title: [Dysmenorrhea: a problem for the pediatrician?].
abstract: Dysmenorrhea is common in adolescent years, especially after the onset of ovulatory cycles, usually 2 to 3 years after menarche. Pain and symptoms are responsible for school absenteeism and interruption of sports and social activities.
  
  
  OBJECTIVE
  This study aims to measure the prevalence of severe dysmenorrhea and its consequences on adolescent girls in Switzerland. Treatment of dysmenorrhea is discussed and recommendations for clinical practice are given.
  
  
  METHODS
  Cross sectional survey (SMASH 02) on a nationally representative sample of adolescents (n=7548; 3340 females), aged 16 to 20 years who attended post-mandatory education. A self-administered questionnaire was used to assess the severity of dysmenorrhea and its consequences on daily life pursuit of medical help and medications used.
  
  
  RESULTS
  Among 3340 girls, 86.6% suffered from dysmenorrhea-related symptoms: 12.4% described having severe dysmenorrhea and 74.2% moderate dysmenorrhea. Girls with severe dysmenorrhea described heavier consequences on daily activities compared with girls without dysmenorrhea: 47.8% of girls with severe dysmenorrhea reported staying at home and 66.5% declared reducing their sportive activities. Yet, fewer than half have consulted a physician for this complaint and even fewer were treated properly.
  
  
  CONCLUSIONS
  The pediatrician has a pivotal role in screening young patients for dysmenorrhea, as well as, educating and effectively treating adolescent girls with menstruation-associated symptoms. Non-steroidal anti-inflammatory drugs are considered the first-line of treatment for dysmenorrhea, and adolescents with symptoms that do not respond to this treatment for 3 menstrual periods should be offered combined oestroprogestative contraception and must be followed up, as non-responders may have an underlying organic pathology.
  
  
  CONCLUSIONS
  Dysmenorrhea is a frequent health problem in adolescent years and adolescent care providers should be able to care for these patients in an efficient way.
authors.affiliation: Unité santé jeunes, département de l'enfant et de l'adolescent, université de Genève, hôpitaux universitaires de Genève, 87, boulevard de la Cluse, 1211 Genève 14, Suisse. francoise.narring@hcuge.ch
authors.forename: F
authors.initials: F
authors.lastname: Narring
authors.forename: M
authors.initials: M
authors.lastname: Yaron
authors.forename: A-E
authors.initials: AE
authors.lastname: Ambresin
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D004412:Dysmenorrhea / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D010372:Pediatrics; D015995:Prevalence; D012720:Severity of Illness Index; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult