# Identification and Evaluation of Menstruation-Related Disorders in Adolescent Girls Attending a Tertiary Care Center: An Observational Study

## TL;DR

This study found that most adolescent girls in South India experience menstrual disorders, which significantly affect their school attendance and daily activities.

## Contribution

The study provides a detailed evaluation of menstrual disorders' prevalence and impact in a South Indian tertiary care setting.

## Key findings

- 94.4% of adolescent girls had at least one menstrual disorder, with dysmenorrhea and premenstrual syndrome being most common.
- Menstrual disorders caused significant absenteeism and restricted social or physical activities in nearly half of the participants.
- Overweight and obesity were significantly linked to menstrual irregularities, and WHODAS disability scores correlated strongly with symptom severity.

## Abstract

Background

Menstrual disorders such as dysmenorrhea, menorrhagia, oligomenorrhea, and premenstrual syndrome are believed to be the most common yet under-recognized causes of morbidity in adolescent girls. Many adolescents around the world experience menstrual dysfunction, and in India, cultural stigma, poor awareness, and nutritional imbalance are believed to exacerbate the burden. Despite national initiatives focusing on menstrual hygiene and anemia prevention, only a few studies in India have systematically evaluated the clinical spectrum, determinants, and functional impact of menstrual disorders in tertiary-care settings. This study aimed to assess the prevalence, pattern, and clinical correlates of menstruation-related disorders among adolescent girls attending a teaching hospital in South India and to identify the functional limitations imposed by these conditions.

Methods

A hospital-based cross-sectional observational study was conducted among 72 post-menarcheal adolescent girls (10-19 years) attending the outpatient department of Obstetrics and Gynecology, Sree Balaji Medical College and Hospital, Chennai. Participants were assessed using a validated, semi-structured questionnaire covering sociodemographic data, menstrual characteristics, hygiene practices, and psychosocial impact. Clinical evaluation included anthropometry, hemoglobin estimation, thyroid function testing, and pelvic ultrasonography where indicated. The severity of symptoms and functional disability were assessed using the Pictorial Blood Assessment Chart (PBAC), Visual Analogue Scale (VAS), and WHO Disability Assessment Schedule (WHODAS 2.0).

Results

The mean age at menarche was 12.6 ± 1.2 years, with 69.4% reporting regular cycles and a mean duration of flow of 4.9 ± 1.6 days. The overall prevalence of menstrual disorders was strikingly high (94.4%). Dysmenorrhea (72.2%) and premenstrual syndrome (75.0%) were the most common, followed by menorrhagia (25%) and oligomenorrhea (13.9%). Anemia was observed in 33.3%, thyroid abnormalities in 8.3%, and polycystic ovary syndrome (PCOS) features in 13.9% on ultrasonography. Overweight and obesity were significantly associated with menstrual irregularities (p=0.013). Functionally, participants missed an average of 1.8 ± 0.9 school days per cycle, with 38.9% reporting absenteeism and 47.2% restricting social or physical activities. The mean WHODAS disability score was 8.6 ± 3.5, showing a strong correlation (r=0.62; p<0.001) with menstrual symptom severity.

Conclusion

Menstrual disorders are highly prevalent among adolescents and impose significant physical and psychosocial burdens. Integrating menstrual health education, nutritional interventions, and early clinical screening into adolescent programs is vital to improving reproductive health and educational outcomes.