the second and third year after menarche , menstrual cycles of less than 21 days and more than 45 days are considered irregular, and from the fourth year – less than 21 days and more than 35 days. From the second year after menarche, menstrual irregularities are considered to be more than 90 days for any cycle. Primary amenorrhea is indicated by the absence of menarche at 15 years, or 3 years after telarche. Ultrasound is not used as a criterion for PCOS in the first 8 years after menarche due to the high frequency of ovarian multifollicularity in adolescence. Therefore, adolescent girls in the presence of menstrual disorders and hyperandrogenism may be diagnosed with «PCOS. Phenotype B» (ultrasound signs are not taken into account). Adolescents who have signs of PCOS but do not meet the diagnostic criteria are at risk for PCOS. The most important stage of PCOS therapy is lifestyle modification, normalization of body weight and metabolic processes. Combined oral contraceptives in adolescents are more often prescribed not for direct purposes (contraception), but as off-label therapy not only at diagnosis, but also in the «risk group», which involves the treatment of irregular menstrual cycles and / or clinical hyperandrogenism. In the absence of the effect of lifestyle changes, proper nutrition to correct metabolic disorders in addition to combined oral contraceptives may be prescribed metformin, inositol and etc.

Тhe diagnosis of polycystic ovary syndrome (PCOS) in adolescence still raises many questions. The problem is that the characteristics of normal puberty often coincide with the symptoms of PCOS. The article presents the criteria of a normal menstrual cycle, clinical and laboratory hyperandrogenism. In the diagnosis of the latter, the most informative indicators are the determination of the index of free testosterone and androstenedione, and the assessment of free and total testosterone are relatively low sensitivity. Clinical hyperandrogenism in adolescents includes only severe acne and hirsutism. The level of antimullerian hormone has no independent significance. Irregular menstrual cycles during the first year after menarche represent a normal period of puberty. At the second and third year after menarche , menstrual cycles of less than 21 days and more than 45 days are considered irregular, and from the fourth year – less than 21 days and more than 35 days. From the second year after menarche, menstrual irregularities are considered to be more than 90 days for any cycle. Primary amenorrhea is indicated by the absence of menarche at 15 years, or 3 years after telarche. Ultrasound is not used as a criterion for PCOS in the first 8 years after menarche due to the high frequency of ovarian multifollicularity in adolescence. Therefore, adolescent girls in the presence of menstrual disorders and hyperandrogenism may be diagnosed with «PCOS. Phenotype B» (ultrasound signs are not taken into account). Adolescents who have signs of PCOS but do not meet the diagnostic criteria are at risk for PCOS. The most important stage of PCOS therapy is lifestyle modification, normalization of body weight and metabolic processes. Combined oral contraceptives in adolescents are more often prescribed not for direct purposes (contraception), but as off-label therapy not only at diagnosis, but also in the «risk group», which involves the treatment of irregular menstrual cycles and / or clinical hyperandrogenism. In the absence of the effect of lifestyle changes, proper nutrition to correct metabolic disorders in addition to combined oral contraceptives may be prescribed metformin, inositol and etc.

Abstract: Adolescence is an important period to develop their first decade of life. At this age, an adolescent girl begins to get their first menstrual period (menarche). After getting menstruation, adolescent girls need to know how to maintain their reproductive health. One effort that can be done to take care of the reproductive health has adopted the behavior of menstrual hygiene. This study aims to determine the level of knowledge of elementary school girls about reproductive health and menstrual hygiene behavior in the period of menarche. The population of this study was all students grades 5 and 6 at SDN 4 Pacarkembang Surabaya and already through menarche. This study has 30 samples and the method of data collection conducted by survey method using a questionnaire with closed questions. The variables are categorized into three categories: good knowledge level if the score range between 76-100%, the level of knowledge sufficient if the range between 56-75% and the level of knowledge is deficient when the score <56%. Variable action using the same category as the level of knowledge. The average age of menarche here is 11-12 years old. All of the respondents had got information about health reproduction and menstruation. Most respondents had heard that information from their mother. But the majority of respondents have “less” knowledge (53.33%) about health reproduction. For the practice of menstrual hygiene, respondents had the moderate level. Keyword: health reproduction, menstrual hygiene, adolescence, menarche AbstrakMasa remaja menjadi waktu yang sangat penting untuk membangun perkembangan mereka dalam dekade pertama kehidupan. Pada usia ini, remaja putri mulai mendapatkan menstruasi pertamanya (menarche). Setelah mendapatkan haid, remaja putri perlu mengetahui cara menjaga kesehatan reproduksinya. Salah satu upaya yang dapat dilakukan untuk menjaga kesehatan reproduksi adalah dengan menerapkan praktik menstrual hygiene. Penelitian ini bertujuan untuk mengetahui tingkat pengetahuan remaja putri sekolah dasar mengenai kesehatan reproduksi dan praktik menstrual hygiene pada periode menarche. Populasi penelitian adalah seluruh siswi kelas 5 dan 6 yang sudah melalui masa menarche di SDN 4 Pacarkembang Surabaya. Jumlah sampel yang digunakan adalah sejumlah 30 sampel. Penelitian ini merupakan penelitian deskriptif kuantitatif dan menggunakan total populasi sebagai responden. Cara pengumpulan data dilakukan dengan metode survei menggunakan instrumen kuesioner dengan pertanyaan tertutup. Variabel dikategorikan menjadi tiga kategori yaitu tingkat pengetahuan baik apabila skor 76-100%, tingkat pengetahuan cukup apabila skor 56-75%, dan tingkat pengetahuan kurang apabila skor <56%. Variabel tindakan menggunakan kategori serupa dengan tingkat pengetahuan. Hasil rata-rata usia menarche responden adalah usia 11 sampai dengan 12 tahun. Hampir seluruh responden sudah mendapatkan informasi terkait menstrual hygiene sebelum responden mengalami menarche dari orang tua perempuan responden. Namun sebagian besar responden memiliki tingkat pengetahuan yang kurang (53.33%) dan perilaku menstrual hygiene responden sudah cukup baik (60.0%).Keyword: kesehatan reproduksi, menstrual hygiene, remaja, menarche

