Primary Dysmenorrhea and its Impact on Academic Performance Among Adolescent Females- A Cross Sectional Study.
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Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 4, 2021, Pages. 13681 - 13689
Received 05 March 2021; Accepted 01 April 2021.
Primary Dysmenorrhea and its Impact on Academic Performance Among
Adolescent Females– A Cross Sectional Study.
1
Dharshini, 2*A.V.Anuja, 3A.Sangeetha, 4
Hemachandrika C
1
I MBBS, Saveetha Medical College, Chennai, Tamilnadu, India.
2*
Department of Physiology, Saveetha medical College and hospital, Chennai, Tamilnadu,
India.
3
Department of Physiology, Saveetha medical College and hospital, Chennai, Tamilnadu,
India.
4
Department of Physiology, Saveetha medical College and hospital, Chennai, Tamilnadu,
India.
*
Corresponding author
Name: Dr. A. V.Anuja
ABSTRACT:
Introduction: Menstrual cycle is an important indicator of women's reproductive health.
Primary dysmenorrhea (PD) is the most common of gynaecologic complaints. It affects half
of all female adolescents today and represents the leading cause of periodic college/school
absenteeism among that population. Aim: The aim is to assess the association between
dysmenorrhea and academic performance. Materials and Method: A cross sectional study
was conducted among 103 adolescent females. The participants were asked to complete a
self-reported questionnaire. Questions were related to menstruation elucidating variations in
menstrual patterns, history of dysmenorrhea and its severity, pre-menstrual symptom and
absenteeism from college and /or class; participants were given 30 minutes to complete the
questionnaire. Result: Pearson Chi-square test revealed that severity of pain among
dysmenorric students had effect on their class absenteeism (x2 = 15.7, pAnnals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 4, 2021, Pages. 13681 - 13689
Received 05 March 2021; Accepted 01 April 2021.
Dysmenorrhea refers to the occurrence of painful menstrual cramps of uterine origin. It is the
most common gynaecologic complaint in adolescents and young women [1]. Majority of
women experience some degree of cramping, especially in the first year of their reproductive
life (2). Pain may radiate to the back of the legs or the lower back. Menstruation is associated
with nausea, vomiting, diarrhoea, headache, weakness and major symptoms, including pain,
adversely affects daily life and school performance, causing recurrent short-term school
absenteeism among female adolescents [3] Primary Dysmenorrhea (PD) is a key women’s
health burden [4] and is also one of the public problems in the world [5].
Global statistical data shows that 51% of the population comprises of female adolescents
(6,7). Globally, the prevalence rates have been reported to be as high as 90% and as low as
43% (8,9). Primary dysmenorrhea is the leading cause of work or school absenteeism in
women and a leading cause of recurrent short-term school absenteeism among adolescent
girls [10]. Several research findings showed that the proportions of PD and/or dysmenorrhea
in young females are higher. Dysmenorrhea is highly prevalent among female medical
students; it is related to college/class absenteeism, limitations on social, academic, sports and
daily activities. Maximum participants do not seek medical advice and self treat themselves
with prostaglandin inhibitors; like Ibuprofen [11,12]. The lacunae identified were that there is
little attention given to the need to compensate lost classes and improve poor performance of
the students suffering from dysmenorrhoea. Therefore, this study aimed to assess the
prevalence of dysmenorrhea and its effect on academic performance and seek appropriate
strategy as a remedy.
MATERIALS &METHODS:
Institutional basedcross sectional study was conducted among medical undergraduates in
Saveetha Medical College & Hospital to assess the prevalence of dysmenorrhoea, its effect
on academic performance among female students. The study proposal was approved by the
board of the institute (SMC/IEC/2019/01/IRB23). The study performed on a total of 250 girls
with age range between 17-24yrs. Participants with endocrine disorders, bleeding disorders,
and hypothyroidism were excluded from the study. A structured questionnaire comprising of
20 items were developed, which included menarche age, anaemia before 6 months, exercise
routine, menstrual pain, pain intensity, menstrual symptoms. In addition, questions about
whether dysmenorrhoea affects their routine physical activities and academicperformance
http://annalsofrscb.ro 13682Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 4, 2021, Pages. 13681 - 13689
Received 05 March 2021; Accepted 01 April 2021.
were also solicited. The study was conducted maintaining the anonymity and confidentiality
of the participants.
