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Common Menstrual Problems Among Slum Adolescent Girls of Western Maharashtra, India Mohite RV1*, Mohite VR2, Kumbhar SM1, Ganganahalli P1 1Dept

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Common Menstrual Problems Among Slum Adolescent Girls of Western Maharashtra, India Mohite RV1*, Mohite VR2, Kumbhar SM1, Ganganahalli P1 1Dept JKIMSU, Vol. 2, No. 1, Jan-June 2013 ISSN 2231-4261 ORIGINAL ARTICLE Common Menstrual Problems among Slum Adolescent Girls of Western Maharashtra, India Mohite RV1*, Mohite VR2, Kumbhar SM1, Ganganahalli P1 1Dept. of Community Medicine, Krishna Institute of Medical Sciences, 2Krishna Institute of Nursing Sciences, Karad - 415539 (Maharashtra) India Abstract: (63.91%) had regular and 83(36.08%) had ir- Background: Menstruation, an important part regular menstrual cycle with mean age at me- of female reproductive cycle but menstrual narche by recall method was 12.8 yrs. The per- dysfunction in adolescent girls may affect nor- centage of common menstrual problems such mal life of adolescent and young adult women. as oligomenorrhea, menorrhagia, metrorrhagia, Objectives: To assess the percentage of com- hypomenorrhea, dysmenorrhea, and premen- mon menstrual problems among adolescent strual syndrome were 16.08%, 17.82%, 27.39%, girls from urban slums and to determine the cor- 59.56%, 49.13% and 46.52% respectively, relation between common menstrual problems however amenorrhea ( primary ) was seen in 3 with nutritional status of these girls. Method- (0.01%) girls. Prevalence of undernutrition and ology: A cross sectional study was conducted anemia was 40.86% and 60.43%. Health seek- among adolescent girls residing in urban slum ing behavior for common menstrual problem area under the field practice area of Krishna In- was seen in only 25.75% girls. Oligomenor- stitute of Medical Sciences Karad of western rhea, menorrhagia, hypomenorrhea, dysmenor- Maharashtra, India during the month of Novem- rhea, and premenstrual syndrome were signifi- ber - December 2011. 237 adolescent girls, cantly associated with anemia; however BMI age between 12-19 years were interviewed and was significantly associated with dysmenorrhea, examined using pretested semi-structured ques- hypomenorrhea and premenstrual syndrome. tionnaire. Data was collected by researchers Conclusion: Menstrual health is fundamental with the help of Medical Officer and Medical to womens sexual and reproductive health. The Social Worker of Urban Health Training Cen- present study has observed mean age at me- ter by personal interview and clinical examina- narche of 12.8year and prevalence of undernu- tion method. Data was compiled and presented trition and anemia as 40.86% & 60.43% re- into frequency percentage distribution. Chi- spectively. Poor nutritional status and anemia square test was applied to determine the asso- were associated with common menstrual prob- ciation between common menstrual problems lems among adolescent girls from slum area. with body mass index and anemia. Results: Out Key words: Menstrual problems, BMI, Ane- of total 237 adolescent girls, 230 (97.04%) had mia, Adolescent girls attained menarche of which, 147 girls Ó Journal of Krishna Institute of Medical Sciences University 89 JKIMSU, Vol. 2, No. 1, Jan-June 2013 Mohite R V et al Introduction: poor access of health care services lead to a Menstrual problems are generally perceived as high morbidity and mortality among the women only minor health concern and thus irrelevant in reproductive age group (15-45 yrs.) resid- to the public health agenda particularly for ing in slum area [3,4]. Various factors such as women in developing countries who may face heredity, environmental conditions, body stat- life threatening conditions. Menstrual cycle is ure, socioeconomic status, nutritional and normal physiological process that is character- health status, family size, level of education, ized by periodic and cyclic shedding of en- and psychological well being are known to in- dometrium accompanied by loss of blood which fluence the age of menarche and common men- is a vital sign for assessment of normal devel- strual problems, which are diagnosable and opment in adolescent and young girls. World mostly treatable even at peripheral level in early Health Organization has defined adolescence stage, but this part of womens health is often as a period between 10-19 years. In Indian con- ignored by primary health care in India. text, adolescents constitute over 21.4% of the In view of this, a study to estimate the frequency total population and this age group needs spe- percentage of common menstrual problems cial attention because this period is very cru- faced by urban slum dwalling adolescent girls cial since these are the formative years in the and to assess the influences of anemia and nu- life of an individual when major physical, psy- tritional status on common menstrual problems chological and behavioral changes take place was