TNU Journal of Science and Technology
230(01): 209 - 216
http://jst.tnu.edu.vn 209 Email: jst@tnu.edu.vn
A STUDY OF MENSTRUAL DISORDERS AND SOME ASSOCIATED FACTORS
IN FEMALE STUDENTS AT HANOI MEDICAL UNIVERSITY
Do Thanh Tung1*, Lo Ba Cuong1, Tran Minh Duc1, Pham Hong Ha1, Nguyen Phuong Tu1,
Nguyen Hai Phuong2
1Hanoi Medical University, 2National Hospital of Obstetrics and Gynecology
ARTICLE INFO
ABSTRACT
Received:
19/8/2024
Menstrual disorders can have a significant impact on women's health
and quality of life, especially among medical university students. Our
study aimed to assess menstrual disorders and some associated factors
in female students at Hanoi Medical University. The descriptive
cross-sectional study was conducted on 312 female students from
August 2023 to January 2024. The results showed over half (55.45%)
of the students reported menstrual irregularities. The most common
issues were oligomenorrhea (46.15%) and menorrhagia (8.33%).
Notably, 95.83% experienced premenstrual symptoms; dysmenorrhea
were the most prevalent during menstruation (93.91%). Menstrual
disorders were significantly associated with BMI, family history of
menstrual disorders, and place of residence before university
admission. Our study’s results provided a better understanding of the
factors associated with menstrual disorders, thus having potential
applications in the prevention and control of the disease.
Revised:
17/10/2024
Published:
18/10/2024
KEYWORDS
Menstrual disorders
Associated factors
Medical students
BMI
Family history
NGHIÊN CỨU TÌNH TRẠNG RỐI LOẠN KINH NGUYỆT VÀ
MỘT SỐ YẾU TỐ LIÊN QUAN Ở SINH VIÊN NỮ TRƯỜNG ĐẠI HỌC Y HÀ NỘI
Đỗ Thanh Tùng1*, Lỗ Bá Cương1, Trần Minh Đức1, Phạm Hồng Hà1, Nguyễn Phương Tú1,
Nguyễn Hải Phương2
1Trường Đại học Y Hà Nội, 2Bệnh viện Phụ sản Trung ương
TÓM TẮT
Ngày nhận bài:
19/8/2024
Rối loạn kinh nguyệt ảnh hưởng đáng kể đến sức khỏe và chất lượng
cuộc sống của phụ nữ, đặc biệt là nữ sinh viên trường y. Nghiên cứu
này nhằm đánh giá tình trạng rối loạn kinh nguyệt và một số yếu tố
liên quan ở sinh viên nữ Trường Đại học Y Hà Nội. Nghiên cứu mô
tả cắt ngang được thực hiện trên 312 sinh viên nữ từ tháng 8 năm
2023 đến tháng 1 năm 2024. Kết quả cho thấy hơn một nửa (55,45%)
số sinh viên bị rối loạn kinh nguyệt. Các vấn đề phổ biến nhất là kinh
thưa (46,15%) và rong kinh (8,33%). Đáng chú ý, 95,83% có triệu
chứng tiền kinh nguyệt; đau bụng kinh là triệu chứng phổ biến nhất
trong khi hành kinh (93,91%). Rối loạn kinh nguyệt liên quan có ý
nghĩa thống kê đến BMI, tiền sử gia đình về rối loạn kinh nguyệt và
nơi sống trước khi vào đại học. Kết quả nghiên cứu của chúng tôi
cung cấp hiểu biết tốt hơn về các yếu tố liên quan đến rối loạn kinh
nguyệt, do đó có tiềm năng ứng dụng trong phòng ngừa và kiểm soát
bệnh tật.
Ngày hoàn thiện:
17/10/2024
Ngày đăng:
18/10/2024
DOI: https://doi.org/10.34238/tnu-jst.10975
* Corresponding author. Email: tungoct404@gmail.com
TNU Journal of Science and Technology
230(01): 209 - 216
http://jst.tnu.edu.vn 210 Email: jst@tnu.edu.vn
1. Introduction
Menstruation is the periodic shedding of the uterine lining, leading to vaginal bleeding.
Menstrual disorders involve changes in the frequency, regularity, duration, or amount of
menstrual bleeding compared to a normal cycle [1]. These irregularities can cause a range of
health problems including anemia, vaginitis, endometrioma, ovarian inflammation, and fertility
problems. Additionally, they can significantly impact a woman's daily activities, mental, and
sexual health.
Menstrual disorders are a significant global health concern. A study in Hue city identified that
up to 73.6% of women experience such issues before menopause [2]. Multiple studies have
reported high rates of menstrual disorders among university students: 55% had menstrual
irregularities at Al Neelain University, 80.7% among Lebanese nursing students; especially,
97.8% at Makerere University College had at least one type of menstrual disorder [3]-[5].
Previous research has indicated that students experiencing menstrual disorders reported a lower
quality of life [5], [6]. Furthermore, Enguday Demeke et al. (2023) showed a decrease of 0.19
points on a 4.0 scale in the average academic grades of students with irregular menstruation
compared to those with regular menstruation [7]. Therefore, measures should be implemented to
mitigate the prevalence of menstrual disorders among students, particularly medical students,
since they experience heightened stress levels and potentially lower quality of life compared to
students in other disciplines [8], [9].
Understanding the underlying causes and contributing factors of menstrual disorders is crucial
for developing targeted interventions, managing reproductive health issues, and ultimately
enhancing menstrual health outcomes. While some research in Vietnam has explored
characteristics and types of menstrual disorders, studies investigating the factors associated with
these issues in students, particularly those facing a demanding academic environment, are
lacking. For these reasons, we conducted a study titled "A Study of Menstrual Disorders and
Some Associated Factors in Female Students at Hanoi Medical University" to assess the
prevalence and patterns of menstrual disorders, and identify factors associated with menstrual
disorders among female students at Hanoi Medical University.
2. Materials and methods
2.1. Study population
Inclusion criteria: Female students of Hanoi Medical University who volunteered to
participate in the study.
Exclusion criteria: Female students who were pregnant, one year postpartum and
breastfeeding, seriously ill, or did not agree to participate in the research.
2.2. Place and time
This study was conducted at Hanoi Medical University, Hanoi, Vietnam from August 2023 to
January 2024.
2.3. Study design
Descriptive cross-sectional study.
2.4. Variables
The variables of this study included: (1) socio-demographic characteristics; (2)
anthropometric characteristics; (3) menstrual characteristics, (4) lifestyle characteristics, and (5)
family history of menstrual disorders.
2.5. Sample size and sampling methods
The formula for estimating sample size is given by (1).
TNU Journal of Science and Technology
230(01): 209 - 216
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𝑛 = 𝑍1−𝛼/2
2× 𝑝(1 − 𝑝)
𝑑2
(1)
With α = 0.05, Z(1–α/2) = 1.96, d = 0.05, p: estimated proportion of menstrual disorders is
80.7% [4]. The needed sample size is 240. A total of 312 subjects were finally enrolled in our
study through the convenience sampling method.
2.6. Data collection and statistical analysis
A pre-designed online questionnaire was used to collect data, with data being captured using
the REDCap software. Data was analyzed in Stata 14 using descriptive statistics such as
percentages, frequencies, means, and standard deviations. Inferential statistics were used to
determine significant differences, with p < 0.05 considered statistically significant.
2.7. Ethical issues
Informed consent was obtained from all participants. Data sets were stored securely and used
for research purposes only.
3. Results and Discussion
3.1. General characteristics and menstrual characteristics of the research subjects
Table 1. Socio-demographic and anthropometric characteristics of the study participants
Variable
Categories
Frequency (n)
Percent (%)
Age
< 20 years old
114
36.54
20 - 22 years old
154
49.36
> 22 years old
44
14.10
Ethnicity
Kinh
275
88.14
Others
37
11.86
Residence before
university admission
Urban
102
32.69
Rural
210
67.31
Current residence
Dormitory
70
22.44
Lodging
186
59.62
Staying with family
56
17.95
School year
First year
62
19.87
Second year
62
19.87
Third year
76
24.36
Fourth year
49
15.71
Fifth year
26
8.33
Sixth year
37
11.86
Majors
General medicine
99
31.73
Odonto-Stomatology
33
10.58
Traditional medicine
25
8.01
Preventive medicine
16
5.13
Nursing
72
23.08
Nutrition
19
6.09
Medical testing techniques
10
3.20
Rehabilitation techniques
2
0.64
Optometry
17
5.45
Public health
19
6.09
BMI
Underweight (<18.5 kg/m²)
86
27.56
Normal (18.5-22.9 kg/m²)
193
61.86
Overweight (23-24.9 kg/m²)
20
6.41
Obesity I (25-29.9 kg/m²)
10
3.21
Obesity II (30-50 kg/m²)
3
0.96
TNU Journal of Science and Technology
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The general characteristics details are provided in Table 1. The mean age of study participants
was 20.24 ± 1.75 years. A significant portion of the students (67.31%) came from rural areas
before attending university and did not live with their families during university (82.05%). The
average BMI of the participants was 19.96 ± 2.52.
Table 2. Menstrual characteristics of the study participants
Variable
Categories
Frequency (n)
Percent (%)
Frequency of menstrual cycle
2 times every 1 month
5
1.60
1 time every 1 month (normal)
257
82.37
1 time every 2 months
36
11.54
1 time every 3 months
9
2.88
1 time every 6 months
5
1.60
Age of menarche
< 9
3
0.96
9 - 15 (normal)
300
96.15
> 15
9
2.88
Menstrual cycle length
< 21 days
11
3.53
21 - 35 days (normal)
148
47.44
> 35 days
153
49.04
Do menstruation come on the
same day or around the same day?
