Self-treatment patterns among adolescent girls with dysmenorrhea.
OBJECTIVE
To describe both non-pharmacologic and pharmacologic treatments used by adolescents with dysmenorrhea.


METHODS
Cross-sectional study.


METHODS
Urban academic medical center.


METHODS
Healthy adolescents aged 19 years or younger (n = 76) with moderate to severe primary dysmenorrhea were included; those using hormonal contraception were excluded.


METHODS
We collected baseline data via interview from adolescent girls at enrollment in a clinical trial of oral contraceptives versus placebo for primary dysmenorrhea. The interview data, collected prior to any intervention, included information on demographics, dysmenorrhea duration and severity, and self-treatment. We used the validated pain subscale of the Moos Menstrual Distress Questionnaire and a 0-10 pain rating scale to estimate pain severity.


METHODS
Investigator-administered questionnaire.


RESULTS
Adolescents' mean age was 16.8 years (SD = 2). Similar proportions described themselves as white (26%), black (30%) or Hispanic (28%). Dysmenorrhea was moderate in 42%, severe in 58%, associated with nausea in 55%, and vomiting in 24%. Of those attending school (n = 66), 46% reported missing one or more days monthly due to dysmenorrhea. Nearly all discussed their pain with someone; however, a minority sought formal medical care. All used nonpharmacological remedies such as sleeping and heat application. Nearly all used at least one medication, 31% reported using two, and 15% used three medications (not concurrently). Many participants reported using medication at sub-therapeutic doses for pain.


CONCLUSIONS
Adolescents with moderate and severe dysmenorrhea reported high morbidity. Girls used numerous non-pharmacologic remedies as well as medications for pain but infrequently accessed formal medical care. Medication dosing was often sub-therapeutic.
O'Connell
Katharine
K
Columbia University Medical Center, Department of Obstetrics and Gynecology, New York, New York 10032, USA. ko2032@columbia.edu
Davis
Anne Rachel
AR
Westhoff
Carolyn
C
D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004412:Dysmenorrhea / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009017:Morbidity; D009519:New York City / Q000453:epidemiology; D010147:Pain Measurement; D017699:Pelvic Pain / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D015995:Prevalence; D012648:Self Care / Q000523:psychology / Q000706:statistics & numerical data*; D012651:Self Medication / Q000523:psychology / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014505:Urban Population
D000700:Analgesics