title: Epidemiology of dysmenorrhea among secondary-school students in Northern Saudi Arabia.
abstract: BACKGROUND
  Dysmenorrhea is one of the most common and important health problems, especially among young girls. It results in absence from school and work. It has some negative effects on the daily activities of patients. Because of cultural problems, patients ordinarily do not seek help from others in this situation. Identification of abnormal menstrual patterns during adolescence may permit early prevention of potential health concerns in adulthood.
  
  
  OBJECTIVE
  The aim of this study was to determine the prevalence, severity, and impact of dysmenorrhea in secondary-school students and its association with school absenteeism in Arar city.
  
  
  METHODS
  A cross-sectional descriptive study was conducted in four secondary schools for girls in Arar city on 344 secondary school students during the academic year 2015-2016. A self-administered questionnaire was distributed to all participants; questions were related to menstruation, elucidating variations in menstrual patterns, history of dysmenorrheal, and absenteeism from school.
  
  
  RESULTS
  All adolescent school girls completed the questionnaire (n=344). The prevalence of dysmenorrhea was 74.4% (n=256) (mild=21.1%, moderate=41.4%, and severe=37.5%). Family history of dysmenorrhea was reported among 65.6% and fatigue was the most commonly associated symptom (79.7%) among dysmenorrheic girls. Limitation of activities was reported by the majority of participants with dysmenorrhea. Activities affected by dysmenorrhea included homework (78.9%), daily activities (75%), class concentration (71.9%), school attendance (59.4%), and academic performance (52.3%); about 50.8% reported social withdrawal due to dysmenorrhea. Eighteen percent consulted a school physician and 57.8% received herbal drinks to alleviate symptoms of dysmenorrhea.
  
  
  CONCLUSIONS
  Dysmenorrhea is highly prevalent among adolescent secondary-school girls and is associated with school absenteeism and limitations on social and academic activities. Given that most adolescents do not seek medical advice for dysmenorrhea, healthcare providers should screen routinely for dysmenorrhea and offer treatment. As dysmenorrhea reportedly affects school performance, school administrators may have a vested interest in providing health education on this topic to their students. Health education has to be supplemented by availability of other services such as consultation with school nurse and school physician and availability of drugs that alleviate pain.
authors.affiliation: aFaculty of Medicine, Department of Public Health and Community Medicine, Al-Azhar University, Assiut, Egypt bIntern, Northern border medical college, Arar, Saudi Arabia.
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: Abd El-Mawgod
authors.forename: Arwa S
authors.initials: AS
authors.lastname: Alshaibany
authors.forename: Aeshah M
authors.initials: AM
authors.lastname: Al-Anazi
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000067697:Adolescent Health / Q000706:statistics & numerical data*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004412:Dysmenorrhea / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015995:Prevalence; D012529:Saudi Arabia / Q000453:epidemiology; D012574:Schools; D013334:Students; D011795:Surveys and Questionnaires