INTRODUCTION:

Health is Wealth goes the saying. Health is an essential factor for a happy contented life. Based on the Alma – Ata’s declaration, much emphasis is being placed on health promotion and preventive health care.

Encouraging people to adopt healthy life styles and appropriate coping a strategy is the key aim in health promotion.

Adolescent girls constitute one fifth of the female population in the world. Generally this group is considered healthy and has not been given adequate attention in health programmes. The reason is age specific mortality is comparatively low in this age group as compared to others. In countries like India, adolescent girls face serious health problem due to socio-economic, environmental conditions and gender discrimination. These factors make them more vulnerable to health risks.

Menstruation is a landmark in every woman's life. It is a major physical event that transmits the female from girlhood to womanhood. Its onset may occur as early as 9 years or as late as 17 years, but age 12 is the average. Menstrual cycles are not always regular or stable; they may be disturbed by many disorders which commonly occur at the extremes of reproductive age. The causes of menstrual disorders can be triggered by a number of different factors, such as hormone imbalances, genetic factors, blood clotting disorders, and pelvic diseases.

One of the major physiological changes that take place in adolescent girls is the onset of menarche, which is often associated with problems of irregular menstruation, excessive bleeding, and dysmenorrhea. Of these, dysmenorrhea is one of the common problems experienced by many adolescent girls.

Globally adolescents account for 1/5^th of the population that is more than 1 billion. 4 out of 5 adolescents live in developing countries. According to Population Bureau in 1996, 30% of the total population was that of adolescents (284.02 million). Due to gradual decrease in the growth rate of the overall population, there is little increase in the number of adolescents in population projections till the year 2016 (Population projection 1996-2016) census of India.

The first menstrual period is called menarche. It usually starts between the ages 11 and 14. But it can happen as early as age 9 or as late as 15. Menarche is the sign of growing up. In the days before the periods start, the adolescent may feel tense or emotional, gain water weight and feel bloated, pain in the abdomen, back or legs that lasts few hours or more.

Premenstrual syndrome (PMS) is a common disorder of young and middle aged women characterized by cyclic occurrence in the luteal phase of the menstrual cycle of a combination of distressing physical, psychological and behavioral changes of sufficient severity to result in deterioration of interpersonal relationships and/or interference with normal activities, which remit upon onset or immediately after menstruation.

Pre-menstrual syndrome (PMS) is recurrent variable cluster of troublesome physical and emotional symptoms that develop 7–14 days before the onset of menstruation and subsides when menstruation occurs. The PMS consists of low backache, fatigue, breast heaviness, abdominal bloating, increased weight, headache, irritability, skin disorders, aggressiveness, depression, gastrointestinal symptoms and loss of appetite.

Premenstrual syndrome (PMS) is a set of physical, emotional, and behavioral symptoms that occur a week before menstruation in most cycles. The physical symptoms are: breast tenderness or swelling; weight gain due to fluid retention; abdominal bloating; fatigue; dizziness; nausea and vomiting; acne or worsening of an existing skin disorders; muscle aches; pelvic heaviness; appetite change; constipation; headache and backache. The emotional symptoms are: insomnia; sadness; irritability; tension; anxiety; restlessness; loneliness and food cravings. There are also behavioral symptoms such as: difficulty concentrating; forgetfulness and social avoidance.

Many women experience various premenstrual physical, emotional or behavioral changes, which at times reach such levels of severity that may have substantial social impact upon the woman herself, her associates and her work. So a descriptive study was undertaken to study the prevalence of premenstrual syndrome among adolescent girls of selected schools at Erode.

STATEMENT OF THE PROBLEM:

A study on the prevalence of premenstrual syndrome among adolescent girls in a selected school at Erode

OBJECTIVES:

1. To estimate the prevalence of premenstrual syndrome among adolescent girls

2. To rank the common symptoms associated with premenstrual syndrome among adolescent girls

3. To find out the association between prevalence of premenstrual syndrome among adolescent girls with their selected demographic variables.

ASSUMPTION:

The study assume that,

§ Premenstrual symptoms are common among adolescent girls.

§ Premenstrual syndrome is a major cause of less academic performance and school absenteeism among students who suffer from the same.

DELIMITATIONS:

The study is limited to,

1. Prevalence of premenstrual syndrome

2. Adolescent girls

3. Selected schools, Erode.

MATERIALS AND METHODS:

Research approach

A quantitative research approach was selected to collect the data from the adolescent girls to study the prevalence of premenstrual syndrome.

Research design:

A cross sectional descriptive research design was used

Research setting:

The study was conducted in Seventh Day Adventists School, Erode.

Population:

The population for the present study was all the adolescent girls between the age group of 14 – 18 years in selected school, Erode.

Sample:

The sample consisted of 200 adolescent girls of Seventh Day Adventists School, Erode.

Sampling technique:

Stratified random sampling technique was used to select the sample for the study. In 9^th standard which comprises of total 143 female students, 10^th standard which comprises of total 168 female students, 11^th standard which comprises of total 197 female students, 12^th standard which comprises of total 224 female students. Thus four classes comprises of around 732 students. Among the four standards of female students, from each standard 50 samples were selected by using stratified random sampling technique and the criteria for the stratum is class of the study i.e., A, B, C, D and E class. Thus from each stratum 10samples were selected. Hence total 200 samples were selected from four standards.

