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The MDOT Study: Prevalence of Menstrual Disorder of Teenagers; exploring typical menstruation, menstrual pain (dysmenorrhoea), symptoms, PMS and endometriosisParker, Melissa, n/a January 2006 (has links)
There are few data available about the menstrual patterns of Australian teenagers and
the prevalence of menstrual disorder in this age group.
Aims
To establish the typical experience of menstruation in a sample of 16-18 year
old women attending ACT Secondary Colleges of Education.
To determine the number of teenagers experiencing menstrual disorder that
could require further investigation and management.
Method
The MDOT questionnaire was used to survey participants about their usual pattern of
menstruation, signs and symptoms experienced with menses and how menstruation
affected various aspects of their lives including school attendance, completion of
school work, relationships, social, sexual and physical activity. Data analysis included
exploration of aggregated data, as well as individual scrutiny of each questionnaire to
determine menstrual disturbance requiring follow up. Those participants whose
questionnaire indicated a requirement for further investigation, and who consented to
being contacted, were followed up through an MDOT Clinic.
Results
One thousand and fifty one (1,05 1) completed questionnaires - 98% response rate.
The typical experience of menstruation in the MDOT sample includes: bleeding
patterns within normal parameters for this age group; menstrual pain, 94%; cramping
pain, 71 %; symptoms associated with menstruation, 98.4%; PMS symptoms, 96%;
mood disturbance before or during periods, 73%; school absence related to
menstruation, 26%; high menstrual interference on one or more life activity, 55.8%;
asymptomatic menstruation, 1 %; True response to 'My periods seem pretty normal'
7 1.4%.
Statistically significant associations were found between each and all of: menstrual
pain, symptoms, interference on life activities and school absence. The prevalence of
significant menstrual disturbance in the sample is approximately 25% where: 2 1 %
experienced severe pain; 26% reported school absence; 33% had seen a GP about
periods; 26.9% think there is something wrong with periods; 23.5% require follow up
based on individual scrutiny of each questionnaire; 10- 14% require further
investigation to rule out endometriosis. Referral and investigation of menstrual pain,
symptoms, and diagnosis of menstrual pathology in the sample was low.
Conclusion
The MDOT questionnaire has helped to establish a clearer picture of typical
menstruation in the population sample. Where 1% of girls reported having
asymptomatic menstruation, the majority of teenagers in the study reported menstrual
pain and symptoms that could be experienced as part of the dysmenorrhoeic syndrome
of symptoms, PMS, or underlying pathology such as endometriosis. Due to the
overlap in symptoms and a propensity to be dismissive of menstrual pain and
symptoms, many girls are suffering menstrual morbidities that could be well managed
with NSAIDs and the oral contraceptive pill (OCP) if non-pathological, or
investigated further if a menstrual pathology is suspected.
Considering these results the reported school absence rate of 26% is not surprising.
Whilst this study does not cost the true impact of menstrual disturbance on schooling,
the results of the MDOT questionnaire reflect significant physical and emotional
impact on a considerable number of teenager's lives which could also have
repercussions on education, schooling performance and other areas of their lives.
Future research is planned to determine the MDOT questionnaire's validity for
identifying pathological menstrual disorder so it can act as a screening tool to
facilitate earlier detection. Replication of the MDOT study should be done in younger
teenagers (from menarche) to determine menstrual disturbance in the younger age
group.
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