Diagnosing polycystic ovary syndrome (PCOS) during adolescence is challenging due to features of normal pubertal development overlap with adult diagnostic criteria. The international evidence-based PCOS guideline aimed to promote accurate and timely diagnosis, to optimize consistent care, and to improve health outcomes for adolescents and women with PCOS. This article is a descriptive review of published data and synthesizes adolescent PCOS guidelines recommendations. Specific criteria to improve diagnostic accuracy and avoid over diagnosis include: 1) Irregular menstrual cycles defined according to years’ post-menarche; > 90 days for any one cycle (> 1-year post-menarche), cycles <21 or>45days (>1 to <3years post-menarche); cycles < 21 or > 35 days (> 3 years post-menarche) and primary amenorrhea by age 15 or>3years post-thelarche. Irregular menstrual cycles (< 1-year post-menarche) represent normal pubertal transition; 2) Hyperandrogenism defined as hirsutism, severe acne and/or biochemical hyperandrogenism confirmed using validated high-quality assays; 3) Pelvic ultrasound not recommended for diagnosis of PCOS within 8years post menarche; and 4) exclusion of other disorders that mimic PCOS. For adolescents who have features of PCOS but do not meet diagnostic criteria an ‘at risk’ label can be considered with appropriate symptomatic treatment and regular re-evaluations. Menstrual cycle re-evaluation can occur over 3years post menarche and where only menstrual irregularity or hyperandrogenism are present initially, evaluation with ultrasound can occur after 8years post menarche. Screening for anxiety and depression is required and assessment of eating disorders warrants consideration. Recommendation of healthy lifestyle interventions to prevent excess weight gain should be recommended. For symptom management there are different options. In conclusion, PCOS is diagnosed in adolescents with otherwise unexplained persistent hyperandrogenic anovulatory symptoms that are inappropriate for age and stage of adolescence. The diagnosis of PCOS has lifelong implications, with increased risk for infertility, metabolic syndrome, type 2 diabetes mellitus, cardiovascular events, and endometrial carcinoma.

Lack of knowledge about menarche and how young girls handle it, can lead to various problems. Self-development programs can provide anticipatory guidance for children in early adolescence to become independent individuals. One of them is self-care skills such as using and changing sanitary napkins during menstruation. The limited sources of information about reproductive health that are appropriate for adolescents and the absence of reproductive health material in the school curriculum make it urgent to provide education to children. The aim of this activity is to provide education to children in early adolescence about menstruation and simulate pre-menstrual skills. The methods used are interactive lectures and simulations. The location of the activity is SDN Tegalrejo 1, Yogyakarta. The results of this activity showed that there was an increase in pre-menstrual knowledge and skills by 31.4%, which was in the very good category. The conclusion of this activity is that education using interactive lecture methods and simulations is effective in increasing pre-menstrual knowledge and skills in children in early adolescence.Kurangnya pengetahuan mengenai Menarche (menstruasi pertama kali pada perempuan) dan cara penanganannya pada anak perempuan dapat memicu munculnya berbagai masalah. Program pengembangan diri dapat menjadi anticipatory guidance pada anak dengan early adolescence untuk menjadi individu yang mandiri. Salah satunya adalah keterampilan mengurus diri seperti menggunakan dan mengganti pembalut saat menstruasi. Terbatasnya sumber informasi tentang kesehatan reproduksi yang sesuai dengan usia remaja, serta belum ada materi kesehatan reproduksi pada kurikulum sekolah menjadi urgensi untuk memberikan edukasi pada anak. Tujuan kegiatan ini adalah memberikan edukasi pada anak dengan early adolescence tentang menstruasi dan simulasi keterampilan pramenstruasi. Metode yang digunakan adalah ceramah interaktif dan simulasi. Lokasi kegiatan di SDN Tegalrejo 1 Yogyakarta. Hasil dari kegiatan ini menunjukkan terdapat peningkatan pengetahuan dan keterampilan pramenstruasi sebesar 31,4% dan berada dalam kategori sangat baik. Kesimpulan dari kegiatan ini adalah edukasi dengan menggunakan metode ceramah interaktif dan simulasi efektif dalam meningkatkan pengetahuan dan keterampilan pramenstruasi pada anak dengan early adolescence.

Background: Adolescence is the transitional period from puberty to adulthood, causing rapid physical, cognitive, social and emotional changes. Any deviation of normal menstrual pattern is one of the reasons of severe stress and academic losses on many. The aim of the study was to determine prevalence and pattern of menstrual disorders in college going adolescent girls.Methods: A descriptive cross-sectional study was conducted in a medical college of Gurugram district of Haryana, North India. A semi-structured, pretested questionnaire was used to ask about the characteristics of girl’s menstruation: age of menarche; regularity/irregularity of menstruation, interval and duration; presence of amenorrhoea; amount of blood loss; degree of pain during menstruation; activity during menstruation and BMI.Results: All the girls were in the age group 17 to 19 years i.e.; in the late adolescent period with the mean age of 18.2±0.7 3 years. 81.66% girls attained menarche between 12 to 14 years of age. 3.66% girls attained early menarche and 0.33% girls attained menarche late. 19 had scanty menstrual bleeding and 7 suffered from secondary amenorrhea. 27 girls suffered from heavy menstrual bleeding. 78.3% adolescent girls had various degrees of dysmenorrhea with 8.66% had severe dysmenorrhea. 17.66% girls had high BMI and 11% girls for underweight.Conclusions: There was a high prevalence of menstrual disorders among adolescent girls which affects their social and academic lives. Thus, more attention should be paid to identify and treat these menstrual morbidities.

