Quality of life of adolescents with menstrual problems in Klang Valley, Malaysia: a school population-based cross-sectional study

Objective To describe the prevalence of menstrual problems (heavy menses bleeding, dysmenorrhoea and oligomenorrhoea) and its impact towards quality of life among adolescents in Klang Valley, Malaysia. Design Cross-sectional study. Setting Adolescent girls at secondary schools in the Klang Valley, Malaysia. Population 729 adolescents aged between 13 and 18 years. Method A questionnaire survey using Menorrhagia Questionnaire and Paediatric Quality of Life-Teen Report Ages 13-18 (PedsQL). Main outcome measures Self reports of menstrual bleeding patterns, morbidities and effect on quality of life. Results The prevalence of menstrual problems among adolescents was 63.9% in the Klang Valley. Adolescents with menstrual problems had significant lower mean total score of PedsQL (70.23 +/- 13.53 vs 76.36 +/- 14.93, p=0.001), physical health summary score (74.10 +/- 16.83 vs 79.00 +/- 15.86, p<0.001) and psychosocial health summary score (68.05 +/- 14.27 vs 73.21 +/- 13.09, p=0.001) compared with those without menstrual problem. Adolescents experiencing heavy menses bleeding had the lowest physical and emotional function. Those with oligomenorrhoea had the lowest social function, whereas those with dysmenorrhoea had the lowest school function. Cigarette smoking, alcohol and medical illness had lower health-related quality of life, whereas taking oral contraceptive pills for menstrual problems was associated with higher scores in these adolescents. Conclusion Menstrual problems among adolescents have a significant impact on their quality of life. It is probably wise to screen them at the school level, to identify those with low functional scores and to refer them for proper management at a tertiary adolescent gynaecology centre.