Published: 2021-08-27

Prevelance of symptoms during menstruation and its management among adolescent girls

Angitha Saji, Krupa Ann Sunil, Agatha Mary John, Abhilash Kumar B., Abel Abraham Thomas


Background: Menstruation is a natural phenomena of the female reproductive cycle in which discharge of blood from the uterus exits through the vagina every month, it is the spontaneous onset of puberty. 75% of girls confront some problems associated with menstruation including delayed, irregular, painful and heavy menstrual bleeding. Menstruation can be accompanied with premenstrual and postmenstrual symptoms which include both physiological symptoms and psychological symptoms. It is important to treat both physiological and psychological symptoms with pharmacological and nonpharmacological treatment approaches.

Methods: The study was a prospective observational study done with a sample size of 650 subjects of 9 to 18 age group in whom menstruation already occurred were recruited from five different schools in regions of Pathanamthitta and Alappuzha. The study was conducted in 3 phases, where initially a predesigned well-structured questionnaire was provided to assess the attitude, awareness and practices.

Results: Subjects experienced some or other type of symptoms and had better knowledge regarding menstrual symptoms and its importance of management when compared to subjects from other regions of India which was imparted from a developed and supporting society but still, they lacked some adequate and updated information on symptoms and management of symptoms during menstruation.

Conclusions: So, this study laid the groundwork for discussion on menstrual symptoms, various approaches of treatment to the adolescent girls, providing them the information they lacked and better guidance.


Premenstrual symptoms, Post menstrual symptoms, Menstrual pain, Physiological symptoms, Psychological symptoms, Home remedies

Full Text:



Clevel and Clinic. Normal menstruation. Available at: Accessed on 22 June 2021.

Period pains: Can anti-inflammatory drugs help? Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006.

Healthline. Fact sheet: Home remedies to relieve menstrual pain, 2020. Available at: Accessed on 1 June 2021.

Healthline. Fact sheet: What causes nausea before your period, and how is it treated? Available at: Accessed on 1 June 2021.

Healthline. Fact sheet: Why do I get diarrhea during my period? Available at: Accessed on 1 June 2021.

Jo J, Lee SH. Heat therapy for primary dysmenorrhea: a systematic review and meta-analysis of its effects on pain relief and quality of life. Sci Rep. 2018;8(1):16252.

Khayat S, Kheirkhah M, Moghadam ZB, Fanaei H, Kasaeian A, Javadimehr M. Effect of treatment with ginger on the severity of premenstrual syndrome symptoms. ISRN Obstet Gynecol. 2014;2014:792708.

Rahnama P, Montazeri A, Huseini HF, Kianbakht S, Naseri M. Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmenorrhea: a placebo randomized trial. BMC Complement Altern Med. 2012;12:92.

Jaafarpour M, Hatefi M, Najafi F, Khajavikhan J, Khani A. The effect of cinnamon on menstrual bleeding and systemic symptoms with primary dysmenorrhea. Iran Red Crescent Med J. 2015;17(4):27032.

Gebeyehu MB, Mekuria AB, Tefera YG, Andarge DA, Debay YB, Bejiga GS, et al. Prevalence, impact, and management practice of dysmenorrhea among university of gondar students, Northwestern Ethiopia: a cross-sectional study. Int J Reprod Med. 2017;2017:3208276.

Padubidri VG, Daftar S. Dysmenorrhea and pre-menstrual syndrome. Shaw's Textbook of Gynecology. 16th ed. New Delhi: Reed Elsevier India Private Limited; 2014: 471-4.

Patel V, Tanksale V, Sahasrabhojanee M, Gupte S, Nevrekar P. The burden and determinants of dysmenorrhoea: a population-based survey of 2262 women in Goa, India. BJOG. 2006;113(4):453-63.

Poureslami M, Ashtiani FO. Assessing knowledge, attitudes, and behaviour of adolescent girls in suburban districts of Tehran about dysmenorrhea and menstrual hygiene. J Int Women Studies. 2002;3(2):51-61.

Armour M, Parry K, Al-Dabbas MA, Curry C, Holmes K, MacMillan F, et al. Self-care strategies and sources of knowledge on menstruation in 12,526 young women with dysmenorrhea: a systematic review and meta-analysis. PLoS One. 2019;14(7):0220103.

Chia CF, Joyce HY, Lai JHY, Cheung PK, Kwong LT, Lau FPM, et al. Dysmenorrhoea among Hong Kong university students: prevalence, impact and management. Hong Kong Med J. 2013;19(3):222-8.

Alsaleem MA. Dysmenorrhea, associated symptoms, and management among students at King Khalid University, Saudi Arabia: an exploratory study. J Family Med Prim Care. 2018;7(4):769-74.

Avasarala AK, Panchangam S. Dysmenorrhoea in different settings: are the rural and urban adolescent girls perceiving and managing the dysmenorrhoea problem differently? Indian J Community Med. 2008;33(4):246-9.

Zhang WY, Po LW. Efficacy of minor analgesics in primary dysmenorrhoea: a systematic review. Br J Obstet Gynaecol. 1998;105(7):780-9.

Marjoribanks J, Ayeleke RO, Farquhar C, Proctor M. Non-steroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev. 2015;2015(7):001751.

Tangchai K, Titapant V, Boriboonhirunsarn D. Dysmenorrhea in Thai adolescents: prevalence, impact and knowledge of treatment. J Med Assoc Thai. 2004;87(3):69-73.

Marchini M, Tozzi L, Bakshi R, Pistai R, Fedele L. Comparative efficacy of diclofenac dispersible 50 mg and ibuprofen 400 mg in patients with primary dysmenorrhea. A randomized, double-blind, within-patient, placebo-controlled study. Int J Clin Pharmacol Ther. 1995;33(9):491-7.

Wijesiri HSMSK, Suresh TS. Knowledge and attitudes towards dysmenorrhea among adolescent girls in an urban school in Sri Lanka. Nurs Health Sci. 2013;15(1):58-64.

Vani RK, Veena KS, Kumar VRH, Bupathy A. Menstrual abnormalities in school going girls-are they related to dietary and exercise pattern. J Clin Diagn Res. 2013;7(11):2537-40.

Nagar S, Aimol KR. Knowledge of adolescent girls regarding menstruation in tribal areas of Meghalaya. Studies Tribes Tribals. 2010;8(1):27-30.

Agarwal AK, Agarwal A. A study of dysmenorrhea during menstruation in adolescent girls. Indian J Commun Med. 2010;35(1):159-64.

Zeraati F, Shobeiri F, Nazari M, Araghchian M, Bekhradi R. Comparative evaluation of the efficacy of herbal drugs (fennelin and vitagnus) and mefenamic acid in the treatment of primary dysmenorrhea. Iran J Nurs Midwifery Res. 2014;19(6):581-4.