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

Abstract

BackgroundWomen 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.MethodsA 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.Results2737 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.ConclusionThe 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.