Development of tool:

A baseline Proforma and checklist on the common premenstrual symptoms was prepared with the help of review of literature , personal experience and discussion with experts.

Description of the tool:

Section A: Baseline Proforma of the samples

Section B: Checklist on the common premenstrual symptoms

Tools are prepared in English.

Section A: Baseline Proforma:

It contained items for obtaining information regarding age, age at menarche, duration of cycle, type of flow, family history of PMS, academic performance, school absenteeism and source of information

Section B: Checklist on the common premenstrual symptoms:

It consisted of 32 items in 3 different areas. They were 16 physical symptoms, 6 psychological symptoms and 10 behavioural symptoms. The subjects had to tick mark in the relevant column based on the presence or absence of the symptoms

Plan for data analysis:

The data were analysed by using both descriptive and inferential statistics

Ø Baseline proforma of the samples were described by frequency and percentage distribution

Ø Mean, standard deviation and mean percentage was used to rank the common premenstrual symptoms among adolescents.

Ø Chi square test was used to find out the relationship between selected variables of adolescents with their prevalence of premenstrual syndrome.

RESULTS:

Section A: Most (62%) of the adolescents girls were in the age group of 15 -16 years. However 73% of the adolescents girls attained menarche at the age of above 13years, 64% of adolescents girls were in > 28 days cycle, Most (63%) of adolescents girls were 5-7 days flow, 56 % of them had family history of premenstrual syndrome, 42 % of adolescents girls had low academic performance 54% of adolescents girls were school absenteeism and 52% of them had source of information from peers.

Section B: The findings revealed that the prevalence of premenstrual syndrome based on Shortened Premenstrual Assessment scale the majority (54%) of the samples had mild PMS, 28% as moderate and 18% of them had severe PMS.

Section C: The findings shows that 88% were experiencing abdominal discomfort as a most common premenstrual symptom, 86% fatigue, 82% low back pain, Irritability, mood swings, 80% generalized aches and pains, Joint and muscle pain Poor concentration, social withdrawal, restlessness, decreased interest in activities, 74% anxiety, forgetfulness, 62% headache, insomnia, 60% depression, 58% nausea, 54% increased perspiration, increased body temperature 42% vomiting, 34% breast tenderness, 22% diarrhea, increased appetite changes, depression, 12% hypersomnia 8% constipation, food cravings, 4% swelling in the extremities, weight gain, suicidal ideation, confusion.

Section D: There was a significant association between the prevalence of PMS scores and variables like age (χ²= 4.51, p > 0.05) and school absenteeism (χ²= 6.62, p > 0.05). But there was no significant association with prevalence of PMS among adolescent girls and other variables like age at menarche, duration of cycle, type of flow, family history of PMS, academic performance and source of information

CONCLUSION:

é The findings revealed that the prevalence of premenstrual syndrome based on Shortened Premenstrual Assessment scale the majority (54%) of the samples had mild PMS, 28% as moderate and 18% of them had severe PMS.

é The commonest symptoms experienced by the adolescent girls who had PMS is abdominal discomfort, fatigue, low back pain, Irritability, mood swings , generalized aches and pains, Joint and muscle pain Poor concentration, social withdrawal, restlessness, decreased interest in activities, anxiety, forgetfulness, headache, insomnia, depression, nausea, increased perspiration, increased body temperature

é There was a significant association between the prevalence of PMS scores and variables like age and school absenteeism.

é There was no significant association between the prevalence of PMS scores and variables like age at menarche, duration of cycle, type of flow, family history of PMS, academic performance and source of information

RECOMMENDATIONS:

1. A study can be conducted with large samples to generalize the findings.

2. A comparative study can be done between urban and rural adolescent girls.

3. A comparative study can be done between married and unmarried women.

4. SIM can be developed based on the learning needs of the adolescent girls regarding PMS and its self care management.

5. Intervention study can be conducted to know the effect of various treatment methods in reducing PMS.

REFERENCES:

1. Parker M A, etal. “The menstrual disorder of teenagers: determining typical menstrual patterns and menstrual disturbance in a large population based study of Australian teenagers, BJOG; 2010Jan; 117(2):p185-92

2. Anil.k agarawal and Anju Agarwal. A study of dysmenorrehea during menstruation in adolescent girls. Indian journal community medicine.2010 january.35(1).159-164.

3. Braverman PK. Premenstrual syndrome and premenstrual dysphoric disorder. J Pediatr Adolesc Gynecol. 2007 ;20(1):3-12

4. Anandha Lakshmi et. al., Prevalence of Premenstrual Syndrome and Dysmenorrhoea among Female Medical Students and its Association with College Absenteeism. Int J Biol Med Res. 2011; 2(4): 1011 -1016 Mahin Delara.et.al., Health related quality of life among adolescents with premenstrual disorders: a cross sectional study. Health and Quality of Life Outcomes 2012, 10:1 doi:10.1186/1477-7525-10-1.

Received on 27.06.2012 Modified on 15.07.2012

Asian J. Nur. Edu. and Research 2(3): July-Sept. 2012; Page 154-157