Menstrual Disturbances in Junior High School Students: Prevalence and Factors Related to Severity

Background: Menstrual disturbances remain a common health issue among adolescent girls, affecting quality of life and academic performance. Objectives: This study aimed to determine the prevalence and identify risk factors of menstrual disturbances among junior high school students. Methods: A cross-sectional study was conducted between June and December 2016 in four junior high schools in Bali, Indonesia, including two urban schools (State 1 and 3, Denpasar) and two rural schools (State 4 and 6, Negara), using stratified random sampling. Inclusion criteria were adolescents aged ≥15 years who had menstruated for at least 2 years. Students with chronic illness or hormonal therapy were excluded. Menstrual disturbances were defined as irregular cycles (<20 or >35 days), lower abdominal pain on the 1 st day of menstruation, swollen or painful breasts, use <3 or >5 tampons/day, or absence of menstruation for 3 months consecutively. Data were collected using questionnaires and analyzed with bivariate and multivariate logistic regression. Results: A total of 314 samples were included (194 urban and 120 rural). All subjects experienced menstrual disturbances. Severe disturbances were more common in urban students (75.3% vs. 25%). The mean age at menarche was earlier in the urban students (12 vs. 13 years). Multivariate analysis identified living in an urban area and frequent fast-food consumption as significant risk factors (odds ratio [OR]: 9.125, P < 0.001 and OR: 4.847, P = 0.001), respectively. Conclusions: Menstrual disturbances are prevalent among junior high school girls, related to the area of living and fast-food consumption. Awareness and prevention targeting modifiable risk factors may improve outcomes.