Adolescent Dysmenorrhea : Prevalence, Severity, Experience and Management in the Use of Medication in High School Girls in Ille-et-Vilaine
Condition: Adolescent Dysmenorrhea
MeSH terms: Dysmenorrhea
Study type: Observational

Summary: 
      Dysmenorrhea or painful menstruation is a common symptom of menses. Dysmenorrhea is defined
      as a painful, cramping sensation in the lower abdomen or back associated with menstrual
      periods and is classified into primary and secondary types. Primary dysmenorrhea is painful
      menstrual periods not due to other diseases, and often occurs soon after menarche. Secondary
      dysmenorrhea is due to an underlying pelvic abnormality, such as endometriosis.

      Dysmenorrhea is the most common gynecological complaint. In many studies, the prevalence of
      primary dysmenorrhea varies between 34 % in 2010 in Egypt, 86.6% in 2002 in Switzerland, and
      21% in 1999 in France.

      Nowadays, physiopathology is better understood, which suggests that the investigators have
      treatments Although dysmenorrhea is a common concern, many women never seek medical advice,
      even though treatments are easily available and simple.

      In fact, despite the high prevalence, dysmenorrhea is undertreated and even disregarded by
      health professionals, and the girls themselves, who may accept it as a normal part of the
      menstrual cycle.

      The pain occurs just before and/or during menstruation ; it can be mild to severe and is
      frequently associated with many other symptoms, like nausea, vomiting, headache, diarrhea,
      tiredness and has many consequences in wellbeing and school. Dysmenorrhea is known to be the
      first cause of absenteism from school, and appears to have many consequences and a real
      impact on women's daily activities, which is why it's a public health problem.

      Because of the lack of recent studies in France, the aim of this study is to evaluate the
      prevalence of adolescent dysmenorrhea. The investigators also assessed its severity, how
      adolescent girls experienced their menses, and how they manage their pain (seeking medical
      consultation, use of medication).

      The investigators used a self-assessment questionnaire in a cohort of high school girls, aged
      15 to 19 years old, during April and May of 2019, in 8 private and public high schools in
      Ille-et-Vilaine.
    

Detailed description: 
      It was an observational, quantitative and prospective study, in a cohort of adolescent girls,
      to assess the prevalence of adolescent dysmenorrhea through an anonymous self-assessment
      questionnaire, which took place in 8 randomised public and private high schools in
      Ille-et-Vilaine, Brittany, France.

      Only adolescents aged between 15 and 19 years old who agreed to participate were included.
      Girls who had experienced primary or secondary amenorrhea for more than 6 months in the past
      year were excluded.

      The target number of participants was 770 adolescents girls aged between 15 and 19 years old.

      The main objective was to determine the prevalence of dysmenorrhea within adolescent girls in
      a sample in France.

      The other objectives were to assess the severity, how girls experienced their menses, the
      consequences on daily living activities or at school, and how they manage their pain.

      The severity of dysmenorrhea were assessed with Andersch and Milsom's scale and Numerical
      Rating Scale (NRS).

      First of all, the investigators also obtained the authorization of the Committee of
      Protection of People of Montpellier University Hospital.

      After that, the investigators contacted the high school principals of the 8 high schools
      which were randomized, and obtained their authorization to organise this study in their
      schools.

      The investigators gave an information to the parents and adolescent girls about ten days
      before the study. If a girl or their parents didn't want their daughter to participate, they
      could inform the high school principal or the school nurse. The investigators asked the nurse
      or the directos of high schools to make a randomisation of the girls.

      Then, the investigators gathered them in a classroom, with no boys, to make sure that the
      girls felt free and confident enough to complete the questionnaire in the most honest way.
      The investigators gave them the questionnaires, and let them complete it, which took about
      15-20 minutes.

      The main investigator was present to answer the girls if any questions were not understood.

      After completion, the questionnaires were immediately retrieved by the main investigator.

      Finally, the investigators briefly communicated what menses are and other symptoms, how to
      relieve the pain, with or without medication, and in what case the girls must see a doctor.
      The investigators gave them an advice sheet. The aim was to improve the management of
      dysmenorrhea and their quality of life by informing adolescent girls of the availability of
      effective therapy and the need to consult a doctor in some situations.

      A sample of 960 adolescents completed the questionnaire, and 19 were excluded. The prevalence
      of dysmenorrhea will be calculated. Then, the investigators will analyze the sample.

      These results will provide a better understanding of dysmenorrhea, its recent prevalence, its
      severity, its influencing factors and its consequences on daily activities. This study will
      help to better know the impact of dysmenorrhea, which is frequently underestimated and
      misunderstood by girls themselves, their parents, their families and their teachers.

      In addition, throughout this study, the reasons why adolescent girls may not want to seek
      medical consultation might be known. The investigators could as general practitionner or
      gynecologist better explain and advise adolescent girls, offer them relief and better
      conditions of life, while staying aware of the possibility of secondary dysmenorrhea.
    

Intervention name(s): Anonymous survey
Intervention type(s): Other
Intervention description(s): Anonymous questionnaire to determine the prevalence of dysmenorrhea of adolescent girls, to assess the severity of dysmenorrhea, how girls experience their menses, the consequences on daily living activities or at school, and how they manage their pain.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Cohort of adolescent girls aged between 15 and 19 years old who go to a private or public
        highschool in Ille-et-Vilaine A sample of 960 girls were obtained
      
Keywords: Dysmenorrhea; Primary dysmenorrhea; Secondary dysmenorrhea; Pelvic pain; Menstrual pain; Adolescent; Endometriosis