{"paper_id":"5d58a946-2505-42ac-a7ef-650702a817a4","body_text":"Abstract\nThis study aimed to investigate the characteristics of symptoms related to the menstrual cycle and their impact on social activities in young teenage girls. Between March and June 2009, all girls born in 1996 who were residents of eight regions in Flanders (Belgium) received a semi-structured questionnaire, including questions about the age of menarche, characteristics of the menstrual cycle, and its impact on social activities. Participants were 792 13-year-old girls (15.7 % of the target population). Out of 363 (47.2 % of participants) postmenarcheal girls, 41.6 % (95 % confidence interval (CI) 36.4–47.0 %) reported painful menstruations. The proportion of girls with painful menstrual periods decreased approximately 16 % with each year the age at menarche increased (relative risk (RR) = 0.84; 0.73–0.98; p < 0.05) and was positively correlated with the amount of blood loss (RR = 0.33; 0.16–0.67; p < 0.05 when little and 1.85; 1.49–2.31; p < 0.001 when abundant, compared to average). One in four (25.4 %) postmenarcheal girls indicated a negative impact of menstruation on social activities, but this proportion was significantly higher in girls who experienced menstruation as painful (41.3 %) compared to those who did not (14.2 %).\nConclusion: Early menstrual complaints are common in young adolescent girls and the likelihood of pain increased significantly with lower menarcheal age.\nWhat is Known? • Menstrual cycle-related symptoms may negatively interfere with school absence and social activities. • Early menarche and severe dysmenorrhea are correlated with endometriosis. |\nWhat is New? • In this large population-based study on the characteristics of the menstrual cycle in young teenage girls at or shortly after menarche, painful menstruation was highly prevalent (41.7 %), but related school absenteeism was low (3.2 %). The likelihood of pain increased significantly with lower menarcheal age. • The findings support the need for a systematic evaluation of the characteristics of the menstrual cycle shortly after menarche. |\nSimilar content being viewed by others\nAbbreviations\n- CI:\n-\nConfidence interval\n- mm:\n-\nMillimeter\n- MDOT:\n-\nMenstrual disorder of teenagers\n- RR:\n-\nRelative risk\n- WHO:\n-\nWorld Health Organization\nReferences\nAgarwal A, Venkat A (2009) Questionnaire study on menstrual disorders in adolescent girls in Singapore. J Pediatr Adolesc Gynecol 22:365–371\nBalbi C, Musone R, Menditto A et al (2000) Influence of menstrual factors and dietary habits on menstrual pain in adolescence age. Eur J Obstet Gynecol Reprod Biol 91:143–148\nBourdel N, Matsusaki S, Roman H et al (2006) Endometriosis in teenagers. Gynecol Obstet Fertil 34:727–734\nDarrow S, Vena J, Batt R, Zielezny M, Michalek A, Selman S (1993) Menstrual cycle characteristics and the risk of endometriosis. Epidemiology 4(2):135–42\nEmmert C, Romann D, Riedel H (1998) Endometriosis diagnosed by laparoscopy in adolescent girls. Arch Gynecol Obstet 261:89–93\nEryilmaz G, Ozdemir F, Pasinlioglu T (2010) Dysmenorrhea prevalence among adolescents in eastern Turkey: its effects on school performance and relationships with family and friends. J Pediatr Adolesc Gynecol 23:267–272\nFederale Overheidsdienst (FOD) Economie, K.M.O., Middenstand en Energie (2009) Statistieken en economische informatie bevolking op 1/1/2009. Bevolking per nationaliteit, geslacht, leeftijdsgroepen. Available via http://statbel.fgov.be/nl/modules/publications/statistiques/bevolking/population_natio_sexe_groupe_classe_d_ges_au_1er_janvier_2009.jsp. Accessed on 30 June 2014\nFederale Overheidsdienst (FOD) Economie, K.M.O., Middenstand en Energie (2011) Statistieken en economische informatie bevolking. Belangrijke arbeidsmarktindicatoren volgens leeftijd en geslacht (België en de regio‟s) – absolute en relatieve cijfers (1999-2Q2011). Available via http://statbel.fgov.be/nl/statistieken/cijfers/arbeid_leven/werk/ Accessed on 30 June 2014\nFinney D (1952) Probit analysis. Cambridge University Press, Cambridge\nGe X, Wang Y, Zhang Y, Li P (2003) Epidemiological study on 132 women in primary dysmenorrhea and clinical observation on efficacy of Dang Gui Shao San. Shu Li Yi Yao Za Zhi [J Math Med] 16:409–410\nGuérin C, Pieters C, Roelants M, Van Leeuwen K, Desoete A, Wiersema K, Hoppenbrouwers K (2012) Sociodemographic profile and health of 6- and 12-years-old youngsters (cohorts JOnG!) in Flanders. Policy Research Centre of Welfare, Health and Family. Report [Dutch]. Available via www.steunpuntwvg.be. Accessed on 20 March 2014\nHan M, Pan L, Wu B, Bian X (1994) A case-control epidemiologic study of endometriosis. Chin Med Sci J 9(2):114–8\nKlein J, Litt I (1981) Epidemiology of adolescent dysmenorrhea. Pediatrics 68:661–4\nKontoravdis A, Hassan E, Hassiakos D, Botsis D, Kontoravdis N, Creatsas G (1999) Laparoscopic evaluation and management of chronic pelvic pain during adolescence. Clin Exp Obstet Gynecol 26:76–77\nLaufer M, Goitein L, Bush M, Cramer D, Emans S (1997) Prevalence of endometriosis in adolescent girls with chronic