July 2024
Menstrual pain in adolescent girls and missed activities
By Dr Emily Lathlean MB BS, FRACGP
A longitudinal survey study has found a large proportion of adolescent girls in Australia experience period pain that affects their participation at school and in other activities.
The study, published in the Medical Journal of Australia, analysed survey data from the Longitudinal Study of Australian Children. Overall, 1600 participants of female biological sex had responded to questions about menstruation during at least one of three waves of data collection.
Dysmenorrhoea was reported by 35% of respondents at wave 6 (when participants were aged 14 years), 50% of respondents at wave 7 (when aged 16 years) and 46% at wave 8 (when aged 18 years). Very painful periods were reported by 12% of partici pants at wave 6, 23% at wave 7 and 18% at wave 8. Onequarter of respondents reported increas ing period pain over time and 10% reported declining pain over time.
‘Highlighting the high prevalence of dysmenorrhoea is needed to overcome the stigma attached to female pain,’ wrote Dr Courtney Munro, Senior Research Officer at Murdoch Children’s Research Institute, and Professor Sonia Grover, Research Fellow at Murdoch Children’s Research Institute and Honorary Clinical Professor in the University of Melbourne’s Faculty of Medicine, Dentistry and Health Sciences, in an accompanying editorial.
‘Like other chronic pain conditions, persistent pelvic pain, including dysmenorrhoea, results from a complex interplay of social, psychological, and biological factors,’ they wrote.
‘Persistent pelvic pain can have a negative effect on mood and mental health, and stressful life events conversely influence pain perception and health risk behaviours,’ they added.
About one-third of respondents reported missing at least one activity (school, social activities, sport or exercise, or work) because of their periods at each of the three waves. Participants with dysmenor rhoea were up to five times as likely to miss school or university as female participants without dysmenorrhoea.
‘An emphasis on diagnosis can delay prompt management of pain and symptoms,’ wrote Dr Munro and Professor Grover, who pointed out that continuous use of the combined oral contraceptive pill to suppress menses was a simple, but underused, method for managing dysmenorrhoea.
They also noted that persis tent pelvic pain received less attention than endometriosis, despite persistent pelvic pain being reported by about 25% of women, and one in 10 women having endometriosis.
‘The study by Cameron and colleagues makes clear that period and pelvic pain must be recognised and evidence based interventions provided to adolescents with persistent dysmenorrhoea if we are to improve their quality of life as adults,’ they stressed.
Med J Aust 2024; doi: 10.5694/ mja2.52288 and doi: 10.5694/ mja2.52290.