Nutritional status and effect of exercise in young women

Nutritional Status and effect of exercise in young Women

having Dysmenorrhea

ANURADHA SHEKAR& SWARADA PITKAR

DR. BMN COLLEGE OF HOME SCIENCE, MATUNGA

DYSMENORRHEA Dysmenorrhea is the occurrence of painful cramps during

menstruation. More than half of all girls and women suffer from dysmenorrhea (cramps), a dull or throbbing pain that usually centers in the lower mid-abdomen, radiating toward the lower back or thighs. Dysmenorrhea is the most common gynecologic disorder among female adolescents, with a prevalence of 60% to 93%. In the United States, dysmenorrhea is the leading cause of recurrent short-term school absenteeism.Several studies have shown that adolescents with dysmenorrhea report that it affects their academic performance, social and sports activities. Physical activity has been viewed as a means of treatment.

AIM:

• Since Primary dysmenorrhea is very common in young women. Physical activity especially yoga has been proved to have an effect on dysmenorrhea so the present study aimed to study the effect of physical activity on the clinical manifestations of dysmenorrhea in young women.

OBJECTIVES:

1. To study the effect of physical activity on the clinical manifestations of dysmenorrhea in young women.

2. To assess the nutritional status of the young women by assessing the anthropometric measurements like height, weight, BMI and waist circumference of the young women before and after intervention.

3. To assess the nutritional status of the young women by 24 hour dietary recall method.

4. To study the physical activity pattern of the young women by pre-prepared questionnaire.

5. To evaluate reproductive health of the young women by a pre- prepared questionnaire before and after intervention.

6. To compare effects of physical activity (yoga and breathing exercises which will be taught to the subjects) on dysmenorrhea in young women before and after intervention.

METHODOLOGY• Dysmenorrhic young women were identified through questionnaire

(sample size n = 80 )

Group 1 Group 2 • (Experimental group) (Control group) sample size, n = 30 sample size, n = 30

exercises Physical activity (bhujangasana, dhaurasana breathing exercises and sit ups) for 8 weeks, Anthropometric and Nutrient assessment

These exercises were taught to the subjects by a yoga teacher and they were asked to do it regularly for 2 months.Questionnaire to

identify intensity of dysmenorrhea

Statistical Data Analysis using

SPSS

RESULTS

• The mean age of subject’s was 17.87 The number of family members ranged from 2 to 12. Majority of the subjects (79 %) were Hindus, followed by 19% Muslims, 2 % Christians and 1 % Parsi. Majority of the subjects that is 70 % (n= 56) had their menarche in between 13 to 15 years of age . They (68.8%) had a 28 day cycle Seventy percent of the subjects had normal bleeding while 27 % of the subjects had “heavy” bleeding. They [subjects (46 %) had bleeding for 5 to 8 days followed by 37.5 % of the subjects had bleeding for 4 days. Nearly half of the subjects (51.3 %) had pain every month. Intensity of pain ranged from 3 to 10 on a 10 point scale. 10 % of the subjects rated ‘10’ as their intensity indicating severe pain while a large number of subjects( 27%) reported their intensity as ‘5’ followed by 21% subjects reporting their intensity as ‘8’ Majority of subjects (90 %) experienced pain only for 1 day .

CORRELATION BETWEENDURATION BETWEEN 2 MENSTRUAL

PERIODS AND AGE AT MENARCHE

Age at menarcheTotal

10 years 11-12 13-15 16 and later

Duration

between 2

menstrual

periods

28 days Count 0 15 38 1 54

% within Age

at menarche.0% 78.9% 67.9% 50.0% 67.5%

< 28 days Count 1 3 11 0 15

% within Age

at menarche33.3% 15.8% 19.6% .0% 18.8%

45 days or

more

Count0 0 2 0 2

% within Age

at menarche.0% .0% 3.6% .0% 2.5%

Very Irregular Count 2 0 3 1 6

% within Age

at menarche66.7% .0% 5.4% 50.0% 7.5%

30 days Count 0 1 2 0 3

% within Age

at menarche.0% 5.3% 3.6% .0% 3.8%

Total Count 3 19 56 2 80

% within Age

at menarche100.0% 100.0% 100.0% 100.0% 100.0%

Value df Asymp. Sig. (2-sided)

Pearson Chi-Square 25.066 12 0.015

Chi square tests

It can be concluded from the above tables that an association exists in duration between 2 menses and age at menarche. Thus, those who get menses early (10yrs) or late (16+ years) have very irregular duration between menses

