Pattern and features of menstruation among adolescent girls in Haldwani: a cross-sectional study


  • Neha Goyal Department of Community Medicine, Teerthanker Mahaveer Medical College and Research Centre, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India



Adolescent, Dysmenorrhea, Menarche, Menstrual pattern


Background: Menstruation becomes an important aspect in life of an adolescent girl once she attains puberty and is often associated with variable characteristics. Being a development process and a reported significant source of morbidity too, it becomes important to study its pattern and characteristics. The purpose of this study was to determine the pattern of menstruation among adolescent girls.

Methods: A cross sectional study was conducted among 574 adolescent girls of 10-19 years age of 6th to 12th grades in four selected government and private schools of Haldwani. Data was collected using a predesigned semi-structured questionnaire with brief interview and examination. Analysis of data was done with help of SPSS version 21.

Results: Mean age of the girls was 14.95±1.41 years. Mean age at menarche was 12.94±1.01 years. Majority of girls 441 (76.82%) had cycle length of 21-35 days and it was found that 95 (16.55%) girls had irregular menstrual periods. Rural and urban differences in regularity of menstruation were statistically significant. Duration of flow in majority 300 (52.26%) of girls was 2-4 days followed by 5-7 days in 222 (38.68%). Dysmenorrhoea was reported by 422 (73.52%) of adolescent girls and of them 259 (61.37%) have never used analgesics while 66 (15.63%) have always used analgesics. Girls with absence of pallor were 1.2 (0.8-1.9) times more likely to have regular menstruation as compared to those showing pallor.

Conclusions: Irregular menstruation was common among girls and significant association was found with place of residence. Dysmenorrhoea was present in three-fourth of adolescent girls still majority of them have never used analgesics. Daily routine was affected in more than 80% of girls during menstruation.



Global Accelerated Action for the Health of Adolescents (AA-HA!): guidance to support country implementation. Geneva: World Health Organization; 2017.p.1. Available at Accessed 9 April 2018.

Park K. Demography and Family Planning. Text Book of Preventive and Social Medicine. 24th ed. Jabalpur: Banarasi Das Bhanot; 2017: p.516.

Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Committee Opinion No. 651. American College of Obstetricians and Gynecologists. Obstet Gynecol 2015; 126:e143-6.

Padubidri VG, Daftary SN. Chapter 4: Puberty, paediatric and adolescent gynaecology. Shaw’s textbook of Gynaecology.16th ed. New Delhi: RELX India Private Limited; 2016. 51-63.

Pathak PK, Tripathi N, Subramanian SV. Secular trends in menarcheal age in India-evidence from the Indian human development survey. PLoS ONE. 2014;9(11):1-13.

Fraser IS, Critchley HD, Broder M, Munro MG. The FIGO Recommendations on Terminologies and Definitions for Normal and Abnormal Uterine Bleeding. Seminars in Reproductive Medicine. 2011; 29(5):383-90. Available at Accessed on 9 April 2018.

Rigon F, De Sanctis V, Bernasconi S, Bianchin L, Bona G, Bozzola M, et al. Menstrual pattern and menstrual disorders among adolescents: an update of the Italian data. Italian J Pediatr. 2012;38(1):38.

Van Hooff MH, Voorhorst FJ, Kaptein MB, Hirasing RA, Koppenaal C, Schoemaker J. Relationship of the menstrual cycle pattern in 14-17 year old adolescents with gynaecological age, body mass index and historical parameters. Human Reproduction (Oxford, England). 1998;13(8):2252-60.

World Health Organization. WHO Growth Reference 2007 for 5-19 years to monitor the growth of school-age children and adolescents; 2014. Available at: Accessed 9 April 2018.

Nair P, Grover VL, Kannan AT. Awareness and practices of menstruation and pubertal changes amongst unmarried female adolescents in a rural area of East Delhi. Indian J Community Med. 2007;32:156-7.

Tarannum F, Khalique N, Eram U. A community-based study on age of menarche among adolescent girls in Aligarh. Int J Community Med Public Health 2018; 5:395-400.

Mittal K, Goel MK. Knowledge regarding reproductive health among urban adolescent girls of Haryana. Indian J Comm Med. 2010;35(4):529-30.

Thakre S.B, Thakre S, Ughade S, Thakre A.D. Urban-rural differences in menstrual problems and practices of girl students in Nagpur, India. Indian Paediatr. 2012;49:733-6.

Iyer P, Modi JN. Menstrual cycle characteristics and associated physical problems among school going adolescent girls. Int J Reprod Contracept Obstet Gynecol. 2015;4:1076-8.

