title: Age at menarche and menstrual cycle pattern among school adolescent girls in Central India.
abstract: BACKGROUND
  The onset of menstruation is part of the maturation process. However, variability in menstrual cycle characteristics and menstrual disorders are common. The purpose of this study was to determine the age at menarche and patterns of menstruation among school adolescent girls and explore its variation across socio-economic and demographic factors.
  
  
  METHODS
  This is a cross-sectional descriptive study carried out on 1100 school adolescent girls in district Wardha, Central India. Data were collected using a self-administered structured questionnaire on menstruation. Data was entered and analyzed by using Epi Info 6.04 software package. Chi- square value was used for testing statistical significance.
  
  
  RESULTS
  Mean ages of menarche were 13.51 + 1.04 years and 13.67 + 0.8 years for urban and rural areas respectively. Abnormal cycle length was common and affected 30.48%. The majority 56.15 experienced dysmenorrhoea and 56.16 percent had premenstrual syndrome. Self medication was practiced by 7.13% of the adolescent girls. The most common premenstrual symptom was headache 26.74%. Absenteeism from the school 13.9% was the effect of menstruation related problems on their daily routine. Dysmenorrhea and premenstrual symptoms were perceived as most distressing symptoms leading to school absenteeism. Majority of the girls 75.58% had discussed menstrual problems with someone, most commonly with their mothers 38.15%. There was a general lack of information about menstrual issues especially with regards to cycle length, duration of menses and age at menarche. Girls from families of high socio-economic class have significantly lower mean menarcheal age in both urban and rural area. The mean age of menarche was significantly higher in girls involved in vigorous sporting activity in urban area compared to their non-sporting counterparts.
  
  
  CONCLUSIONS
  Age at menarche was delayed. The menstrual disorders among female adolescents are common. A school health education on menstrual problems targeting adolescent girls and their parents and routine screening for menstrual problems by healthcare providers can help to prevent the absenteeism in the school.
authors.affiliation: Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Maharashtra, India. darampal21@yahoo.com
authors.forename: Dharampal G
authors.initials: DG
authors.lastname: Dambhare
authors.forename: Sanjay V
authors.initials: SV
authors.lastname: Wagh
authors.forename: Jayesh Y
authors.initials: JY
authors.lastname: Dudhe
mesh_terms: D000293:Adolescent; D000367:Age Factors; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008572:Menarche; D008597:Menstrual Cycle / Q000502:physiology*; D008599:Menstruation Disturbances / Q000453:epidemiology* / Q000503:physiopathology*; D015995:Prevalence; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires