Author(s): Bijoy Kumar Dutta, Tanma Saikia, Prafulla M

BACKGROUND The onset of menstruation or menarche is a hallmark of female pubertal development. Menstrual disorders are common among adolescent girls and are a significant source of morbidity in this population. Several environmental factors, status of nutrition in childhood, malnutrition ranging from undernutrition (underweight) to overnutrition (overweight/obesity) affect the regulation of menstrual cycles in females. Purpose of this study was to determine the menstrual cycle characteristics of adolescent girls and its relation to Body Mass Index (BMI). MATERIALS AND METHODS Hospital based observational study was carried out on 200 Adolescents with menstrual cycle disorders attending a tertiary care hospital. All these girls were interviewed for detailed history including age at menarche, menstrual cycle characteristics like length, flow duration, regularity, pain during menstruation, a thorough general-physical and systemic examination were carried out after obtaining written informed consent. Height, weight and BMI were calculated. Statistical analysis was done using SPSS (version 17) software. Relationship between BMI and other parameters were tested by Chi-square test for association. A P value of 0.05 or less was considered as statistically significant. RESULTS In the present study, 45.5% girls had normal BMI, 30% were underweight and 24.5% were overweight. Most (60.5%) of the girls attained menarche by 12 years of age. Mean age at menarche was 12.3 years ± 1.01. Dysmenorrhoea (38%) was the most common menstrual complaint followed by increased cycle length (16.5%) and excessive bleeding (15%). Significant correlation was observed between BMI with menstrual cycle length (p<0.001), oligomenorrhoea (p<0.001), secondary amenorrhoea (p<0.001), BMI with menstrual flow duration (p=0.014), perception of flow (p=0.001) and dysmenorrhoea (p<0.001). However, we found no correlation between BMI and premenstrual syndrome (p=0.15) and BMI with menstrual cycle regularity (p=0.23). CONCLUSION Present study was an overview of adolescent menstrual problems and their relation to BMI. The study showed that almost half of the adolescents had abnormal BMI i.e., both under-weight and overweight. Menstrual problems are common in adolescent girls because of premature HPO Axis physiologically. But changing lifestyle has increased incidence of bulimia nervosa, anorexia nervosa, obesity and sedentary life style. All these factors have an influence on developing adolescent girl. This is a vicious cycle of over-eating/malnutrition adding to abnormal BMI which has an effect on physical activity of these girls which leads to menstrual problems.