The prevalence and risk factors of school absenteeism due to premenstrual disorders in Japanese high school students-a school-based cross-sectional study

Prevalence and associated factors of premenstrual dysphoric disorder among high school students in Finote Selam town, northwest Ethiopia

Background

Premenstrual dysphoric disorder (PMDD) is the most prevalent but neglected psychiatric disorder, with somatic symptoms that are severe enough to markedly affect usual daily activities and have a negative impact on mental health and quality of life by affecting female patients' behavior and cognition. Studies regarding premenstrual dysphoric disorder and associated factors among high school students in low- and middle-income countries are limited. Therefore, the aim of this study was to assess the prevalence and associated factors of PMDD among high school students, and this is pivotal in further investigation.

Methods

A school-based cross-sectional study was conducted from March 25 to April 17, 2023 using a simple random-sampling technique to select a sample of 564 participants. Premenstrual dysphoric disorder was assessed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Self-administered standardized questionnaires were used to collect data.

Result

A total of 548 study participants participated, with a 97.2% response rate. The prevalence of premenstrual dysphoric disorder among high school students was found to be 33.03% (95%CI: 29.20-37.09). In a multivariable analysis, irregular menstruation cycle (AOR = 4.242, 95%CI = 2.182-8.246), depression (AOR = 5.272, 95%CI = 2.779-10.002), having greater than 4 days of menstruation bleeding duration (AOR = 2.138, 95%CI = 1.105-4.138), and high perceived stress (AOR = 3.468, 95%CL = 1.217-9.880) were the factors significantly associated with premenstrual dysphoric disorder.

Conclusion

The overall prevalence of PMDD which was one-third among high school students was high. Moreover, long duration of menstruation bleeding, depressive symptoms, irregular menstruation cycle, and high perceived stress were significant factors in PMDD. Therefore, it needs early screening and intervention in primary healthcare settings, especially for those who have high perceived stress, having depression, having a long duration of menstruation bleeding, and having an irregular menstruation cycle, so as to have good academic achievement and psychological wellbeing.

The Changes in Menstrual and Menstrual-Related Symptoms among Japanese Female University Students: A Prospective Cohort Study from Three Months to Nine Months after Admission

Menstrual and menstrual-related symptoms can significantly impact an individual's physical and psychological health. Understanding how these symptoms evolve over time is crucial to provide appropriate support and healthcare services to young women. This study aimed to investigate changes in menstrual and menstrual-related symptoms among first-year female university students. A prospective longitudinal design was used to compare the symptom profiles between two time points (three and nine months after admission). Out of 100 female university students, 30 responses were analyzed. Data on menstrual and menstrual-related symptoms were collected using standardized questionnaires focusing on menstrual status and the Menstrual Distress Questionnaire (MDQ); no notable changes occurred between the time points. Approximately half reported having irregular menstruation during the three time periods. Among the sub-scales, premenstrual "impaired concentration" showed a tendency to be lower, whereas menstrual "water retention" tended to be higher in timepoint 2 compared to timepoint 1. "Distractible" was found to be significantly lower in timepoint 2 compared to timepoint 1. There was a significant association between a sleep duration of <7 h and worsened MDQ scores. These findings may underscore the importance of providing comprehensive lifestyle and menstrual education to new university students, along with access to appropriate medical care.

Physical activity and combined hormonal contraception: association with female students' perception of menstrual symptoms

Aim: The aim of this study was to examine the association between physical activity (PA) and combined hormonal contraceptive (CHC) on female students' self perceptio of their menstrual cycle symptoms. Methods: Healthy French female students (n = 834) completed an online questionnaire to assess their PA level (Group 1: non-active; Group 2: moderate physical activity; Group 3: high physical activity; Group 4: very high physical activity), menstrual status or contraception use, self-reported diet and medication, impact on engagement in some social activities, and self-assessment of perceived mental and physical symptoms during the week prior to menses (PM) for students with a normal menstrual cycle (NMC), and the week of menses (ME) for normal menstrual cycle students and those using combined hormonal contraception. Results: Whatever the conditions (PM and ME, NMC and CHC), fewer self-perceived symptoms and self-reported alteration in fat intake were reported by the students in Group 4, and more analgesic and anti-inflammatory medication use was reported by Group 1. Fewer self-perceived symptoms were also found in CHC vs NMC female students for all physical activity levels, but in a more marked way when associated with very high physical activity. In addition, less university and sports practice absenteeism was observed with high and very high physical activity. Conclusion: In conclusion, the perception of menstrual cycle symptoms was lower with very high physical activity, as with combined hormonal contraception. Moreover, female students training more than 5 h/week also reported less university absenteeism and impairment in physical activities. Further studies are necessary to establish the causal link of physical activity and combined hormonal contraception on menstrual symptoms.

