Self-treatment patterns among adolescent girls with dysmenorrhea

Abstract

Study objective: To describe both non-pharmacologic and pharmacologic treatments used by adolescents with dysmenorrhea.

Design: Cross-sectional study.

Setting: Urban academic medical center.

Participants: Healthy adolescents aged 19 years or younger (n = 76) with moderate to severe primary dysmenorrhea were included; those using hormonal contraception were excluded.

Intervention: We collected baseline data via interview from adolescent girls at enrollment in a clinical trial of oral contraceptives versus placebo for primary dysmenorrhea. The interview data, collected prior to any intervention, included information on demographics, dysmenorrhea duration and severity, and self-treatment. We used the validated pain subscale of the Moos Menstrual Distress Questionnaire and a 0-10 pain rating scale to estimate pain severity.

Main outcome measure: Investigator-administered questionnaire.

Results: Adolescents' mean age was 16.8 years (SD = 2). Similar proportions described themselves as white (26%), black (30%) or Hispanic (28%). Dysmenorrhea was moderate in 42%, severe in 58%, associated with nausea in 55%, and vomiting in 24%. Of those attending school (n = 66), 46% reported missing one or more days monthly due to dysmenorrhea. Nearly all discussed their pain with someone; however, a minority sought formal medical care. All used nonpharmacological remedies such as sleeping and heat application. Nearly all used at least one medication, 31% reported using two, and 15% used three medications (not concurrently). Many participants reported using medication at sub-therapeutic doses for pain.

Conclusions: Adolescents with moderate and severe dysmenorrhea reported high morbidity. Girls used numerous non-pharmacologic remedies as well as medications for pain but infrequently accessed formal medical care. Medication dosing was often sub-therapeutic.