A study to assess the prevalence of pre-menstrual syndrome among adolescent girls in a selected college at Mangalore

Brincy L D’Souza*, Praseetha P. Nair, Ancy Varghese, Joslin Coelho, Soumya Naik,

Annmary Scaria, Boby Paulose, Jerrin Jose, Melbin Scaria, Mithun Raj, Shameena Nazeer

S.C.S. College of Nursing Sciences, Hoegebail, KECT Towers, Ashoknagar, Mangalore- 575006

*Corresponding Author Email: brincy85@gmail.com

ABSTRACT:

Context: Adolescent girls constitute 1/5^th of the female population in the world. Generally this group is considered health and not been given adequate attention in health programmes. Menarche is sign of growing up. This period constitutes between 11-14 years. Pre-menstrual syndrome is a set of physical, emotional and behavioural symptoms, that occurs a week before menstruation in most of the cycles. The physical symptoms includes acne, breast tenderness, swelling in the legs, weight gain, abdominal bloating, fatigue, dizziness, nausea and vomiting, pelvic heaviness, appetite changes, constipation, heart palpitations, muscle aches, headache and backache. The emotional symptoms includes irritability, mood swings, sadness, tension, restlessness, loneliness, food craving, stress, insomnia/ hypersomnia, anxiety, anger and behavioural symptoms include poor problem solving, poor concentration, forgetfulness and social avoidance, confusion.

The purpose of the study was to find out the prevalence of PMS among adolescent girls.

Objectives

To find out the prevalence of PMS among adolescent girls

To describe the severity of physical and emotional symptoms related to PMS

To find out the association of the demographic characteristics

Methods

Non-experimental study with descriptive design was used for the study. The sample consisted of 30 adolescent girls who met the inclusion criteria and selected using stratified random sampling technique. The study was conducted in S.C.S. college of nursing sciences, Mangalore. Formal informed consent was obtained from the concerned authorities and the participants prior to data collection. The tool was administered for 15 minutes. The data was collected using checklist to assess PMS.

Result

With regard to the study the mean and SD of the physical symptoms were 10.87 and 4.32 respectively and for emotional symptoms were 7.33 and 2.73 respectively. The result showed that there is a prevalence of mild to moderate symptoms of PMS among adolescent girls with score ranging from 0-35.

Interpretation and conclusion

Prevalence of PMS among adolescent girls ranges between mild and moderate.

KEYWORDS: Assess, PMS, adolescent girls, prevalence

INTRODUCTION:

Adolescent girls constitute 1/5^th of the female population in the world. Generally this group is considered healthy and has not been given adequate attention in the health programs. The reason is specific mortality is comparatively low in this age group. Menarche is a sign of growing up. Girls usually attain their first menstrual cycle at the age of 11-14 years. In these days the girls feels tensed or may experience emotional variations, gain water weight and feel bloated, pain in the abdomen back or legs that lasts few hours or more. This is termed as premenstrual syndrome (PMS)¹.

PMS is a set of physical, emotional and behavioural symptoms, that occur a weeks before menstruation in most of the cycles. It should typically resolve within 4 days after bleeding starts and not star until at least 13^th day in the cycle¹. The physical signs include: acne, breast tenderness, swelling in the legs, weight gain, abdominal bloating, fatigue, nausea and vomiting, pelvic heaviness, appetite changes, constipation, heart palpitations, muscle aches, headaches and backache. The emotional symptoms include: irritability, mood swings, sadness, tension, restlessness, food cravings, stress, insomnia or hypersomnia, anxiety, anger. The behavioural symptoms include: poor problems solving, poor concentration, forgetfulness and social avoidance, confusion¹.

Females who had high stress before cycles where 25 times more likely to experience physical and psychological symptoms related PMS. PMS is also found to be related with high suicide and accident rates, poor employment and school attendance, poor academic performances and psychiatric problems¹.

An observational study was conducted to find the prevalence of PMS among school children and describe their severity of symptoms at four selected schools in Thiruvallur district in Tamil Nadu. It showed prevalence of PMS to be 45% according to the ICD-10 criteria, among which 21% had mild, 20.4% had moderate and 3.6% had severe symptoms².

A study was conducted to assess the prevalence of PMS among 60 adolescent girls between the age group of 17-20years in a Government school in Tamil Nadu in 2013. The data showed that 82% of the adolescent girls attained menarche, 75% had a >28 day menstrual cycle, 72% had a flow for 5—7 days, 67% had a family history of PMS, 53% had low academic performance, 63% had school absenteeism and taking self treatment. The findings showed a ‘t’ value regarding PMS and background factors: age of menarche in years=1.46 (p=0.15), duration of cycle=0.13(p=0.89), type of flow=0.79 (p=0.43); family history=1.11(p=0.27; academic performance=0.21(p=0.84); school absenteeism= 0.16 (p=0.87); use of home remedies =0.77(p=0.44). thus the study show that the prevalence of PMS is aggravated with several factors which can be easily controlled, hence reducing its severity¹.