CORRELATION BETWEEN FLOW OF BLEEDING DURING PERIODS AND

AGE AT MENARCHE

Age at menarche Total

10 years 11-12 13-15 16 and later

Flow of

bleeding

Heavy Count1 8 13 0 22

% within Age

at menarche 33.3% 42.1% 23.2% .0% 27.5%

Normal Count2 11 42 1 56

% within Age

at menarche 66.7% 57.9% 75.0% 50.0% 70.0%

Very Less Count0 0 1 1 2

% within Age

at menarche .0% .0% 1.8% 50.0% 2.5%

Total Count3 19 56 2 80

% within Age

at menarche 100.0% 100.0% 100.0% 100.0% 100.0%

Value df Asymp. Sig. (2-sided)

Pearson Chi-Square 21.866 6 .001

Chi square tests

An inference can be drawn from the above tables that there was a highly significant difference between flow of bleeding and age at menarche. Thus, it can be concluded that normal will be the flow of bleeding if menarcheal age is 13 – 15 years.

CORRELATION BETWEEN DURATION OF BLEEDING AND

AGE AT MENARCHE

Age at menarche Total

10 years 11-12 13-15 16 and later

Duration of

bleeding

4 days Count 1 4 24 1 30

% within? 33.3% 21.1% 42.9% 50.0% 37.5%

< 4 Count 1 2 7 0 10

% within Age

at menarche?33.3% 10.5% 12.5% .0% 12.5%

5-8 Count 1 13 25 0 39

% within

When did you

get your 1st

period?

33.3% 68.4% 44.6% .0% 48.8%

> 8 days Count 0 0 0 1 1

% within Age

at menarche.0% .0% .0% 50.0% 1.3%

Total Count 3 19 56 2 80

% within Age

at menarche100.0% 100.0% 100.0% 100.0% 100.0%

Chi square tests

Value df Asymp. Sig. (2-sided)

Pearson Chi-Square 45.758 12 0.000

The tables illustrates that there exists a significant association between number of days of bleeding and the menarcheal age. Hence it can be concluded that later the menarche, less will be the number of days of bleeding.

3 4 5 6 7 8 9 100

5

10

15

20

25

30

35

pre interventionpost intervention

COMPARISON BETWEEN INTENSITY OF PAIN PRE VERSUS POST INTERVENTION

Though the reduction in pain was not statistically significant, the above figure indicates that there is reduction in percentage intensity of pain of values 6,8,9 and 10. While there is increase in 3, 4, 5 and 7. This indicates that there is overall reduction in intensity of pain.

0 1 2 3 4 50

10

20

30

40

50

60

70

80

90

Pre interventionpost intervention

COMPARISON BETWEEN DOSES OF MEDICINE PRE VERSUS POST INTERVENTION.

The above figure indicates that there was a slight reduction in the use of dose medicine after intervention.

Anthropometric and Nutrient analysis

Mean N Std. Deviation

Pair 1 Weight Pre 48.24 44 11.785

Weight Post 48.2386 44 11.77477

Pair 2 BMI Pre 20.42 44 4.37

BMI Post 20.1809 44 4.35930

Pair 3 Waist

Circumference

Pre

76.40 44 9.393

Waist

Circumference

Post

76.3977 44 9.39296

Hardly any reduction was seen in body weight , BMI; and waist circumference of the subjects as shown below.

There was not much change observed in energy and protein intakes of the subjects which could be due to short duration of the study.

LIMITATIONS 1. Duration of the study was very short2. Regular follow up of the subjects could

not be maintained due to time constraints.

3. Sample size was small.4. The data from control group was not

taken after intervention.

RECOMMENDATIONS

1. While selecting the subjects, a more accurate method like sonography or a check up by a gynaecologist could to be done to rule out possibility of secondary dysmenorrhea.

2. Duration of the study could have been longer and it is recommended that it should at least be for a period of 6 months.

3. The subjects should be kept on a regular follow up and could have been given a review of the physical activity once a week during the intervention period.

4. A Larger Sample size could have been taken.

Mrs. Anuradha Shekhar Associate ProfessorHead of the Dept. Food Science and NutritionDr. BMN College Of Home Science,338, Ra Kidwai Road, Matunga. Mumbai.Contact No:+91-98206 17577Work : 022 4095792www.bmncollege.come-mail ; [email protected]