The study was conducted as descriptive-sectional to investigate the age of menarche and the influencing factors of female students studying in the preparatory class of a state university. The universe of this research was the female students between February 2014-May 2015 in school of foreign languages at a state university. The study was held with all universe instead of sampling selection. 738 female students were voluntary participated into the study. Data were collected by the survey form. The menarche age of the participants is 13,3±1,12 (10-17) years old, and there is statistically significance between menarche age and body mass index (p<.001). The other statistically significance was available between menstrual period and weight change (p<.05). It has been found that the menarche age decreases as the students’ weight and BMI increases and the duration of the menstruation cycle increases. Factors affecting students’ menstruation order were investigated and it was determined that only weight change affects menstruation order. In the study, significant results were found between body mass index and age of menarche.

Background: Adolescence is a relatively fast period of physical change experienced by adolescents when puberty is marked by the first menstruation (menarche). Menstruation and menstrual habits continue to encounter numerous social, cultural, and religious barriers, which make it extremely difficult to maintain good hygiene during the menstrual cycle. Objective: Analyzing menstruation practices and the prevalence of dysmenorrhea in adolescent female is the goal of this study. Method: The cross-sectional investigation was carried out in Sukoharjo and Surakarta. The research was carried out between December 2023 and January 2024. Adolescent female samples had reached menarche. WaLIDD score is an instrument used to measure dysmenorrhea. Results: The results of this study show as many as 71.7% of Menarche adolescent girls at the age of 12-14 years. As many as 44.4% of respondents said dysmenorrhea almost always interfered with work activities. Data also shows that nearly 100 % of respondents wash their hands before and after replacing menstrual materials. The majority of them wash their genitals using soap (79.1%) and replace pads (>3 times) 72.5%. Conclusion: Most respondents practice good menstrual hygiene, characterized by frequent washing of hands and genitals. Adolescent females who are knowledgeable about their periods can make hygienic and safe menstrual habits.

Background: Adolescence is the period of rapid physical growth, psychological and social changes. This period is marked by the onset of menarche in the girls. Menstruation is a natural biological process experienced by all adolescent girls and women in reproductive age. The menstrual cycle is characterized by variability in volume, pattern and regularity. Conversely, variability in menstrual cycle characteristics and menstrual disorders are common among adolescent girls. The objectives of the study were to determine patterns of menstruation, prevalence of menstrual disorders and hygienic practices during menstruation in the adolescent school girls.Methods: A cross-sectional study was conducted among 210 adolescent school girls of Delhi.Results: The mean age at menarche in the study subjects was 13.47±0.87 years. Average menstrual interval was days. Dysmenorrhea was reported by 76.1% of the girls, body ache was experienced by 64 (30.4%). Majority of girls 174 (82.8%) used sanitary pads as absorbent during cycle.Conclusions: Menstrual problems are frequent among adolescent girls. Dysmenorrhoea was the commonest problem among the adolescents. Adolescent girls withstand their pain and think it as a normal phenomenon. Educating students about menstrual health by health professionals and teachers can help in reducing their psychological and physical stress.

The menstrual history is an integral part of the evaluation of the adolescent femaie. Abnormal menstrual flow or timing may be the first sign of systemic illness or sexually transmitted disease. Amenorrhea may signal an endocrine or genetic disorder or may suggest structural abnormalities of the genital tract. Most importantly, any abnormality in menstruation should alert the clinician to the possibility of pregnancy. Normal Menstrual Cycle The average age of menarche in the United States is 12.8 years and ranges from 9 to 16 years. Menarche usually occurs 2 to 2.5 years after breast budding and 1 year after the growth spurt. Consequently, the absence of menarche at 15 years of age may be normal in an adolescent who just passed her growth spurt but abnormal in an adolescent who completed puberty 2 years earlier. Most early menstrual cycles are anovulatory. As a result, menses in the young adolescent often are irregular and may be prolonged or heavy. Dysmenorrhea and premenstrual symptoms tend to accompany ovulatory cycles and, therefore, are more common in the older adolescent. Regular ovulatory cycles usually are established within 1 to 2 years of menarche. Although normal cycle length ranges from 21 to 45 days, the length for a given individual is fairly constant.

Background: Menstrual abnormalities are menstrual problems that women face during their reproductive years. Globally, they are the most prevalent disorders affecting quality of life in females. This study aimed to assess the prevalence of menstrual abnormalities, its effects and health seeking behaviour of the respondents. Methods: A cross-sectional study of 30 days was conducted among the undergraduate female students of BP Koirila Institute of Health Sceince who were more than 18 years and had attained their menarche. Total number of responses recorded were 137. Data was collected online via google forms and descriptive analysis was done using SPSS 23.Results: Out of 137 participants, 94.89% had menstrual abnormalities. Among which, 75.38% females sought treatment. Dysmenorrhea and Pre-menstrual syndrome were found to be the most prevalent abnormality. The quality of life was affected in most of the females in terms of lack of concentration in study (91.54%), missing the opportunity for socialization (95.39%), inability to perform physical exercises (82.31%), extra hours of confinement to bed (38.46%) and unable to attend lectures (30%).Conclusions: The prevalence of menstrual abnormalities were high. Quality of life was affected in all the subjects with menstrual abnormality but only few of them were seeking treatment with a professional doctor.Keywords: Menstrual abnormality effects; menstrual abnormality prevalence; menstrual abnormality medical students.

Background: The word adolescent is derived from Latin word adolescence which means to grow into maturity. Adolescence is a period of transition from childhood to adulthood. WHO has defined adolescence as the age group 10-19 years. These are formative years when maximum amount of physical, psychological, developmental and behavioral changes take place. In India adolescent girls accounts for a little more than one- fifth of the population. The onset on menstruation is one of the most important changes occurring among the girls during the adolescent years. The event of menarche may be associated with taboos and myths existing in our traditional society which has a negative implication for women’s health, particularly their menstrual hygiene. Women having better knowledge regarding menstrual hygiene and safe practices are less vulnerable to reproductive tract infections.Methods: This was a cross-sectional descriptive study. The sample size of 184 is obtained in each group and rounded off to 190 (urban and rural schools). The duration of the study was for 5 months among adolescent high school girls in randomly selected schools.Results: The mean age of urban girls was 12.87±0.94 years whereas rural girls it was 12.85±0.86 years. Among 380 study subjects 43.4% were aware about menstruation before attaining menarche, 62.4% were aware that menstruation is a natural process. Majority of study subjects (58.9%) were using sanitary pads during menstruation and 46.8% of study subject’s changes absorbents twice a day. Conclusion: Knowledge and practice regarding menstrual hygiene among adolescent high school girls is better in rural area as compared to urban adolescent high school girls.

Adolescence is a period of transition between age and adulthood, where growth spurts occur, secondary sex-features arise, fertility occurs and better psychological and cognitive conditions, in which girls are marked by the emergence of menstruation (menarche). Menarche is the first menstrual period that occurs during puberty in a woman. In some cases, this accelerated growth can affect a woman's psychological, changes that can occur include or mistakes that often occur. Information that really can be used to improve the ability of young women.Health efforts that can be done to increase knowledge to learn the correct information about menarche for young women, one of which is health promotion through health education. The purpose of this study was to find out the Psychological Impression of Pre-Adolescent Girls (the fifth grade students) Facing Menarche at SDN 02 Sanur, Denpasar.

Abstract. Menarche refers to the first occurrence of menstrual bleeding in a woman’s uterus, indicating that she has reached puberty and begun the reproductive phase and menstrual cycle. This bleeding typically occurs during adolescence as a sign that the body is undergoing hormonal changes to prepare for future fertility. The age of menarche has decreased in various countries since the early 20th century.This study aims to describe the age of menarche among undergraduate students under the age of 19 at the Islamic University of Bandung. The research employs a retrospective cohort method based on primary data. The total sample consists of 111 participants. The age of menarche is categorized into three groups: early menarche, normal menarche, and late menarche. Analysis using SPSS Statistic revealed that 103 participants (92.79%) experienced normal menarche, while early and late menarche were each experienced by 4 participants (3.60%). The average age of menarche was 12.30 years, with a median of 12.00 years, a minimum age of 9.00 years, and a maximum age of 16.00 years. Abstrak. Menarche adalah peristiwa perdarahan pertama yang terjadi pada rahim seorang wanita, menandakan bahwa seorang wanita telah mengalami pubertas dengan dimulainya fase reproduksi dan siklus menstruasi. Perdarahan ini biasanya terjadi pada usia remaja, sebagai tanda bahwa tubuh mulai mengalami perubahan hormon yang mempersiapkan kemampuan untuk hamil di masa depan. Usia menarche telah menurun di berbagai negara sejak awal abad ke-20. Penelitian ini bertujuan untuk mengetahui gambaran usia menarche pada mahasiswi S1 yang berusia maksimal 19 tahun di Universitas Islam Bandung. Penelitian ini menggunakan metode cohort retrospektif berdasarkan data primer. Total subjek penelitian ini melibatkan 111 sampel. Usia menarche dikategorikan menjadi tiga: menarche dini, normal, dan terlambat. Analisis menggunakan SPSS Statistik menunjukkan menarche normal sebanyak 103 orang atau (92,79%), menarche dini dan menarche terlambat yaitu masing-masing sebanyak 4 orang atau (3,60%). Untuk rerata menarche yaitu 12,30 tahun, median 12,00 tahun, dan minimum yaitu 9,00 tahun, dengan nilai maksimum yaitu sebesar 16,00 tahun.

Background: Onset of first menstrual cycle also termed as “menarche” signifies the initiation of sexual maturation of girls. The present study aims to represent an amalgam of menstrual awareness, perceptions and hygiene in light of the associated menstrual practices prevalent in the adolescence girls of Nahan.Methods: A cross-sectional data of 189 girls aged between 10 to 16 years were collected from Nahan, district Sirmaur in Himachal Pradesh. Data regarding perceptions, awareness and hygienic conditions during menstruation were also gathered through an interview based schedule.Results: Menarche was known to be a normal physiological process by only 53.43% girls, while the rest of the participants didn’t know the reason for its occurrence. For 81.2% girls the informant was their mother and a very little role was played by sisters (5.36%), books (0.67%), friends (6.04%) and relatives (5.36%). Most of the girls (95.28%) used sanitary napkin as absorbent for menstrual flow, but the use of single sanitary napkin for 7 to 8 hours by 48% participants was of alarming concern. Stomachache was the most common problem associated with menarche, whereas breast heaviness (16.98%), body ache (16.03%) and backache (26.41%) were witnessed in considerable proportion of girls. A significant number of girls (78.3%) were prohibited from entering in the holy places/temples during this period.Conclusions: Although menarcheal health is acquiring greater significance across the globe, but the age old social restrictive practices associated with menstruation are still common and prevalent in this societies.

Introduction: Normal and regular menstrual cycle is an important physiological function that indicates valuable information about women reproductive health, as well as the overall health. A lifestyle pattern could have influence on hormone activity and potential impact on menstrual regularity. Menstrual abnormalities are very common among adolescents. Aim: The aim of this study was to explore if the change of everyday habits, during pandemic, had an influence on hormone activity and menstrual regularity among young women. Material and methods: This study included 169 girls, from 15 to 25 years old, that were doing questionnaire based on menstruation characteristic and daily habits in period from December 2019 to October 2020. Average duration of menstrual cycle, before and during SARS-CoV-2 pandemic, was analyzed. Results: Average time of menarcha was age 12. During 2019, 17.2% of respondents had irregular menstrual cycle. Change of dietary habits, in the time of pandemic, was reported by 30% of girls and sleep habit by 35.5%. Additionally, 44% of them had less activities for school and 77% girls spent more time on their mobile phones. Conclusion: Analyzing data from menstrual history of examined girls, there was no statistically significant difference in menstrual cycle duration during pandemic, comparing it to previous period, despite the change of daily habits.

: Menarche, among Adolescence girls, signifies the adaptation to womanhood as it is associated with pubertal changes and beginning of the capacity to reproduce. This is a period of gonadal development and growth spurt. Menstrual hygiene is crucial to healthy reproductive system and in return to good physical health and wellbeing. Therefore, enhanced awareness regarding menstruation and related hygiene, right from adolescence may escalate safe practices that are helpful in alleviating the distress of millions of women.: To assess the knowledge and practices related to menstruation and menstrual hygiene among adolescent girls of selected schools of District Ambala, HaryanaA descriptive cross sectional study was conducted in selected schools of Mullana and Barara District Ambala, Haryana. Total enumeration sampling technique was used to enroll 192 adolescent girls from class 9 to class 12 from selected schools after obtaining written informed consent from parents and verbal consent from girls. Ethical clearance was obtained from Institute Ethics committee. Doubts of the participants were cleared after data collection.Among 192 girls, nearly half girls were aware of menstrual hygiene and reported use of sanitary nepkins and 40.1% girls were aware of the symptoms of poor menstrual hygiene. . There is a need to implement an education program for adolescent girls on menstruation and menstrual hygiene to ensure healthy menstrual practices.

: Menarche, among Adolescence girls, signifies the adaptation to womanhood as it is associated with pubertal changes and beginning of the capacity to reproduce. This is a period of gonadal development and growth spurt. Menstrual hygiene is crucial to healthy reproductive system and in return to good physical health and wellbeing. Therefore, enhanced awareness regarding menstruation and related hygiene, right from adolescence may escalate safe practices that are helpful in alleviating the distress of millions of women.: To assess the knowledge and practices related to menstruation and menstrual hygiene among adolescent girls of selected schools of District Ambala, HaryanaA descriptive cross sectional study was conducted in selected schools of Mullana and Barara District Ambala, Haryana. Total enumeration sampling technique was used to enroll 192 adolescent girls from class 9 to class 12 from selected schools after obtaining written informed consent from parents and verbal consent from girls. Ethical clearance was obtained from Institute Ethics committee. Doubts of the participants were cleared after data collection.Among 192 girls, nearly half girls were aware of menstrual hygiene and reported use of sanitary nepkins and 40.1% girls were aware of the symptoms of poor menstrual hygiene. . There is a need to implement an education program for adolescent girls on menstruation and menstrual hygiene to ensure healthy menstrual practices.

Background: The menstrual cycle, which occurs on a monthly basis from menarche to menopause and facilitates fertilization and conception, is a normal function in the female reproductive system. A 28-day cycle is the typical length. Any variations from the typical menstrual cycle in terms of frequency, irregularity of onset, duration of flow, or volume of blood are referred to as menstrual abnormalities. Aim: The current study set out to evaluate nursing students’ awareness regarding menstrual abnormalities. Materials and Methods: In a descriptive study of the quantitative method, the sample of 100 female students was conducted at the University of Sulaimani/Nursing College from January 15 to May 30, 2024. A questionnaire format was created according to the aim of the study and delivered by a team of six experts, consisting of three parts. Part one: sociodemographic characteristics of students. Part two: Menstrual patterns of students. Part three. Awareness of students regarding menstrual abnormalities. Data were collected by direct interviews with the students. Statistical Package for the Social Science version 22 was used for analyzing the data. The frequency, percentage, and Chi-square test were used. Results: Results of the present study indicated that the highest percentage of participants were in the age group (20–24); they mostly dwelled in dormitory. Financial state for the majority was sufficient and the vast majority were unmarried. The majority of participants experienced painful menstruation which affected their academic performance. Moreover, only one-fifth of participants had a high awareness regarding menstrual abnormalities. Finally, the study showed that there was a significant association between the group age of students and their awareness regarding menstrual abnormalities. Conclusion and Recommendations: The research concludes that the majority of participants demonstrated low awareness of menstrual abnormalities. Information, education, and awareness programs need to be strengthened to spread awareness regarding menstrual abnormalities.

ABSTRAK Masa remaja menjadi perhatian penting terlebih pada usia remaja awal yang akan memasuki usia menarche. Kebersihan pada saat menghadapi menstruasi sangat perlu untuk diketahui karena bisa menajaga Kesehatan reproduksi remaja sampai seterusnya. Hal ini dapat dicegah dengan menerapkan manajemen kebersihan menstruasi yang baik. Manajemen Kebersihan Menstruasi yang salah dapat menimbulkan berbagai masalah baik itu jangka pendek ataupun jangka Panjang. Manajemen Kebersihan Menstruasi (MKM) adalah pengelolaan kebersihan dan kesehatan pada saat perempuan mengalami menstruasi. Untuk meningkatkan pengetahuan kesehatan tentang Manajemen Kebersihan Menstruasi (MKM) pada Remaja putri terlebih khusus yang akan memasuki usia menarche sebagai pengetahuan dasar dalam Penerapan Prilaku Menjaga Kebersihan Diri dan Lingkungan. Edukasi ini berupa penyuluhan yang dilakukan secara offline pada remaja yang berjumlah 18 orang di Desa Wae Kanta. Media yang mendukung kegiatan adalah materi power point dan video , leaflet, LCD. Pelaksanaan dilakukan dengan membagikan kuisoner sebelum dan sesudah penyuluhan. Pada saat pre test sebagian besar responden memiliki pengetahuan yang kurang tentang manajemen kebersihan menstruasi yaitu 89% dan setelah dilakukan penyuluhan Sebagian besar remaja putri memiliki pengetahuan baik yaitu 72% dengan jumlah 13 orang. Terdapat peningkatan pengetahuan remaja putri sebelum dan sesudah dilakukan penyuluhan. Kata Kunci: Manajemen Kebersihan Menstruasi, Remaja Putri, Usia Menarche ABSTRACT Adolescence is an important concern, especially in early teens who are about to enter menarche. It is very important to know about hygiene when facing menstruation because it can maintain the reproductive health of adolescents and beyond. This can be prevented by implementing good menstrual hygiene management. Improper Menstrual Hygiene Management can cause various problems, both short and long term. Menstrual Hygiene Management (MKM) is the management of hygiene and health when women experience menstruation. To increase health knowledge about Menstrual Hygiene Management (MKM) in young women, especially those who are about to enter menarche, as basic knowledge in implementing behavior to maintain personal and environmental hygiene. This education takes the form of counseling conducted offline for 18 teenagers in Wae Kanta Village. Media that support activities are power point and video materials, leaflets, LCD. Implementation was carried out by distributing questionnaires before and after the counseling. During the pre-test, most of the respondents had poor knowledge about menstrual hygiene management, namely 89% and after counseling, most of the young women had good knowledge, namely 72% with a total of 13 people. There was an increase in the knowledge of young women before and after the counseling was carried out. Keywords: Menstrual Hygiene Management, Teenage Girl, Menarche Age

Abstract Introduction Abnormal uterine bleeding is more frequent in adolescence. Although, most commonly, it has a non-structural etiology, it may be due to any cause described. Clinical case A 12-year-old adolescent, with no relevant personal history, menarche 1 month before, was observed in the emergency department for severe menstrual bleeding with progressive worsening, and hemodynamic repercussion in need of transfusion support. Physiological ovulatory dysfunction associated with possible previously unknown coagulopathy was considered to be the most likely diagnosis and medical treatment was initiated. Without response, the patient was submitted to sedated observation and uterine aspiration, which ultimately led to the diagnosis of a Burkitt Lymphoma. Discussion Although structural causes, and particularly malignancy, whether gynecological or not, are a rare cause of abnormal uterine bleeding in this age group, they must be considered, thus enhancing the fastest and most appropriate treatment.

Background: The aim of the study was to evaluate average age of menarche, the pattern and types of menstrual disorders and their relation with BMI, dietary habits, physical exercise and stress.Methods: A cross sectional prospective study was conducted on female medical students during the academic year 2018-2019 at Mallareddy medical college for women, Suraram, Hyderabad, India. The various life style factors including BMI, junk food consumption and physical exercise were factored. Prevalence of each different menstrual abnormality were identified and analyzed by Chi-squire test and p value <0.005 was considered as statistically significant.Results: Study included 255 medical students who had attained menarche without known medical problems. Mean age of menarche was 12.81years. The most frequent menstrual disorders were premenstrual syndrome 192 (75 %), dysmenorrhoea 146 (57 %), and irregular cycle 97(38%). Statistically significant association of Body mass index (BMI) related to premenstrual syndrome (PMS) and dysmenorrhoea was reported (both p<0.05). Similarly, statistically significant association of lack of physical activity had greater risk of premenstrual syndrome and dysmenorrhoea (both p<0.0001). Unhealthy dietary patterns had statistically significant higher risk for dysmenorrhoea (p<0.0001).Conclusions: In conclusion premenstrual symptoms, dysmenorrhoea and menstrual irregularities were more prevalent. Majority of symptoms were stress, pain abdomen, irritability, mood swings. Comprehensive education programs on lifestyle modifications like regular physical activities, promoting healthy eating habits should be emphasised to prevent menstrual abnormalities of young students as early as at school level.

Background: Adolescence period (10-19 years) is a transitional stage. Adolescents constitute 20% of the total population in India. Menarche marks the beginning of a multitude of physical, physiological, and psychological changes in the lives of the girls. During menstruation, hygiene-related practices are of considerable importance because lack of knowledge and poor menstrual hygiene practices makes them prone to reproductive tract infections.Methods: The study was carried out among 13-17 years adolescent girls studying in the Government Senior Secondary Schools at Nagkalan and Sohian Kalan and out of school adolescent girls of the same age group who were residents of these two villages. Base line information was collected from eligible girls and then IEC activities were conducted on menstrual hygiene practices. After three months the impact of IEC activities was assessed and valid conclusions were drawn.Results: 81.13% have attained menarche. 40.6% were using both sanitary pads and cloth, only 7.4% were using only cloth as menstrual absorbent. Almost 3/4th (72.27%) respondents used dumping into open space and pond as method of disposal for used absorbent and after intervention this percentage was decreased to 44.9%.Conclusions: After IEC activities a greater number of adolescent girls were aware regarding safe menstrual hygiene practices.

Dysmenorrhea is the most common complaint of menstrual pain during adolescence. Relevant risk factors for this condition include early menarche (<12). At this age, the reproductive organs have not fully developed, and the narrowing of the cervix can lead to pain during menstruation. The duration of menstruation may be influenced by continuous uterine contractions, which interrupt blood flow to the uterus. The length of the menstrual cycle plays a role in this, as a longer cycle leads to the release of more prostaglandins, causing pain. A family history of dysmenorrhea is an unmodifiable risk factor. This study aims to identify the predispositional factors that affect dysmenorrhea. The research design used is an analytical survey with a cross-sectional approach, which is a study aimed at exploring the correlation between causative factors and their effects, conducted simultaneously. The population consists of all students who experience menstrual pain. The sampling method used in this study was simple random sampling. The results show that the majority of subjects experienced dysmenorrhea, with 44 subjects (60,3%). Conclusion, there is a relationship between family history and exercise habits with the occurrence of primary dysmenorrhea, while no relationship was found between menarche age, menstrual duration, and nutritional status with the occurrence of primary dysmenorrhea.