Deo DS, Ghattargi CH. Menstrual problems in the adolescent school girls: a comparative study in rural and urban area. Ind J Prev Soc Med. 2007; 38(1,2).

Ambade R, Sagdeo M. Age at menarche and the menstrual pattern of secondary school adolescents in central India. Int J Res Med Sci. 2017; 5:3610-4.

Vani R, Veena K.S, Subitha L, Kumar H.V. Menstrual abnormalities in school going girls-are they related to dietary and exercise pattern. J Clin Diag Res. 2013;7(11):2537.

Jain K, Garg SK, Singh JV, Bhatnagar M, Chopra H, Bajpai SK. Reproductive health of adolescent girls in an urban population of Meerut, Uttar Pradesh. Health and Population: Perspectives and Issues 2009;32(4):204-9.

Jailkhani SM, Naik JD, Thakur MS, Langre SD, Pandey VO. Patterns and problems of menstruation amongst the adolescent girls residing in the urban slum. Sch J App Med Sci. 2014;2:529-34.

Dambhare DG, Wagh SV, Dudhe JY. Age at menarche and menstrual cycle pattern among school adolescent girls in Central India. Global J Health Sci. 2012;4(1):105.

Kanotra SK, Bangal VB, Bhavthankar DP. Menstrual pattern and problems among rural adolescent girls. Int J Biomed Adv Res. 2013;4(8):551-4.

Indupalli AS. Health status of adolescent girls in an urban community of Gulbarga district, Karnataka. Indian J Public Health. 2009; 53(4):232-4.

De Sanctis V, Bernasconi S, Bianchin L, Bona G, Bozzola M, Buzi F, et al. Onset of menstrual cycle and menses features among secondary school girls in Italy: A questionnaire study on 3,783 students. Indian J Endocrinol Metab. 2014;18(Suppl 1):S84.

Sharma S, Deuja S, Saha CG. Menstrual pattern among adolescent girls of Pokhara Valley: a cross sectional study. BMC Women's Health. 2016;16(1):74.

Esimai OA, Esan GO. Awareness of menstrual abnormality amongst college students in urban area of Ile-Ife, Osun State, Nigeria. Indian J Comm Med. 2010;35(1):63-6.

Solanki H, Gosalia V, Patel H, Vora F, Singh MP. A Study of Menstrual Problems and practices among girls of Mahila College. NJIRM. 2012;3(4):24-7.

Lee LK, Chen PC, Lee KK, Kaur J. Menstruation among adolescent girls in Malaysia: a cross-sectional school survey. Singapore Med J. 2006;47(10):869-74.

Salve SB, Dase RK, Mahajan SM, Adchitre SA. Assessment of knowledge and practices about menstrual hygiene amongst rural and urban adolescent girls–a comparative study. Int J Recent Trends Sci Technol. 2012;3(3):1-3.

Davis AR, Westhoff CL. Primary dysmenorrhea in adolescent girls and treatment with oral contraceptives. J Pediatr Adolesc Gynecol. 2001;14:3-8.

Cakir M, Mungan I, Karakas T, Girisken I, Okten A. Menstrual pattern and common menstrual disorders among university students in Turkey. Pediatr Int. 2007;49(6):938-42.

Sachan B, Idris MZ, Jain S, Kumari R, Singh A. Age at menarche and menstrual problems among school-going adolescent girls of a North Indian district. J Basic Clin Reprod Sci. 2012;1:56-9.

Sangwan G, Vashisht BM. Menstrual pattern and prevalence of dysmenorrhea among school going adolescent girls in a rural block of Haryana: A cross sectional study. Global J Med Public Health. 2017;6(2):1-5.

Agarwal A.K, Agarwal A. A study of dysmenorrhea during menstruation in adolescent girls. Indian J Comm Med. 2010;35(1):159-64.

Avasarala AK, Panchangam S. Dysmenorrhoea in different settings: are the rural and urban adolescent girls perceiving and managing the dysmenorrhoea problem differently. Indian J Comm Med. 2008;33(4):246-9.

Chan SS, Yiu KW, Yuen PM, Sahota DS, Chung TK. Menstrual problems and health-seeking behaviour in Hong Kong Chinese girls. Hong Kong Med J. 2009;15(1):18-23.

Kulkarni MV, Durge PM. Reproductive health morbidities among adolescent girls: Breaking the Silence! Studies on Ethno Med. 2011;5(3):165-8.

Miiro G, Rutakumwa R, Nakiyingi-Miiro J, Nakuya K, Musoke S, Namakula J, et al. Menstrual health and school absenteeism among adolescent girls in Uganda (MENISCUS): a feasibility study. BMC Women's Health. 2018;18(1):4.






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