SSR Inst. Int. J. Life Sci., 10(1): 3463-3469, Jan 2024

Prevalence and Factors of Early Onset of Menarche among Adolescent Girls Studying in Selected Schools at Bagalkot-A Descriptive Study

 

Kamala KN¹, Deelip S Natekar², Anil Kumar³, Akkamma Bavikatti³*, Daneshwari³, Ruksar³, Vijaylaxmi³, Anju Sunny³

¹Head, Dept of Obstetrics and Gynaecological Nursing, Shri B.V.V.S Sajjalashree Institute of Nursing Sciences, Navanagar, Bagalkot, Karnataka, India

²Principal cum H.O.D, Department of Community Health Nursing, Shri B.V.V.S Sajjalashree institute of Nursing Sciences, Navanagar, Bagalkot, Karnataka, India

³Student, Dept. of Obstetrics and Gynaecological Nursing, Shri B.V.V.S Sajjalashree Institute of Nursing Sciences, Navanagar, Bagalkot, Karnataka, India

 

^*Address for Correspondence: Akkamma Bavikatti, Student, Dept. of Obstetrics and Gynaecological Nursing, Shri B.V.V.S Sajjalashree Institute of Nursing Sciences, Navanagar, Bagalkot, Karnataka, India

E-mail: akkammabavikatti@gmail.com

ABSTRACT Background: Adolescence is the transition period from childhood to adult life, during which pubertal development and sexual maturation take place. The reproductive life span of a woman begins with the onset of menstruation. Menarche is the first periodic flow of blood from the uterus in all healthy. The main objective of the study was to explore the prevalence and factors of the early onset of menarche among adolescent girls. The prevalence &factors of early is estimated to be 72% of early menarche & 28% of normal menarche. The study was conducted at selected schools in Bagalkot, Karnataka. The present study aimed to find out the prevalence and factors of early onset of menarche among adolescent girls at selected schools of Bagalkot.

Methods: A descriptive survey design was used for the study. Simple random technique was used to obtain 100 samples from Basaveshwer New High School, Bagalkot. Data was collected using semi-structured questionnaire to assess the prevalence and factors of early onset of menarche among adolescent girls. The collected data were analyzed by using descriptive and inferential statistics.

Results: The study shows that the prevalence of early onset of menarche among 100 samples 72% adolescent girls are early menarche, 28% adolescent girls are normal menarche, majority have early onset of menarche. In this study shows that Sexual awareness (p<0.023), Vegetables (p<0.029) and Fast food (p>0.008) variables are associated with early onset (p<0.05) and remaining variables are not associated with early onset of menarche (p>0.05).

Conclusion: The total of 100 adolescent girls were included in the study. 72% adolescent girls have early menarche, 28% adolescent girls have normal menarche. So, in our study majority of adolescent girls attained early menarche (72%).

Key Words: Adolescent, Early, Factors, Girls, Menarche, Onset, Prevalence

INTRODUCTION- Adolescents is a period, which is the transition from girlhood to womanhood & marked by with onset of menarche. First menstrual bleeding is called menarche^.[1] The first sign of puberty is breast budding & followed by the appearance of pubic hair, axillary hair and axillary odour. The average age of menarche, as per the studies, is 12.77 years. Several studies have reported age at puberty and Menarche to have declined in developed countries and have also been noted in developing countries.^[2] Early menarche is usually defined as menarche before the age of 12 years. According to our study, early menarche is 78% & Normal menarche is 28%.^[3]

Although some researchers set it at ≤10 or 11 years. In Korea, 21.4% of subjects experienced menarche before the age of 12 years in 2001 versus 34.6% in 2010/2011.^[4] Its onset hormonal changes during puberty. The menstrual flow consists of a combination of fresh and clotted blood with endometrial tissue.^[5] The initial flow of menarche is usually brighter than mature menstrual flow.^[6] a number of factors, such as Nutritional, environmental, physical, and psychological factors, influence its timing. The age at menarche is not fixed and varies from population to population. It may also vary with race, size of the family and environmental factors.^[7]

According to a WHO multicenter case-control study, the median age of menarche was 14 years, with a range of 13-16 years from the centre to center.^[8] Studies done in Europe have put the mean age of menarche at 12.5-13.6 years, 12.2 years for African Americans, and 12.8 years for whites in the United States, while the mean menarche age among Asian girls is 13-13.5 years. There is also variation in the age at menarche noticed in studies done in Africa, with a range of 13.54-13.79 years reported.^[9] A growing body of literature has reported a downward trend in the age at which menarche is attained across different populations.^[10]

MATERIALS AND METHODS- A descriptive survey design was used for the study. A simple random technique was used to obtain 100 samples from Basaveshwer New High School, Bagalkot. Data was collected using semi-structured questionnaire to assess the prevalence and factors of early onset of menarche among adolescent girls. The collected data were analyzed by using descriptive and inferential statistics.