The effect of peer education compared to education provided by healthcare providers on premenstrual syndrome in high school students: A social network-based quasi-experimental controlled trial

AIM

This study aimed to compare the effect of peer education and education provided by healthcare providers on PMS in high school students.

MATERIALS AND METHODS

This quasi-experimental non-randomized controlled trial with a three-armed parallel design was performed on 90 students allocated in three groups, namely, education by peer (intervention group 1 = 30), education by a healthcare provider (intervention group 2 = 30), and a control group (n = 30). The primary outcome was a change in the score of PMS, and the secondary outcomes were changes in the general health score and the frequency of premenstrual dysphoric disorder (PMDD). Education about PMS management was held in WhatsApp messenger in six sessions (two sessions per week) for both intervention groups. All three groups received routine school counseling. The researchers applied repeated-measures ANCOVA, McNemar, and post-hoc Bonferroni tests.

RESULTS

Education in intervention group 1 (Partial Eta Squared = 0.67, p < 0.0001) and intervention group 2 (Partial Eta Squared = 0.82, p < 0.0001) significantly reduced the PMS score compared to the control group. In addition, the change in general health score in the intervention groups compared to the control group showed the effectiveness of the intervention (p < 0.001). Education did not significantly reduce PMDD frequency in the intervention groups compared to the control group (p > 0.05).

CONCLUSION

This study suggests education by peers and healthcare providers effects on PMS and general health in adolescents. It suggested that the effectiveness of these approaches be investigated in other adolescents' health conditions.

Prevalence and factors associated with chronic school absenteeism among 207,107 in-school adolescents: Findings from cross-sectional studies in 71 low-middle and high-income countries

BACKGROUND

Despite the negative impact of chronic school absenteeism on the psychological and physical health of adolescents, data on the burden of adolescent chronic school absenteeism (ACSA) and interventions and programs to address it are lacking. We estimated the global, regional and national level prevalence of ACSA and its correlation with violence and unintentional injury, psychosocial, protective, lifestyle, and food security-related factors among in-school adolescents across low and middle-income, and high-income countries (LMICs-HICs).

OBJECTIVES

This study aimed to estimate the prevalence of chronic school absenteeism (CSA) as well as to determine its associated factors among in-school adolescents across 71 low-middle and high-income countries.

METHODS

We used data from the most recent Global School-based Student Health Survey of 207,107 in-school adolescents aged 11-17 years in 71 LMICs-HICs countries across six WHO regions. We estimated the weighted prevalence of ACSA from national, regional and global perspectives. Multiple binary logistic regression analyses were used to estimate the adjusted effect of independent factors on ACSA.

RESULTS

The overall population-weighted prevalence of CSA was 11·43% (95% confidence interval, CI: 11·29-11·57). Higher likelihood of CSA was associated with severe food insecurity, peer victimisation, loneliness, high level of anxiety, physically attack, physical fighting, serious injury, poor peer support, not having close friends, lack of parental support, being obese, and high levels of sedentary behaviours. Lower likelihood of CSA was associated with being female (odds ratio, OR = 0·76, 95% CI: 0·74-0·78).

CONCLUSION

Our findings indicate that a combination of different socio-economic factors, peer conflict and injury factors, factors exacerbate CSA among adolescents. Interventions should be designed to focus on these risk factors and should consider the diverse cultural and socioeconomic contexts.

