LETTER TO EDITOR
|Year : 2007 | Volume
| Issue : 2 | Page : 156-157
Awareness and practices of menstruation and pubertal changes amongst unmarried female adolescents in a rural area of East Delhi
Parvathy Nair, Vijay L Grover, AT Kannan
Department of Community Medicine , University College of Medical Sciences & GTB Hospital, Dilshad Graden, Delhi - 110095, India
|Date of Submission||28-Apr-2005|
Department of Community Medicine , University College of Medical Sciences & GTB Hospital, Dilshad Graden, Delhi - 110095
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Nair P, Grover VL, Kannan A T. Awareness and practices of menstruation and pubertal changes amongst unmarried female adolescents in a rural area of East Delhi. Indian J Community Med 2007;32:156-7
|How to cite this URL:|
Nair P, Grover VL, Kannan A T. Awareness and practices of menstruation and pubertal changes amongst unmarried female adolescents in a rural area of East Delhi. Indian J Community Med [serial online] 2007 [cited 2019 May 20];32:156-7. Available from: http://www.ijcm.org.in/text.asp?2007/32/2/156/35668
This community-based cross-sectional study was conducted in the village of Gazipur in East Delhi from April 1998 to November 1998. Unmarried girls between the ages of 10-19 years comprised the study group. Only girls from the local permanent population who had resided in the village for at least five years before the inception of the study were included. There were 500 adolescent girls in the study area out of which 251 formed the study group. The 251 girls were interviewed through a door-to-door survey, using a precoded, pretested, and close-ended questionnaire. The main limitation was that whereas our inclusion criteria specified only unmarried, adolescent girls as eligible for the study, the average age at marriage in the study area was low and most older adolescent girls were already married. Out of the 251 girls, 127 had attained menarche.
Of the 251 girls, 71 (28.2%) were in the age-group of 10-11 years, 60 (23.9%) were in the age-group of 12-13 years, 52 (20.7%) were in the age group of 14-15 years, 35 (14%) were in the age-group of 16-17 years, and 33 (13.2%) were in the age-group of 18-19 years [Figure - 1].
The mean age at menarche was 13.6 years in the study group. Nearly half (45.7%) of the girls who had attained menarche and 29% of pre-pubertal subjects said that they had prior knowledge about menstruation. Mothers (41%) were the most common source of information about menstruation, followed by elder sisters (22.4%), friends (21%), relatives (6.7%), television (4.4%), books (3.3%), and doctors (1.1%).
While 92% of the girls said they were restricted from worshipping, 70% were restricted from participating in household activities, and 56% girls did not eat oily, cold, or spicy foods such as pickles during menstruation. Only 1.6% avoided bathing during menstruation. Ten girls reported that they did not observe restrictions of any kind. The majority (74.8%) of the girls used homemade sanitary pads, nearly 24% used ready-made sanitary pads, while 1.5% used cotton wool.
During menstruation, complaints like irritability, headache, malaise, and tenderness of the breasts affected 62.9%, 49.6%, 24%, and 9.4%, respectively. Dysmenorrhea was prevalent in 63.75%. Only one-third of the girls did not complain of any premenstrual symptoms. The association of age with premenstrual complaints was not significant ( P >0.05)
Almost all the girls were aware of the weight and height gain that occurred with puberty; 59.7% were aware of the breast enlargement and 33.8% of the growth of axillary and pubic hair that accompanied puberty. Two-thirds of the study subjects had knowledge of menstruation. Only a third (33.4%) of the girls were aware of all the pubertal changes. The association between awareness of pubertal changes and increasing age was statistically significant ( P <0.001).
The mean age at menarche in our study group (13.6 years) was consistent with the 13.6 years and 13.5 years observed in the Chennai  and Delhi  surveys, respectively.
In the present study 45.5% of the girls had knowledge of menstruation prior to menarche, which is similar to the observations made by Gandhi.  Ahuja et al .  reported lower levels of awareness (28%), while in the ICMR Delhi survey , awareness was found to be 66.1%. These variations can be due to the different regions surveyed and differences in the socioeconomic status and literacy status of the study subjects in the respective studies.
Restrictions on many day-to-day activities during menstruation was common in our study group, which has also been reported by other Indian studies. Two different studies have reported that 81.5% and 50% of girls in Guntur  and Pant Nagar,  respectively, were forbidden from worshipping. More than half (56%) of the girls in the Guntur study observed restrictions on food.  The ICMR study on Delhi slum children reports that 10-20% of the girls observed taboos or restrictions during periods. Differing observations may be accounted for by rural-urban differences and regional variations in views and attitudes. 
The prevalence of dysmenorrhea in our study (63.75%) was comparable to the 57% and 61% prevalence found in the Mumbai  and Chennai  studies, respectively. The majority of the study subjects were aware of menarche, while awareness regarding breast development and the appearance of axillary and pubic hair with puberty was low, which is consistent with the results from the Pant Nagar survey. 
| References|| |
|1.||Shiela, W, Malathy K, Premila, S. Menstrual and gynaecological disorders in 500 school girls in Madras city. J Obstet Gynaecol India 1993;43:940-5.th |
|2.|| Grover VL. Final report on a study of reproductive health awareness and sexual behaviour among adolescents in Delhi: Report submitted to ICMR: Delhi; 1998.th |
|3.|| Gandhi AB, Kakodkar PC, Raval MY. The role of audio-visual programmes in creating awareness about 'Reproductive Health' in adolescent girls. J Obstet Gynaecol India 1993;43:257-61. |
|4.||Ahuja A, Tewari S. Awareness of pubertal changes among adolescent girls. J Fam Welfare 1995;41:46-50. |
|5.||Drakshayani Devi K, Venkata Ramaiah P. A study on menstrual hygiene among rural adolescent girls. Indian J Med Sci 1994;48:139-43. [PUBMED] [FULLTEXT]|
[Figure - 1]
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