 

Research Approach- The survey research approach is non-experimental research that focuses on obtaining information regarding the activities, beliefs, preferences, and attitudes of people via direct questioning of a sample of respondents. A descriptive survey approach is designed when the purpose of the study is to describe the prevalence or incidence of a phenomenon or to estimate the value of the phenomenon for a population.

In the present study, the main aim is to assess the Prevalence and Factors of early onset of menarche among adolescent girls studying at Basaveshwar New High School in Bagalkot. A descriptive study and, hence, A descriptive survey approach design was used.

 

Research design- A researcher s overall plan for obtaining answers to the research question or for testing the research hypothesis is referred to as research design. A descriptive survey design was selected for the present study. A descriptive survey design is a study that involves a one-time assessment of data from adoloscent girls to determine the prevalence and factors of early onset of menarche and associated factors. The study design represents the population, sample size, variables, data collection tool and techniques and plan for data analysis.

 

Variables

Study variables 1- Prevalence and factors associated with early onset of menarche. It includes nutritional factors, environmental factors, physical factors psychological factors etc.

 

Study variables 2- Socio-demographical factors are Age, Standard, Place of residence, Monthly family income, Religion, Type of family, Education of father, and Education of mother.

 

Setting- The study was conducted in Basaveshwar New High School, Bagalkot, India.

 

Population- A population is a complete set of persons or subjects that possess common characteristics that is of interest to the researcher.

 

Target population- Target population of the present study consist the adolescent girls studying in various schools at Bagalkot.

 

Accessible population- The accessible population for the present study were adolescent girls studying in New Basaveshwar High school Bagalkot.

 

Sampling size- The total Sample size for the present study was 100, which comprises 72 early menarche and 28 normal menarche adolescent girls studying in the new Basaveshwar High School Bagalkot.

 

Sample Size Estimation- The sample size was estimated using the formula:

N = (Z)² (δ) ²/ (E^m)²

where, Z value =1.96; δ =Standard deviation; E^m= Margin of error; E^m= Critical value + Standard error; Standard error = δ/√n

 

References- Based on the authors Dinesh Kumar Dhanwal and Mala Dharmalingam, in the year 2016, the estimated prevalence of hypothyroidism was 13% with 5% precision and 95% confidence, and the estimated sample size was 100. However, a sample size of 100 was taken for the main study due to time limitations.

 

Inclusion criteria

1. Age group 12 & below 12, 13 & above 13

2. Those who are willing to participate

3. Adolescent girls attained menarche age between 13 years

 

Exclusion criteria

1. Adolescent girls not attained the menarche

2. Absent at the time of data collection

3. Sick and unable to cooperate through the data collection procedure

 

Data collection tool- Data collection tools are the procedures or instruments used by the researcher to observe or measure the key variables in the research problem. A semi-structured questionnaire was used to collect the data in the present study.

 

Content validity- To ascertain content validity, a tool from the nursing discipline was given to 3 experts and two obstetricians for content validation. Based on the suggestion given tool was modified.

 

Reliability of the tool- The reliability of the tool was established by using the test-retest method. The tools were administered to 10 adolescent girls. The data was obtained. The same tools were administered to the same subject after ten subjects (Retest). Scores of both observations were organized and Karl Pearson s co-efficient correlation r was computed for finding out reliability.

r =

The obtained value of r was 1, indicating that the tool is highly reliable and feasible for the main study.

 

Procedure for data collection- Prior permission was obtained from Formal permission was obtained from Principal. Subjects who fulfilled the inclusion criteria were selected by using a simple random technique. The researcher explained the purpose of the study to the participants and Informed consent was taken from subjects. Data was collected from adolescent girls who fulfilled the inclusion criteria. Prevalence was assessed by using semi-structured questionnaire. Approximately 10-12 subjects were assessed per day. Each respondent had spent approximately 35-40 minutes to complete the questionnaire.

