Defert Coralie, Cousin Ianis, Marchand Isabelle Chauvet-Le, Burgazzi Catherine, Pabic Estelle Le, Arnaud Alexis P
Department of Pediatric Surgery, University Hospital of Rennes, Brittany, France.
Department of Pediatric Surgery, University Hospital of Brest, Brittany, France.
Arch Pediatr. 2024 Feb;31(2):141-147. doi: 10.1016/j.arcped.2023.09.018. Epub 2024 Jan 24.
The age of menarche has been gradually declining since the end of the 20th century. Few studies have been carried out about dysmenorrhea in Europe and they mainly included girls over the age of 15 years.
We conducted an observational study among sixth-grade schoolgirls (usually 11-12 years) during the 2020 academic year in 72 randomly selected public schools in a French region (approval number #20.94).
Among 1712 girls interviewed, 257 (23 %) had reached menarche. Overall, 83 % of these teenagers had dysmenorrhea. Symptoms were reported to occur since the first periods in 59 % of the girls. School absenteeism was positively correlated with severe abdominal pain (p = 0.001). Median age at menarche was 11 years (10.7-11.5). Periods lasted less than 3 days, 3-8 days, and more than 8 days in, respectively, 18 %, 70 %, and 7 % of the girls. Symptoms were significantly more frequent and more severe in the urban group than the rural group (p = 0.005). Symptoms were abdominal pain (70 %), fatigue (48 %), difficulty in concentrating (26 %), headache (25 %), digestive disorders (16 %), and breast discomfort (11 %). Of the girls with dysmenorrhea, 61 % took painkillers; 10 % were uncomfortable despite taking painkillers. Sport exemption was more frequent in the urban group (p = 0.003) and among girls with severe abdominal pain (p = 0.001).
The duration of the menstrual cycle was similar between the various socioeconomic groups, but symptoms and ways of coping were significantly different. Dysmenorrhea is definitely an issue that has to be raised with teenagers as soon as menarche occurs or even before that. Easy access to skilled health practitioners should be widespread.
自20世纪末以来,月经初潮的年龄一直在逐渐下降。欧洲针对痛经开展的研究较少,且主要纳入的是15岁以上的女孩。
在2020学年,我们对法国一个地区随机选取的72所公立学校六年级女生(通常为11 - 12岁)进行了一项观察性研究(批准文号#20.94)。
在接受访谈的1712名女孩中,257名(23%)已月经初潮。总体而言,这些青少年中有83%患有痛经。据报告,59%的女孩自初潮起就出现了症状。缺课与严重腹痛呈正相关(p = 0.001)。月经初潮的中位年龄为11岁(10.7 - 11.5岁)。分别有18%、70%和7%的女孩经期持续时间少于3天、3 - 8天和超过8天。城市组的症状明显比农村组更频繁、更严重(p = 0.005)。症状包括腹痛(70%)、疲劳(48%)、注意力难以集中(26%)、头痛(25%)、消化系统紊乱(16%)和乳房不适(11%)。在患有痛经的女孩中,61%服用止痛药;10%尽管服用了止痛药仍感到不适。城市组(p = 0.003)以及患有严重腹痛的女孩(p = 0.001)中,体育免修更为常见。
不同社会经济群体的月经周期时长相似,但症状及应对方式存在显著差异。痛经绝对是一个在月经初潮发生时甚至在此之前就必须向青少年提出的问题。应广泛提供方便就医的途径,让青少年能够轻松接触到专业的医疗人员。