Mehnaz Khakwani, Hasan Imran Zaidi, Nabila Tariq.
Adolescent age group; normal menstrual cycle and menstrual disorders.
Professional Med J Jan ;13(4):543-9.

Introduction: Puberty in girls is the phase of transition from child to mature woman. Menarche is the first menstrual period at puberty. The individual then becomes functionally capable of reproduction. Normally, it is a coherent process involving estrogen production, increased somatic growth and development of secondary sexual characteristics. Objective: To investigate the normal menstrual cycles and menstrual disorders in adolescent age group. Study design: Population based survey. Setting: Study was conducted in the various schools of Multan city. Material and Methods: 500 school going girls. Results: The pattern of menstrual bleeding among Pakistani girls. Majority of the (i.e. 170 (34%) girls had normal pattern of bleeding. The day of heaviest flow was day 2 i.e. 292(49%) followed by day 1 i.e. 192(38.4%) of the cases. Menorrhagia as revealed by passage of clots was present in 65(13%) of the cases. Majority of girls had their cycle duration between 28-30 days. More than 85% of girls used home made pads during periods. Majority 156(48.4%) of girls had dysmenorrhoea for 1st and 2nd day of the cycle. Dysmenorrhoea was found to be present in 322(64.4%) of the girls. About half of subjects developed dysmenorrhoea with the onset of menarche and about quarter started having dysmenorrhoea 3 months after menarche. Minority of the girls received education or information regarding periods prior to menarche. The majority was educated either with or after the menarche. Majority of subjects belonged to middle socio-economic status. Majority of girls had regular periods since menarche. Majority of the remaining had irregular periods for sometimes due to anovulatory cycles which were spontaneously normalized. Those girls who had irregular periods, in majority of cases the irregularity was corrected spontaneously after 3 months probably favouring earlier anovulatory cycles. Premenstrual symptoms were complained by 258(51.6%) of the girls. Majority 248(49.6%) of girls took menstruation as normal change of life. In majority 248(62.5%) of cases the mother and elder sister provided the information. Out of 500 girls, 397(79.4%) girls were either informed or educated about periods.

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