Data analysis:
Statistical analysis was done using SPSS Version 22.0. Descriptive variables were
reported (Mean with standard deviation, Percentage) for all demographic variables. Chi-
square test was used to assess association between pain intensity and working ability. The
significance level was set at 0.05.
RESULT:
The majority of the participants, around 51% of the girls were 18 years, and in the remaining
population, 36% were of 19 years, 9% were of 20 years, 2% were of 17 years, and the rest
were 21-24 years. The average age of the majority of the participants [54%] were between
13-14 years. And the rest 29% started menstruating in the age 10-12 years and 17% started
menstruating at the age of 15-17 years. Majority of participants [82.5%] have reported
menstrual pain and 17.5% have reported to not have any menstrual pain. And those
participants who have menstrual pain seems to have 1-2 days pain in majority [40%], and the
rest 30% have pain for one day, 15% have pain for 2-3 days,3% have pain for 3 days and the
rest 12% unaffected [Table 1].
Only 4% of the total participants take analgesics such as acetaminophen, ibuprofen, or
naproxen. And 9% of the participants take home medications like fenugreek seeds, brown
sugar water, hot pack, etc., Majority of the participants have menstrual symptoms that is
almost 55% of them, and the rest 45% show no symptoms. And females with menstrual
symptoms show back pain, mood swings, menstrual cramps, breast soreness, face puffiness,
headache, lower abdominal pain before and in the course of menstruation, leg aches, acne,
pimples, etc., [Table 2]. Around 61% of the participants have reported that due to menstrual
symptoms their working ability has been moderately affected and 34% of them it has not
been an issue and the rest 5% it is completely inhibited. It also affects the academics, 21% of
the participants have reported taking a day leave from classes due to the menstrual symptoms
and 9 % with half day leave, and 3% with 2 days of absenteeism, and the rest unaffected
[Table 3]. Because of these the participants have also been suffering from lagging of topics
and also lack of concentration in studies.
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Received 05 March 2021; Accepted 01 April 2021.
Table 1: Details of Prevalence, severity and symptoms of dysmenorrhea among female
students
PARAMETER NUMBER PERCENTAGE Mild Mod Severe
Age 17 3 2.91 26 28 1
18 51 49.51
19 37 34.95
20 10 9.70 1 28 15
21 1 0.97
23 1 0.97 1 0 4
Religion Hindu 80 77.7
Christian 12 11.65
Muslim 4 3.88
Others 7 6.8
Family Nuclear 86 83.5
Joint 16 15.53
Extended 1 0.97
SES High 20 19.41
Medium 75 72.81
Low 8 7.8
Family history Yes 52 50.48
in
Menstrual pain
No 51 49.51
Menarche age 10-12 30 29.12
13-14 56 54.36
15-17 17 16.50
Anemia Yes 18 17.47
(before six
months)
No 85 82.52
Exercise Yes 28 27.18
No 17 15.53
Sometimes 60 57.28
Table 2: Details of Menstrual Pain, Pain Length, Pain Intensity Among Female
Adolescents:
PARAMETER NUMBER PERCENTAGE
Menstrual Pain Yes 85 82.52
No 18 17.47
Pain length 1 day 31 30.1
1-2days 41 39.80
2-3 days 15 14.56
http://annalsofrscb.ro 13684Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 4, 2021, Pages. 13681 - 13689
Received 05 March 2021; Accepted 01 April 2021.
