Problem statement

“EFFECTIVENESS OF MINT LEAVES PASTE

ON DYSMENORRHEA AMONG
ADOLESCENT GIRLS”
 introduction
• Adolescence is a transition period from childhood to
adulthood and is characterized by a spurt in physical,
endocrinal, emotional, and mental growth, with a
change from complete dependence to relative
independence. The period of adolescence for a girl is a
period of physical and psychological preparation for
safe motherhood. As the direct reproducers of future
generations, the health of adolescent girls influences
not only their own health, but also the health of the
future population. Almost a quarter of India's
population comprises of girls below 20 years. 1
• One of the major physiological changes that take place in
adolescent girls is the onset of menarche, which is often associated
with problems of irregular menstruation, excessive bleeding, and
dysmenorrhea. Of these, dysmenorrhea is one of the common
problems experienced by many adolescent girls.1
• Globally adolescents account for 1/5th of the population that is
more than 1 billion. 4 out of 5 adolescents live in developing
countries. According to Population Bureau in 1996, 30% of the total
population was that of adolescents (284.02 million). Due to gradual
decrease in the growth rate of the overall population, there is little
increase in the number of adolescents in population projections till
the year 2016(Population projection 1996-2016) census of India.2
• The first menstrual period is called menarche. It usually starts between
the ages 11 and 14. But it can happen as early as age 9 or as late as 15.
Menarche is the sign of growing up. In the days before the periods start,
the adolescent may feel tense or emotional, gain water weight and feethat
lasts few hours or more.3
• Menstruation is a normal, healthy occurrence for many years in life. Yet
many women, across a range of different cultures, experiences menstrual
problem that range from mild discomfort to acute pain. Although most
women have some physical or emotional changes or discomfort linked to
menstrual cycle, a small number of about 5% find that the problems are
more serious and may have to seek some kind of treatment.2
• The term dysmenorrhea is derived from the Greek words ‘dys’ meaning
difficult/painful,‘Meno’ meaning month and ‘rrhea’ meaning flow.
Dysmenorrhea is defined as pain or discomfort (cramps) during or just
before a menstrual period. Two types of dysmenorrhea are primary and
secondary dysmenorrhea. When the menstrual cycle begins
prostaglandins are released by the endometrial cells as they are shed from
the uterine lining causing the uterine muscles to contract. If excessive
prostaglandin is present, the normal contraction response can become
strong and painful spasm. Uterine muscles deprive for oxygen and cause
cramps.4
• Dysmenorrhea is the most common gynecological problem in
women in all ages. Most adolescence experience dysmenorrhea in
the first 3 years after menarche. Young adult women ages 17 to 24
years are most likely to report painful menses between 50% and
80%of women report some level of discomfort associated with
menses and 10 to 18% report severe dysmenorrhea. It has been
estimated that up to 10% of women have severe pain which interfere
with their functioning for 1-3 days a month.5
 Need for study
• Menstrual disorders are a common presentation by late adolescence, 75%
of girls experience some problems associated with menstruation.
Dysmenorrhea is a common problem in women of reproductive age.
Primary dysmenorrhea is defined as painful menses in women with
normal pelvic anatomy, usually begins during adolescence. It is unusual for
symptoms to start within first six months after menarche. Affected women
experience sharp, intermittent spasm of pain usually concentrated in the
suprapubic area. Pain may radiate to the back of the legs or the lower
back. Systemic symptoms of nausea, vomiting, diarrhea, fatigue, mild
fever and headache or light headedness are fairly common. Pain usually
develops within hours of the start of the menstruation and peaks as the
flow becomes heaviest during the first day or two of the cycle. During the
first two year after menarche, most cycles are an ovulatory. Despite this,
they are somewhat regular within a range of approximately 21 to 42 days,
in contrast to an adult woman, whose cycles typically range between 21
and 35 days. The mean duration of menses is 4.7 days; 89% of cycles last 7
days, the average blood loss per cycle is 35 ml. 7
• Dysmenorrhea is the most common of gynecologic complaints. It affects
half of all female adolescents today and represents the leading cause of
periodic college/school absenteeism among that population. A cross-
sectional descriptive study was conducted in Rewa, Madhya Pradesh to
evaluate the menstrual problem specially dysmenorrhea and its severity in
female medical students and its effect on their regular activities. The study
was conducted among 107 female medical students, all participants were
given a questionnaire to complete; questions were related to
menstruation elucidating variations in menstrual patterns, history of
dysmenorrhea and its severity, pre-menstrual symptom and absenteeism
from college and /or class; to detect the severity of dysmenorrhea verbal
multi-dimensional scoring system was used, the participants were given
20 minutes to complete the questionnaire. The mean age of subjects at
menarche was 12.5 (±1.52) years, with a range of 10-15 years. The
prevalence of dysmenorrhea was 73.83%; approximately 4.67%of
dysmenorrhic subjects had severe dysmenorrhea. The average duration
between two periods and the duration of menstrual flow were 28.34
(±7.54) days and 4.5 (±2.45) days respectively.
• A total of 1648 adolescent girls from six districts of Karnataka were
surveyed to find out the incidence of dysmenorrhoea in Karnataka
state. The survey showed that the incidence of dysmenorrhoea was
87.87 percent among the adolescent girls. 8
• The treatment available in the present scenario is not giving
enough relief from dysmenorrheal estimates of the effectiveness of
current treatments including oral Contraceptives and nonsteroidal
anti-inflammatory drugs ranging from 64 to 90% of patients but
some women have intolerable side effects like upset and infertility.
The available treatments decrease impairment but not to the non
menstruating level of productivity for all women. Some patients
resort to surgical treatment. The long-term and associated health
risks of dysmenorrhea have not been studied. Using of treatment
with different mechanism of action for the treatment of
dysmenorrhea may benefit some women to have complete relief
from dysmenorrhea.9
• Herbal supplement is found to be very beneficial for the treatment of
menstrual problems. Prolonged result with zero adverse action on user is
one among the main advantages of using herbal cures. Some of the herbs
like mint leaves, sesame seeds, and bark extract of ashoka tree etc are
best recommended cures for the treatment of menstrual problems.10
• Mint is one of the herbs. It grows like a weed, is perfectly safe for use, and
is an excellent remedy for reducing symptoms related to digestion. It is
well known for its properties related to indigestion, stomach cramps,
menstrual cramps, flatulence, upset stomach, nausea, vomiting, and colic
in children. 11
intervention was given to control group, so the effective
• A pre experimental study was conducted to assess the effectiveness
of the mint extract upon dysmenorrhea among the students at
Apollo school of Nursing, Chennai. Pre experimental design was
adopted and purposive sampling method was used and 35 students
were selected as samples. Self administered questionnaire on
dysmenorrhea was administered. The levels of dysmenorrhea were
assessed before and after mint extract administration for
consecutive days, 5 days before menstruation and 3 days after
menstruation. The pre test level dysmenorrhea score of students
wear high, M =6.46, SD=2.57 in comparison with the score of post
test were M=1.2, SD=1.26 the difference between the experimental
pretest and post test is found to be statistically proven to be
significant (p<0.001). There was no significant association between
the selected demographic variables and pretest post test level of
dysmenorrhea score. The result could be attributed to the
effectiveness of the mint extract.12
•
• 6.3 OBJECTIVES OF THE STUDY
• To assess the level of dysmenorrhea among
adolescent girls, before administration of mint
leaves paste.
• To assess the effectiveness of mint leaves paste
on dysmenorrhea among adolescent girls.
• To find the association between the selected
demographic variables and post level of
dysmenorrhea among adolescent girls.