Yes (normal)
137
43.91
No
175
56.09
Duration of menstrual flow
< 3 days
15
4.81
3 - 7 days (normal)
271
86.86
7 - 10 days
23
7.37
> 10 days
3
0.96
Figure 1. Prevalence of menstrual disorders among participants
Table 2 provides information on the menstrual characteristics of the study subjects. Most of
the participants have a normal age of menarche (96.15%), highlighting that menstrual disorders
are not solely limited to individuals with early or late menarche, even those with a normal age of
menarche can be at risk. Nearly half had menstrual cycles > 35 days, and over half had periods
that did not start on the same day or around the same day each month. The majority of
participants have a normal frequency of menstrual cycle and bleeding duration. There is a small
subset of participants (8.33%, n=26) experiencing menstrual flow exceeding 7 days. For those
with extended menstrual flow, we recommend further evaluation through ultrasound and blood
tests to assess potential underlying causes, such as anemia or ovarian tumors.
Figure 1 shows that 55.45% of participants (n=173) identified as having menstrual disorders
based on their reported menstrual characteristics. This finding aligns with a study at Al Neelain
University with a rate of 55.0% [3]. These results suggest that medical students might be a
population particularly susceptible to menstrual disorders, potentially due to the stress associated
with their demanding academic environment [8], [9]. Further research is needed to investigate
whether medical school specifically, compared to non-medical programs, increases susceptibility
to menstrual disorders. Elucidating the underlying causes of this potential association would be
TNU Journal of Science and Technology
230(01): 209 - 216
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crucial for developing targeted interventions to improve menstrual health in this population.
However, the prevalence observed in this study is higher compared to studies conducted in
Ethiopia with 32.6% and 33.4% [1], [10]. This variation across studies might be due to factors
like living conditions, racial/ethnic backgrounds, lifestyle choices, and nutritional deficiencies
across countries. Additionally, variations in how studies define and diagnose menstrual disorders
can also influence reported prevalence.
Table 3. Distribution and prevalence of menstrual disorders, premenstrual symptoms, and dysmenorrhea
Variable
Frequency (n)
Percent (%)
Oligomenorrhea
144
46.15
Polymenorrhea
11
3.53
Amenorrhea
9
2.88
Menorrhagia
26
8.33
Hypomenorrhea
15
4.81
Premenstrual symptoms
299
95.83
Dysmenorrhea
293
93.91
Distribution and prevalence of menstrual disorders, premenstrual symptoms, and
dysmenorrhea are provided in Table 3. Oligomenorrhea was the most prevalent menstrual
disorder, affecting 46.15% of participants. This is in line with another study in Vietnam with
38.1% oligomenorrhea [11]. Meanwhile, some studies conducted outside Vietnam reported
menorrhagia and polymenorrhea as the most common irregularities [1], [10]. The differences
across studies might be attributed to differences in sample size, and lifestyle factors.
Notably, a large majority of participants reported experiencing premenstrual symptoms
(95.83%) and dysmenorrhea (93.91%). These findings are particularly concerning, especially in
light of previous studies on university students in Turkey, which reported similarly high rates
(Dysmenorrhea: 90.1%, PMS: 71.3%) [6]. Dysmenorrhea is a significant public health issue, as it
can severely impact a woman's quality of life and daily activities. Studies estimate that one in ten
women experiences dysmenorrhea so severe that it disrupts their daily routine for one to three
days per menstrual cycle [12]. Dysmenorrhea is also believed to be the most common menstrual
problem that causes girls to miss school, seek pain relief, seek medical treatment, or even take
long-term absences from school [13]. PMS is characterized by changes in mood, behavior, and
physical symptoms that occur during the premenstrual period and can go away right before
menstruation begins [14]. Although the precise mechanisms underlying PMS are not fully
understood, a potential contributing factor is the impact of progesterone on neurotransmitter
function [14]. Additionally, sympathetic activity may also be activated, resulting in
dysmenorrhea by intensifying uterine contractions [14]. Arshia Syed and Smitha B. Rao reported,
however, lower prevalence rates of dysmenorrhea and PMS, with 45% and 68% respectively
[15]. The differences can likely be attributed to a variety of factors, including BMI, sleep quality,
and stress levels [16]. Regardless of the specific PMS symptoms experienced, both PMS and
dysmenorrhea can significantly impact a woman's quality of life, personal health, and ability to
function in daily activities and social settings.
3.2. Factors associated with menstrual disorders
Table 4. Factors associated with menstrual disorders
Variable
Categories
Menstrual
disorders
OR (95% CI)
p-value
No
Yes
Residence before
university admission
Rural
83
127
1.8628 (1.1228 - 3.0923)
0.0104*
Urban
56
46
Reference
BMI
Underweight/
Overweight
42
77
1.8524 (1.1286 - 3.0525)
0.0098*