Menstrual characteristics and dysmenorrhea among Palestinian adolescent refugee camp dwellers in the West Bank and Jordan: a cross-sectional study

Abstract

Background Women and girls experience menstruation throughout their reproductive years. Normal adolescent menstrual cycles gauge current and future reproductive health. Dysmenorrhea (painful menstruation) is the most prevalent menstrual disturbance in adolescents that can be debilitating. This study examines the menstrual characteristics of adolescent girls living in Palestinian refugee camps in the West Bank of the Israeli-occupied Palestinian territory and Jordan, including estimates of dysmenorrhea levels and associated factors. Methods A household survey of 15 to 18-year-old adolescent girls was conducted. Trained field workers collected data on general menstrual characteristics and dysmenorrhea level using Working ability, Location, Intensity, Days of pain Dysmenorrhea scale (WaLIDD), in addition to demographic, socio-economic, and health characteristics. The link between dysmenorrhea and other participant characteristics was assessed using a multiple linear regression model. Additionally, data on how adolescent girls cope with their menstrual pain was collected. Results 2737 girls participated in the study. Mean age was 16.8 ± 1.1 years. Mean age-at-menarche was 13.1 ± 1.2; mean bleeding duration was 5.3 ± 1.5 days, and mean cycle length was 28.1 ± 6.2 days. Around 6% of participating girls reported heavy menstrual bleeding. High dysmenorrhea levels were reported (96%), with 41% reporting severe symptoms. Higher dysmenorrhea levels were associated with older age, earlier age-at-menarche, longer bleeding durations, heavier menstrual flow, skipping breakfast regularly, and limited physical activity patterns. Eighty nine percent used non-pharmacological approaches to ease menstrual pain and 25% used medications. Conclusion The study indicates regular menstrual patterns in terms of length, duration, and intensity of bleeding and a slightly higher age-at-menarche than the global average. However, an alarmingly high prevalence of dysmenorrhea among participants was found that tends to vary with different population characteristics, some of which are modifiable and can be targeted for better menstrual health.This research emphasizes the need for integrated efforts to assist adolescents with menstrual challenges such as dysmenorrhea and irregular periods to achieve informed recommendations and effective actions.

The hidden burden of dysmenorrhea among adolescent girls in Palestine refugee camps: a focus on well-being and academic performance

“…The social dimension of dysmenorrhea also has a significant effectsthat can be observed in various ways. One way is through the cultural practice of treating menstruation with shame and taboo and by keeping menstruation a secret, which often leads to a lack of understanding and awareness regarding menstrual pain [ 34 , 52 , 53 ].This was clearly evident in earlier phases of this study [ 33 , 54 ] and can potentially hinder students from seeking help or support [ 34 , 55 ], particularly when dysmenorrhea is dismissed as a normal aspect of menstruation. Consequently, there may be underreporting and insufficient support for girls experiencing dysmenorrhea [ 3 , 4 , 17 , 19 ].…”

“…The primary objective of the big study is to address their primary health needs, including nutrition, anemia, reproductive health, and mental health [ 32 ]. Previous publications from this study delved into menstrual preparation, patterns, dysmenorrhea prevalence, and associated factors [ 33 , 34 ]. The current paper specifically examines the effect of dysmenorrhea on general well-being and academic performance.…”