Objectives: To assess the prevalence of menstrual abnormalities among medical students, and to explore its association with stress levels. Method: The cross-sectional study was conducted from May 18 to May 28, 2021, in Baghdad, Iraq, after approval from the ethics review committee of the College of Medicine, Mustansiriyah University, Baghdad, and comprised female medical students in Baghdad. Data was collected using simple random sampling technique and employed an online questionnaire that was distributed through e-mail. The questionnaire had 3 domains: demographic and anthropometric data, menstrual history, and psychological stress. The psychosocial stress levels was assessed using the Perceived Stress Scale-10. Data was analysed using SPSS 25. Results: There were 397 subjects with mean age 20.84±1.621 years (range: 17-24 years). Mean age of menarche was 12.65±1.399 years, mean body mass index was 22.71±6.369kg/m2 and the mean stress score was 22.71±6.016. Dysmenorrhea was seen in 369(92.9%) cases, and premenstrual symptoms in 391(98.5%). Dysmenorrhea, premenstrual syndrome and heavy bleeding were significantly associated with stress level (p<0.05). Conclusion: Most students had heavy bleeding and dysmenorrhea, which were severe enough to require analgesics. There was a significant association between high stress levels and the occurrence of menstrual abnormalities Key Words: Dysmenorrhea, Menarche, Premenstrual, Stress, Psychological, Analgesics

Background: Menstrual irregularity is the most common gynaecological disorder in all age group. Adolescence is a transitional period between childhood and adulthood and involves physical, biological and psychosexual changes and is characterized by hormonal changes. Aim of this study was to find out the prevalence of menstrual abnormality in college girls in Madurai and their association with their Body mass Index (BMI).Methods: A cross sectional study was conducted among 200 girls of age group 18-22 years in a college in Madurai after getting their consent from college authorities and students. All details regarding their age of menarche, type of menstrual disorder and their BMI, stress factors were collected. The results were compared using chi square test and the pattern of menstrual abnormality and its relation with BMI and with stress was obtained.Results: The average age of menarche was 13.38 years in our study, irregular cycle was present in 47.5%, dysmenorrhoea was the commonest disorder and accounts for 26% students requiring medical treatment. Underweight students have irregular cycles compared to other groups. Stress had a significant correlation with menstrual irregularity.Conclusions: Many students in our study was under obese category, lifestyle modification like regular exercise, avoiding junk food and promoting healthy eating habits should be emphasised among students to have a healthy life. Students should also be informed about menstruation, physiological changes and its importance.

Introduction: Adolescence is a significant period in the life of a woman. Menstruation is a naturally occurring physiological phenomenon in adolescent girls and premenopausal women. Menstrual hygiene and management is an insufficiently acknowledged issue and has not received adequate attention. The lack of menstrual hygiene among rural population is alarming, and there is a need for policy-making and awareness programs to be initiated. Aim: Hence the present study was aimed to compare the status of menstrual hygiene among rural and urban adolescent girls. Methods: A community-based cross-sectional study was carried out among 250 adolescent girls (rural & urban), aged between 13 to 19 years residing the in field practice area of IIMSR Medical College, Badnapur, Jalna. Data was analyzed by using MS Excel 2010. Results: Out of 250 participants, 48.8% girls from rural area and 51.2% from urban area. The mean age of the menarche was 12.3 ± 1.4 and 12.34 ± 1.43 in rural and urban girls, respectively. Knowledge of menstruation prior to menarche was found to be less in rural girls compared with urban girls. Regarding menstrual hygiene practices during menstruation, out of the total girls residing in rural area 49.18% girl and out of the total girls residing in urban area 62.5% girls were using sanitary pads. Restriction during menstruation was observed more in rural girls than in urban areas. Conclusion: More awareness regarding menarche and menstruation was among urban girls than. Hygienic practices observed by girls were also more satisfactory in the urban area as compared with rural ones.

Menstrual disorders mainly occur in late adolescence. This condition occurs in the first two years after menarche. This study aims to analyze daily physical activity and irregular menstrual disorders in students at the Faculty of Public Health, Halu Oleo University. The research design used was a cross-sectional study. The subjects in this research were students from the Faculty of Public Health, Halu Oleo University, class 2020-2022, who met the inclusion and exclusion criteria of 90 respondents. The results of this study showed that 50% of respondents were in the moderate physical activity category, and the majority (62.2%) experienced irregular menstrual disorders. The results of statistical analysis of physical activity on menstrual disorders obtained p-value=0.000 (p<0.05). This research concludes a significant relationship between physical activity and menstrual disorders in students at the Faculty of Public Health, Halu Oleo University. Female students need to control their physical activity to overcome menstrual disorders.

Background: Adolescence in girls has been recognized as a special period. Adolescents are a large and growing segment of the world’s population. Adolescence in girls is a turbulent period of development, which includes stressful events like menarche. Some of the special problems of adolescents are nutritional problems, menstrual disorders, leucorrhoea, and psychological problems. Though menstruation is a natural process, it is linked with several misconceptions and practices in India due to different rituals in the communities, which sometimes result in adverse health outcomes. The objective of the study was to assess the knowledge about menstrual hygiene among urban adolescent girls in Bareilly.Methods: The study was conducted in the urban area of Bareilly taking a sample size of 450 girls with multistage sampling technique.Results: About 40% of participants had complete knowledge regarding menstruation, 64.9% of participants regarded menstruation as a curse of God, and 35.6% of the participants perceived urethra as the main source organ for blood during menstruation.Conclusions: This research addressed the issues in managing their menstruation and maintaining a good standard of menstrual hygiene in adolescent girls.