Factors Associated with the Prevalence and Severity of Menstrual-Related Symptoms: A Systematic Review and Meta-Analysis

This study aimed to identify factors associated with the prevalence and severity of menstrual-related symptoms. The protocol was registered in PROSPERO (CRD42021208432). We conducted literature searches of PubMed and Ichushi-Web and used the Jonna Briggs Institute critical appraisal checklist to assess the quality. Of the 77 studies included in the meta-analysis, significant odds ratios (ORs) were obtained for eight factors associated with primary dysmenorrhea (PD): age ≥ 20 years (OR: 1.18; 95% confidence interval [CI]: 1.04−1.34), body mass index (BMI) < 18.5 kg/m2 (OR: 1.51; 95% CI: 1.01−2.26), longer menstrual periods (OR: 0.16; 95% CI: 0.04−0.28), irregular menstrual cycle (OR: 1.28; 95% CI: 1.13−1.45), family history of PD (OR: 3.80; 95% CI: 2.18−6.61), stress (OR: 1.88; 95% CI: 1.30−2.72), sleeping hours < 7 h (OR: 1.19; 95% CI: 1.04−1.35), and bedtime after 23:01 (OR: 1.30; 95% CI: 1.16−1.45). Two factors were associated with severity of PD (moderate vs. severe): BMI < 18.5 kg/m2 (OR: 1.89; 95% CI: 1.01−3.54) and smoking (OR: 1.94; 95% CI: 1.08−3.47). PD severity (mild vs. severe) and prevalence of premenstrual syndrome were associated with BMI < 18.5 kg/m2 (OR: 1.91; 95% CI: 1.04−3.50) and smoking (OR: 1.86; 95% CI: 1.31−2.66), respectively. The identified risk factors could be utilized to construct an appropriate strategy to improve menstrual symptoms and support women’s health.

The Sprint-Interval Exercise Using a Spinning Bike Improves Physical Fitness and Ameliorates Primary Dysmenorrhea Symptoms Through Hormone and Inflammation Modulations: A Randomized Controlled Trial

Dysmenorrhea with high prevalence has been categorized as primary dysmenorrhea (PD) and secondary dysmenorrhea due to differences in pathogenesis. A significant number of reproductive females suffering from monthly menstruation have to deal with negative impacts on their quality of life, work/study productivity, activities, and social relationships. In addition to medical treatment, exercise has been recognized as a complementary and alternative strategy for disease prevention, alleviation, and rehabilitation. This study aimed to investigate the potential effects of exercise on the severity of primary dysmenorrhea, physiological modulation, and physical fitness. Participants consisted of university students who were enrolled in the study and divided into a non-PD (Control) and a PD group based on recruiting criteria, the latter being randomly assigned to either an untreated dysmenorrhea group or a dysmenorrhea group that underwent 10 weeks of high intensity interval training (HIIT) exercise (Dysmen and DysmenHIIT, respectively). The DysmenHIIT group used spinning bikes and the training intensity was validated by heart rate monitors and BORG rating of perceived exertion. Forms containing participant information (premenstrual symptoms, menstrual distress, and a Short Form McGill Pain Questionnaire) as well as physical fitness, biochemical variables, hormone and prostaglandin (PGE2 and PGF2α) levels were assessed before and after the exercise intervention. After intervention, premenstrual symptoms (anger, anxiety, depression, activity level, fatigue, etc.), menstrual distress symptoms (cramps, aches, swelling, etc.), and pain severity were shown to be significantly mitigated, possibly through hormone (estradiol, prolactin, progesterone, and cortisol) modulation. Furthermore, high-sensitivity C-reactive protein (HsCRP), PGE2 and PGF2α levels were also down-regulated, resulting in the amelioration of uterine contraction and inflammation. Participants' physical fitness, including cardiovascular endurance and explosive force, was significantly improved after HIIT. The 10-week HIIT spinning bike exercise used in this study could be employed as a potential and complementary treatment for PD symptoms alleviation and considered as part of an educational health plan for promoting women's health. However, the effects of HIIT utilizing different exercise methods and accounting for different age populations and secondary PD warrant further investigation.