Entire period 4 3.88
Nil 12 11.65
Pain intensity Mild 26 25.24
Moderate 57 55.33
Severe 20 19.41
Menstrual symptoms Yes 57 55.33
No 46 44.66
Frequency of Less frequently 26 25.24
dysmenorrhea
More frequently 36 34.95
Rarely 41 39.08
Taking analgesics Yes 4 3.88
No 90 87.37
Sometimes 9 8.73
Absenteeism Unaffected 68 66.01
½ day 9 8.73
1 day 22 21.35
2days 3 2.9
3 days 1 0.97
Working ability Moderately 63 61.2
affected
Unaffected 36 34
Clearly inhibited 7 5
Table 3: Association between pain intensity and working ability among female students:
Paramete Pain intensity
r
Paramet N Mild Moderate Severe Chi p Value
er square
Age 17-18 yrs 52 13(10.81) (0.44) 30(26.77) (0.39) 9(14.42) (2.03) .17208
(Yrs) 19-20 yrs 45 7(9.36) (0.59) 20(23.17) (0.43) 18(12.48)(2.45) 6.386
21-24 yrs 4 1(0.83)(0.03) 2(2.06) (0.00) 1(1.11) (0.01)
Menarch 10-12 yrs 30 8(7.50)(0.03) 10(15.87)(2.17) 12(6.63)(4.34)
e age 13-14 yrs 57 12(14.25)(0.36) 35(30.14)(0.78) 10(12.61)(0.54) 11.076 .0257**
15-17 yrs 17 6(4.25)(0.72) 10(8.99)(0.11) 1(3.76)(2.03
SES Low 8 1(1.96)(0.47) 5(4.31)(0.11) 2(1.73)(0.04) .3935
Medium 74 21(8.14)(0.45) 40(39.90)(0.00) 13(15.96)(0.55) 4.092
High 20 3(4.900(0.74) 10(10.78)(0.06) 7(4.31)(1.67)
Anemia No 85 20 (20.43)(0.01) 48(45.77)(0.11) 17(18.80)(0.17) 1.586 .4523
Yes 19 5(4.57)(0.04) 8(10.23)(0.49) 6(4.20)(0.77)
Exercise Yes 28 9(6.19)(1.27) 12(13.38)(0.14) 7(8.42)(0.24) 11.306 .0233**
http://annalsofrscb.ro 13685Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 4, 2021, Pages. 13681 - 13689
Received 05 March 2021; Accepted 01 April 2021.
No 16 2(5.75)(2.45) 10(12.42)(0.47) 14(7.82)(4.88)
Sometimes 59 14(13.05)(0.07) 32(28.19)(0.51) 13(17.75)(1.27)
Absentee 2days 4 1(1.01)(0.00) 1(10.89)(0.07) 2(1.01)(0.97)
ism 1day 22 1(5.55)(3.73) 10(10.89) 11(5.55)(5.34) 15.725
Half day 9 3(2.27)(0.23) 3(4.46)(0.48) 3(2.17)(0.23) .0153**
unaffected 68 21(17.17)(0.86) 37(33.670(0.33) 10(17.17)(2.99)
1.Moderately 63 8(18.49)(5.95) 35(25.34)(3.69) 20 (19.17)(0.04) .0233**
Working Affected 36 18(6.46)(20.64) 1(8.85)(16.96) 3(6.70)(2.04) 44.887
Ability 2.Unaffected 7 1(2.05)(0.54) 1(2.82)(1.17) 5(2.15)(3.87)
3.Clearly
Inhibited
**Table 3 shows a statistically significant values between pain intensity and absenteeism and
working ability (pAnnals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 4, 2021, Pages. 13681 - 13689
Received 05 March 2021; Accepted 01 April 2021.
examine the relation between the academic performance and the prevalence of dysmenorrhea,
as for absenteeism to classes in the present study the chi square value is
(x2=15.725;p=0.0153) , whereas the previous study is much higher than the observed value.
Females who suffered from moderate to severe dysmenorrhea are most likely to take leave
for a day and very few females have taken leave for 2 days. This affects their academic
performance in varied ways. Absenteeism was commonly encountered during dysmenorrheic
period. The chi square test done for the working ability the value of chi square is (x2=44.87;
pAnnals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 4, 2021, Pages. 13681 - 13689
Received 05 March 2021; Accepted 01 April 2021.
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