pelvic pain not responding to conventional therapy. J Pediatr Adolesc Gynecol 10:199–202\nLaufer M, Sanfilippo J, Rose G (2003) Adolescent endometriosis: diagnosis and treatment approaches. J Pediatr Adolesc Gynecol 16:S3–11\nMatalliotakis I, Arici A, Cakmak H, Goumenou A, Koumantakis G, Mahutte N (2008) Familial aggregation of endometriosis in the Yale series. Arch Gynecol Obstet 278(6):507–11\nMishra G, Cooper R, Tom S, Kuh D (2009) Early life circumstances and their impact on menarche and menopause. Womens Health 5:175–190\nMissmer S, Hankinson S, Spiegelman D, Barbieri R, Malspeis S, Willett W et al (2004) Reproductive history and endometriosis among premenopausal women. Obstet Gynecol 104(5 Pt 1):965–74\nNnoaham K, Webster P, Kumbang J, Kennedy S, Zondervan K (2012) Is early age at menarche a risk factor for endometriosis? A systematic review and meta-analysis of case-control studies. Fertil Steril 98(3):702–12, e6\nOrganisation for Economic Co-operation and Development (OECD) (2010) Education at a Glance 2010: OECD indicators. Available via http://www.oecd.org/edu/eag2010. Accessed on 20 March 2014\nParent A, Teilmann G, Jull A, Skakkebaek N, Toppari J, Bourguignon J-P (2003) The timing of normal puberty and the age limits of sexual precocity: variations around the world, secular trends, and changes after migration. Endocr Rev 24:668–693\nParker M, Sneddon A, Arbon P (2010) The menstrual disorder of teenagers (MDOT) study: determining typical menstrual patterns and menstrual disturbance in a large population-based study of Australian teenagers. BJOG 117:185–192\nReese K, Reddy S, Rock J (1996) Endometriosis in an adolescent population: the Emory experience. J Pediatr Adolesc Gynecol 9:125–128\nRoelants M, Hauspie R, Hoppenbrouwers K (2009) References for growth and pubertal development from birth to 21 years in Flanders, Belgium. Ann Hum Biol 36:680–694\nSchroeder B, Sanfilippo J (1999) Dysmenorrhea and pelvic pain in adolescents. Pediatr Clin North Am 46:555\nSignorello L, Harlow B, Cramer D, Spiegelman D, Hill J (1997) Epidemiologic determinants of endometriosis: a hospital-based case-control study. Ann Epidemiol 7(4):267–741\nRimpelä TJ (1989) Menstrual pain, health and behaviour in girls. Soc Sci Med 29:163–169\nTreloar S, Bell T, Nagle C, Purdie D, Green A (2010) Early menstrual characteristics associated with subsequent diagnosis of endometriosis. Am J Obstet Gynecol 202:534.e1-6\nVercellini P, Fedele L, Arcaini L, Bianchi S, Rognoni M, Candiani G (1989) Laparoscopy in the diagnosis of chronic pelvic pain in adolescent women. J Reprod Med 34:827–830\nWHO (2001) The Global Burden of Disease 2000 project: aims, methods and data sources. In: Global Programme on Evidence for Health Policy Discussion Paper No. 36 (revised)\nWilson C, Keye W (1989) A survey of adolescent dysmenorrhea and premenstrual symptom frequency. J Adolesc Health Care 10:317–322\nZegeye D, Megabiaw B, Mulu A (2009) Age at menarche and the menstrual pattern of secondary school adolescents in northwest Ethiopia. BMC Womens Health 9:29\nZhu X, Wong F, Bensoussan A, Kai Lo S, Zhou C, Yu J (2010) Are there any cross-ethnic differences in menstrual profiles? A pilot comparative study on Australian and Chinese women with primary dysmenorrhea. J Obstet Gynaecol Res 36:1093–1101\nAcknowledgments\nThe JOnG! cohort study was conducted in the framework of the Policy Research Centre of Welfare, Public Health and Family, and funded by the Flemish Government. This investigation was conducted with the support of the Clinical Research Foundation of the University Hospitals Leuven, the Research Foundation Flanders, and the Special Research Fund of the University Leuven.\nAuthor’s contribution\nKarel Hoppenbrouwers (KH), Mathieu Roelants (MR), Christel Meuleman (CM), Anna Rijkers (AR), Karla Van Leeuwen (KVL), Annemie Desoete (AD), Thomas D’Hooghe (TD)\nKH, KVL, and AD were responsible for the study design and supervised the acquisition of data. AR and MR analyzed the data under supervision of KH, TD, and CM. Results were interpreted by all authors. AR and KH wrote the first draft, which was revised by all authors. All authors approved the final version of the manuscript.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nConflict of interest\nThe authors declare that they have no competing interests.\nEthics approval and consent to participate\nWritten informed consent was obtained from each participant and from a parent or legal guardian. The JOnG! study was approved by the Medical Ethics Committees of the University of Leuven and of the University of Ghent.\nAdditional information\nCommunicated by Patrick Van Reempts\nRights and permissions\nAbout this article\nCite this article\nHoppenbrouwers, K., Roelants, M., Meuleman, C. et al. Characteristics of the menstrual cycle in 13-year-old Flemish girls and the impact of menstrual symptoms on social life. Eur J Pediatr 175, 623–630 (2016). https://doi.org/10.1007/s00431-015-2681-7\nReceived:\nRevised:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00431-015-2681-7","source_license":"public-domain-us","license_restricted":false}