Differences in Menstruation-Related Symptoms of University Students Depending on Their Living Status in Japan

Mothers and family members of young female students play important roles for guiding their self-care strategies for menstruation-related symptoms; which often affect their daily life and academic life. The aim of this study is to clarify the differences in menstruation-related symptoms before and during menstruation in university students living alone and university students living with their family in Japan. We conducted a cross-sectional online survey to assess menstruation-related symptoms before and during menstruation using the menstrual distress questionnaire (MDQ). Among 135 students; the proportion of students living alone was 60.7% and the proportion of students living with their family was 39.3%. Before menstruation; the MDQ total score and the scores for negative affect and behavior change were significantly higher in students living alone than in students living with their family. During menstruation; scores for negative affect and impaired concentration were also significantly higher in students living alone. In addition; before menstruation; scores for an increase in appetite and craving for sweets were significantly higher in students living alone. Thus; living alone affected the psychological aspects of menstruation-related symptoms in young women. The results suggest that university students who live alone should be aware of the importance of talking about their menstruation problems with family members and seeking their advice

A comparison between the effects of school-based education programs provided by peer group versus health practitioners on premenstrual syndrome in adolescents: A protocol for a non-masked clinical trial

Aim

To compare the effect of school‐based education programs, by peer group versus health practitioner on Premenstrual Syndrome (PMS) in adolescent girls.

Design

Non‐masked three‐armed clinical trial.

Methods

Ninety 11th‐grade students with moderate to severe PMS will be allocated to Intervention Group 1 (IG1), Intervention Group 2 (IG2) and Comparison Group (CG). Three weeks (six online sessions) of parallel education will be implemented in IG1 by trained peer educators and in IG2 by a health practitioner. The primary outcome will be changes in PMS severity score between three groups over time (measured by Daily Record of Severity of Problems). Secondary outcomes include changes in Premenstrual Dysphoric Disorder and General Health. Data collection will be conducted in two‐time points, at baseline, and at the end of the intervention.

Results

Our study will explore the effect of school‐based education programs, by peer group versus health practitioner on PMS. This will add to the evidence‐based interventions to PMS management and the effectiveness of peer education in health promotion of adolescents girls.

Effect of pilates exercises on premenstrual syndrome symptoms: a quasi-experimental study

OBJECTIVES

This study was done to identify the effect of pilates exercises on the symptoms of premenstrual syndrome.

DESIGN

A quasi experimental was conducted on university student with premenstrual syndrome.

METHODS

Population of the study included midwifery students with premenstrual syndrome at Istanbul University Faculty of Health Sciences (N = 286) and 50 of them became the sample (25 in experimental group and 25 in control group). Non-probablistic sampling method was used. While the students in experimental group were asked to practice the pilates exercises for three months, the students in control group were told to maintain their routine habits. At the end of the three months, premenstrual syndrome problem of experimental and control group was diagnosed and the effect of pilates on premenstrual syndrome was evaluated. Premenstrual Syndrome symptoms were evaluated through Premenstrual Syndrome Scale (PMSS). The high score received from PMSS shows that the symptoms are intensive.

RESULTS

It was seen that the students in the experimental and control group were similar in terms of their aspects which were individual, health and could affect premenstrual syndrome (p > 005). A statistical significant difference was not found between total scores and sub-dimension scores of PMSS in experimental and control group (p < 0.05). It was seen that PMSS total score of experimental group was significantly lower than that of control group (p < 0.001). When in-group comparisons were examined, it was identified that PMSS scores of control group did not change at the beginning and end of exercise, but PMSS score of experimental group at the end of exercise was lower than their score received at the beginning of exercise and, the difference was statistically significant to the highest degree (p < 0.001).

CONCLUSION

It was seen that the pilates exercises, which were practiced in this research, decreased the PMS symptoms considerably. In this regard, the pilates exercises have an important role in healing the PMS symptoms.