undertaken. The health information obtained and additional roles and responsibilities are from the present study will be useful in orga- expected from them [1, 2]. A vast majority of nizing and modifying health programme activi- adolescent girls in India are suffering from ties for young females with a view to improve reproductive health morbidities which may reproductive health of women. affect normal life of adolescent and young adult Methodology: women. Physical, mental, social, psychologi- A cross sectional study was undertaken in cal and reproductive problems are often asso- urban slum area under field practice area of ciated with menstrual irregularities and men- Krishna Institute of Medical Sciences (KIMS) strual problems. The literature available in In- Karad, Maharashtra, India during the month of dia and abroad mainly highlights the reproduc- November-December 2011. Urban Health tive problems among adolescent girls residing Training Centre (UHTC) under Dept. of Com- in rural and urban establishments, however lit- munity Medicine, KIMS provides health care erature for slum dweller adolescent girls was services to urban slum dwellers. At the time of very scanty. Due to lack of health care facili- study total 237 unmarried adolescent girls were ties in slum area, poverty, ignorance, malnutri- found in the study area, of which 230 had at- tion, poor knowledge of health and diseases, tained menarche, however 7 had not. Study tool low level education, cultural taboos and belief, included pretested semi-structured question- poor standard of living, male dominance and Ó Journal of Krishna Institute of Medical Sciences University 90 JKIMSU, Vol. 2, No. 1, Jan-June 2013 Mohite R V et al naire, weighing machine, height measuring height in m2 respectively [5, 6]. scale, hemoglobin assessment kit used to col- Haemoglobin: was estimated by Sahlis lect data. Prior to data collection, aim of the method using a haemoglobinometer. present study was explained and verbal consent It is simple, reliable, inexpensive and effec- was obtained from parents as well as the ado- tive medical device recommended by World lescent girls. Health Organization (WHO) for accurate esti- Data was collected by investigator with the help mation of haemoglobin levels in blood [5]. The of UHTC team which included medical officer blood samples were collected by trained UHTC (female), gynecologist (female), medical laboratory technician by a finger prick method social worker, Lab technician and helper. The and haemoglobin concentration was estimated. pretested semi-structured questionnaire which According to WHO, anemia was classified as included questions related to menstruation, and mild, moderate and severe as hemoglobin con- other study parameters related to health seek- centration range between 10 -12, 7 -10 and less ing behavior. Study subjects were referred to than 7gm% respectively [7]. the UHTC with their family members on sched- Cases were treated adequately at UTHC and uled date and time and information was collected Krishna Hospital Karad. by face to face interview and clinical examina- Analysis: tion by experts. Information about the men- strual history and date of menarche was col- The data so collected were compiled in MS lected by recall method. Excel and analyzed into tabular and graphical form. Chi-square test was used to assess the Measurements: statistical association between common men- Weight was measured in kilogram, without foot strual problems and nutritional status. wear using a regularly standardized beam bal- Common menstrual problems definitions ance during study period having a precision of used to collect data [8, 9, 10, 11]: 0.1kg. Checks on the scale were made routinely Regular menstrual cycle: Cycle that occurs before recording the weight of each girl. every 28 ± 2-3 days in which the menstrual flow Height was also taken barefooted in centime- lasts for 3-5 days with an average flow of 50- ter using standard measuring tape fixed verti- 200 ml. cally and care was taken to see that there was no Irregular menstrual cycle: any deviation fold or tilting to any side. Height was recorded from cyclic occurrence of menstrual cycle i.e. to the nearest 1 cm to avoid possible error. 28 ± 2-3 days. Body Mass Index (BMI) was calculated as Amenorrhea (primary): total absence of weight in kg/height in m2. According to BMI, menstruation in girls upto the age of completed nutritional status was classified as overweight 16 years. (over nourished), normal and undernourished Oligomenorrhea: very light menstruations, as BMI more > 25, 18.5-24.99 and < 18.5 kg/ usually 4-9 periods per year. Ó Journal of Krishna Institute of Medical Sciences University 91 JKIMSU, Vol. 2, No. 1, Jan-June 2013 Mohite R V et al Menorrhagia: denotes bleeding, which is ex- Fig 1: Pattern of Menstrual cycle cessive in amount i. e .>500ml ( soaked pads > 5/day) or periods that last longer than 7 days. Metrorrhagia: breakthrough
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