Study objective: Adolescence, the transitional phase of physical and mental development between childhood and adulthood, is characterized by immense hormonal changes. Owing to the immaturity of the hypo-thalamo-pituitary-ovarian axis, menstrual cycles tend to be rather irregular. This variability poses a dilemma for physicians treating these girls and may result in a delay in the diagnosis and treatment of underlying problems. The purpose of this study was to collect data on the characteristics of menstrual cycles in Singapore adolescents to determine the prevalence of menstrual abnormalities and the pattern of use of medical treatments for these abnormalities.
Design: Cross-sectional study using a self-administered, 27-point structured questionnaire.
Setting: Sixty-two secondary schools and junior colleges in Singapore from January to December 2004.
Participants: Data from 5561 girls, 12 to 19 years old, were included in the analysis.
Results: Of the 5561 participants, 23.1% reported having irregular cycles. Oligomenorrhea was the most frequently reported problem (15.3%), and polymenorrhea was much less prevalent (2.0%). With increasing body mass index (BMI), there was a significant increase in the prevalence of oligomenorrhea, whereas polymenorrhea was more prevalent in the girls with a low BMI. Dysmenorrhea was a significant problem, with 83.2% respondents reporting it in various degrees and 24% girls reporting school absenteeism owing to it. Dysmenorrhea was severe enough to require analgesics for pain relief in 45.1% of all subjects. In spite of menstrual problems being common, only 5.9% girls reported seeking medical advice for them. Traditional Chinese medications were used most commonly for menstrual cycle problems, and over-the-counter medications for dysmenorrhea. The use of oral contraceptives for menstrual problems was minimal.
Conclusion: Menstrual problems among adolescent females are common and a significant source of morbidity in this population. However, adolescent girls are reluctant to seek medical treatment, leading to delay in diagnosis and treatment. Appropriate health education measures need to be put into place to prevent this trend.