Effects of a social-media-based support on premenstrual syndrome and physical activity among female university students in South Korea

Introduction: This study examined the effects of social-media-based support on premenstrual syndrome (PMS) and physical activity among female South Korean university students.Methods: This quasi-experimental study with an equivalent-control-group pretest-posttest design randomly assigned 64 female students with PMS to the experimental or control group. The experimental group received social-media-based support through a smartphone application, text messaging, and e-mail for one menstrual cycle between September and December, 2016. Descriptive and inferential statistics included a Chi-square test and independent and paired t-tests.Results: Significant differences emerged between the experimental and control groups in total PMS scores (p = .003), 14 premenstrual symptoms, and physical activity (p = .010).Conclusions: Female university students with PMS experienced decreased premenstrual symptoms and increased physical activity with social-media-based support, which could be an efficacious, accessible, and widely available nursing intervention to manage PMS and physical activity.

Development of a Japanese Version of the Daily Record of Severity of Problems for Diagnosing Premenstrual Syndrome

Background: Premenstrual syndrome (PMS) causes physical and mental symptoms in women during the luteal phase of the menstruation cycle. To confirm the relationship between symptoms and the menstruation cycle, daily symptom records are essential for diagnosing PMS. The daily record of severity of problems (DRSP) is currently the most validated tool for tracking symptoms to confirm and scale the severity of PMS, but there has been no validated Japanese version of this instrument. We developed a Japanese version of the DRSP and assessed its psychometric properties.

Methods: A Japanese version of the DRSP was developed following the translation guidelines of the latest Patient-Reported Outcomes Consortium. We conducted a computational psychometric study among 119 women, all of whom completed the Japanese version of the DRSP, the Center for Epidemiologic Studies Depression Scale (CES-D), the Premenstrual Dysphoric Disorder (PMDD) scale, and a Numerical Rating Scale (NRS) for general health status. Each was filled out twice, 2 weeks apart, so that one set was completed in the luteal phase.

Results: The Japanese version of the DRSP was developed with translation and cultural adaptation. The internal consistency coefficient for the total score was 0.93. The DRSP in the luteal phase correlated highly with the CES-D, PMDD scale, and NRS for general health status.

Conclusions: Our Japanese version of the DRSP, developed as a PMS/PMDD diagnostic tool, was shown to provide substantial validity and reliability to rate premenstrual symptoms for Japanese women.

Lifestyle Factors Associated with Premenstrual Syndrome: A Cross-sectional Study of Japanese High School Students

STUDY OBJECTIVE

To investigate the relationships between premenstrual syndrome (PMS) and lifestyle, sleep, and dietary habits among Japanese high school students.

DESIGN

Cross-sectional study.

SETTING

Two public high schools in Sendai, the largest city in northeastern Japan.

PARTICIPANTS

A school-based survey was conducted among 1818 female Japanese high school students in 2015, and 1022 students with regular menstrual cycles (25-38 days) completed the questionnaire.

INTERVENTIONS AND MAIN OUTCOME MEASURES

Relationships between PMS and lifestyle, sleep, and dietary habits.

RESULTS

The rates of moderate to severe PMS and premenstrual dysphoric disorder were 9.7% (99/1022) and 2.2% (22/1022), respectively. A total of 121 students (11.9%) were classified as having PMS-the PMS(+) group. Significant differences were observed between the PMS(+) group and those without PMS-the PMS(-) group-in age at menarche (P = .022), menstrual pain (P < .001), hypnagogic disorder (P < .001), long Internet use time (P < .001), eating breakfast (P = .018), chewing well (P = .037), and belonging to a sports club (P = .046). Multivariate analysis revealed that the risk factors for PMS were menstrual pain (odds ratio [OR], 4.74; 95% confidence interval [CI]: 2.83-7.95), hypnagogic disorder (OR, 2.22; 95% CI, 1.47-3.35), stress fracture (OR, 2.19; 95% CI, 1.21-3.98), and Internet use time (OR, 1.003; 95% CI, 1.001-1.005). Belonging to a sports club decreased the risk of PMS (OR, 0.57; 95% CI, 0.35-0.91).

CONCLUSION

Sleep, dietary habits, belonging to a sports club, and screen time affect PMS among high school students.