OBJECTIVES:

To find out the prevalence of premenstrual syndrome in adolescent girls and to describe the severity in terms of physical and emotional symptoms

METHODS AND MATERIALS:

A non-experimental, descriptive research approach was used. Extraneous variables include age, religion, family history. This study was conducted among 30 nursing students belonging to the age group of 17-20 years in a nursing college, Mangalore in 2013.Students with menstruation more than 8 days and less than 2 days were excluded, also those detected with menstrual abnormalities and who were on hormonal therapy were excluded.

The data was collected using a 3 point rating scale, with response scoring as never (0), sometimes(1) and always (2), and total of 25 items were present. 16 items were from physical symptom area and 9 were from emotional symptom area. There were positive and negatively scored items. Permission was obtained from the concerned authorities and participants. Final tool was developed after validity, reliability and pretesting. Pilot study was conducted and the main data was collected. The reliability was found to be 0.91. The samples were selected based on the inclusion criteria using stratified random sampling. Data was analysed using frequency, mean, SD, and chi square, presented in tables and graphs.

RESULT:

The demographic data was obtained as follows

Table 1: Description and association of demographic data (N=30)

Demographic data	Percentage (%)	p value	Chi-square
Age in years
18	16.67	0.826	24.500**
19	50
20	33.33
Religion
Hindu	10	0.955	7.778**
Christians	90
Positive Family history
Yes	13.33	0.059	25.637**
No	86.67
Age of menarche in years
12	26.67	0.310	52.311**
13	36.67
14	20
15	16.66
Duration of menstrual flow
3-4 days	60	0.838	24.167**
5-6 days	33.33
7-8 days	6.67
Remedies used
Home	36.67	0.370	50.636**
Allopathic	10
Ayurvedic	50
No treatment	3.33

(* significant ** not significant) (p< 0.05)

The overall prevalence of PMS was found to be higher with physical symptoms as depicted in the figure 1.

Figure 1: Prevalence of PMS

The majority of the symptoms obtained were in the severity of mild to moderate as depicted in the figure 2.

Figure 2: Severity of PMS

This indicated that adolescent girls experience PMS during their menstrual period. And this can have a very adverse course if not dealt properly

DISCUSSION:

The majority of women exhibit some symptoms during the late luteal phase of the menstrual cycle (Biggs and Demuth 2011). Some 5 to 8% of women have symptoms severe enough to be distressing and debilitating (Yonkers et al. 2008), and experience disruptions to relationships, work and social activities³. Premenstrual conditions grouped into 3 broad categories: Severe PMDD that affects about 2% to 9% of girls, moderate to severe PMS that affects about 20% to 40% of girls, and mild PMS which affects up to 80% of girls at the reproductive age (Bornstein et al., 2003)⁴. PMS, however, is more common as evidenced by prevalence rates ranging from 18.6%–0.7% (Steiner et al. 2003b; Wittchen et al. 2002)⁵. The highest prevalence of premenstrual dysphoric and have been already reported in adolescent girls aged 14 and over. Approximately 50- 80% of girls experienced at least a few premenstrual symptoms that may be varied from mild to severe (Wittchen et al., 2002)⁶.

REFERENCES:

1. Padmavathi P, Sankar R, Kokilavani N. A Correlation Study on Perceived Stress and Premenstrual Symptoms Among Adolescent Girls. Asian journal of nursing education and research, 3 (1); 2013: 14-17.

2. Prevalence of PMS among adolescent school going girls. Nightingale nursing times. 8(9); 2012: 12-14.

3. Biggs, W. S., and R. H. Demuth 2011. Premenstrual syndrome and premenstrual dysphoric disorder. American family physician, 84(8); 2011:918-24

4. Borenstein JE, Dean BB, Endicott J, Wong J, Brown C, Dicerkson V. Health and economic impact of the premenstrual syndrome. J Reprod Med, 48; 2003 :515–524.

5. Steiner M, Macdougall M, Brown E. The premenstrual symptoms screening tool (PSST) for clinicians. Arch Womens Ment Health, 6; 2003:203–209.

6. Wittchen HU, Becker E, Lieb R, Krause P. Prevalence, incidence and stability of premenstrual dysphoric disorder in the community. Psychol Med, 32;2003:119–132.