 

Statistical Analysis- The study has used SPSS 25 for effective analysis. The data were analyzed using descriptive statistics and inferential statistics. Descriptive statistics were used to describe the participants' demographic characteristics and their knowledge about UTIs at both time points. Inferential statistics were used to compare the knowledge of the intervention and control groups at both time points. MS Excel was used for creating graphs and other calculations. the continuous data were expressed as mean standard deviation while the discrete data were expressed as frequency and its respective percentage. The study used ANOVA as the statistical tool for comparing the variables. The level of significance was considered to be p<0.05.

 

Ethical Approval- Ethical clearance has been obtained from the institutional ethical clearance committee, BVVS Sajjalashree Institute of Nursing Sciences, Bagalkot.

 

RESULTS- The study shows the prevalence of early-onset menarche among 100 samples. Total 72% adolescent girls have early menarche, 28% of adolescent girls have normal menarche, and the majority have early-onset menarche. This study shows that Sexual awareness (p<0.02), vegetables (p<0.02) and fast food (p>0.01) variables are associated with early onset (p<0.05) and the remaining variables are not associated with early onset of menarche (p>0.05).

Demographic Variable- Table 1 represents the overall socio-demographic of early onset menarche in this study. Was majority (54%) of adolescent girls belong to the age group of 13 years. 35% of adolescent girls are studying in 7^th standard of education, 79% of adolescent girls belong to an urban area, 36% of adolescent girls have 10-15,000 monthly family income, 85%b of adolescent girls belong to the Hindu Religion, 58% of adolescent girls belong to the nuclear family, 40% of adolescent girl s fathers having primary education, 57% of adolescent girl s mothers having primary education.

 

Table 1: Description of Socio-demographic Variable

A total of 100 adolescent girls were included in the study. 72% of adolescent girls have early menarche, 28% of adolescent girls have normal menarche (Table 2).

 

Table 2: Description of Prevalence of early onset of menarche

 

There is no significant association between variable factors and early onset of menarche (Table 3).

 

Table 3: Association between Variable factors and early onset of menarche

B: Unstandardized beta; SE: Standard Error; *All the values are statistically non-significant

 

There is no significant association between physical factors and early onset of menarche (Table 4).

 

Table 4: Association between Physical factors and early onset of menarche

B: Unstandardized beta; SE: Standard Error; *All the values are statistically non-significant

 

There is a significant association between sexual awareness and early onset of menarche (Table 5).

 

Table 5: Association between environmental factors and early onset of menarche

B: Unstandardized beta; SE: Standard Error; *All the values are statistically non-significant

 

There is no significant association between family factors and early onset of menarche (Table 6).

Table 6: Association between family factors and early onset of menarche

B: Unstandardized beta; SE: Standard Error; *All the values are statistically non-significant

 

There is significant association between Nutritional factors such as vegetables and fast food with early onset of menarche (Table 7).

Table 7: Association between Nutritional factors and early onset of menarche

B: Unstandardized beta; SE: Standard Error; *All the values are statistically non-significant

 

DISCUSSION- Percentage-wise distribution of adolescent girls refers to those who all are studying in 6^th, 7^th and 8^th standard at Basaveshwar new high school, Bagalkot. According to their age groups reveals that out of 100 subjects, the majority (54%) of adolescent girls are in the age group of 13 years, and (11%) of adolescent girls are in the age group of 12 years. In a similar study majority of adolescent girls, 36% were in the age group of 20 years ^[11]. The majority (54%) of adolescent girls are in the standard of 8^th and (35%) of the adolescent girls are in the standard of 7^th. As compared to the previous study majority, 30% of adolescent girls are in the 9^th standard ^[12].

