title: The menstrual disorder of teenagers (MDOT) study: determining typical menstrual patterns and menstrual disturbance in a large population-based study of Australian teenagers.
abstract: OBJECTIVE
  The aim of this study was to: (1) establish the typical experience of menstruation for senior high school girls and (2) determine how many experience considerable menstrual disturbance that could require further investigation and management of underlying pathology.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Senior High Schools in the Australian Capital Territory (ACT), Australia.
  
  
  METHODS
  A total of 1051 girls aged between 15 and 19 years.
  
  
  METHODS
  Data based on a quantitative survey.
  
  
  METHODS
  Self-reports of menstrual bleeding patterns, typical and atypical symptoms and morbidities.
  
  
  RESULTS
  Typical menstruation in adolescence includes pain (93%), cramping (71%), premenstrual symptoms (96%) and mood disturbance (73%). Highly significant associations were found between increasing severity of menstrual pain, number of menstrual-related symptoms, interference with life activities and school absence. These associations indicate that approximately 25% of the sample had marked menstrual disturbance: 21% experienced severe pain; 26% school absence; 26% suffering five or more symptoms; > or =24% reporting moderate to high interference with four out of nine life activities. Approximately 10% reported atypical symptoms associated with menstruation. Diagnosis of menstrual pathology in the sample was low, even though 33% had seen a GP and 9% had been referred to a specialist.
  
  
  CONCLUSIONS
  Menstrual pain and symptoms are common in teenagers. Girls indicating moderate to severe pain in association with a high number of menstrual symptoms, school absence and interference with life activities should be effectively managed to minimise menstrual morbidity. Those girls who do not respond to medical management should be considered for further investigation for possible underlying pathology, such as endometriosis.
authors.affiliation: Australian National University Medical School, Garran, Canberra, Australia. melissa.parker@act.gov.au
authors.forename: M A
authors.initials: MA
authors.lastname: Parker
authors.forename: A E
authors.initials: AE
authors.lastname: Sneddon
authors.forename: P
authors.initials: P
authors.lastname: Arbon
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D002648:Child; D003277:Contraceptives, Oral, Combined / Q000627:therapeutic use; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004412:Dysmenorrhea / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D004715:Endometriosis / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008572:Menarche / Q000502:physiology; D008598:Menstruation / Q000502:physiology* / Q000523:psychology; D008599:Menstruation Disturbances / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D011788:Quality of Life; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D003277:Contraceptives, Oral, Combined