title: Dysmenorrhea, absenteeism from school, and symptoms suspicious for endometriosis in adolescents.
abstract: OBJECTIVE
  To quantify in adolescents the prevalence of dysmenorrhea and other symptoms found to be suggestive of future diagnosis of endometriosis, in particular their impact on monthly absenteeism from school/work, activity impairment, and sexual life and to quantify the awareness of endometriosis in adolescents.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Academic institution.
  
  
  METHODS
  Adolescents (n = 250) aged 14-20 years referring to 3 family Counseling services.
  
  
  METHODS
  Participants completed an anonymous questionnaire.
  
  
  METHODS
  Prevalence of dysmenorrhea and absenteeism from school/work during menses. Other outcomes were impairment of daily activities, dyspareunia, and awareness of endometriosis as a pathologic condition.
  
  
  RESULTS
  68% (170/250) of the participants complain of dysmenorrhea, 12% (30/250) lose days of school/work monthly because of dysmenorrhea, 13% (33/250) complain of intermenstrual pain which limits daily activities, 27% (56/208) of the adolescents who are sexually active complain of dyspareunia, 82% (203/250) have never heard about endometriosis and 80% (200/250) would like to know more about it. A significant association was found between severe dysmenorrhea, absenteeism from school/work, and basic level of education. Absence from school/work during menses showed an adjusted odds ratio for severe dysmenorrhea about 28 times greater than those who did not declare absenteeism (95%CI 7.898-98.920, P<.000).
  
  
  CONCLUSIONS
  The rates of dysmenorrhea and school absenteeism caused by dysmenorrhea are high. According to recent studies these patients are at higher risk of further development of endometriosis, whereas the knowledge of the disease is low among the adolescents investigated, so those involved with adolescents both in the health profession and particularly in schools and Family Counseling Services should be educated about endometriosis and its symptoms to reduce the significant lag time between symptoms and diagnosis.
authors.affiliation: Pelvic Endoscopy and Minimally Invasive Gynaecologic Surgery, S.Orsola Malpighi University Hospital, Bologna, Italy. Electronic address: letizia.zannoni@studio.unibo.it.
authors.forename: Letizia
authors.initials: L
authors.lastname: Zannoni
authors.affiliation: Pelvic Endoscopy and Minimally Invasive Gynaecologic Surgery, S.Orsola Malpighi University Hospital, Bologna, Italy.
authors.forename: Melinda
authors.initials: M
authors.lastname: Giorgi
authors.affiliation: Pelvic Endoscopy and Minimally Invasive Gynaecologic Surgery, S.Orsola Malpighi University Hospital, Bologna, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Spagnolo
authors.affiliation: Pelvic Endoscopy and Minimally Invasive Gynaecologic Surgery, S.Orsola Malpighi University Hospital, Bologna, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Montanari
authors.affiliation: Pelvic Endoscopy and Minimally Invasive Gynaecologic Surgery, S.Orsola Malpighi University Hospital, Bologna, Italy.
authors.forename: Gioia
authors.initials: G
authors.lastname: Villa
authors.affiliation: Pelvic Endoscopy and Minimally Invasive Gynaecologic Surgery, S.Orsola Malpighi University Hospital, Bologna, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Seracchioli
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D003430:Cross-Sectional Studies; D004412:Dysmenorrhea / Q000453:epidemiology*; D004414:Dyspareunia / Q000453:epidemiology; D004715:Endometriosis / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D015995:Prevalence; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Adolescents; Dysmenorrhea; Endometriosis; Endometriosis diagnosis; Pain adolescents