The majority (79%) of adolescent girls are in the urban, and (21%) of the adolescent girls are in the rural. In a similar study majority of adolescent girls 76% in urban areas ^[13]. The majority (36%) of adolescent girls are in the 10-15,000 income and (24%) of the adolescent girls are in the <10,000 income. In a similar study, 74.5% of adolescent girls had an income between 10,000-20,000 per month ^[14]. A majority (85%) of adolescent girls are in the Hindu religion, and (9%) of the adolescent girls are in the Muslim religion. In comparison to the previous study, 91% of adolescent girls were Hindu.^[15]

The majority (58%) of adolescent girls are in the nuclear family and (42%) of the adolescent girls are in a joint family. In a similar study, 83.5% of them were in a nuclear family. ^[16] The majority (83%) of adolescent girls do not know the information, and (17%) of adolescent girls do know the information. In a previous study majority of adolescents, 50% of girls, do not know the information ^[17]. The majority (40%) of adolescent girl s fathers have primary education, and (35%) of adolescent girl s fathers have secondary education. In a similar study majority, 37.5% of adolescent fathers had agriculture as an occupation ^[18]. The majority (57%) of adolescent girl s mothers have primary education and (21%) of adolescent girl s mothers have secondary education. In a previous study, 29% of adolescent mothers had secondary education ^[19-25].

CONCLUSIONS- A total of 100 adolescent girls were included in the study. 72% of adolescent girls have early menarche, and 28% of adolescent girls have normal menarche. So, in our study majority of adolescent girls attained early menarche (72%).

Some of the factors that influence early menarche for that give health education like diet, exercise and, advice to avoid bad habits for adolescent girls, awareness about menstrual hygiene and prevention of the occurrence of diseases. It is helpful to prevent further complications.

 

ACKNOWLEDGMENTS- We thank the anonymous referees for their useful suggestions. My heart is full, and words are few to express my sincere gratitude towards those helping hands.

CONTRIBUTION OF AUTHORS

Research concept: Anilkumar, Akkamma, Daneshweri, Ruksar, Vijayalaxmi, Anju sunny, Kamala K.N

Research design: Anilkumar, Akkamma, Daneshweri, Ruksar, Vijayalaxmi, Anju sunny, Kamala K.N

Supervision: Anilkumar, Akkamma, Daneshweri, Ruksar, Vijayalaxmi, Anju sunny, Deelip S Natekr

Materials: Anilkumar, Akkamma, Daneshweri, Ruksar, Vijayalaxmi, Anju sunny

Data collection: Anilkumar, Akkamma, Daneshweri, Ruksar, Vijayalaxmi, Anju sunny

Data analysis & Interpretation: Anilkumar, Akkamma, Daneshweri, Ruksar, Vijayalaxmi, Anju sunny

Literature search: Anilkumar, Akkamma, Daneshweri, Ruksar, Vijayalaxmi, Anju sunny

Writing article: Anilkumar, Akkamma, Daneshweri, Ruksar, Vijayalaxmi, Anju sunny

Critical review: Kamala K.N, Deelip S Natekar

Article editing: Anilkumar, Akkamma, Daneshweri, Ruksar, Vijayalaxmi, Anju sunny, Kamala K.N, Deelip S Natekar

Final approval: Anilkumar, Akkamma, Daneshweri, Ruksar, Vijayalaxmi, Anju sunny, Kamala K.N, Deelip S Natekar

REFERENCES

1.     Bhattarai S, Subedi S And Acharya SR. Factors Associated with Early Menarche Among Adolescents Girls: A Study from Nepal. SM J Community Med., 2018; 4(1): 10-28.

2.     Siregar MFG. Association Between Menarche Age and Menstrual Disorder with the Incidence of Uterine Fibroid in Medan, Indonesia: Based on Hospital Data. Int J Reprod Contracept Obstet Gynecol., 2015; 4(10): 25-46.

3.     Jesna J, Sushmitha RK, Shobha K. Factors Influencing Early Onset of Menarche Among School Children A Case Control Study in Manipal. Indian J Public Health Res Develop., 2020; 11(11): 34-40.

4.     Idris M. Idris, Samuel J, Wolday B, et al. Factors associated with early age at menarche among female secondary school students in Asmara. J Nurs Care, 2017; 2(10): 20-25

5.     Osemwenkha AP, Osaikhuwuomwan JA, Chukwudi EO. Age At Menarche Among Secondary School Girls in an urban population of Nigeria. Niger J Exp Clin Biosci., 2014; 2: 95-99.

6.     Namboothri NG, Chacko VI, Rashmi A, et al. Factors Influencing Age at Menarche-A School Based Cross-Sectional Study. Indian J Comm Health. 2020; 32(2): 444-46.