Effects of Sleep Pattern, Stress, Menstrual Attitude, and Behavior That Reduces Exposure to Endocrine Disrupting Chemicals on Premenstrual Syndrome in Adolescents

PURPOSE

The study aimed to examine the effects of sleep pattern, stress, and attitude towards menstruation, and behavior that causes a reduction in exposure to endocrine disrupting chemicals (EDCs) in the course of premenstrual syndrome (PMS) in female adolescents. METHOD: In total, 200 girls attending middle school in K city were recruited via convenience sampling between December 11 and 31, 2018, and 192 subjects were selected for the analysis. Data were analyzed using descriptive statistics, an independent t-test, ANOVA, Pearson's correlation coefficient, and multiple regression.

RESULTS

Overall, 9 (4.7%), 152 (79.2%), and 31 (16.1%) students had morning-, intermediate-, and evening-type sleep pattern, respectively. The mean scores for school-related stress were highest. Scores for stress regarding relationships with friends were the lowest. The mean score for attitudes toward menstruation was 72.33 out of 147. The mean score for behavior that led to a reduction in EDCs exposure was 56.57 out of 85. The mean scores for PMS severity were 25.30 and 38.39 out of 60. Analysis of factors affecting PMS revealed that severity of menstrual pain (β=.28), use of analgesics during menstruation (β=.17), family history of PMS (β=-.16), stress (β=.19), and behavior that reduces EDCs exposure (β=-.17) exerted significant effects on PMS. The explanatory power of these variables was 37%.

CONCLUSION

The findings propose the necessity of a health intervention program including educational information, which can reduce PMS in adolescents, induce the behaviors which can decrease exposure to EDCs, and activities for managing the stress levels.

A potential relation between premenstrual symptoms and subjective perception of health and stress among college students: a cross-sectional study

Background

A majority of women from all cultures and socioeconomic levels experience myriad symptoms known as premenstrual syndrome during the days prior to menstruation. The present study investigated commonly reported symptoms in the premenstrual phase among college students. The authors further scrutinized potential factors, including subjective perceptions of health, which may be related to the premenstrual-symptom constellation.

Methods

We conducted a cross-sectional survey, which included 200 participants (mean age: 19.8 ± 0.1 years old). The subjects completed a rating of their premenstrual experiences relative to 46 symptoms in eight categories of the self-reporting menstrual distress questionnaire (MDQ) to evaluate the prevalence and severity of premenstrual symptoms. The participants also answered a standardized health questionnaire regarding subjective perceptions of health, self-rating stress, lifestyle, and demographic variables.

Results

Regardless of severity, the 10 symptoms most often occurring among the participants included skin disorders, irritability, fatigue, mood swings, general aches and pains, lowered school or work performance, backache, painful breasts, weight gain, and swelling. Stepwise multiple regression analysis revealed subjective perception of health (β = 0.28; p <  0.001) and self-rating stress (β = 0.18; p = 0.008) as the factors most strongly related to the MDQ total scores. In addition, the 19 women who evaluated themselves as “unhealthy and stressed” had greater prevalence of severe or extremely severe physical (general aches and pains) and psychosocial symptoms (confusion, lowered school or work performance, decreased efficiency, loneliness, anxiety, restlessness, mood swings, and depression), compared to the healthy and non-stressed women.

Conclusions

The present study indicates the prevalence of premenstrual symptoms, regardless of severity and number, among college students and suggests that negative subjective perceptions of health and stress may be related to the intensity of premenstrual symptomatology.

Menstrual disorders and medical counseling among schoolgirls in South Egypt: a cross-sectional study

BACKGROUND

Menstrual disorders are common gynecological problems among adolescents, however, medical counseling for these disorders is not well documented in developing countries.

OBJECTIVES

This study aimed to assess medical counseling for menstrual disorders among schoolgirls in Beni-Suef city in South Egypt.

METHODS

Using a multi-stage random sampling, a total of 970 preparatory schoolgirls were included in this study. We used a self-administered questionnaire to detect the premenstrual and menstrual disorders as reported by the schoolgirls during the previous 6 months. Medical counseling for the menstrual disorders and other demographic characteristics were also surveyed.

RESULTS

The mean age of the schoolgirls was 15.4 ± 0.8 years, age of menarche 13.2 ± 1.1 years and menstrual flow days 5.0 ± 1.3. During the past 6 months, 19.4% of the schoolgirls reported medical counseling for at least one menstrual symptom. Dysmenorrhea (89.2%), premenstrual fatigue (32.4%) and headache (31.1%) were the most often reported symptoms. After adjustment for personal and gynecological characters, abdominal bloating [odds ratio (OR) 3.66; 95% confidence interval (CI) 2.18-6.17], flow days >4 (OR 1.73; 95% CI 1.21-2.47), acne flare (OR 1.42; 95% CI 1.01-1.99), dysuria (OR 2.09; 95% CI 1.35-3.22) and facial hair (OR 6.89; 95% CI 3.47-13.69) were associated significantly with a higher likelihood of medical counseling.

CONCLUSION

Menstrual disorders are highly prevalent among preparatory schoolgirls in Beni-Suef, however, there is a noticeable lack of the medical counseling for these disorders. Future research should focus on the barriers to medical counseling for menstrual disorders among adolescents.

Association between menstrual disorders and school absenteeism among schoolgirls in South Egypt

Background Menstrual disorders are highly prevalent among girls and may interrupt school attendance. This study aimed to investigate the association between menstrual disorders and school absenteeism among schoolgirls in South Egypt. Subjects and methods A multi-stage random sampling method was adopted to select 930 schoolgirls. A self-administered questionnaire composed of 3 sections (socio-demographic characteristics, menstrual disorders, and school absenteeism) was used to assess the relationship between different menstrual disorders and school absenteeism during the previous 6 months. Results The mean age of the participating schoolgirls was 15.5 ± 0.8 years, age of menarche 13.2 ± 1.2 years, menstrual cycle duration 28.8 ± 7.3 days with average flow days 5 ± 1.3. During the previous 6 months, 43.9% of schoolgirls reported school absenteeism. Dysmenorrhea (89.1%) and premenstrual symptoms, especially abdominal spasm (62.2%), fatigue (32%), and headache (22.7%) were heavily reported during the same period. Menstrual flow >4 days [odds ratio (OR) 1.37, 1.04-1.80], premenstrual abdominal spasm (OR 1.60, 1.22-2.11), fatigue (OR 1.69, 1.27-2.24), breast tenderness (OR 1.67, 1.17-2.38), insomnia (OR 1.92, 1.31-2.80), abdominal bloating (OR 2.29, 1.34-3.91), dysmenorrhea (OR 4.44, 2.58-7.62), dysmenorrhea for more than 1 day (OR 1.38, 1.03-1.84), menstrual acne flare (OR 2.23, 1.68-2.97), dysuria (OR 1.96, 1.31-2.93), and facial hair (OR 2.59, 1.26-5.31) were significantly associated with school absenteeism. Conclusion Premenstrual and menstrual disorders are associated with school absenteeism among schoolgirls in South Egypt. Future research should focus on the effect of school counseling on reducing the absenteeism rate attributed to menstrual disorders.

Effect of an educational program on adolescent premenstrual syndrome: lessons from the Great East Japan Earthquake

Background

Catastrophic disasters such as great earthquakes cause tremendous physical and mental damage. We previously reported that the Great East Japan Earthquake worsened premenstrual symptoms among adolescent girls in the disaster-stricken area.

Objectives

We reanalyzed these data to determine the positive effects of education on premenstrual symptoms.

Materials and methods

Annual school-based surveys about premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) have been conducted in Sendai since 2009. The Great East Japan Earthquake occurred on March 11, 2011. First-year students in one school had received education on PMS/PMDD before the earthquake, whereas those in another school had not. We reanalyzed data for 1431 girls (November 2010) and 1489 girls (December 2011) aged 15-18 years.

Results

The severity of PMS/PMDD in students who had received the education program showed no changes between before and after the earthquake. However, students who had not received education showed worsening of the severity of PMS/PMDD.

Conclusion

This study showed education had a possible beneficial effect for the prevention of stress-induced PMS/PMDD.