Background: PCOS is an endocrine disorder affecting women across lifespan, initially a disease of the females in the child bearing age group, nowadays maximum adolescent females also present with PCOS. Adolescence PCOS is a heterogenous endocrine disorder diagnosed in 5% to 10% of adolescent girls and is one of the major causes of adolescent hyperandrogenism and menstrual irregularity. Thus, this study was carried out to study the effect of Metformin on adolescent patients with PCOS on Weight reduction and Regularization of Menstrual cycle. Secondary objective is to study the occurrences of various manifestations in patients with PCOS.Methods: Patients aged 10-20 years diagnosed PCOS attending the outpatient department of OBGY over a period of two years were included in the study. Out of 100 patients, 20 patients were excluded because of other causes of anovulation viz thyroid abnormalities, prolactin level abnormalities and patients who did not turn up for follow up. Study was done on 80 patients of PCOS. Patients were divided into two groups A and B. Group A (n=40) received 500 mgs Metformin and Group B (n=40) received placebo. Results were analysed using statistical package of social sciences (SPSS) 21.0. Statistical significance was set at p ≤0.05.Results: In the present study Irregular cycle was the commonest occurring menstrual irregularity. Menstrual Cycle was regularised in 95% of the study group while only 35% of the control group. 85% patients in the present test group had lost weight at the end of 6 months while only 55% in the control group had lost weight in 6 months. Thus A 6-month course of metformin improves menstrual cyclicity in women with the PCOS.Conclusions: In patients with PCOS, the addition of insulin sensitizers viz metformin along with diet and lifestyle modifications has resulted in significant weight loss and improvement in cyclicity of menstrual cycle. Thus, Insulin-sensitizing agents provide a rational approach to the treatment of the metabolic and endocrine abnormalities in PCOS women

AbstractAim: Analysis of the menstrual cycle and associated issues in adolescent girls.Material and Methods: This is a cross-sectional study was conducted in the Department of Pediatrics, IGIMS,Patna, Bihar, India. All the girls in the age group of 11-16 years, who had attained menarche & were willing toparticipate in the study, were included as study participants were included in the study. Pretested, semi-structuredquestionnaire consisted of issues like age at menarche, patterns and problems and hygienic practices related tomenstruation.Results: Mean age of menarche was 13.45±0.86, only one girl attained menarche at 11 year and majority attainedmenarche at 12to 14 years age group. When analyzed for inter-menstrual gap, majority 159 (75.7%) girls were inthe group of 21-35 days. Days of flow of blood was classified as less 3 days, 3-5 days and more than 5 days. Mostof the girls were in 3-5 days 155 (73.8%), few girls 10 (4.7%) in less than 3 days group and remaining were havingblood flow for more 5 days. In menstrual symptoms (Table 2), abdominal pain or cramps was experienced bymost of the girls 176 (83.8%), body ache was experienced by 64 (30.4%) and 56 (26.6%) were irritable duringcycle. Adolescent school girls were analyzed for hygienic practices during their cycle (Table 3). Sanitary padswere used by 174 (82.8%) girls and remaining used both sanitary napkins and cloth. Majority 160 (76.2%)changed their absorbent less than 4 times and remaining changed more than 4 times. Majority 150 (71.5%) cleanedtheir genitalia only with water during cycles and remaining cleaned with soap and water. Dysmenorrhea wasexperienced by 160 (76.1%) adolescent girls (Table 4). Irregular menstrual cycle was observed in 12(5.7%) andpolymenorrhea in 11 (5.2%). Some girls had experienced menorrhagia 14 (6.6%).Conclusion: The timely onset of menarche is a significant milestone in adolescence, indicating the properfunctioning of the female reproductive system. Three-fourths of the teenage females had normal blood flow lengthand cycle interval. Adolescent females often have menstrual issues. Dysmenorrhoea was the most prevalent issueamong teens. Adolescent females endure their suffering and see it as a typical occurrence. 

Abstract Introduction Adolescence in girls is a vulnerable transitional period, characterized by substantial hormonal and physical development, the onset of menarche, dramatic brain development and changes in behavior, including sleep. Menstrual problems, including painful menses, are common among female adolescents, and contribute to school absenteeism. They may also be symptoms of gynecological conditions, which can negatively affect reproductive and general health of women. Limited work has linked sleep disturbances and menstrual problems in adolescents. Here, we examined the association between sleep behavior and menstrual problems in a large sample of adolescent girls in the Adolescent Brain Cognitive Development (ABCD) Study®. Methods We fitted linear mixed effect models to examine the associations between sleep behavior and menstrual problems in 1837 post-menarcheal girls (Year 3, Mean-age = 13.03, [12-15] years), assessed as part of the ongoing ABCD Study®. Sleep was assessed with the Munich Chronotype questionnaire (youth-report) and the sleep disturbance scale for children (caregiver-report). Girls answered questions about menstrual cycles and associated problems. We considered age, time since menarche, BMI, use of hormonal contraceptives, and socio-demographic characteristics in the models. Results Short sleep duration was related to higher menstrual pain intensity (p<.01), irregular menstrual cycles (p<.01) and more premenstrual symptoms (p=.01). Higher total sleep disturbance score (caregiver-reported) was also associated with higher menstrual pain intensity (p<.01) and greater impact of menstrual pain on usual activities (p<.01). Participants with a later chronotype (p=.04) and later wake-up time (p=.02) were more likely to experience an irregular menstrual cycle. Later wake-up time was also related to higher menstrual pain intensity and impact on daily life (p<.01). Girls with recent menarche reported heavier menstrual flow (p=.02), higher menstrual pain intensity, more premenstrual symptoms, and a greater overall impact of menstrual pain on their usual activities (p<.01). Conclusion Our results indicate multiple associations between sleep behavior and menstrual problems in adolescent girls. Both menstrual problems and insufficient sleep/sleep disturbances are important for female adolescent health and should be routinely screened for by healthcare providers and school health education providers. Future work is needed with longitudinal analyses to determine directionality of the associations we found between sleep and menstrual problems. Support (if any) NIH U01DA041022