7.     Gaudinea U. Factors Associated with Early Menarche: Results from The French Health Behaviour in School-Aged Children (HBSC) Study. BMC J Public Health, 2010; 10: 175-80.

8.     Jannatul M, Md-Ariful I, Saima I, et al. early age at menarche and its associated factors in school girls (Age, 10 To 12 Years) in Bangladesh. J Epurb., 2020; 10(3): 13-20.

9.     Ibitoye M, Choi C, Tai H et al. Early Menarche: A systematic review of its effect on sexual and reproductive health in lowand middle-income countries. J Plos One, 2019; 12(6): 178-84.

10.  Agarwal A, Aharwal L, et al. a cross-sectional study of bio-social factors affecting the age of menarche among the adolescent girls of Gwalior, Madhya Pradesh, India. J Nurse Care, 2022; 2(1): 156-70.

11.  Mahata, Latu, Biswas et al. Comparison of Body Composition Between Pre-Menarche and Post-Menarche Sabar Girls of Purulia District, West Bengal, India. ANTPO J., 2022; 5(10): 7-13.

12.  Pongsak N, et al. A Cross Sectional Study Was Conducted on Factors Associated with Early Age at Menarche Among Thai Adolescents in Bangkok. Epurb J., 2018; 7(10): 11-86.

13.  Hamna M, Tarar K, Jameel AS. A cross sectional study was conducted on influence of physiological variables and psychosocial factors on the onset of menarche in schoolgirls of Pakistan. J Plos One, 2023; 14(10): 47-52.

14.   Kursat B, Carman E, Osmangaz I. A Cross Sectional study was conducted on menstruation‐related headache in adolescents: point prevalence and associated factors in Eskisehi Osmangazi University. J Ped., 2020; 11(11): 135-72.

15. Martin Steppan, Ross Whitehead, Juliet Mceachran Et Al. Family composition and age at menarche: findings from the international health behaviour in school-aged children study. SM J Community Med., 2021; 4(1): 10-28.

16.  Izzuddin MA, Wei P, Dana D, et al. Analysis of early-life growth and age at pubertal onset in US Children. JAMA Netw Open, 2022; 5(2): e2146873. doi: 10.1001/jamanetworkopen.2021.46873.

17.  Constanza L, Veronica M, Marcela R, et al. A cohort study was conducted on dietary iron intake in relation to age of menarche. J Nurse Care, 2022; 20(2): 201-05.

18.  Aslan E. Age at onset of menarche and puberty of girls in aydin region and the factors affecting them. J Trends in Pediat., 2021; 10(5): 65-75. doi: 10.5222/TP.2021.65375.

19.  Sawal A, Chimurka R, et al. The factors altering the age of onset of menstruation among adolescent girls in Wardha Region. J Pharm Res Inter., 2021; 10(33): 8-13.

20.  Lyu IJ, Oh SY. Association Between age at menarche and risk of myopia in the United States: Nhanes. J Plos One, 2023; 18(5): 13-72.

21.  Colich NL, Platt JM, Keyes KM, et al. Earlier Age at menarche as a transdiagnostic mechanism linking childhood trauma with multiple forms of Psychopathology in Adolescent Girls. J Psychol Med, 2019; 2(1): 1 9.

22.  Lesser C, Meric Q, et al. Habitual phytoestrogen intake is associated with breast composition in girls at 2 years after menarche onset. Cancer Epidemiol Biomarkers Prev., 2022; 31(7): 1334-40. doi: 10.1158/1055-9965.EPI-22-0016. doi: 10.1158/1055-9965.EPI-22-0016.

23.  Dkerson LM, Mazyck PJ, Hunter MH. Pre Menustrual Syndrome. Women s Health. J Nurse Care., 2015; 84(8): 918-24.

24.  Mandal R, Sarakar Ap Ghorai Premenustrual Syndrome Symptoms. Int J Reproduct Contracep Obstet Gynaecol., 2015; 4(4): 1012-15. doi: 10.18203/2320-1770.ijrcog20150417.

25.  Williams PG Holmbeck GN, Greenly RN. The Importance of Adoloscent Health Psychology. J Consult Clin Psych., 2002; 70(3): 828-42.